One of the most profound skills in DBT is radical acceptance.
It is also one of the hardest DBT skills to grasp, understand and put into practice.
Radical Acceptance is a distress tolerance skill that guides us how to deal with suffering and pain that we cannot change. Things that just are.
Car accidents, relationship break-ups, our own childhoods, and having a mental or physical health condition are all parts of our lives that can feel painful, and can be different to come to terms with.
Most of us either avoid dealing with them or pushing them away, or on the other hand create stories in our mind (and consequently feelings in our body) that try to make sense of the reality by worrying or making assumptions that do not agree with the facts.
In survival of trauma and stress pushing away or making stories may have helped us survive in the shorter term, but in the longer term may increase our suffering and not leave space for healing.
Radical acceptance is the act of accepting reality as it is.
This sounds rather simple and cut and dry, but in practice has a few layers to it that I am going to explain.
The first things we want to accept is reality as it is- not how we want it to be, not how it should be, not how we predict it will be, just how it is.
We do this by observing and describing reality just as it is, with the facts, with our wise mind.
For example for someone who has just experienced a relationship break-up we want to accept: my partner has broken up with me, we are no longer together.
In radical acceptance we do not want to accept things that are not facts. For example: predictions about the future (I will never be in another relationship, they will never speak to me again, I will feel this way forever , etc) as we cannot predict the future with certainty and making those assumptions may increase our suffering.
When we accept reality as it is, we may start to experience uncomfortable emotions (grief, sadness, anger, etc). Radically accepting our feelings in our body that surface is an essential part of reality acceptance.
However emotions that are at our core, even difficult ones, when felt, will ebb and flow and eventually run their course and not feel as strong as when we first experienced the events.
Letting ourselves feel these feelings is an essential part of the human process of healing (and likely what makes people avoid radical acceptance).
Reality acceptance is not a one time skill- we may use reality acceptance over and over again for the same issue. If the feelings become too strong, take a break, use your other distress tolerance skills (distraction, self-soothing, imagery, etc) and seek support from those who care about you.
In DBT radical acceptance is not just a cognitive skill- radical means completely- all the way including with our body and emotions- we can accept reality by using willing hands: opening our hands and softening our body posture to communicate to our nervous system and brain that we are choosing to accept reality.
A summary of the steps involved in Radical Acceptance:
Allow your wise mind to radically accept these are the facts (and only the facts), that reality is what it is
Breathe Mindfully in the moment,
Acknowledge how (until now)not accepting this reality may have helped your survive traumatic or adverse experiences in life
Attend to body sensations and emotions (grief, sadness, disappointment) that you experience as you radically accept this reality
Accept reality with your body and face: for example: half-smile and willing hands
Repeat as this process as needed, continuing to turn towards Radical Acceptance
At any time you may use distress tolerance skills, the support of caring others (such as a friend or therapist) and/or take breaks and return to this skill