What is radical acceptance?

Radical acceptance is an approach named by Marsha Linehan, PhD who created Dialectical Behavior Therapy that is about completely and totally accepting something, stopping the fight against reality, and ultimately, suffering less. Things will regularly happen in our lives that are outside of our control, such as having a diagnosis of bipolar disorder or experiencing a loss of a loved one. Perhaps it’s an experience of a trauma in the past. There are also things that we will do in our lives that we regret but at the same time have no power to go back in time to change them. Radical acceptance is about accepting the reality of the situation which allows us to shift from fighting our situation toto having more space to figure what you want to do to move forward. Dr. Linehan explains the three components of radical acceptance:

“The first part is accepting that reality is what it is. The second part is accepting that the event or situation causing you pain has a cause. The third part is accepting life can be worth living even with painful events in it.”

What is the difference between pain and suffering?

It can be helpful to distinguish between pain and suffering when exploring radical acceptance. Pain is inevitable in life and something everyone faces as a human being. However, suffering and misery are not and are often a result of how we respond to pain. If we fight against our pain, we are more likely to experience shame, hopelessness, anger, etc and get stuck in not seeing action steps we can take in moving forward. Suffering is the interpretation of the story you tell yourself about pain. Through acceptance, one can change that story and reduce suffering. Dr. Linehan states, “pain without acceptance = suffering.”

How can radical acceptance serve someone with bipolar disorder?

There are many things related to bipolar disorder that cause pain, frustration and sadness. Working with patients with bipolar disorder has allowed me to see ways in which radical acceptance has allowed them to acknowledge this pain, reduce their suffering and continue to work towards living their lives fully. I have seen this take shape in the form of radical acceptance of the diagnosis, medication regimens, regrets of actions that occurred during hypomanic and manic episodes, and acceptance of strong emotions that can often come with shifts in moods and result in feeling overwhelmed. It’s a tool that can help someone hold the reality of what is, and also ask the questions of – what do I want to do next now that I have this information.

Willing Hands

One way to support yourself in practicing radical acceptance is to position your body into a pose that promotes acceptance. The willing hands exercise is one way to do this as it cues your mind through your body to emotionally respond to a situation with willingness and acceptance. Dr. Linehan describes it as a “way of accepting reality with your body.” To practice willing hands, try the following:

1. Standing: Drop your arms down from your shoulders, keep them straight or bent slightly at the elbows. With hands unclenched, turn your hands outward, with thumbs out to your sides, palms up, and fingers relaxed.

2. Sitting: Place your hands on your lap or your thighs. With hands unclenched, turn your hands outward, with palms up and fingers relaxed.

3. Lying down: Arms by your side, hands unclenched, turn your palms up with fingers relaxed.

To learn more about radical acceptance and DBT skills talk to your therapist or, if you are in the Bay Area and looking for someone to work with contact me at ggregory@gatewaypsychiatric.com.

– Gina Gregory, LCSW 

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