[content note: brief descriptions of emotionally abusive behavior and suicidality.]
Radical acceptance is one of the core skills in distress tolerance and, perhaps, in all of DBT. It is perhaps best put in the Sequences:
What is true is already so.
Owning up to it doesn’t make it worse.
Not being open about it doesn’t make it go away.
And because it’s true, it is what is there to be interacted with.
Anything untrue isn’t there to be lived.
People can stand what is true,
for they are already enduring it.
The most obvious form of not radically accepting something is denial: ignoring your partner’s infidelity; letting the bills pile up without opening them; pretending desperately to yourself that you’re still going to pass your classes; playing another round of video games because you have plenty of time to get started on your essay. Some people come up with elaborate rationales for their denial. “Okay, so maybe playing the lottery has negative expected value, but it gives me hope!” “Okay, so maybe my best reasoning shows me that God doesn’t exist, but without God how will I be moral?”
Another form is throwing a tantrum about the way reality is. If you’re trapped in rush-hour traffic and you’re going to be late to a very important meeting, a lot of people will start cursing, shouting at the other drivers, waving their fists around. But getting angry won’t actually get you anywhere any faster. All it does is make you miserable. Similarly, if there’s a mixup about the time of your dentist appointment, don’t yell at the poor receptionist making $8/hour who has nothing to do with the problem. That will not actually let you get your teeth cleaned. It will just make both you and the poor receptionist miserable.
You can tell you’re probably throwing a tantrum if your internal monologue starts sounding like the lyrics to a Simple Plan song: “How could this happen to me? I made my mistakes! Why me? This shouldn’t be this way! This is so unfair!” Sorry. The universe is not fair. You are going to have to deal with it.
Lying down and letting the world walk all over you is also a form of tantrum-throwing. Imagine a child who does not want to play cards, but whose parents made him do so anyway. He makes loud sighing noises, he deliberately plays badly, he makes upset faces the whole time, and whenever anyone asks him if he really wants to play cards, he says “No, I’m fine, don’t worry about me” in a voice that very definitely means he is Not Fine. If your internal monologue sounds like that child, you are throwing a tantrum.
A third way that not radically accepting something manifests is thinking “I can’t stand this, I can’t endure it, nothing will ever be good again.” If the entire history of humanity has shown anything, it is that people can endure anything. Right now, it seems like an unimaginable catastrophe, but– to quote Anne of Green Gables– “A body can get used to anything, even to being hanged.” Call it the hedonic treadmill, call it “if people got hit on the head with a baseball bat every week pretty soon they’d be okay with it“, it does a lot of bad shit, but when you’re facing down a catastrophe, it’s your best friend.
Cliff Pervocracy calls this The Worst Thing In The World:
I remember when my first “I love you” relationship ended. I couldn’t abide the thought. I screamed. I cried. I tried to seduce him. (While still crying. Sexxxay.) I threatened to harm myself if he didn’t come back. I called him until he stopped taking my calls. The ridiculous thing is, I didn’t even like him that much. It wasn’t about getting the joy of the relationship back. It was about avoiding [The Worst Thing In The World].
At some point I bawled myself to sleep, and the next morning I woke up and had to pee. Because even in the wake of The Worst Thing In The World, you still have to pee. I peed and went to work. It was the day after the end of eeeeeverything, but the bus still picked me up at 7:08 and I still got a half-hour and a chicken sandwich for lunch. I was in pain, I was in badpain, but I had thought it would be infinite pain, and it was finite. It was only a six-foot cockroach.
I can’t say “and then I never believed in TWTITW again,” but it was the start of a journey. Failing a class helped too, as did getting fired from a job, as did very messily breaking up with a very close friend. Not because these things weren’t bad. All of them sucked, all of them cost me opportunities I would never get back, all of them caused real and irreparable harm, yet the morning after… I still had to pee.
Normal life continues. Your cat is hungry. The weather will get colder and you will need a jacket. Tomorrow morning, you will have to pee.
A lot of the people I know with very serious mental illnesses end up living pretty ordinary lives around experiences that other people find unthinkably, unendurably horrifying. “I don’t want anything more than death, and I’m not sure if I’m going to make tofu with peanut sauce or rice with kale and yams for dinner.” “I believe I am an Evil Overlord, worse than Hitler, and I am cleaning the cat’s litterbox.” “Every time I look in the mirror I want to vomit, and I’m so excited about the new Marvel movie.” “The demons are telling me to draw pentagrams on the walls, and my mom forgot to buy tampons.” Eventually, the Worst Thing just becomes an everyday annoyance.
And the thing is… that’s hopeful. Because it means that if the Worst Thing happens you can cope. People have coped with what you’re going through and worse for thousands of years. You will get used to it. Normal life goes on. Most of the time, when you say “if this happens my life wouldn’t be worth living!”, your life can still be worth living, if you choose to make it so. Your life might not be as happy as it could have been. It might suck. But it can still be worth living.
(How this point intersects with my pro-suicide politics is too long and too tangential for this blog post, but I’ll write a post about it if there’s interest.)
Radical acceptance is perhaps poorly-named, because it definitely doesn’t refer to some of the things people think when they see the word “acceptance”. It doesn’t mean refusing to try to change things. In fact, you can’t change things unless you radically accept them. If you don’t acknowledge that something is there to be interacted with, how can you interact with it to change it? And isn’t it a lot easier to change something if you aren’t wasting a ton of energy on denial, throwing tantrums, and catastrophizing?
And radical acceptance doesn’t mean you have to be happy about what’s happening. You don’t have to like it. You don’t have to find the positives. (Actually, finding the positives can be a form of denial. Sometimes you just need to say “this sucks and I’m really unhappy about having to deal with it.”) It is okay to feel grief, or disappointment, or anger.
But a lot of times what you feel is relief.
Have you ever worried and worried and worried about something bad happening, and then it happened, and you felt better? “At least it’s over”, you might think. “At least I don’t have to worry about it anymore.” That’s radical acceptance. The Worst Thing happened, and you acknowledged it, and now you can deal with it.
(The secret is that you don’t have to wait for the Worst Thing to happen to feel that relief.)
One issue that radical acceptance comes up around a lot is actually the kernel of Stoicism. Consider Epictetus:
Some things are in our control and others not. Things in our control are opinion, pursuit, desire, aversion, and, in a word, whatever are our own actions. Things not in our control are body, property, reputation, command, and, in one word, whatever are not our own actions.
In short: you can control what you choose to do, in this moment. You cannot control the past, the future, other people’s actions, acts of God, or the physical laws of the universe.
There is a distinction between “control” and “influence”. Imagine you want to date the guy you have a crush on. You can certainly influence his decision to date you: you can shower and brush your teeth, smile a lot and laugh at his jokes, compliment him, express your attraction instead of using the Telepathy Method, and refrain from drunken phone messages about how you have already named all twelve of your and his offspring. But you cannot control his decision: ultimately, whether he dates you or not is up to him and not within your power.
On the other hand, you can control whether you brush your teeth. That is 100% up to you.
We get into two problems here. First, we act like we can control things we can’t. The classic Nice Guy ™ (as opposed to the kind that is a euphemism for “ugly person has the temerity to be sexually attracted to people”) has this problem: they think that, goddammit, they should be able to control whether they can date people, and it is completely unfair that even if they’ve done everything right people can still decide not to date them. Many a partner of a mentally ill person has this problem: if they just do everything right, if they’re perfectly kind and perfectly supportive and never say the wrong word, then their partner won’t be miserable anymore. The worrywart who spends hours fretting about whether Alice secretly hates them is under the impression that they can prevent Alice from hating them if they just ruminate about it enough. And how many neurodivergent people have said something like “oh, this time I’ll be able to cook meals every day, I’ll just use my willpower!”
(The Stoics believed that we could control our System 1s. With the advent of modern psychology, I think it is time to admit we have only influence over the asshole roommates living in the back of our skulls.)
Second, we act like we can’t control things we can. “It’s not my fault. It’s like something came over me.” Sound familiar? But no one forced you to yell at the waitress, or lie to your friend, or not answer your emails. That was all you. That was your decision. You can either say “I fucked up. I will figure out how to do better next time”, or you can say “I did the best I could given the constraints of the situation, and I would make the same decision next time.” You must take responsibility for the things that are in your control.
So. I’ve been talking a lot about radical acceptance. How do you do it?
First, notice that you’re not accepting reality. Appropriate triggers for radical acceptance include anger, bitterness, avoidance, annoyance, “Why me?”, “Why is this happening”, “I can’t stand it”, and “this shouldn’t be this way.”
The next step is to say to yourself “I am going to accept reality as it is.” It can help to have mantras: you can say the Litany of Gendlin or Litany of Tarski or “rejecting reality doesn’t change reality” or “the path out of hell is through misery” or “this is what happened, I can’t change it” or “life can be worth living even with pain.” You can do a little doublethink here: you can say to yourself “I don’t actually have to accept it right now. Right now I’m just promising that I will accept it.”
Now there are a couple of different things you can do. You might feel sad or angry: that’s okay. Let yourself feel the feelings that naturally arise from what you’re accepting. It can help to pay attention to what’s going on in your body: your pulse, your stomach, your breath, the feel of your feet in your shoes. You can take a page out of the Stoics’ book and think about what you would do if the Worst Thing happened, if you lost something precious to you, or if you accepted the thing you don’t want to accept; plan what you would do until you no longer feel the sinking sense of doom when you think about it. You can think about what you’d do if you’d accepted all the facts, and act that way: “fake it till you make it” is an excellent strategy.
Ultimately, you want to do something DBT calls “willingness”. Willingness is active participation in reality, playing the hand you’re dealt, doing the best you can given the circumstances. Willingness is doing what you need to do in each situation without dragging your feet or being reluctant. The opposite of willingness is willfullness: trying to fix everything, giving up, being in control, being attached to yourself and your own desires, refusing to change when you need to, refusing to put up with things, “NO NO NO NO NO NO”, and generally behaving in an ineffective way. Willfulness is deliberately doing something that you know isn’t going to work– whether you’re aware you’re being willful or not. Just as willingness is the product of radical acceptance, wilfulness is the product of failures to radically accept. Be careful: wilfullness can disguise itself as pragmatism, can seem completely reasonable. But ask yourself “okay, what is actually going to work in this situation?”
It is perfectly normal to have to turn the mind towards radical acceptance and willingness over and over again, perhaps dozens of times in a minute. But if you find yourself resisting radical acceptance very hard, there are several strategies.
The first step is to check for obvious interfering factors. Do you believe, on some level, that accepting things means condoning them? Are you overemotional or in crisis and thus your emotions are getting in the way of radical acceptance? The second step is to do pros and cons. What are the advantages of accepting whatever you don’t want to accept? What are the disadvantages?
Another common failure mode is to find ourselves accepting something that isn’t actually true. If you find yourself accepting that you will never ever ever find someone who likes you and you are doomed to die alone with your cats, you might have a problem. It can be helpful to work through a standard CBT worksheet and assess the evidence for and against the thought. Often, these thoughts are exaggerated versions of things we ought to accept: for instance, you might need to accept “I am lonely” or “no one in my current circles likes me very much”.
If you still find yourself resisting, ask yourself “what’s the threat?” A lot of times, when we have a hard time accepting something, it’s because we’re afraid that something awful will happen if we accept it. Something terrible will happen! The worst thing in the world! At its core, the opposite of radical acceptance is avoidance.
Avoidance is an important coping strategy. A lot of the crisis survival tactics are basically avoidance: you can’t deal with the thing now, so you’re going to have a cup of tea and watch some television until you can. And that’s fine. If avoidance is going well for you, then by all means continue avoiding. However, a lot of times, avoiding a problem long-term just means the problem gets bigger and bigger and bigger. When you’re doing good avoidance, when you think about something you’re like “eh, I’m not going to deal with that”; when you’re doing bad avoidance, you feel upset, a flinch in your brain.
Don’t assume that just because it doesn’t feel like you’re avoiding anything that you aren’t avoiding anything. A lot of avoidance is very subtle, sophisticated, and deniable. I am an agoraphobe, by which I mean my brain has decided that it absolutely does not want to go outside no way no how. It is astonishing how cunning my brain is in getting me to go outside. I’ll look at my empty refrigerator, two hours away from dinner time, and say “well, going outside would be very time-consuming, I’m not sure it’s a good use of time, I should work on a blog post instead.” And until I say it to someone else who says “that doesn’t make any goddamn sense” it sounds exactly the same as my brain doing sensible prioritization of goals.
Avoidance is often caused by fear. And we know how to deal with fear: you do the thing you’re afraid of, over and over again, until it no longer frightens you. So if you are avoiding a truth, and it’s the bad kind of avoidance, you need to make a special effort to look the fear in the eye, to not flinch away, to think about it, again and again, until it is no longer frightening.
Finally, there are three small techniques that help radical acceptance for some people. One is half-smiling with willing hands. The idea behind this one is that smiling makes you happier, because bodies are absurdly poorly designed. To half-smile, relax the entire face, then let the corners of your lips go slightly up– ideally, only you should be able to see it. To have willing hands, relax your hands and adopt an open posture– palms up, fingers relaxed, hands turned outward, no tension in your arms. Imagine you are a monk meditating and you’ll get it. You may find yourself unconsciously clenching your hands as you attempt to radically accept something; that’s fine. Just relax them again. I will be the first to admit that half-smiling doesn’t do shit for me and I feel much better with a full grin; play around with the postures until you find something that works for you.
The other useful technique is mindfulness. Step back from your thoughts and observe them as they run in and out of your mind. If you want, you can say something like “I think [thought]”, or imagine them as waves coming and going, or zap them like they’re Space Invaders. Do not act on your thoughts. Remember that your thoughts are not reality, and that in other times you have thought very different thoughts. We are very smart people who come up with very persuasive, elaborate rationalizations about our thoughts, but that still doesn’t mean they’re necessarily true. They might be true; they might not be. Right now, we’re just watching them. Do not judge your thoughts; instead, try embracing them or adopting a gentle, curious mindset about them. Do not analyze your thoughts. Do not try to block thoughts. If you want, ask yourself “what is this thought trying to avoid?” or “what does this thought want me to do?” and turn your mind to that, then back to your thought; repeat as much as you like.
If you are having problems with radical acceptance, it can be wise to put aside a few minutes each day to practice half-smiling with willing hands and/or mindfulness; after enough regular mindfulness practice, you will find yourself suddenly becoming mindful during everyday activities, including when you’re upset and need to accept something. You can also plan out opportunities to practice radical acceptance. At first, it’s best to choose relatively small things for practice: don’t begin with your mother’s death, your shit career, or your awful love life. For instance, between late trains and traffic jams, transportation offers nearly endless opportunities for radical acceptance practice. You might also want to practice with your annoying coworker, your cat’s vomit, or your partner’s habit of leaving socks on the bed.