Radical acceptance for BPD

A cornerstone of dialectical behavioral therapy (DBT) is radical acceptance, which is a therapeutic technique that can help individuals with borderline personality disorder (BPD) better cope with emotional dysregulation.

Emotional instability, a distorted sense of perception, and impulsive behavior are all symptoms that sufferers of BPD contend with. ^[1]

Part of maturing as a human is learning to cope with the different aspects of life as they crop up – good and bad. People with BPD struggle to comprehend the realities of their lives, often feeling intense bouts of negative emotions, harboring deeply upsetting thoughts and a diminished sense of self-worth. ^[1]

Through the practice of radical acceptance, sufferers can regulate their emotions and face the trials of everyday life, despite their instinct to run from perceived pain and other uncomfortable feelings.

What is radical acceptance?

Radical acceptance encourages people to accept that reality is what it is – you do not need to work to alter it. ^[2]

Accepting the present is necessary for changing the future; if we do not take this first step, we may quickly feel overwhelmed and struggle to create the positive outcomes we desire. ^[2]

Our futures are shaped by factors that have occurred in our lives, other people’s lives, and the environment that connects us. If we do not address the factors that affect us, we cannot change our realities. ^[2]

For example, imagine that a man breaks his leg in a soccer match as a result of a dangerous tackle by an opponent. The man loves sports and outdoor hobbies. He did nothing wrong but is now faced with 6 months of rehabilitation, a hefty medical bill, and a stretch of time without his favorite activities in life.

It is crucial that he accepts that this is his reality. Without that acceptance, he will not adapt to his current situation and do the physiotherapy required to heal. If he wallows in the injustice of the situation or withdraws from life, he will not achieve the outcomes that benefit him long-term.

This man may feel devastated, sorrowful, and helpless. But he has a choice – to wallow and withdraw or to accept his new reality and figure out how to live a life worth living whilst rehabbing from his injury.

To get a grip on his life he has to accept that he can come through this situation and build a better life for himself – that life is worth living even when it contains pain. ^[2] This is a central tenet of radical acceptance.

What is not radical acceptance?

1. It is not approval ^[2]
2. It’s not compassion or love
3. It’s not giving up or giving in
4. It is not anti-change

Radical acceptance is purely about accepting your reality. Only then can you change your reality. Pain cannot be avoided and if you reject reality – you will cause yourself more pain. Accepting reality, however, can bring freedom. Managing painful situations, instead of rejecting them, can limit suffering. ^[2]

Steps to implement radical acceptance

People with BPD experience intense reactions to challenging situations. They struggle to accept reality and may shut down if they feel circumstances are not in their favor. This can lead to intense anguish, distressing thoughts, and harmful behaviors.

Radical Acceptance encourages people with BPD to accept reality without suffering – to take life in their stride by accepting the facts of life. Below are some steps people with BPD can take to embrace radical acceptance:

1. Acknowledge your feelings: Begin by recognizing and acknowledging your emotions and thoughts related to the situation. Understand that it’s natural to have a range of feelings in response to difficult circumstances.
2. Recognize what you cannot control: Identify the aspects of the situation that are beyond your control. Accept that there are things you cannot change, and trying to control them will only lead to frustration and distress. Loved ones will pass away, partners may break your heart, and friends may lose touch – the only things you can control in a situation are yourself and your reaction to the situation.
3. Identify the causes of the negative situation: What caused the situation? What were the events that led up to it? Were you at fault? It can feel tempting to harshly blame yourself or loved ones when you have BPD – so it can be helpful to get counsel from some objective third parties. Often, it is not you who has caused the present situation, and this knowledge is integral in achieving radical acceptance.
4. Accept the reality: Make a conscious decision to accept the reality of the situation, no matter how painful or challenging it may be. This means acknowledging that the situation is what it is, without trying to deny or minimize it. This may feel exhausting, both physically and mentally, and counterintuitive. However, it is the central tenet of radical acceptance; using tools like mindfulness, self-talk, and other relaxation techniques can help you focus on what is happening right now, rather than dwelling on the past or worrying about the future.
5. Allow any negative feelings to arise: As you notice these feelings crop up, do not attempt to suppress them. Let them all wash over you – grief, anger, frustration, irritation, despair – it is important you allow yourself to feel each one in order to accept them.
6. Radical acceptance statement: Create a mantra or statement that underscores your acceptance of the situation. Repeating this to yourself when you start to feel overwhelmed can feel helpful. For example, “It is what it is, and I can handle it.”
7. Recognize that life is worth living despite pain: Feelings of pain and hardship are difficult to navigate past – but they are not unbearable – in fact, nothing is unbearable. You can always regain purpose and perspective in life- no amount of pain can prevent you from doing so, no matter what your mind is telling you.
8. Seek professional help: If you are struggling to embrace radical acceptance and you feel your symptoms of BPD are worsening, seeking professional help may be a wise move. Taking care of your mental health is imperative – book an appointment with your healthcare provider as soon as possible and they can refer you to an appropriate specialist.

Remember that radical acceptance is a lifelong process, and it may not make the situation itself easier, but it can help you cope with it more effectively and reduce unnecessary suffering caused by resistance and judgment. It’s a valuable skill to cultivate for emotional well-being and personal growth.