How DBT’s Radical Acceptance Can Help with Teen Trauma, Anxiety, Depression and Any Other Painful Feelings

Radical Acceptance is a skill in Dialectical Behavior Therapy (DBT) that helps people learn how to accept very painful events, people, or aspects of their life. It’s one of the skills found in the Distress Tolerance module of DBT.

When Would You Use Radical Acceptance in DBT?

You use the skill of Radical Acceptance when you have trouble “getting over” or “moving on from” a painful or traumatic incident in the past or present. Especially one that you had or have no control over. For example, someone might have done something to you that was extremely hurtful. You don’t know how you’ll ever forgive them for it. Or you might have experienced a loss of a loved one, or a traumatic breakup. And you’re still in denial that such an event actually happened.

You could use radical acceptance with yourself: there could be aspects of yourself that you don’t like at all, or parts of yourself you still can’t believe are part of you.

Radical acceptance works with more minor experiences, too. Say you invested lots of effort, time, and money into a big decision, and it didn’t end up working out the way you envisioned it would. Or, something out of your control – a natural event or someone else’s carelessness — damaged something dear to you.

In all of these scenarios, things did not work out the way you wanted them to.

You end up thinking: This is not the way it was supposed to be. This is not the life I want.

And you are very angry, sad, frustrated, ashamed, bitter, or (fill in the blank) that this is so.

Deciding to Accept Reality

Radical acceptance is a complete acknowledgment of reality as it is in that precise moment. It means accepting that all of these painful situations or aspects happened or are currently happening. It means deciding to accept the facts of reality.

Just reality, and that’s it.

Radical acceptance is not being happy about the situation. It does not mean you endorse what happened. When you decide to radically accept a situation, that doesn’t mean you are choosing to forgive the person who wronged you. It doesn’t say you should become friendly with them again.

However, it does mean accepting – in your mind, heart and soul – that what happened actually happened. It means fully coming to terms with reality. It means realizing that you cannot change the past, and that there is no short-term solution for what’s happening in the present.

How Does DBT’s Radical Acceptance Help?

As DBT founder Marsha Linehan asserts, “rejecting reality usually turns pain into suffering.” You may notice that you are having a hard time accepting reality if you feel like you are fighting a difficult event that happened (or is happening) or your mind keeps coming back to something excruciatingly painful that you had/have no control over.

When you engage in radical acceptance, you embrace facts. This helps you cope with reality and live your life. It also reduces the impact of the painful emotions associated with the incident.

For many people, just learning about this concept helps push them on the path towards radical acceptance. Dr. Lauren Kerwin, Executive Director of Evolve Treatment Centers for Teens in Los Angeles, shares that the concept of radical acceptance resonated with her immediately when she first learned about it in graduate school. “At the time my son was 3 months old, and I was struggling to be both a mom and a Ph.D. student. Once I found and embraced the concept of radical acceptance, I was able to find peace and give up trying to be perfect in either role.”

She shares some examples of how this DBT skill has helped her in life.

“When frustrated, I like to ask myself what I am struggling to accept. Whether it’s rain on my wedding day (which it actually did) or the doorbell ringing just as my infant daughter is falling asleep, figuring out what I am not accepting helps me accept the reality of the present and get the anger down, so that I can solve the actual problem: call and rent a tent for the wedding or mute the doorbell during certain times.”

How Do You Radically Accept?

Radical acceptance is a difficult skill. It is very, very hard to accept something painful about life, about someone else, or about yourself. It’s okay if you cannot conquer this skill immediately. It may take days, weeks, or sometimes years to come to a full, complete acceptance of a very painful aspect of life. It may also bring up very difficult emotions in you. But after radical acceptance usually comes deep calmness.

So, how do you do this skill?

Unlike some other Distress Tolerance skills, radical acceptance is a skill that requires no tools or props. All you need is an open mind.

First, observe whether you are struggling to accept something in your life. Allow grief, anger, pain, and disappointment to arise within you as you think about something painful that happened in the past, or something that’s currently bringing you distress in your life as it is. Be mindful of your somatic sensations (what’s your body telling you?) and emotions. Notice that your distressing emotions may be a result of you fighting what happened or rejecting reality. Tell yourself that as unpleasant and upsetting your current reality is, it cannot be changed. Keep reminding yourself: Unfortunately, this is just what happened.

While you may not be able to engage in a full, complete acceptance of what happened at this very moment, you may be able to in the near future.

Dialectical Behavior Therapy RTC, PHP, IOP

Radical Acceptance is a skill usually taught in a group setting at an established Dialectical Behavior Therapy Residential Treatment Center, Partial Hospitalization Program, or Intensive Outpatient Program. A trained DBT therapist helps adolescents master this DBT skill, as well as the other skills in the four DBT core modules (Mindfulness, Emotion Regulation, Distress Tolerance, Interpersonal Effectiveness).

If you’re a teen struggling with depression, trauma, PTSD, addiction, borderline personality disorder, bipolar disorder, ODD, DMDD, psychosis, or other mental health or behavioral issues, DBT can help. Get in touch with an adolescent DBT treatment program today to see how it can help you discover a life worth living.