Learning Center - DBT Therapy Training

DBT Radical Acceptance

In DBT, the concept of radical acceptance is arguably one of the most difficult ideas to grasp. In my mind, it's fairly straightforward and I hope to clarify confusion around this concept. The old adage, "no use crying over spilled milk." is one way to simplify it. The past is.... well, the past. We can't change it. It's done. Before we can do what we want with the present and our future we must put the past behind and look forward.  This means, accepting things as they were and life as it is.

This isn't always an easy thing to do.  In 12-step programs, the very first step involves admitting to ourselves that we have a problem.  Many on this site have been involved in a 12-step program, and can attest that this is one of the hardest parts of the program.  I've heard people explain that they could quit whenever they want, that it's not really a problem but could become one.  I believed that my own issues weren't anywhere near as bad as others in the group.  Yet, 12-steppers will tell you, until you've taken this step, you can't get anywhere.

A year or so ago, I went to a government sponsored "Healthy Family" class.  Most of the students were in the middle of a divorce, or had recently been through one.  This means, their marriage is over.  The only thing they can reasonably do, is look forward and build a better future for themselves and their children.  Yet, virtually all of them routinely discussed frustrations and conflicts that happened during their marriage.  "She always _______!", "He never _______!"  I get it, I really do. All of them lived through a lot of conflict, it's fresh in their minds. They probably haven't had any closure about these issues. At the same time, time machines are still science fiction.  The past will always be as it was.  There is simply nothing we can do about it, regardless of how unjust, frustrating or upsetting it may have been. As hard as it is to swallow, DBT radical acceptance means accepting the past as it was and move on from there with what we have.

We have only 100% of our energy, there's nothing more.  We can split that up however we choose.  The amount of energy and attention we give to the past, can not be used to improve the future.  If we spend even 40% of our time ruminating over what we should have done, we're left with only 60% of our energy to focus on making the future better.  Sure, we're human and may need some time to feel that frustration. Still, doesn't it make sense to focus as much of our energy and time on making the future better than the past?

A Radical Acceptance Analogy

In Section 5 - Distress Tolerance Overview, I used the example of Income Taxes. Anyone of us who works legally in the US, gets a pay check. Depending upon our salary, about one third of our hard earned money goes to various taxes. When I received my very first paycheck, as a young teenager, I was shocked and in complete disbelief. After taxes, insurance, and everything else "they" took out, I had barely enough to get me to work and buy lunch. I thought something was wrong, someone's made a mistake. I spoke to payroll and they chuckled, while explaining why they took all that money away from me... it's just part of life. Something none of us really likes, but that's just the way it is. I was completely beside myself. I felt violated, robbed, cheated.... angry. Now, after decades of paychecks, I just take it in stride. In fact, I don't even think about it. So what, we pay taxes. It certainly doesn't dominate my thoughts the way it did after my very first check. I've Radically Accepted taxes, DBT radical acceptance in practice.

Now that I've radically accepted paying taxes, I can manage it more effectively. Instead of feeling all those negative feelings about it, somewhere along the line, I made a choice. As much as I would like ALL the money I earned, I can't have it. Now I'm free to focus all my energy looking for legal ways to reduce my taxes. I save receipts, I use a good tax accountant to do my taxes, and I listen to her advice each year. When I put together my budget, I first figure out what I'll actually receive (after taxes), and work with that. In my mind, I consciously changed from taxes being a source of frustration, to it being a part of life to be managed.

To many, I've used a few words that just don't seem to fit here: "chose" and "changed my mind". You may ask, "What about those things that I have no choice about, where I can't simply change my mind? What about if I'm the victim of a crime? I didn't chose to be violated the way that I was. That crime hurt me and I'm angry about it, I'm scared that it'll happen again."  That's absolutely true, none of us choose to be the victim of a crime. At the same time, whether we know it or not, we do choose what to think, feel and do in response to it.

Let me back up here. As we discussed in mindfulness-reduces-stress-says-new-study, we're not simply feeling or responding to things that happen to us in life. We actually go through a very fast, almost instantaneous process: Experience something, think about what that experience means, form emotions based solely on our own thoughts and judgments about the experience, determine how to respond, then we respond. In many cases, we have very little control over what we experience. Sure, if we want to avoid something, we can often stay away from it. But we can't always avoid unpleasant things. At the same time we have 100% complete and utter control over our own thoughts, feelings and responses to anything, even if it doesn't feel like it most of the time.

Most people think this can't be right. Let's say you are running, and trip on something, you fall down and hurt yourself. You feel the pain and may cry or shout out in pain. Did you choose that? No, you didn't choose to trip, fall and hurt yourself. At the same time, everything that happens after that you ARE choosing! You may think to yourself, "boy, that wasn't smart, I shouldn't have been running". Based on that thought, you feel "ashamed" and "embarrassed". You'll choose a reaction in line with your feelings. But if you look over the whole thing, those thoughts, feelings and reaction were all yours. In Section 5 - Distress Tolerance Overview, I described my $100 bill philosophy. The experience of tripping, falling and hurting myself was yet another $100 bill life hands us.

Many of us are here, learning DBT, because we haven't yet learned how to truly exercise control over our own thoughts, feelings and reactions. By practicing Mindfulness skills, we can develop the ability to separate raw experiences from our judgments. But, to successfully gain control of our own issues, we need to go a step further. We need to actually CHANGE our judgments, recognize the feelings we feel, and consciously choose responses that IMPROVE our lives, rather than ones that destroy our lives.

Using Mindfulness skills, we are able to see that we tripped and bruised ourselves, free from judgments. With DBT radical acceptance, we let the past go and apply the acceptance to our thoughts and judgments. Instead of looking for blame and guilt, "That was stupid of me to run like that", "I tripped because my child left that toy there", we accept the fact that we tripped. We accept the fact that we have a bruise. We don't have to like it, we don't have to be happy that it happened. But we can acknowledge that it happened. That forges a very different path for our feelings to follow.

Let's move on to another example. A few years ago, I went to my car to commute to work. I noticed shattered glass on the ground below the drivers side door. When I got to the car, I realized that someone had broken my window and stolen my laptop. Not being very Mindful, I thought badly about myself: "Why did I leave the laptop in full view? I'm so stupid." "Where was the security patrol and the police!" "Why do people violate me like this?" "I need to find another place to live, it's not safe here!" "My boss is going to kill me, that was a company computer!" "Now all that stuff I'd been working on, my computer files are gone!" I felt shame, embarrassment, fear, and guilt. I felt myself starting to sweat, my heart was racing, I started shaking.

Ideally, with DBT skills, here's how I hope I would handle this in the future. I'd see the broken glass below my car. I'd notice that my window was smashed and laptop missing. No guilt, no blame, no judgments. It is what it is. I'd recognize the facts, my window is broken and laptop missing, then I'd Radically Accept these facts as a reality. I must live with them, because they've already happened. I can't change the past. Next, I move into Wise Mind.  I'd recognize and acknowledge my own discomfort with the experience and try to determine the most effective way to handle the situation. I start sorting out how I chose to respond.

I may think: I've been the victim of a crime, this feels uncomfortable and a bit scary.  I need to report it to the police and local security. My car is damaged, so I'll need to report this to my insurance company and find a way to repair it. This will cost me some money (my deductible), do I have it? Can I get the money? I'm unhappy about having to spend money on repairing this car.  My laptop is missing, it belong to my employer, so I'll need to let them know I'll need a replacement. I feel stupid for not having taken my laptop out of the car, or at least hiding it, I'll have to remember to do that next time.  The laptop contained a good deal of my recent work, so is there a backup somewhere, have I put it on a disc, have I e-mailed it? I've lost work, so I need to let my employer know and figure out how to get caught up or redo the work.  I put a lot of effort into that work, and I'm disappointed that it's now gone.

From this illustration, it's clear that with DBT radical acceptance, I can move quickly to wise mind, and begin to effectively manage the experience.  This is quite different than going on the tangent that I usually take: blaming thoughts, negative and exacerbated emotions and inappropriate responses.  Ruminating on the past.

As a useful reference, you may wish to check out the Crisis Survival Cheat Sheet.

When you're ready to move on go to: Section 12 - DBT Emotion Regulation.

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