Wednesday, February 25, 2015

Radical Acceptance

One of the most powerful things we have learned through participating in and now leading a Family Connections program is the concept of radical acceptance. It is an approach that can take one from powerless suffering to building a happy life despite pain.

Developed by Dr. Marsha Linehan, radical acceptance has three simple (haha!) steps:
  1. Accept reality for what it is. 
  2. Things are the way they are for a reason.
  3. Life can still be worth living.
These steps are not linear (you'll likely revisit each step many times), but they are all intimately connected.


The thing to note here is that accepting reality does not necessarily mean that you approve or endorse it. If something good is happening in our lives, then yes, we generally do accept it. But when it's something painful, like a death of a loved one, the end of a marriage, or a serious illness, accepting reality takes time and conscious effort.

In fact, you have to keep doing it, over and over and over again.

I've hit this snag with accepting that I have diabetes. Every so often, I find myself shrugging off taking my medications (all those pills!), as if that will make the diabetes less real. It's as if some part of my brain were saying, "Nope. Uh uh. Not today. Today I do not have diabetes."

As you might surmise, this attitude does not improve my health -- or my reality.

In fact, refusing to accept reality is a roadblock in the way of moving forward.

It may not be obvious, but accepting reality very often means grieving. To wholeheartedly accept the shitty hand you have been dealt, you have to allow yourself to be sad for the dreams that will not come true.


Carrying on with my diabetes situation, there are reasons why my blood sugar concentrations are high: my pancreas isn't producing enough insulin; my body resists the insulin when it is present; I have a family predisposition to the disease; and I did not do all I could in terms of diet and exercise.

All of those things have lead up to today's reality: I have medication-dependent diabetes. Some I can change (diet, exercise, medication compliance); some I cannot (heredity). But in either case, I can't go back in time and undo any of the conditions that brought me here.

Understanding as many of the pieces of the puzzle that we can helps us to integrate reality into our brain. If we continue to think that the tragedy is senseless, we will continue to deny its reality; this is called cognitive dissonance.

Note: acknowledging the reasons does not mean that we have to like them!


When we're faced with a painful situation, especially something that really hurts us to the core, some of us (especially those with emotion dysregulation or Borderline Personality Disorder) fall into despair, anger, bitterness. We can succumb to the weight of powerlessness.

Radical acceptance suggests that, instead, we build a life worth living. This can involve consciously appreciating the things that already exist in our life, as I did during the "100 Happy Days" exercise (a habit, I might add, that I still use today -- you have no idea how many times a day I mentally snap  a picture and imagine sharing it with you).

But it also means actively creating a life that you love, despite the painful event or circumstances. Imagine you have been falsely imprisoned. If you focus solely on the injustice instead of finding ways to feel fulfilled and grateful (pursuing a degree, for example, or developing healthy relationships with other inmates), you may become bitter and angry. You will continue suffering.


I hope most people know better than to tell someone who is suffering to "get over it" or just "move on."

But the sentiment is often shrouded in advice: You should see a therapist. Why don't you just look for a new relationship? Have you tried exercise?  

Or cloaked in judgment: You seem to be wallowing in it. You're really milking this for all it's worth. It's time to leave Pity City. Call the Wahmbulance.

Can you see how those statements put the sufferer on the defensive?

What radical acceptance proposes, instead, is that we help the sufferer look at cold, hard reality, see it for what it is, and then grieve the loss of the wished-for reality. We can help them understand all the pieces that led to the painful situation. And then we can help them turn their minds and hearts to building the best life they can -- with patience and compassion. Read that again: with patience (lots of it) and compassion (not judgment).

The concept of radical acceptance applies to all of us, not just those of us faced with mental illness.

For more about radical acceptance, watch this video by Dr. Marsha Linehan.

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