This thing called "Acceptance": how do I do that?

In the last blog we started to explore what acceptance is. I first came across the concept when I was working as an Assistant Psychologist (many years ago!) with people who had dementia.  If I’m honest, I was struggling to hold hope in my work with people who I couldn’t make “better” and my supervisor started to discuss the importance of acceptance and finding meaning in things that might at times seem ‘meaningless’. She recommended that I read Viktor Frankl’s book, Man’s search for Meaning (2004). It’s a beautifully written book about his experiences of being in Auschwitz, but the point of the book isn’t to write about the horrors he endured, but how it is possible to find meaning in life and acceptance even during (and after) something terrifying and where survival is arbitrary.  So I figured, if he and others can accept and find fulfilment in life having endured such things, then perhaps there is something to learn here, perhaps anything can be accepted, no matter how hard.

Acceptance and Commitment Therapy (ACT; Hayes, Strosahl & Wilson) and Dialectical Behaviour Therapy (DBT; Linehan, 1993) have acceptance as a core part of the therapy.  They talk about ‘opening up’ to the experience that is difficult, that we want to push away and being ‘willing’ to have it without trying to change it. This isn’t easy, so in the previous blog I suggested starting small.

Here are a few suggestions to help you with acceptance. 

Awareness

You might want to start with simply being more aware of the things that you are struggling to accept. Are there things that you often have thoughts like “this shouldn’t be happening”, “it’s not fair”, “it shouldn’t be this way”? If so, these are good indicators that you are not accepting. Try to be mindful of when you have these thoughts and notice what comes up for you when you do. Are there images or body sensations or feelings that go with the thoughts? You might find you get tearful, or angry, that your stomach is in knots or indeed that you push the experiences away and try to ignore them in the hope that they will go away. Notice what the level of distress or discomfort is.  What’s the level of willingness to have the experience without trying to change it? When the level of discomfort is high and the willingness level is low, we suffer and get stuck (Hayes & Smith, 2005). We are aiming to get the willingness level to 10/10, that is completely open to having the experience, whatever the pain it brings with it, without trying to change it (remember this doesn’t mean you are approving or giving up!). Try simply playing with the level of willingness and gradually working your way up.

Imagery

Sit somewhere quiet and comfortable, where you won’t be disturbed. Choose something that is mildly irritating, painful (not the worst thing) that you have experienced recently. Start with taking a few deep breaths and tune in to you sitting on the chair. Slowly, get an image of the thing you want to practice accepting in mind and just notice. What do you feel in your body? What are the feelings that are showing up? Notice any urges to push it away or change it and see if you can just come back to noticing it.  If it had a shape, what would that be? Get to know it, allow it to be there. Do this for a short time, 2-3 minutes if you can.

Break it down

Sometimes the thing we want to accept feels very overwhelming or painful and we don’t know where to start. Dismantling it into smaller bits can be helpful. For example, if you are wanting to accept having a physical health problem, you might want to start with one thing that’s hard about it, e.g. not being able to go cycling or eat something that you used to love.

Willingness

DBT and ACT both talk about willingness being a key component in helping people accept difficult things. Willingness means doing what you need to, in a skilful way, wholeheartedly (Linehan, 2015). It is not refusing to have the feelings or thoughts, it is not trying to change something you cant change, it is not refusing to solve something you can solve! You can even accept that you do not want to accept! 

Act Opposite/turn towards

Linehan (2015) talks about turning towards the pain or discomfort. Doing the exact opposite of what you might want to do. Her term ‘radical acceptance’ is about going all the way with acceptance, not being half hearted about it. So, watch your body and your face as you try to accept something; smooth your face, try to keep it open. If we are screwing up our face and turning away from something we are not accepting it!

Another key skills here is to do all of these things mindfully. Keep things present focused: “in this moment it hurts”, not bringing in all the pain you have ever felt.  For more guidance on mindfulness, check out what we're written about it!

I appreciate that acceptance is challenging, it is something you might have to practice and come back to (that pendulum swing). If you feel that you would like some support with accepting something, do get in touch.

References

Frankl, V. (2004). Man’s Search for Meaning. Rider: London.
Hayes, S, C. & Smith, S. (2005). Get Out of Your Mind and into Your Life: The New Acceptance and Commitment Therapy. New Harbinger.
Hayes, S. C., Strosahl, K. D. & Wilson, K. G. () Acceptance and Commitment Therapy: The Process and Practice of Mindful Change. Guilford Press.
Linehan, M. M. (1993). Cognitive-Behavioral Treatment of Borderline Personality Disorder (Diagnosis and Treatment of Mental Disorders). Guilford Press.
Linehan, M. M. (2015). DBT Skills Training Manual. 2nd Ed. Guilford Press.