The word dialectic (in dialectical behavior therapy) means to balance and compare two things that appear very different or even contradictory. In dialectical behavior therapy, the balance is between change and acceptance (Linehan, 1993a). You need to change the behaviors in your life that are creating more suffering for yourself and others while simultaneously also accepting yourself the way you are. This might sound contradictory, but it’s a key part of this treatment. Dialectical behavior therapy depends on acceptance and change, not acceptance or change. Most of this book will focus on skills you can develop to change your life. But this section will focus on how to accept your life. In fact, it will teach you how to radically accept your life.
Radical acceptance is one of the hardest skills to master because it will require you to look at yourself and the world in a different way. However, it’s also one of the most important skills in dialectical behavior therapy (Linehan, 1993a).
Radical acceptance means that you accept something completely, without judging it.
For example, radically accepting the present moment means that you don’t fight it, get angry at it, or try to change it into something that it’s not. To radically accept the present moment means that you must acknowledge that the present moment is what it is due to a long chain of events and decisions made by you and other people in the past. The present moment never spontaneously leaps into existence without being caused by events that have already taken place. Imagine that each moment of your life is connected like a line of dominoes that knock each other down.
But remember, radically accepting something doesn’t mean that you give up and simply accept every bad situation that happens to you. Some situations in life are unjust, such as when someone abuses or assaults you. But for other situations in life, you share at least some responsibility. There’s a balance between what you created and what others have created. However, many people struggling with overwhelming emotions often feel like life just “happens” to them, not recognizing their own role in creating a situation. As a result, their first reaction is to get angry.
In fact, one woman said that anger was her “default emotion,” meaning that when she was just being herself, she was angry. Her excessive hostility caused her to hurt herself—by drinking heavily, cutting herself, and constantly berating herself—and it also led to her hurting the people she cared about by constantly fighting with them.
In contrast, radically accepting the present moment opens up the opportunity for you to recognize the role that you have played in creating your current situation. And as a result, it also creates an opportunity to respond to that situation in a new way that’s less painful for yourself and others. In many ways, radical acceptance is like the Serenity Prayer, which says: “Grant me the serenity to accept the things I cannot change, courage to change the things I can, and the wisdom to know the difference.” In the exercise below, you will find some questions to ask yourself when you want to use radical acceptance. But first, let’s look at an example of how radical acceptance can help a person in a distressing situation.
Example: Using Radical Acceptance
Christine and her boyfriend John had a difficult relationship. John spent a lot of his free time at the bar drinking with his friends, and in response, Christine would get mad, threaten to leave him, and then do something destructive to “piss him off.” This occurred regularly for five years. Then one night Christine came home from work angry, and when John wasn’t around to talk to, she suddenly felt hopeless about their relationship. So she called John at the bar to tell him that she was going to kill herself because she couldn’t put up with his behavior any longer. John raced home to find Christine swallowing a handful of pills, and he made her spit them out. Then he made her promise that she wouldn’t do it again. She promised, and then John left, taking the keys to Christine’s car so that she couldn’t go anywhere. Now Christine got even angrier and called the police to report that her keys had been stolen. Then she walked up to the bar, found John’s car, and smashed his windshield with a brick. She would have broken the other windows too, but the police stopped her and arrested her. Needless to say, neither Christine nor John gave any consideration to using radical acceptance in this situation. Both of them were angry at each other, and by acting on their anger, they both ended up hurting themselves and the other person. So how could this situation have occurred differently if radical acceptance had been used? Let’s consider the situation from Christine’s point of view. Instead of threatening to kill herself, maybe she could have used one of the distress tolerance skills you learned in the last chapter. Remember your strategy for dealing with distressing situations is to distract, relax, and cope. Maybe Christine could have screamed into a pillow and then gone outside for a long walk. Or maybe she could have called one of her friends to talk for a little while. Then after she’d cooled off a bit, maybe she could have asked herself the following questions and used radical acceptance to reexamine her situation.
What events led up to Christine’s situation? She and John had been behaving and fighting like this for years. This night was nothing new. But she had come home angry about work, and she became even angrier with John because he wasn’t around.
What role did Christine play in creating this situation? Instead of trying to cope with her anger and frustration in a healthy way, she took her emotions out on herself and John. Also, Christine had had many reasons and opportunities in the past to end this relationship if she wanted to, but she had chosen to stay in this destructive relationship.
What role did John play in creating this situation? John had an alcohol addiction that had been interfering with their relationship for five years. This night, he also didn’t take the time to discuss Christine’s suicidal behaviors with her. Instead, he chose to return to the bar, which made her even angrier.
What does Christine have control of in this situation? She can end the relationship if she wants to, or she can choose a different way to cope with this distressing situation.
What doesn’t Christine have control of in this situation? Ultimately, it is John who has to seek help to stop his alcohol addiction. Christine can’t make him stop drinking. She also doesn’t have control of how John chooses to behave toward her in this situation.
What was Christine’s response to this situation? She tried to kill herself, and then she smashed John’s windshield.
How did her response affect her own thoughts and feelings? Her actions made her feel worse about herself and her relationship, and she kept thinking about why she was still in this destructive relationship.
How did her response affect the thoughts and feelings of other people? Christine and John were arrested, which made both of them feel worse than they already did about themselves and their relationship.
How could Christine have changed her response to this situation so that it led to less suffering for herself and John? She could have used other distress tolerance skills to cope with her pain and anger. She could also have used radical acceptance to reevaluate the situation so that she could choose to react in a different way. And perhaps she could even have chosen to leave John that evening, even temporarily, which might have been less painful for the both of them.
How could the situation have occurred differently if Christine had decided to radically accept the situation? If she had used some type of distress tolerance skills that evening, maybe she could have waited until the next morning to talk to John about how angry she felt at work and how upset his drinking made her feel. Or maybe if she had ended the relationship, she could have made space in her life for a healthier relationship or simply spared herself the reoccurring pain of a destructive relationship.
Exercise: Radical Acceptance
Now answer the same questions for yourself.
Think of a distressing situation that you experienced recently.
Then answer these questions that will help you radically accept the situation in a new way:
What happened in this distressing situation?
What past events happened that led up to this situation?
What role did you play in creating this situation?
What roles did other people play in creating this situation?
What do you have control of in this situation?
What don’t you have control of in this situation?
What was your response to this situation?
How did your response affect your own thoughts and feelings?
How did your response affect the thoughts and feelings of other people?
How could you have changed your response to this situation so that it led to less suffering for yourself and others?
How could the situation have occurred differently if you had decided to radically accept the situation?
It’s very important to remember that radical acceptance also applies to accepting yourself. In this case, radical acceptance means embracing who you are without judging or criticizing yourself. Or, to put it another way, radically accepting yourself means loving yourself just the way you are, with all of your goodness and all of your faults. Finding the goodness inside of yourself might be a difficult challenge, especially if you’re struggling with overwhelming emotions. Many people with this problem often think of themselves as being defective, bad, or unlovable. As a result, they overlook their good qualities and add more pain to their lives. This is why radically accepting yourself is so extremely important.
Distress Tolerance Skills:
- DISTRESS TOLERANCE SKILLS
- RADICAL ACCEPTANCE
- DISTRACT YOURSELF FROM SELF-DESTRUCTIVE BEHAVIORS
- DISTRACT YOURSELF WITH PLEASURABLE ACTIVITIES
- DISTRACT YOURSELF BY PAYING ATTENTION TO SOMEONE ELSE
- DISTRACT YOUR THOUGHTS
- DISTRACT YOURSELF BY LEAVING
- DISTRACT YOURSELF WITH TASKS AND CHORES
- DISTRACT YOURSELF BY COUNTING
- CREATE YOUR DISTRACTION PLAN
- RELAX AND SOOTHE YOURSELF
- Self-Soothing Using Your Sense of Smell
- Self-Soothing Using Your Sense of Touch
- Self-Soothing Using Your Sense of Taste
- Self-Soothing Using Your Sense of Hearing
- Self-Soothing Using Your Sense of Vision
- Self-Soothing – CREATE A RELAXATION PLAN
Advanced Distress Tolerance Skills: