Radical Acceptance

This workshop is about coping and using the tool of radical acceptance and mindfulness.  'Radical' is used in the medical sense such as radical surgery, or radical mastectomy - designed to remove the root of a disease or all diseased and potentially diseased tissue.

Radical acceptance was developed by Marsha Linehan, PhD. from the University of Washington (see article) and is based on the ancient Zen philosophy that each moment is complete by itself, and that the world is perfect as it is. Zen focuses on acceptance, validation, and tolerance instead of change.  Mindfulness is “allowing” experiences rather than suppressing or avoiding them. It is the intentional process of observing, describing, and participating in reality non-judgmentally, in the moment, and with effectiveness. Ethereal as it may sound, Linehan's methods have been independently studied by clinical researchers and shown to be effective.

The prime dissatisfaction for many of us is the sense that we are unworthy according to Tara Brach, PhD. We aren’t enough, we don’t do enough, we don’t have enough.  We live in a trance of unworthiness. It’s a trance because the pain of KNOWING the unworthy feelings is rather deep. So we keep really busy, so there’s no time to sit and know. We embark on self-improvement projects to try to be good enough. We avoid risks to avoid more pain. We withdraw from knowing our current experience.  We become self-critics. And like most self critics, we also become critical of others.  The trance of unworthiness involves being in close touch with a self that’s fearful, wanting, feeling alone and separate.  The self caught in desire, aversion, delusion. It means losing sight of the self who’s connected, whole, in the ‘fullness of being.’

“When we learn to face and feel the fear and shame we habitually avoid, we begin to awaken from the trance.”

Radical acceptance is a concept everyone that interfaces with a borderline person should understand - be it a spouse, a child, and step mom, or an ex.  

There are three parts to 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.

I hope this workshop is helpful.

Skippy

I went to DBT and although I did not finish the course, I do think it is a tremendous tool for the Non.

Radical Acceptance can enable the Non to see their situation as it is without judgement about their own feelings. Part of the issue for some Nons is denial of their own experience. Often once the Non moves away from denial they encounter feelings of profound self judgment and can get stuck.

In order for the Non to heal and begin to put things in perspective Radical Acceptance helps the Non forgive themselves for their part in the relationship.

Thank you for sharing your work and valuable insights. I can understand how the DBT for Non's can be quite valuable. Is it effective to learn if your significant other does not acknowledge BP?

What I gather right now from it is to step outside my husband's behavior, and not take him on as my problem, however I desperately want him to get the help he deserves.

If you are interested in working on acceptance, there is another acceptance-based behavior therapy that is related to DBT but has been shown to be effective in a variety of conditions/situations that some of you might be interested in. It was developed by Steve Hayes at the University of Nevada at Reno, and it is called Acceptance and Commitment Therapy or ACT (you can learn more at www.contextualpsychology.org/). The approach focuses on cultivating acceptance (not resignation) and making decisions/taking action based on your values. There is also a great workbook associated with it called "Get Out of Your Mind and Into Your Life" if you can't/don't want to find an ACT therapist but are interested in the approach.

Best,

Kristalyn

K. Salters-Pedneault, Ph.D.

About.com Guide to Borderline Personality Disorder

www.BPD.about.com

I forgot to add a link -Here is a good overview of what ACT is about.  I've also ordered "Get Out of Your Mind and Into Your Life: The New Acceptance and Commitment Therapy" by Steven Hayes. 

Once I've read it I'll post a review.

Other tools that may be helpful in practicing mindfulness on your own are CDs by Marsha Linehan, which you can get at behavioraltech.org - I like From Suffering to Freedom through Acceptance.

There are also several CDs and guides available at Shinzen Young's website www.shinzen.org/ - a lot of his material is available on the website.

Mindfulness is woven throughout all of the DBT skill modules. The other pieces I find particularly helpful are the pieces in the distress tolderance module on accepting reality and the piece in emotion regulation on letting go of emotional suffering. (Sorry if this is a duplicate from those areas!)

The concepts include:

*Replace willfulness with willingness

   -WILLFULNESS :

● is refusing to make changes that are needed, giving up, refusing to tolerate distress, or trying to fix every situation.

● causes you to fight any suggestions that will improve the distress and thus make it more tolerable.

● It is the opposite of doing what works, of being effective.

    -WILLINGNESS:

● is doing just what is needed in each situation, in an unpretentious way, focusing on effectiveness, listening very carefully to your WISE MIND, acting from your inner self.

● Ask yourself, in 5 years from now, will the situation that causes the distress matter?

To me the difference is sort of like the difference between approaching a situation or person trying to control tightly in a fist versus letting go of the control you do not have anyway and approaching with open hands lifted upward, relaxed.

     -TURNING THE MIND

● Acceptance of reality requires an act of CHOICE. It is like coming to a fork in the road. You have to turn your mind towards the acceptance road and away from the rejecting reality road.

● You have to make an inner COMMITMENT to accept. The commitment to accept does not itself equal acceptance. It just turns you toward the path. But it is the first step.

● Sometimes, you have to make the commitment many times in the space of a few minutes.


    -RADICAL ACCEPTANCE

● Freedom from suffering requires ACCEPTANCE of what is, FROM DEEP WITHIN.

● It is allowing yourself to go completely with whatever the situation is. Let go of fighting reality.

● ACCEPTANCE IS THE ONLY WAY OUT OF HELL. THIS MUST NOT BE INTERPRETED AS APPROVAL OF THE DISTRESSING SITUATION

● Pain creates suffering only when you refuse to ACCEPT the pain.

● Deciding to tolerate the moment is ACCEPTANCE.

● ACCEPTANCE is acknowledging what is.

● To accept something is not the same as judging it to be good.

● By stopping your self from fighting, the rage or anger you feel will dissipate as long as you continue to accept your condition or your faulty perceptions to events or interpersonal communications difficulties. You will be amazed at how much better you will feel when you are able to accept.

Radical acceptance is simply coming to terms with what is rather than dwelling in what we wish had happened.

It is letting go of "ostrich behavior" and letting go of "if I coulda shoulda woulda" to be able to deal with what IS.

The main idea from emotional suffering is that we cannot (always) control whether pain enters our lives. However, we have some influence over how much we suffer. Pain is not the same thing as suffering.

These are some tips:

It is possible to let go of emotional suffering.

   Letting go of emotional suffering is not the same thing as letting go of the emotions themselves.

   We can learn how to let go of emotional suffering.

We do not mean getting rid of or stuffing the emotions.

   What we are talking about is dealing with these emotions in a way that will relieve some of the suffering that goes with them. The emotions are valid and represent experiences and interactions that were or are painful.


In learning to let go of our emotional suffering, we use the mindfulness skills of observing and describing.

   These skills give some distance from the emotions so we can see them more clearly.

Some ways to try getting some distance from a painful emotion that you have:

   Put it over there and look at it, maybe as if it were on a screen or a stage.

   Describe in words what the experience of that emotion is like. This also helps to give you distance and perspective.

By looking at your emotions you are exposing yourself to them. You are not necessarily acting on them, and not being swallowed or overwhelmed by them.

Emotions come and go.

   Most last only from seconds to a few minutes if allowed to run their natural course.

   They are like waves in the sea – they gather speed, roll in, crash upon the shore, then fade away. Although emotions come and go, they can also be self-perpetuating – that is, they can keep feeding off themselves and restarting (emotions love themselves).

When we accept our unpleasant, difficult emotions, we begin to loosen the hold they have on us and the suffering they cause decreases. 

   Accepting our emotions, letting ourselves realize that we have the emotions and that they are real and valid, is NOT approving of our pain or approving of the events that preceded these emotions.

   We DON’T have to approve of our unpleasant emotions to be able to accept them.

   Just let the feelings in and acknowledge their presence.

Debye

Here is an easy example of radical acceptance.

If you are like me, you arent fond of dental work. It sucks. It sometimes hurts. Its inconvenient, its icky, its something you wish you didnt need, but you do.

Ok. So... I use radical acceptance, and I see the dentist anyway. Or, ladies, getting a mamogram or pap smear... we just accept that there is some unpleasentness AND we have it done, anyway.

  Now... what if you fought and fought the dentist idea? I HATE GOING, why do I have to go, I KNOW its going to be horrible, I wish it wasnt like that, why do *I* have to have a root canal, how can I get out of this, I think Ill put it off, I am terrified, I dont think anyone has ever had it as bad as I do, I cant stand it, I cannot handle it, I cannot deal with it, I WONT DO IT, I refuse to accept that I need my teeth taken care of, why me, why is my dentist so mean, why is he so expensive, why is the office so crowded, why do those shots hurt, why am I always the one that has to wait, I know the dentist doesnt like me... .

Radical acceptance says : It isnt my favorite thing to do, maybe I am scared... AND I need to go anyway.

Anyone notice how much energy it takes to fight it, and how it doesnt solve anything? And just understanding that yea, I dont like this, and even so, thats the way it is... .calms the adrenalin, calms the mind and it makes it all so much easier.

Steph

Great overview.  "Radical acceptance and ACT doesn't just pertain to Staying with a disordered partner... .  All of us have "things" in our life that we have to "radically accept".  I'm working through some of this radical acceptance myself right now, and it doesn't have that much to do with my BPD-ish exh.  I've made bad decisions; I've wound up in a couple of difficult situations, but now I just have to keep putting one foot in front of the other and do what I can do.  I've got to stop banging myself on the head (figuratively) with the "Why didn't I... ." and the "if only

These are great tools. I wasn't sure what the words for it were but this makes sense. It is what it is. I am with my boyfriend because he is who he is. That is with craziness and moods. I realize he is working to get better, but if things are never different from how they are now... .that is ok.

When you don't get as angry or as upset over what they do.

When you can have true compassion for the pain they are in.

When your gut no longer tightens up in fear and dread.

When your love for them stills the spiteful words you would normally speak.

When you have lowered your defenses and no longer feel the need to explain or justify yourself.

When you can listen to the words they are saying, and find the emotions that are behind them.



It isn't a miraculous event, but a process that needs to be reaffirmend over and over and over again.

p.s. - I'm still working on this myself... .it ain't easy, but it is worth it

This is a good discussion

That is an interesting article, skip!  Years ago, something I heard on Dr. Laura (of all things) really stuck in my head (I'm paraphrasing from memory here): "Happiness is not the same thing as pleasure. Pleasure is what you feel when the chocolate hits your tongue, or your body parts touch another person's. Happiness is that good feeling of well being you can have about yourself when you are treating other people well and meeting your responsibilities. Mindless pursuit of pleasure ultimately works against happiness".

Regarding radical acceptance ... .for me it means accepting that the brick wall really is made of brick, and it's always going to be harder than my head, no matter how good I get at beating my head against it. I will never break a hole in the brick wall that way. I can try to go over or around the wall, I can even have a picnic next to it, but all the wishing, hoping, and gnashing of teeth in the world will never let me break through it with my head.

I don't know how to put this properly, and I swear I'm not trying to make trouble.

I know we are talking about "relatively healthy" relationships with disordered people, but I wonder... .I stayed in my marriage and put up with physical and verbal abuse to maintain a seemingly loving relationship between my son and his father.  When it was "just" slaps, and the occasional screamed nasty names, I put up with it, until I got too angry and envisioned greater happiness for myself.  Then it all escalated.

Could I have radically accepted a slap here and there that really wasn't so painful, and could that have actually lead to some kind of improvement, down the line, when I stopped letting it be a fight for control between the two of us?  Like maybe he would have gotten tired of that when he saw it didn't have an effect, and I accepted him for who he was? He still would have been sick, and occasionally abusive, but maybe he wouldn't hit me anymore.  I got the sense that he never really enjoyed doing it.  What if I had tried harder to turn the other cheek and accept that it might happen?  Would it have changed things?

Believe it or not, I'm actually asking this question, based on these articles, and the knowledge that 99% of the world's population is worse off then I was back then.  I think of the violence Gandhi and his followers, in the past and today, withstand in the name of loving their enemies, and I wonder if I could/should have tried harder to use peace and acceptance to stop the violence in my family.

I don't think so.  Everything I've read and heard about domestic violence indicates that it increases when unchecked.

Radical acceptance is for things you can't change.  But you can set boundaries against abuse.

Radical acceptance is not always obvious on the surface... .it takes time to understand it.

The key sentence in your post, Mousse, is really the one highlighted above.

Opening Post: The prime dissatisfaction for many of us is the sense that we are unworthy according to Tara Brach, PhD. We aren’t enough, we don’t do enough, we don’t have enough.  We live in a trance of unworthiness. It’s a trance because the pain of KNOWING the unworthy feelings is rather deep. So we keep really busy, so there’s no time to sit and know. We embark on self-improvement projects to try to be good enough. We avoid risks to avoid more pain. We withdraw from knowing our current experience.  We become self-critics. And like most self critics, we also become critical of others.  The trance of unworthiness involves being in close touch with a self that’s fearful, wanting, feeling alone and separate.  The self caught in desire, aversion , delusion. It means losing sight of the self who’s connected, whole, in the ‘fullness of being.’

Radical acceptance in this case most likely is about accepting that it was an unfair situation, accepting that you have some doubt - the answer wasn't black and white and that is OK, accepting that you did some things right and some wrong and that is OK, accepting that it is in the past and done - accepting all these feelings but at the same time letting go of the fears and the paralyzing aspects of them.

I hope this example helps.  It is a difficult concept to grasp (I'm just learning it myself)... .

xoxox

Skippy

Almost exactly 3 years ago today, I wrote a post at BPDR about getting an unexpected phone call from the man over whom I had the breakdown that led to my eventual recovery. It was about  5 months since we had talked – and almost exactly a year since my breakdown – and I was surprised by his call, and it brought up some hard emotions, even though we talked like old friends and had a fun time. This is what I wrote 3 years ago, right after I hung up with him:

Quote from my BPDR post:

Every moment has its own beauty…

... even this intolerable moment right now, this moment of nothing but pain, tears filling up all of the space of this one forever moment. After this moment I can't get through is another one just as hard as the other. But then this moment I have now I am not crying so hard. And this moment here is bringing me a bittersweet longing that hurts, but that I can manage.


I really wish he would not have called in this night's moments: not after my healing 5 months of having the last of his voice fading away from my mind so that I didn't recognize it tonight at first; not this week - this week that makes it a year since... .; not during this time when I'm planning the ritual to free me of that year-heavy load of pain.

But he did call. And we talked very easily, like old friends. And it was good to hear the voice I had forgotten. Missing him felt like an ache in the very skin of me. But I was happy he was happy even though he's now very far away, I had no idea he was so far away now. And we laughed about how evil dolphins are and other silly things. And we made it okay between us again, and said goodbye again.

This moment is not intolerable even if I wish there was no pain in this one, because this moment is the only one I have and I choose - no matter what it contains - to make it precious and beautiful and all mine.

That's my take on it as a person who had BPD. It would apply to loved ones of people with BPD mostly through accepting that the person with BPD is not who you want them to be - they are mentally ill. Yes, recovery may come. But it is not here NOW. Now they are mentally ill. To accept that is to accept reality, which is a form of grace [like Skip's article mentioned]. It's "radical" in the way a radical mastectomy is: brutal, but necessary. It is what it is, not what we wish it to be. Suffering - like someone already has said - comes when what want and how the world really is don't match. So choose which one to change. I'd go with the easier one... .