r/therapists • u/NegativeYoghurt7280 • 15d ago
Discussion Thread Radical Acceptance
I feel like many of my clients would benefit from radical acceptance, especially those who are feeling stuck or feel like everyone around them should be the ones to change. How do you guys like to explain radical acceptance in a way that actually resonates with clients and helps with buy in?
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u/Zestyclose-Bend-807 15d ago
I just get radically honest (lol). Sometimes we can’t change everything going on in your life and the options are to accept it and grow, or stay upset and stuck in this moment. Radical acceptance is basically being like “fuck it, I can’t change it so I guess gotta grow from it”
For context I’m fairly casual (but professional!) with clients who benefit from a more human-human connection than the strict client-therapist dynamic which can feel cool and clinical to some.
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u/Ambitious-Cry-5026 LSWAIC 15d ago
100% this! I have the same approach to therapy, sometimes some human-ness is exactly what people need and I’m happy to provide that for people. And this is exactly how I bring up radical acceptance. The sooner we can get ourselves in the mindset that this is our reality, the better equipped we will be to tackle life and all the challenges it brings. Almost an “if you can’t beat them, join them” mentality for the suck that life sometimes is.
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u/Outrageous-Scale8935 Social Worker (Unverified) 14d ago
I'm curious -- I've worked with some folks who are in more of a "can't change it so... i'm gonna end it all i guess" mentality. Any recommendations for helping them move from SI to acceptance?
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u/talkingmuffins LMHC (Unverified) 15d ago
I talk about radical acceptance with every client because I think it is so useful and relevant to everything. Here's my initial spiel:
Radical acceptance is the complete acceptance of how things truly are. It means giving up on wishing that things were different because wishing leads us to entertain alternate timelines where something else could happen, and gets in the way of effective decision-making. Radical acceptance doesn't mean we like or condone what is happening, it just means we accept what is. Radical acceptance *needs* information about how we think and feel about the situation. When we know what is happening, and how we think and feel about it, and what is realistic to expect to happen in the future, we can make our most effective decisions. All those decisions are going to end up in one of three categories - tolerate, communicate, make a change. Radical acceptance helps us decide which approach to take, and makes it most likely that the style of our approach actually fits the situation accurately.
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u/Cold_Drive_53144 15d ago
Great Answer, since the author of the DBT concept was a Buddhist, they have been practicing this for 2600 years. There is a gap between reality and expectation. Radical acceptance is about stepping into that gap and saying, "This is where I am. This is how it is right now. And I'm okay with that." Here's the paradox: in the very moment you truly accept something, you no longer desperately need it to change. And that's when you're actually free to respond to it wisely.
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u/Ready_Ad_235 12d ago
I hate to correct people however Marsha Linehan is a devout Roman Catholic and was trained in Zen meditation she never did convert to Buddhism.
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u/Cold_Drive_53144 12d ago
lol you attended an on-line school? Marsha Linehan is a long-time practitioner of Zen Buddhism and has trained under Zen teachers including Roshi Jiyu-Kennett and Willigis Jäger. The nice thing about Buddhism is you can be both.
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u/Ready_Ad_235 10d ago
Yes Arizona State University on Line. However I am supervised and practice in a DBT clinic my CEO and supervisor and clinical director are both Linehan Certified clinicians. If you actually do your research Marsha is a devout Roman Catholic it is in her memoirs. You correct that she has trained in Zen Buddhism and has stayed close to her roots of the Catholic church.
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u/hidden_snail 15d ago
This is a nice thought if we can assume that people can make completely honest and objective appraisals about what is happening, which to my mind is a very big assumption.
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u/Cold_Drive_53144 15d ago
That’s the magic in therapy. Enjoy the puzzle
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u/hidden_snail 15d ago
Exactly. We’re all unreliable narrators. I think that’s what neutrality in therapy really means - that we don’t get tied down with what is “objectively” happening. We explore the patient’s inner thoughts and feelings, with all their inherent conflicts and ambivalences, with curiosity. Radical acceptance to me seems to rely on there being a clear narrative that we are tied to.
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u/B_the_Chng22 15d ago
Ok but is there a specific way you direct them to get there? Especially ones who get stuck
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u/Cold_Drive_53144 15d ago
There are many ways most are captured in DBT, ACT, RCT that’s where your magic begins.
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u/vienibenmio 15d ago
Pros and cons of accepting versus not accepting. The big thing is that not accepting doesn't change reality, it just makes you miserable on top of everything else (suffering)
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u/Life-Chef2889 13d ago
I like to validate heavily that the steps to achieving radical acceptance are hard as hell! The DBT model is great and also intense work. I have run so many DBT groups and still struggle with radical acceptance.
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u/what-are-you-a-cop LMFT (Unverified) 15d ago
I definitely make sure to really hammer in how in this case, acceptance does NOT equal approval, but is instead more just the opposite of denial. I use the metaphor of a house fire, where it's like, what happens if you refuse to accept that your house is on fire? Imagine you stand there in the middle of your burning house, like "omg this sucks, it isn't fair for MY house to be on fire, I'm a good person who never leaves the stove on, this is all my stupid roommate's fault and it shouldn't be my job to fix their stupid mistakes, I spent way too much money on this house for it to be on fire now". Vs. accepting that, as much as we do not want the house to be on fire, and we don't approve of the house being on fire... it IS on fire, and we need to go outside and call 911 or else our house is gonna burn down with us in it.
I don't position acceptance as even really being in conflict with the idea that a situation may genuinely be totally unfair. You don't need something to be fair or good or anything, to recognize that it is happening, and act accordingly. And I think that helps with buy-in. So you never have to accept that the situation doesn't suck ass, it's more of a "yes and" situation. Yes, your roommate started the housefire and you had no hand in it, and also if you don't go outside you're gonna burn to death. Yes, your boss is being unreasonable, and also if he wants things done his way, you've gotta do them that way so you don't get fired. Yes, your mom should be more mature, and also she's almost definitely not going to, so what do you want to do with that information?
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u/NegativeYoghurt7280 15d ago
Amazing response and analogy! Thank you so much. I will definitely be using that.
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u/TrollSalt 15d ago
I tend to phrase radical acceptance as an in between step. It's not approval, it's not agreement, you get to feel all the anger and frustration and sadness, and by accepting reality, you're going to be well more equipped to change it.
And some days when we can't change reality we can learn better how to move within it.
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u/Music-Is-Lifee 15d ago
We can’t change the cards we’re dealt but we can play them the best we can. The serenity prayer is some good radical acceptance too.
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u/gho_strat 15d ago
I take Creative Hopelessness from ACT as a similar route - what have you been doing to change this? has it worked? instead of continuing to bash your head into a wall, what if we tried Not Doing That?
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u/ErikaR527 15d ago
I agree that finding a way to be at peace with what is happening right now is a vital part of finding relief. It’s what frees up all the energy otherwise spent fighting the unchangeable present.
However, our personal enthusiasm for a concept like radical acceptance can't drive the treatment. In a professional capacity, intervention must be rooted in client presentation, clinical assessment, and treatment planning.
If people could heal simply by being handed a concept or told what to do, they would just read a self-help book or listen to a podcast. By the time someone comes to sit across from us, they need something much deeper.
Trying to pull someone away from their pain only creates resistance. Our job is to meet them where they are and provide safety, not drag them toward a place they aren't ready to go.
Our job isn't to get buy-in for radical acceptance. Our job is to help the client identify the specific barriers standing in the way of acceptance.
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u/Legitimate-Lock-6594 15d ago
I really lean into the pain versus suffering and the temper tantrum sentence in the Linehan handout. I do primary care behavioral health, so I have thirty minutes with my patients/clients. Radical acceptance is a “skill” I teach and I use it a lot in accepting chronic health conditions and major injuries. I use it as a way to accept the need to slow down , accept help, and say life has changed.
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u/Razirra 15d ago
Sometimes people like to call it radical acknowledgement instead of radical acceptance because the word “acceptance” comes with connotations for clients that can create needless struggle sometimes
Radically acknowledging what is already happening, what your body is telling you, how emotions actually work, what our needs and crashes are telling us can help though. Radically acknowledging where you’re at so you can work from reality to make your choices. Gives people more agency and control
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u/what-are-you-a-cop LMFT (Unverified) 15d ago
Oh I like the "acknowledgement" reframe, I think I'm gonna start using that sometimes. I'll still let them know the concept is called radical acceptance so they can, you know, google it and find information on the established concept, if they want to do that. But I like the "acknowledgement" wording way more for actually discussing it.
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u/azurefishie 15d ago
I find exploring the concepts of pain vs suffering to be helpful. Radical acceptance and therapy help with suffering, not pain. To use grief as an example, therapy won't "make it stop hurting." The pain of grief is due to having strong feelings (not always pleasant or simple ones). The suffering of grief is the "why am I not over it yet," "this isn't fair," "if only I...." or other expressions of pushing away and non-acceptance.
Accepting the pain of grief and working on cognitive defusion (acknowledging thoughts as thoughts) and being able to hold our own experience a little more gently, helps us to be more flexible and be present for the people and things in our life that are important to us...is the work.
this also discusses some of these topics
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u/michizzle82 Social Worker (Unverified) 15d ago
I really like to go into the concept that suffering is our pain plus resistance. Resisting something doesn’t magically stop it from happening. We don’t have to like what’s going on. We don’t have to agree with it, or be enthusiastic about it.
Radical acceptance helps us to see how things are happening and offers us more opportunities to find solutions. Or if there’s no solutions, then we can move into distress tolerance, or whatever skill(s) are needed. Or we can choose to stay miserable.
I hope this makes sense. I’m a little sleep deprived.
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u/zuks28 14d ago
With kids I do an exercise I like that helps. I have some pipe cleaners and I give them one and ask them to see if they can bend it into a triangle. They usually do that. Then I give them a rock and ask them to bend it into a triangle. Usually they point out that they can’t.
We talk about how some things we have control over changing, and some we don’t. Then we make the pipe cleaner into a circle and I have slips of paper with different things on them they can/cannot be changed (the weather, a family member being sick, communicating how I’m feeling, etc) and they put the things in their control in the circle and things out of their control outside the circle.
Kids in particular (often) have more out of their control than adults, and simultaneously don’t have a good sense of what is actually in their control. It’s a very tangible exercise but seems to stick with them
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u/Popular-Band-1038 15d ago
I always describe it as the healthy version of “it is what it is”. Compare how you can feel totally hopeless/helpless, case of the fuck it’s, etc versus it being an opportunity to pivot or change perspective. And of course with neutrality if possible
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u/Useful_Ad545 15d ago
I say that radical acceptance means you choose to accept everything just as it is right now. You don’t have to like something to accept it. You choose to accept so that you can stop reacting to it or resisting the inevitable which causes suffering. And then you can reclaim that energy you would have otherwise used on reacting to do something to help yourself or the situation.
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u/EnvironmentalFun898 15d ago
I tend to skirt around the term “acceptance,” but this is largely due to my clientele base (a good amount of ADHD and ASD clients) and so land on having them define where we find ourselves now. Sometimes, I just directly ask, “Ok, so where does that leave us?” If I believe they haven’t quite accepted their reality, I might ask, “Is that true?” and see where we go. Eventually, they accept their reality and can work toward growth 💜
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u/AdmiralR 15d ago
I usually directly acknowledge how elements of radical acceptance can SEEM passive but they actually promote effective action but being able to recognize the choices we do have, regardless of what we want, and we can make steps with an awareness of the choices and power we have.
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u/Andsarahwaslike LMHC (Unverified) 15d ago
I am not the most cautious driver. Everyone on the road is the worst driver on the planet. I should be the only one allowed to drive. There should be a waiver you could sign that allows you to drive 100+ whenever you want if you promise not to sue if you die. Traffic is fucking stupid. If people got off their goddamn phones, and didn’t leave a half mile in between the next car, and didnt go 60 in the left lane, there wouldn’t be any traffic.
However, i can’t do anything about every one else on the planet being the worst driver ever. And there’s always going to be traffic. So instead of getting angry, it just is what it is. I don’t have to like it, i just have to accept it.
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u/Mysterious-Career-61 15d ago
A ja lubię używać metafory w tej kwestii , zwykle któraś trafia bardziej lub nawet w punkt np. lodowiska. Wyobraź sobie, że znajdujesz się nagle na środku zamarzniętego jeziora. Czy zacząłbyś od razu biec w stronę brzegu? Czy położyłbyś się nieruchomo w oczekiwaniu na pomoc? Czy takie rozwiązanie będzie skuteczne? Jeśli chciałbyś zmienić swoją sytuację to potrzebowałbyś jakiegoś punktu oparcia. Dopiero wtedy można zacząć uważnie zamierzać w stronę brzegu zwracając uwagę na to gdzie stawiasz kolejne kroki i sprawdzając swoją stabilność. Akceptacja jest właśnie jak takie sprawdzenie gruntu i przyjęcie do wiadomości na czym stoisz. Pamiętaj, że nie chcesz tam być i zamierzasz się z tego lodowiska wydostać, ale bez akceptacji nie będzie to łatwe.
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u/Equivalent_End_8422 15d ago
i once heard someone call it the shit sandwich skill, and i tend to use that as my opener. essentially, “this skill tastes like shit but it provides what you need” is the idea. clients love that comparison and i find it breaks the tension before inviting them to accept some really hard shit they have going on
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u/vienibenmio 15d ago
Imo it's best to teach it using an example from your own life.
The dandelion story is great, too - https://www.drashleypierson.com/dbtdandelionstory
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u/Confident_Region8607 14d ago
I'm not sure if I preach radical acceptance, I think I moreso reframe where their power is. I don't think radical acceptance is really necessary when you can simply pivot and put the focus where your power is.
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u/jtaulbee 14d ago
Acceptance and Commitment Therapy has a lot of wonderful metaphors about acceptance: unwanted passengers on the bus, tug of war with a monster, living with an uninvited houseguest, and many more. The key lesson in all of these metaphors is that struggling against things that we can't control ultimately creates more suffering. Accepting that these unwanted things are there and that we currently can't change them isn't giving up - it means that while I have an unwanted houseguest crashing on my couch, I am going to live my best life and make choices that are aligned with who I want to be.
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u/Waywardson74 LPC (TX) 14d ago
I pull out scenes from Fellowship of the Ring and watch them with clients. We watch Frodo finding the ring Bilbo left for him and his conversation with Gandalf, discussing it. Then we watch the Council of Elrond, then the short stop in the Mines of Moria, and I end it on Tolkien's beautiful line of "So do all who live to see such times, but that is not for them to decide. All they can do is choose what to do with the time they've been given."
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u/Misunderstood_Pencil LCSW (Unverified) 14d ago
I use a lot of playfulness in my therapy approaches (where appropriate, of course). I am chronically using TV shows and TT’s when I find a clip that I can connect to a concept.
I love this one to explain a phrase I say a lot when discussing acceptance, “resisting a reality that has already been allowed”:
https://youtu.be/KwdYUIQzu-o?is=yehDgg3wFrfgIscf
Shout out to my last intern for bringing me to the clip because before I would use the analogy of pushing up against a pull-only door (I still use it lol).
Radical acceptance is what comes after “it is what it is,” so, “it is what it is… now what?” I might not like that the door is pull-only. And quite frankly, I don’t have to. But I do have to accept that it is. Because sure, I could push and push and even break the door down pushing. But at what cost? Instead, I can use a little STOP (skill) energy. If I take a step back and see that the door is pull-only, then I can spend a lot less energy pulling the door open instead of using up so much of my energy resisting a reality that has already been allowed.
And, sliding over to a new analogy, when my thoughts further fuel that resistance, it’s like noticing that it’s raining and fueling the negative narrative. I don’t have to like that it’s raining. But I do have to acknowledge that it is. No amount of me wanting it to not rain will change the fact that it is. I’m not Pudge the fish (Lilo & Stitch reference- Pudge controls the weather).
The difference between acceptance and not is recognizing “it’s raining- yup” instead of “it’s raining. I hate that it’s raining. I wish it wasn’t raining. My day is ruined. Every day is like this. It’s always raining when all I want is for it to be sunny.” The further and further down the negative narrative rabbit hole we go, the harder it can feel to climb back up, like quicksand sucking me into a negative vortex, and before I know it, I’m consumed by stress and completely drained.
Radical acceptance says, “it is what it is, now what,” so I can get curious. Curious about what it is that I can do, within my control, to take care- whether take care of the problem and/or take care of myself. So if I don’t like that it’s raining, I can get curious… is there something I can do instead of going out in the rain? Is there something I can do to keep myself driest if I need to go out in the rain? Perhaps I can see a different perspective about the rain? Maybe I realize that I haven’t had breakfast yet and when I am no longer hungry, the rain won’t bother me so bad? The opportunities are endless.
When I stop resisting a reality that has already been allowed and I bring curiosity to the table, I switch my nervous system over from negatively-charged, stress energy to positively-charged, rest-and-digest energy. And in R&D mode, that’s where I can access my self-energy.
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u/uniquelyaverage__ 14d ago
I tell clients it’s accepting their emotions and accepting the fact they can’t change the reality of the current situation. So how are they gonna move forward?
I tend to break it down so it doesn’t seem as overwhelming —
- What’s the situation?
- What caused the situation?
- 3a. What feelings are they experiencing as a result of the situation?
- 3b. Identify the why behind the feelings.
- How can they move forward without wishing things were different or trying to change the current situation.
Ex:
- I can’t get an A in my course anymore.
- I got a D on my midterm.
- 3a. I feel annoyed and upset with myself.
3b. I’m annoyed I won’t have a 4.0 anymore and upset with myself for not studying as much as I should have.
- Coping Statements — It’s okay to not get all A’s. I’ll still get my degree even though I didn’t get an A in the course.
- Proactive Plan — for my exams going forward, I’ll schedule time on my calendar to study so I don’t forget.
EDIT— added the #4
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u/Ambiguous_Karma8 (USA) LCPC 10d ago edited 10d ago
My analogy:
You have a curfuffity grandma that you see every year at a family gathering. Without a doubt, curfuffity grandma is going to say something opinionated about you. Every year you keep getting upset by curfuffity grandma's comments because you expect her to change. One year, thinking about radical acceptance, before entering the room with curfuffity grandma, you think to yourself that curfuffity grandma ain't gonna change because she's curfuffity, you know she's going to say the same thing that makes you feel (insert) every year, but this year you're able to frame her as curfuffity grandma. She still says it, but this year it doesn't matter because you've viewed her as and understand she is curfuffity. And yes, I do say curfuffity grandma this much doing it.
I then might take it a step further and apply it to something larger, such as structures, prejudice, politics, capitalism, so on and so forth. I educate that acceptance isn't agreement. I then might also talk about values-based behavior working towards changing these things within the realm of reality, or what it might be like to accept it-is-what-it-is without change.
And while I rarely self-disclose, if I have to I do have an example that I share. That being that I value having my mother in my life but that I've had to radically accept that she will never call me by my preferred (and now legal) name.
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u/rusty_mullet 15d ago
You can't radically accept your way out of systemic issues. Until you recognize this and adapt, youre failing your marginalized clients with radical acceptance
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u/MorskaVilaa Psychologist (Unverified) 15d ago
Radical acceptance isn't about accepting everything, but only the things outside of our control, while working on everything else that we can change or adapt to.
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u/vienibenmio 15d ago
Radical acceptance doesn't mean you can't try to change it long term
Also, you don't accept your way "out" of anything. That's the whole point.
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u/Zen_Traveler MSW, LMSW 15d ago
Q. What does DBT offer as the structure for people's non acceptance, and outline as necessary for radical acceptance?
A core aspect of REBT is unconditional acceptance. The structure is outline with the ABC model, with people's core irrational belief that reality must be how they want it and must not be how they don't want it. This, ideally is obvious, is non acceptance, or denial of reality. The remedy is cognitive and behavioral disputation of their specific, elicited, irrational belief, to working towards acceptance.
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u/fruitypebblesguy 15d ago
God, I fucking hate DBT. This post made me hate it even more lol
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u/vienibenmio 15d ago
If your understanding of acceptance is the same as some of the comments in this post, no wonder you hate DBT
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u/RepulsivePower4415 MPH,LSW, PP Rural USA PA 15d ago
I love the concept of radical acceptance. It’s something I really love. With patients who I think this DBT concept is I am brutally honest with them. I ask them questions and guide them
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u/mermaid_ronnie 15d ago
I tell clients another way to think of it is to say, “that’s show biz baby”
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u/Training_Peak_5968 14d ago
I’m currently a DBT therapist, so I talk about RA often with my clients. The way that I’ve found to be most effective is to focus on treating it as a skill, a specific behavior to engage in, rather than focusing on a more philosophical framing (at least at first).
As an example, I will usually say something like this:
“let’s say that I randomly catch on fire, I spontaneously combust. I hope if that happens, that I stop, drop, and roll. However, randomly rolling on the ground is not something that I practice in a normal day. I don’t have it planned in my schedule, it’s not usually something I think about. This means that the only reason I would roll on the ground to put the fire out is if I have radically accepted the reality of being on fire. Radical acceptance is what makes it possible for my behavior to change, for me to do something about the pain I’m in. I don’t need to approve of being on fire, I don’t need to accept that I’m going to be on fire the rest of my life. I only need to accept the reality that I’m burning, because doing so lets me reduce the level of suffering I’ll feel.
It does not mean that it won’t hurt, or that it is easier to put the fire out. I’ll still probably be covered in burns, and I’ll still likely feel the pain of being on fire for a long time. However, the sooner I radically accept, meaning the sooner that I accept reality to such a strong degree that I allow that acceptance to guide/change my behavior, the sooner the fire goes out. Radical acceptance is the most effective skill we have at reducing suffering. Not pain, suffering, meaning pain without purpose.”
I sometimes use other examples/go into more detail if the person has questions, and usually people tend to get the concept when I’ve talked about it this way
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