Radical Acceptance is a distress tolerance skill in Dialectical Behavior Therapy (DBT). It teaches us to accept things as they are, completely and fully. It means not resisting, or not attempting to change. Rather it means seeing things as they are.
This can be a challenging skill in DBT! It can be hard to look at our problems and say “I accept it for exactly what it is.” We want to change things that are unfair, painful, or problematic. But radical acceptance forces us to look at something and say, “it is what it is.”
It’s important to clarify with this skill that it doesn’t necessarily mean that we are approving of something. Acceptance does not mean approval. It does not mean we have to like something. It simply means we recognize the facts of the situations.
Acceptance also doesn’t mean agreeing. I can accept that something is happening without agreeing with it. For example, let’s say you’ve asked your boss for a raise, and your boss says no. Despite the fact that you’ve worked late, taken on extra projects, and have definitely earned your raise. You might completely disagree with this decision, and you can still radically accept that this is the final decision.
Radical Acceptance does not mean that we tolerate abusive behavior. Radical Acceptance does allow us to recognize abusive behavior, however, and help us decide how to respond to it. Once I recognize that something is happening, once I radically accept it, I can then decide how to respond to it. Moreover, by accepting our pain, we reduce our suffering. As the famous saying goes, “Pain is inevitable. Suffering is optional.” Radical Acceptance helps us reduce suffering.
As with all of our DBT skills, Radical Acceptance takes a lot of practice. It is not easy to accept things as they are. To practice, start first by practicing small things. If it’s raining out and you were hoping to go on a hike, radically accept the weather. If you wanted to pick up a bottle of olive oil and the grocery store is already closed, radically accept that you’ll go to the store the next day. As you feel comfortable practicing these smaller instances, you’ll be able to start practicing radical acceptance with bigger issues that come up for you.
Self-soothing is a distress tolerance skill uses our senses to calm ourselves. We use our senses to soothe ourselves when we are feeling on edge, nervous, distracted, dissociative, or any other unpleasant feeling we might be experiencing. Our senses can ground us in the present, and help us regulate our emotions. When using this skill, try different methods to soothe using your senses. You might find some techniques are more effective than others.
Self-Soothing with Sight
Look at images that soothe you. Find phots of a beach, a mountain, someone you love, or an animal. If you are able to, go out into nature and look at your surroundings. Watch videos of waves rolling or fish swimming. Look at photos from a vacation you took.
Self-Soothing with Sound
Listen to soft music, or classical piano. Listen to nature sounds, such as rainfall or ocean waves. Open your window and notice all of the sounds you hear. Play an instrument you enjoy listening to.
Self-Soothing with Touch
Put on your favorite sweater, or your softest pajamas. Rub lotion on your skin. Take a bath or shower and notice how the water feels. Get cozy with clean bedsheets. Pet your dog or cat. Hug someone you love.
Self-Soothing with Taste
Cook something you enjoy eating, and then eat it (this also can use your sense of smell!). Eat your favorite piece of candy. Drink a cup of hot tea, coffee, or hot chocolate. Eat your favorite comfort foods.
Self-Soothing with Smell
Light a scented candle. Bake your favorite desserts and notice the smells. Use lavender oil in an oil diffuser, or use lavender scented lotion. Smell your fresh laundry as it comes out of the dryer. Smell flowers in your yard.
For more information on how to use Self-Soothing, listen to our latest episode, “”DBT Skill: Self-Soothing” on our podcast, Taproot Therapy: A Mindful Moment.
In the Netflix show, “Unbreakable Kimmy Schmidt,” the title character, Kimmy, has to turn a crank. It’s an endless and meaningless activity that she is forced to do. To get through the activity, she counts to 10. And when she gets to 10, she starts again. Kimmy states that she can do anything for 10 seconds.
There’s research that supports this! Researchers estimate that our feelings only last approximately 90 seconds. It’s a bit longer than 10 seconds, but 90 seconds is astonishingly short.
Practicing Riding the Wave
Riding the Wave of Emotion is a distress tolerance skill. Imagine your feeling as if it were a wave. It starts small, barely noticeable. It grows, until it reaches its peak. The peak of that wave lasts approximately 90 seconds. And then, our feeling naturally starts to decrease in intensity, until it subsides completely. While the entire wave of emotion might last longer than 90 seconds, the emotion at its most intense point will be short lived. In order to practice this skill, you simply have to be mindful of how you are feeling, and where you are on that emotional wave.
This skill allows you to track your emotion as it hits the peak and declines. This skill is helpful when you are feeling overwhelmed by emotion, but aren’t necessarily sure how to respond to it. By simply being present to the wave, you are responding to your emotion! This is also a helpful skill for navigating urges. Our urges, just like our emotions, will subside. Urges can include self-harm, overeating, using substances when you don't want to, or any other habits you are hoping to break.
This skill is also helpful because there are times when we want to remain upset, anxious, angry, or whatever big feeling we are experiencing. And yet, as with all things in our lives, our emotions have a natural start and end point. They come and go. And when it is time for them to subside, this skill can help us do that. If you start to feel yourself trying to climb back up to the peak of the emotional wave, remind yourself that emotions are meant to crash on the shores, just like waves.
Distress tolerance skills help us tolerate distressing moments in our lives, by validating the distress while actively engaging in activities to ease it. One of the skills DBT prescribes is ACCEPTS. ACCEPTS is an acronym for active things we can do to support ourselves through these times.
A: Activities. Simply put, do something to get busy. Exercise, clean the house, engage in a hobby. Get moving! Do something that requires enough of your attention to distract you from your unpleasant feeling. In doing so, you’ll also feel productive!
C: Contributing. By giving our time and energy to others, we feel connected to our friends, family and community. This helps us build our positive emotions! In this pandemic, you may feel limited in what you can do. It’s important to remember that any little bit helps: shopping locally, tipping our delivery people well, video chatting with a friend who may be quarantined alone, sending a Venmo tip to our musician and comedian friends continuing to put their work out in the world. Now more than ever is a great time to contribute to others in any way we can.
C: Comparisons. This skill is a tricky one. On one hand, comparing ourselves to others can lead to negative self-image. We can feel scarce, rather than abundant in what we have. Comparison can also be problematic when we use it to compare suffering. All suffering is valid and warrants validation. Comparison, however, can be helpful when expressed from a place of gratitude. It can also be helpful when we compare ourselves to our previous selves, and recognizing the progress we have made.
E: Opposite Emotions. Actively do the opposite of what you are feeling. If you are feeling sad, watch a funny movie. If you feel anxious, do something that calms you down, such as meditation or gentle yoga. If you are feeling like you want to pull away from someone you love and trust out of embarrassment, fear, or shame, reach out to them.
P: Pushing Away. We do not have control over the first thought we have. Many of our thoughts are automatic. We do, however, have control over what follows our automatic thoughts. Our brain is incredibly powerful and can be used to reframe thoughts and use visualization to reduce unwanted thoughts and replace them with wanted thoughts.
T: Thoughts. Distract yourself with a positive thought. Say a prayer, count to 10, count your breaths, think about someone you love. Making a list ahead of time of our positive thoughts can also be helpful.
S: Sensations. Use a physical sensation to provide you with a distraction. This is helpful when we are feeling more dysregulated than usual; times when we feel we’ve tried everything in our bag of tricks, and nothing seems to be helping. Intense sensations, such as splashing cold water on your face, calms the brain for a brief period of time, giving us space to implement other calming tools. Other sensations can be taking a hot or cold shower, listening to loud music, or even listening to soothing sounds, such as rain falling or a meditation bell.
DBT provides many mindfulness tools. One of those tools is the Half Smile meditation.
The Half Smile meditation is a tool that can be soothing, silly, or comforting. It is a tool we can use to honor what we need in that moment.
What is the Half Smile Meditation?
The Half Smile meditation is a practice where we gently smile as we meditate. Here are the steps to practice the Half Smile meditation:
1. Sit in a comfortable position. You can sit with your legs crossed on the floor, or sitting in a chair with your feet firmly planted on the ground.
2. Start by taking slow breaths.
3. After a few breaths, and after you feel grounded into your seat, begin to smile. Do not create a full smile; rather, form a small half smile to the extent that you feel able.
4. Sit, half smiling, for as long as you wish.
Why the Half Smile Meditation is helpful?
Sometimes, we feel so sad that the last thing we want to do is smile. When we smile, however, we are sending a message of comfort and support to our brain. Thus, by doing a half smile rather than a full smile, we are engaging in an activity that might feel manageable when a full smile does not feel possible.
Sometimes, this activity can feel a little silly. And that’s ok! If you feel silly during this exercise, it might be an indication that you want or need a good laugh. Other times, a half smile can simply soothe and comfort us. With all mindfulness activities, participate in the activity and trust where the meditation takes you. Your only job is to notice what arises as you practice.
We have two ways in which we think and process: emotionally and logically. While both are important, we cannot be completely logical, nor can we be completely emotional. When we are facing a challenging decision, or trying to figure out how to respond to a situation, it is important for us to integrate both our emotional mind and our logical mind. This is the skill DBT refers to as Wise Mind.
Emotion mind is the part of our mind that feels, loves, cares, gets angry, becomes passionate. Our emotions are powerful. With our emotions, we fall in love, we care for our pets, or we become activists about something we feel passionate. Our emotions guide us in reaching out to a friend we love, or caring for our family members. On the other hand, our emotions can be impulsive. We can act out in anger, only to calm down afterwards and wish we had responded differently. Our emotions are big, and when we feel them, they can be all-consuming.
Logic mind is the part of our mind that solves problems and processes the facts of a situation. Logic mind helps us make decisions based solely on facts, leaving out all emotion. Logic mind is helpful in that it can allow us to take a non-biased stance. But, operating only from logic mind is far from optimal because it disengages us from ourselves, from our loved ones, and from our communities. We can become robotic.
Wise Mind is the integration of these two minds. It is the optimal way in which we think and move through our worlds. Using our Wise Mind, we integrate both emotion and logic. Wise Mind is when we allow the hard hit of emotions to diminish, and we arrive at a grounded state of knowing. It’s the feeling when we know something deep in our gut to be the right thing for us to do. It is responding with both the calm, cool facts and the passion of our emotion.
Experiencing Wise Mind
According to Marsha Linehan, American psychologist and creator of DBT, states that we all have Wise Mind within us, we simply have to practice engaging our Wise Mind. Like any new skill, this takes practice! Here is one practice I use to engage my Wise Mind:
Riding the Wave of Emotion
This practice is actually its own DBT skill, but I find it helpful for engaging Wise Mind.
Imagine your emotion as a wave. It gradually, or sharply, rises. It hits its peak, and then it begins its decline. All of our emotions follow this trajectory. When I attempt to engage Wise Mind, I first notice where on this wave of emotion I am. If I am at the peak, this is not the time to make moves! Rather, it’s a time to move through the emotion.
When you start to feel your emotion rise, pause. Take a deep breath. Simply notice what you are feeling and thinking. Then, when you reach the peak of your emotion, repeat the practice. Finally, when you start to feel the decrease in the intensity of your emotion, notice what you are thinking and feeling. Once you feel that the intensity of your emotion has passed, your emotional wave has crashed on the shore, notice how your thoughts and feelings shifted between each of those phases. This practice helps us see how we engage our emotion mind and our logic mind, and once the intensity of the emotion mind has decreased, we can integrate the two.
Listen to our podcast next week for more information on Wise Mind, as well as a guided Wise Mind practice: