On Radical Acceptance (Part 2)

February 5, 2020

This feature by Randy Wolbert is the second part in his two-part series about the DBT Skill of Radical Acceptance. Part 1 discussed what Radical Acceptance means as well as the origin of the skill. In this part, Randy explains how the Radical Acceptance skill impacts both clients and DBT therapists.

In the first part of this feature on Radical Acceptance, we learned what Radical Acceptance means and where the skill came from. Now, let’s talk about why we need it.

What do our clients need to accept?  Clients have to accept one set of problems in order to work on another.

They have to accept the mistakes of the past, the reality of the present, and limitations on the future. Accepting the past is the way out of suffering; refusing to accept maintains the status quo of a miserable existence.

They also need acceptance of the reality of the present as the only moment that matters, the only moment that we control. The pain of the present exists as it is. Suffering occurs when dwelling in the past. Thinking “things have always been this way” intensifies and perpetuates the misery. Speculating on the future prompts further suffering, and thoughts that the future will not differ from the present can lead to anxiety.

Residing in this one moment allows problem solving to occur, and residing in a different moment inevitably results in suffering.

What do we as therapists need to accept? 

The therapist must also practice radical acceptance. This includes staying in touch with the unity of all things and being secure in the experience of therapy as a real relationship between equals.

The process of treatment is transactional in nature and approached with humility. DBT therapists must radically accept that individuals with BPD tend to make slow episodic progress and that working with suicidal individuals portends the possibility of suicide by these clients.

To effectively teach radical acceptance the therapist should have their own life examples of the need to radically accept.  It should be a story about a time when failure to accept something – maintaining the status quo – kept us suffering.  As soon as acceptance occurred, we were able to problem solve and move on. 

A very simple example is misplacing your car keys and then to keep returning to places that you already looked.  Looking again in your coat pocket from last night or the hook you usually hang things on multiple times is a failure to radically accept that your keys are not there.  Once you radically accept that your keys are not in the places in which you already looked, you can go about the task of actually locating them. 

So, the next time you teach radical acceptance, you can start with this example and then move on to something more serious that you did not want or like but failure to accept kept you miserable. Ultimately, acceptance was the way out of this suffering. 

Remember the pathway to joy arises out of radical acceptance. May your clients and you find joy.  

For more on how DBT can impact your practice as a therapist, read this two-part piece on Staying Balanced When Treating Patients at Risk for Suicide.

Randy Wolbert, LMSW, CAADC, CCS is a DBT trainer with Behavioral Tech Institute.  Randy has been practicing DBT since 1995 and was a contractual trainer with BTECH since 1998 and transitioned to a full time trainer/consultant in 2015. Read his full biography here.


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