Core DBT Skills: Radical Acceptance

If you’ve heard of Dialectical Behavior Therapy (DBT), then you’ve probably heard of radical acceptance. Maybe your child mentioned it, or maybe their therapist told you about it. Maybe you’ve seen the phrase as you researched DBT online. This article will give you an expanded understanding of radical acceptance, and how can it help your family.

What is Radical Acceptance?

Radical acceptance is the idea that accepting painful situations in life will help reduce your suffering. This concept was developed by Dr. Marsha Linehan, founder of DBT, in the late 1980s. Dr. Linehan believed that fighting reality or refusing to accept the facts of what is occurring or has occurred often makes people feel even worse than they could be feeling if they accepted things as they are.

To illustrate this idea, think of an event in your life that makes you angry, upset, ashamed, or sad. It could be an event in the past or something happening now. Think of something that hurt, but you had no control over. Or think of a mistake you made that you cannot reverse.

Now ask yourself:

Have you really accepted what happened?

If you’ve ever found yourself thinking “It shouldn’t have been like that!” or your mind keeps coming back to that event, you may be having a hard time accepting the trauma that happened. You may be rejecting reality – which is not a good habit.

That’s where radical acceptance comes in.

How Can Radical Acceptance Help Me?

Radical acceptance means acknowledging the facts of the painful past or present in its entirety. When you radically accept a situation, or a person, or even yourself, it will help you cope, process, and move on. In that way, radical acceptance helps you live with less stress and suffering. Radical acceptance also helps lessen the painful emotions associated with the traumatic incident. When you accept what has occurred, you may feel like a weight has been lifted from your chest.

The goal is to realize:

This is what happened.

Even if it’s not OK, it is what happened.

Note that radical acceptance does not mean being happy with what occurred. Acceptance is different than happiness or approval. Dr. Marsha Linehan emphasizes this often. You do not have to be happy about a situation or person that brought you pain. Nor should you, in most instances. However, if you want to move past it, you do have to accept it. Only when you accept what happened, or is happening, can you work on finding solutions or ways to cope.

For example, let’s say your teen experimented with a dangerous drug and overdosed. Or you found out your teen was thinking of suicide. Both these situations can be traumatic for parents. And while you shouldn’t approve of their teen using drugs or be complacent about your teen engaging in suicidal ideation, you do need to accept that this is the current state of reality. Only after you accept and acknowledge your teen’s substance use or mental health issues can you work on solutions, such as arranging a mental health assessment, talking to a licensed mental health professional, and finding them treatment.

Denial Exacerbates Problems

When faced with shocking or devastating facts about their teens, parents often freeze, like a deer in headlights. They feel stuck, unable to move on or even wrap their minds around the idea that my teen sent that inappropriate message or my child was smoking or my teen was acting out like that.

Faced with the impact of this painful reality, many parents simply cannot accept the truth. They simply cannot believe what happened or is happening. As a result, they experience intense cycles of anger, denial, and stress. Their pain becomes suffering, rendering them unable to deal with the problem. Instead of coping, they turn within, and hide in their own shell of grief.

Radical acceptance helps parents who deny the reality of their teen’s behavior.

For these parents, going through the steps of radical acceptance help them deal with the problem and work on finding solutions. As our Executive Clinical Director Alyson Orcena says, “Radical acceptance means accepting that this is the way things are today—even if we don’t like it.”

Here are the 10 steps of radical acceptance, based on Dr. Marsha Linehan:

The 10 Steps of Radical Acceptance

1. Notice when you fight reality. If you find yourself saying things like “It shouldn’t be this way!” you’re probably fighting reality.
2. Tell yourself, “This is what happened.” Repeat to yourself that although what happened wasn’t what you wanted, you can’t change reality.
3. Explain to yourself how things happened. If you know the sequence of events that led to what happened, go over it.
4. Practice accepting with your mind, your heart, and your body – completely and totally. Radical means all the way, total, complete. If you need assistance with this, use mindfulness techniques and self-talk that promotes acceptance.
5. Write down all the things you would do if you accepted reality. Then, do those things—as if you had already accepted reality.
6. Imagine yourself accepting the painful situation. See yourself practicing radical acceptance in your mind.
7. Observe what happens in your body as you think about accepting the situation.
8. Let your emotions flow. Allow any pain or discomfort to arise within you. Do not fight grief, sadness, or disappointment. Let it flow. Cry if you need to.
9. Recognize that, despite the pain, life is worth living.
10. If you find yourself resisting all the steps above, make a pros and cons list – accepting vs. not accepting.

How Mental Health Treatment Centers Help Teens in Radical Acceptance

One important note: for teens, the above steps work best with the help of a licensed mental health professional at a high-quality DBT mental health/substance abuse treatment center. At adolescent treatment centers that specialize in dialectical behavior therapy, therapists and program directors are trained in DBT and have the knowledge, experience, and skillset to implement Dr. Marsha Linehan’s idea of radical acceptance – and all the other DBT skills – into practice.

Radical acceptance is just one skill in dialectical behavior therapy. It’s part of the DBT module called Distress Tolerance Skills. The other core modules in DBT, containing dozens of other practical skills, are called Mindfulness, Interpersonal Effectiveness, Emotion Regulation. In DBT for adolescents, there’s also a module called Walking the Middle Path.

DBT at Mental Health Treatment Centers for Teens

Radical acceptance can apply to people, too. In fact, Dr. Marsha Linehan first developed DBT after finding that the best way to help her suicidal/self-harming clients was to envelop them first in an environment of acceptance. Only after she established an atmosphere of acceptance and validation did she then work on “extinguishes bad behaviors, drag[ging] good behaviors out of the patient, and figure[ing] out a way to make the good behaviors so reinforcing that the patient continues the good ones and stops the bad ones.”

This is exactly what we do at Evolve.

At Evolve, we embrace all teens the way they are when they walk through our doors. We establish a warm, nurturing, and affirming environment where teens feel accepted and validated. Only afterward we establish trust do we work on changing unhealthy target behaviors and replacing them with healthy ones. That’s why DBT works for teens with trauma, depression, anxiety, addiction, borderline personality disorder, and other mental health or behavioral issues. Teens struggling with these issues need a supportive environment of acceptance and validation: that’s the kind of atmosphere that allows them to accept where they are, determine where they want to go, and accept the treatment and support that will help them get there.