Marsha Linehan is one of my heroes.
Some of you may be thinking: who the heck is Marsha Linehan? Where is she going with this?? (We’ll get there).
So in case you haven’t heard of her: Marsha M. Linehan, PHD, ABPP, is the developer of Dialectical Behavior Therapy (DBT) and a professor of psychology, adjunct professor of psychiatry and behavioral sciences, and director of the Behavioral Research and Therapy Clinics at the University of Washington.
Her primary research interest is in the development and evaluation of evidence-based treatments for populations with high suicide risk and severe mental and emotional disorders.
Dr. Linehan’s contributions to suicide research and clinical psychology research have been recognized with numerous awards, including the Gold Medal Award for Life Achievement in the Application of Psychology from the American Psychological Foundation, the Scientific Research Award from the National Alliance on Mental Illness, and more.
But that doesn’t really tell you much about why she’s my hero.
This past summer I read her memoir, “Building a Life Worth Living,” where she talked about the circumstances that led her to developing DBT.
At eighteen years old she suddenly ended up in a mental institution, where she spent several years as an extremely high risk patient.
She described the experience in her memoir, saying:
“…but I survived. And toward the end of my time at the institute, I made a promise to God, a vow, that I would get myself out of hell—and that once I did, I would find a way to get others out of hell, too.”
I think that it takes a special kind of person to be able to witness extreme suffering like that and to run towards it, and not away.
Dr. Linehan’s work has helped so many people across the world who suffer from severe emotional distress, and she fought back against everyone who said DBT wasn’t an effective form of therapy.
I like to think of DBT as life skills.
Maybe these are skills that no one ever taught you, or you lost them a little bit along the way. DBT is a way of looking at your problems and saying “here is what you need to do in that situation to fix it.”
We all know I’m not a therapist, but rather a 24 year old who is writing this blog while laying in my bed surrounded by 1000 pillows, laundry, and a bag of tortilla chips (gluten free!)
So I want to make it clear that I am not qualified to determine whether DBT is the right fit for you, and that’s not really what I’m here to talk about anyway.
I wanted to focus today on a specific skill from DBT that I am trying to practice more when it comes to dealing with having a chronic illness: radical acceptance.
What is Radical Acceptance?
Radical acceptance is the acceptance of things exactly how they are, with no judgment or questioning.
To radically accept something does not mean that you have to agree with it, which is why it can be a confusing concept to grasp. It simply means you are acknowledging your current reality.
Marsha Linehan explains the reasoning for this in her memoir, “Building a Life Worth Living,” saying,
“You have to accept reality in order to change it. Reality is what it is. If you don’t like it, you can change it. The following are the six key pointers about radical acceptance:
- Freedom from suffering requires acceptance from deep within of what is. Let yourself go completely with what is. Let go of fighting reality.
- Acceptance is the only way out of hell.
- Pain creates suffering only when you refuse to accept the pain.
- Deciding to tolerate the moment is acceptance.
- Acceptance is knowledge of what is.
- To accept something is not the same as judging it as being good
If you surrender and radically accept life as it is—with willingness, without resentment, without anger—then you are in a place from which you can move on. Don’t say, “Why me?” Whatever has happened has happened. To radically accept something is to stop fighting it.”
Radical acceptance involves accepting something completely: mind, heart, body, soul. Accepting that reality is as it is and everything has a cause, and that painful events can happen while still having a life worth living is at the heart of radical acceptance.
Rejecting our reality doesn’t change it.
We can’t avoid pain. Trying to do so through actively rejecting reality is what turns pain into suffering. This is what keeps us stuck in our current reality, which can lead to being stuck in painful emotions such as shame, bitterness, or resentment.
How to Practice Radical Acceptance
Practicing Radical Acceptance Step By Step (paraphrased in my own words so that Marsha does not look down upon me)
- Ask yourself if you are being willful and rejecting reality (are you asking yourself questions such as “why me?” or using phrases such as “this shouldn’t be happening” and “this isn’t how things are supposed to be.”)
- Remind yourself that your current reality is as it is and cannot be changed without accepting it.
- Remind yourself that there are many factors that have caused your current reality. What history led to this? Consider how our lives are shaped by different moments that all had to occur in order to lead to the present
- Practice acceptance. Try to practice accepting completely: mind, heart, body, soul. Utilize different ways to do this and find what works best for you. Use accepting self talk, mindfulness, relaxation exercises, imagery, journaling, or whatever works best for you.
- Practice utilizing a skill called opposite action.
- Practice the coping ahead skill for events or situations that feel too overwhelming or cause too many unpleasant emotions.
- Pay attention and attend to your body sensations as you note the things you need to accept.
- Allow yourself to feel any feelings that may arise such as grief, regret, and sadness.
- Recognize that life can be worth living even with pain.
If you are really resisting practicing acceptance for a certain situation or event, try utilizing pro’s and con’s lists. Create a pro’s/con’s list for both sides of the situation: what would happen both if you accept reality and if you don’t.
And of course, once again….. all of this is easier said than done. Healing is not linear. Feelings are not linear. Radical acceptance is sure as hell not linear (although I kind of wish it was).
Turning the Mind
Dr. Linehan describes radical acceptance like traveling down a road and constantly coming upon forks.
Every time you face a fork in the road, you have to choose which way to go. On the road of radical acceptance, you clearly want to go towards radical acceptance and not towards rejecting reality. She calls this “turning the mind.”
There are a few steps for turning the mind towards radical acceptance:
- Observe that you are not accepting (be mindful of emotions like anger/resentment, avoiding emotions, annoyance, and saying things such as “why me?” “this shouldn’t be happening” “it’s not supposed to be like this” “i hate this”)
- Look within yourself and make an inner commitment to accept reality as it is, without judgment or questioning
- Do it over and over each time you come to those forks in the road
- Develop a plan for catching yourself in the future when you drift out of acceptance
Chronic Illness and Radical Acceptance
Wouldn’t it probably feel a little bit better if I could sit here and tell you that I have radically accepted my illnesses?
I mean, probably, yeah.
Except I promised myself that I was doing all this – sharing my life so publicly – because I wanted to really help someone else one day.
So, while it might make me feel better to pretend that it was so easy for me to do this and I’ve ~radically accepted~ my reality, the actual reality is never as pretty as your average blogger might lead you to believe.
I am not your average blogger (I’d like to think), so I will tell you the whole, ugly, “laying-around-hating-my-life-flat-out-refusing-to-accept-my-reality-don’t-tell-marsha” truth.
- I have said to myself the words “this shouldn’t be happening” and “why me?” more times than I can count
- I have been stuck in my past
- I have been setting limits on myself for the future
- I have refused to accept my reality
And now I know that all of those things have led me here, to finally having the ability and skills to be able to begin working towards radical acceptance of my illnesses.
Rejecting my reality will not change it.
Eliminating my suffering comes from accepting what is now, whether I agree with it or not. Pain does not have to equal suffering.
Counselors from the Bay Area DBT & Couples Counseling Center explain that pain does not equal suffering, writing that:
Pain + resistance = suffering
Pain + radical acceptance = peace
I know that radical acceptance is not something that will be easily achieved when living with a chronic illness, but rather a destination to keep working towards. I hope we all can meet there someday.