Acceptance

In the last post I wrote about Dialectical Behavior Therapy’s use of validation.  Another characteristic that Dialectical Behavior Therapy (DBT) emphasizes is the use of acceptance.  Marsha Linehan, the psychologist who developed DBT says that it adds the technology of acceptance to cognitive behavior therapy.  Years after DBT gained popularity, other therapies have included acceptance as a component but I think that DBT is the most organized and systematic in its use.

Dr. Linehan writes about radical acceptance in the DBT Skills Training Manual stating that “freedom from suffering requires acceptance from deep within of what is.  Let yourself go completely with what is.  Let go of fighting reality.” 

In later writing on DBT we find the equation, suffering = pain + nonacceptance.

Swiss American Psychiatrist Elisabeth Kübler-Ross included acceptance in her description of the stages of grief.  She wrote that people confronted with a loss pass through stages of anger, denial, bargaining, depression and acceptance.  Usually people visit the stages a number of times, working through them until they spend most of their time in the acceptance stage.  My clients often find this structure helpful in dealing with problems.  They usually can identify which stage they are stuck in and, with support, figure out what feelings and thoughts the acceptance stage would contain.  Then, of course, there’s the task of getting there.

Bill Bonacker

Validation

Validation

One of the elements that make Dialectical Behavior Therapy (DBT) unique is its emphasis on validation.     Validation can be described as the acceptance of what is.  The common popular comment, “it is what it is” sort of expresses this.  We don’t have to like it, we don’t have to approve of it, we can work to change it but there it is.  DBT’s creator, Marsha Linehan, contrasts DBT’s focus on validation with Cognitive Behavior Therapy’s constant focus on change.  She says that spending most of the time on changing is invalidating to many people.  They can feel that they shouldn’t have their feelings, thoughts or beliefs about what has happened to them.  They can feel that they should be doing better and that their current behavior is bad.  While Dr. Linehan recognizes that change is necessary and important, she stresses that change must be balanced with validation.  DBT’s individual therapy contains structured ways in which validation is used and therapists who have studied DBT are familiar with them.  Skilled DBT therapists are always working to find the balance between validation and change. 

Bill Bonacker