Radical Acceptance Using DBT

“It is what it is.” Some people utter this cliché when they are overcome with frustration or simply ready to give up. Others use this statement as a reminder to view themselves and the world around them without fear, judgement, or disdain. This second interpretation reflects a life-changing concept called radical acceptance.

What is Radical Acceptance?

Radical acceptance is a distress tolerance skill that clients or patients can develop during dialectical behavior therapy (DBT) sessions. 

At its most fundamental level, radical acceptance is the acknowledgement that some aspects of our lives and the world around us are beyond our ability to influence or control. This understanding, and the ability to view events in the world without reacting to them, can help us prevent current pain from transforming into extended suffering.

As described by DBT founder Marsha Linehan, PhD, radical acceptance involves “letting go of the illusion of control and a willingness to notice and accept things as they are right now, without judging.”

Elaborating on this description, Linehan noted that radical acceptance incorporates three components:

1. Accepting that reality is what it is
2. Accepting that an event or situation that causes pain has a cause
3. Accepting that life is worth living even when it involves pain

It is important to note that practicing radical acceptance does not mean that you have to abandon your efforts to improve your life or the lives of others. Instead, it allows you to move beyond automatic negative reactions to discomfort, so that you can view your circumstances as they truly are and focus your energy where it can make the greatest difference.

How Is Radical Acceptance Reached Through DBT Therapy?

As we mentioned in the previous section, DBT was developed by Marsha Linehan, PhD. She created this approach in the late 1970s while working with suicidal women, many of whom had borderline personality disorder. Through the years, DBT has proved to be beneficial for people who have been impacted by a variety of mental and behavioral health disorders.

In addition to promoting radical acceptance, DBT also helps patients develop an array of other valuable skills in the following four categories:

• Mindfulness: Being able to stay fully present in the moment, paying attention to just one thing at a time, and not judging what you observe or feel
• Interpersonal effectiveness: Being able to advocate for your own needs, developing and maintaining healthy relationships, and resolving conflicts
• Emotion regulation: Identifying your emotions, understanding the connection between emotions and behaviors, and decreasing your vulnerability to upsetting emotions 
• Distress tolerance: Becoming capable of enduring pain without impulsively or reflexively reacting to it, or demanding immediate changes 

The DBT process is organized into four types of sessions:

• Individual therapy: Typically held for 40-60 minutes every week, these one-on-one sessions may address a variety of topics, such as ensuring that the client is safe, reducing unhealthy behaviors, processing personal issues, and building new skills.
• Group skills training: Also usually conducted on a weekly basis, skills groups focus on the four core areas that we listed above. These sessions may involve a variety of activities, such as role-playing exercises, painting or drawing, and journaling. Participants usually have “homework” assignments that involve practicing their newly developed skills in real-world environments. 
• Telephone coaching: This component usually occurs on an as-needed basis between sessions. If a client is struggling or about to engage in a maladaptive behavior, they can get help from their therapist to employ a DBT skill instead of taking a misguided or self-defeating step.
• Team consultations: This is the one component of the DBT structure that does not directly involve clients or patients. Team consultations are forums where DBT therapists can exchange ideas, discuss challenges, and confirm that they are properly adhering to the tenets of this approach.

The amount of time a patient should continue to participate in weekly DBT sessions can vary depending on several factors. Most sources advise remaining in treatment for at least six to 12 months.

How to Practice Radical Acceptance

The principle of radical acceptance isn’t difficult to grasp. Putting this principle into practice, though, can be challenging. Here are a few tips for incorporating radical acceptance into your daily life:

• Be aware of moments when you are actively resisting or attempting to fight back against your current reality. When you have thoughts such as “this isn’t fair,” or “that shouldn’t have happened,” these are times to step back and refocus.
• Pause to acknowledge that difficult, distressing, or otherwise painful occurrences cannot be changed once they have happened.
• Focus on your breath. Pay attention to what it feels like when you slowly inhale and exhale. This can ground you in the present, so you are no longer agonizing over what happened or worried about what may occur next.
• Try to relax your body. Envision the tension leaving your shoulders, your arms, your hips, or wherever else it is stored. Sit in a comfortable chair with your back straight. And continue to focus on your breath.
• Let yourself feel the pain without being consumed by it. Remind yourself that pain is a natural response, and a necessary step on the path toward healing. Attempting to resist the pain, distract yourself from it, or numb yourself to it will only delay this process.
• Think about the long chain of events that led to the painful experience. This can help you accept its inevitability. It can also be a reminder that, while you may have played a role in what transpired, you were not in complete control.
• Make a mental list of what you can control and what you cannot.
• Consider your expectations. Is the pain that you are feeling attributable to a specific event itself, or are you upset because your expectations weren’t met?
• Acknowledge that life is still worth living, even during times of great duress or distress.
• Connect with supportive people. Talk to close friends or trusted family members. If you are having a difficult time with a particular problem, it could be time to consult with a professional.

Come to Montare for Radical Acceptance With DBT

Montare Behavioral Health offers dialectical behavior therapy and several other evidence-based approaches at several convenient locations in the Los Angeles area. Our facilities are places of hope and healing for adults whose lives have been disrupted by anxiety, depression, posttraumatic stress disorder (PTSD) and a variety of other mental health concerns.

For additional information about radical acceptance, DBT, and other aspects of care at our treatment centers – or to schedule a free mental health assessment for yourself or a loved one – please visit our Contact page or call us today.