“Acceptance is the road out of hell.” So says Marsha Linehan, the psychologist who created DBT (Dialectical Behavior Therapy), one of the premier contemporary therapeutic approaches for serious emotional problems that lead some folks to engage in acts of self-mutilation, eating disorders, suicide, and a host of other maladaptive actions.
What does Linehan mean? What, actually, is meant by “acceptance”? And how is it so vital, or even useful, in a therapeutic sense?
Contrary to the way the word is commonly understood in everyday language, in therapeutic terms the term “acceptance” does not mean approval. It also does not necessarily imply acquiescence, giving in, giving up, or “accepting” that something (or someone) we don’t like is actually right. It simply means allowing oneself to be aware: aware of the reality as it is, rather than as we might wish it to be or wish to insist that it must be (when it isn’t). Acceptance is “facing the facts.”
Following the U.S. presidential election in 2000, When Al Gore made his concession speech after the U.S. Supreme Court had ruled against a recount of the Florida vote that Gore believed would have clinched the presidency for him, he said, “I strongly disagree with the Supreme Court’s decision; but I accept it.” In this case, facing the reality led him to concede the election and pursue other endeavors at which, as it turned out, he proved highly successful. Had he persisted, dogmatically, in asserting his rightness by refusing to concede even after the Supreme Court ruling, he would likely have become the object of ridicule. He then would have lost far more than the presidency itself.
In other situations, facing the reality might free us not to give up. The central act of acceptance is that of facing the reality. What we choose to do with ourselves in the face of that reality remains up to us.
Acceptance is much easier said than done, because it usually requires facing some loss. If I accept that I can’t get a high grade on an important exam without several hours of study, I must face the loss of freedom to spend my time playing video games instead of studying while still expecting a good grade. (Note that I remain free to choose the video games, but I’m no longer free to kid myself that the choice won’t carry some consequence.) Indeed, acceptance of any of the things in life that seem unfair, or that we regret, requires facing up to some material or emotional loss. That’s why giving flip advice to others to “accept the reality,” when they are really struggling with that reality, will usually fail. (I generally find it more helpful to validate their struggle, but validation is its own, separate topic.) The “work of acceptance” is actually a type of mourning, and it is accomplishing that mourning that, to paraphrase Linehan, provides the “road out of hell.”
Dr. Stone, a clinical psychologist, is an Assistant Professor of Psychology in Clinical Psychiatry at Weill Medical College of Cornell University, and Director of the Dialectical Behavior Therapy Program for Self-Injuring Adolescents at the Westchester Division of New York Presbyterian Hospital in White Plains, New York. He resides in Pawling with his wife, Susan, and their family.