I took Dialectical behavior therapy (DBT) briefly in my early twenties, after my first brush with psychosis. DBT is a type of psychotherapy that helps people learn to manage their emotions and improve their relationships. During this time, my mental illness was developing, and I was in intense emotional pain. I had experienced so much trauma and pain that I struggled with mindfulness in order to be present at all. It was tough to connect with others and be myself. I took DBT for a year or less, but honestly, the one life lesson, the only concept I held onto, was that of radical acceptance. It was the one guiding principle that stuck and resonated with me.
I tried so hard to listen and retain knowledge on tools to stay present and other life skills in DBT, but for the most part, my reality was so painful that I did everything to avoid these big emotions and circumstances that seemed intolerable to me. It’s not just psychosis that calls for acceptance; it’s all the collateral damage that makes life so excruciating and difficult to accept without judging yourself — loss of job, school, or career, loss of friendships and/or family members, humiliation, potential legal trouble, and facing diagnosis of a stigmatized, chronic illness. Today, I am fully present and have a clear mind, but it has taken me a long time to get here. The concept of radical acceptance got my attention 25 years ago, and I still haven’t forgotten this concept as a guiding principle, which has helped me reach my current state of mind.
Radical Acceptance Defined
Resisting reality has consequences involving an internal struggle, where accepting difficult circumstances helps absolve pain and transition you into a peaceful state of mind. Accepting your situation does not mean you approve and does not mean giving up. You accept that your situation is outside your control and cannot be changed – without judging it. It is through this process that you lose this attachment to your pain and can let go. [1] You can thereby let go of recurring thought traps like “this is unfair,” “why me?” and “why now?” This is not an easy process, especially with psychosis, and it can take a lifetime to apply it to your life effectively. It certainly has for me.
Fully Accepting Realities You’ve Experienced That Weren’t Real
It’s only natural to reject and resist realities you have experienced when psychotic that are potentially harmful to yourself and you feel socially punished for, especially since they are false. Sometimes psychotic breaks, while bogus, still touch on personal themes and truths from your life that make such crises seem much more like a targeted, personal attack that is emotionally painful. It’s hard not to judge what you’ve been through when you can feel judged by others and blamed for something beyond your control. Part of radical acceptance is accepting that there are matters out of your control, and a psychotic break is the quintessential circumstance where you have no control whatsoever.
Despite every understandable reason there is to judge your psychotic breaks, accept them as part of your story and stop fighting them. Don’t judge your hallucinations and delusions, no matter how terrifying or embarrassing they are. Don’t judge yourself for having them, and let go of shame. It is what it is. These painful events happened, and there is no changing them. Pretending they didn’t happen won’t make them go away. You don’t have to forget them (if you actually have a memory of them) to move on.
Disclosure Is a Form of Radical Acceptance
It’s not just any act of disclosure that is radical acceptance. It is disclosing without assigning a value to it or judging it. It is disclosing matter-of-factly, without fear or assuming what another will think or react. I’m 12 years out from my last psychotic break, and I am just getting to this point. Sure, I have disclosed this many times before, but the way I do it now is different. My practice of disclosure is shifting from apologetic, apprehensive, and fearful to a matter-of-fact statement with no positive or negative emotions involved. It truly is what it is now, nothing more and nothing less.
I’m not assigning a value to my mental health history whatsoever, and I’m not trying to play both people in the conversation, allowing myself and the other person to have an authentic conversation based on the present. My biggest problem has been assuming how others will judge me based on how I already judge myself. You really have to look inward and decide not to judge yourself before you have an accurate and healthy perspective on how others would see your illness.
A Powerful Means of Self-Assertion
Radical acceptance means coming to peace with your reality in an integrated way with your mind, body, and spirit. In other words, it is what it is. It is not caving and saying that what happened to you is okay when it is not. It is actually the opposite. Just like the concept of forgiveness — where you forgive for yourself and not for the other person, and set yourself free in the process — it is the same idea with radical acceptance. Through radical acceptance, you are able to feel power over something (psychotic breaks) that used to have so much power over you once you let yourself off the hook for having them.
As soon as you can state what happened to you without judging, you are asserting yourself and defining your future without the framework of mental illness. Just as it is with forgiveness, you will find yourself with a greater sense of peace — like you have let go of this huge load on your back. Once you are content and at peace with who you are, these regrets and painful memories from the past seem irrelevant to who you currently are. In this way, you can separate the core aspects of self and your personal identity from such an intrusive illness.
Radical acceptance is a very personal process of coming to terms with our circumstances that hits at the core of our identity and self-esteem. If you can practice radical acceptance successfully with psychosis, then you have developed an invaluable life skill that can be applied to other life circumstances, too.
References
Görg N, Priebe K, Böhnke JR, Steil R, Dyer AS, Kleindienst N. Trauma-related emotions and radical acceptance in dialectical behavior therapy for posttraumatic stress disorder after childhood sexual abuse. Borderline Personal Disord Emot Dysregul. 2017;4:15. doi:10.1186/s40479-017-0065-5
Original article featured in Psychology Today | December 13, 2024. Image credit: Miami302/ Pexels