Has your life gone to complete shit? More importantly, is your therapist encouraging you to be okay with your situation regardless? As Dr. Phil would say: How is that working for you? I’m a little snarky when posing this question. I am also gesturing to a pretty major issue with the idea of practicing radical acceptance during the context of providing mental health treatment.
To get right to the heart of the matter, I am going to suggest that unless therapists, peers, and mental health professionals practice this supposedly “healthy” technique to help their consumers self-soothe and be at greater peace with their situation, that it can be just as disabling, if not more harmful than dwelling or being upset. Of course, there is a fine line here before helpful becomes harmful. In the mental health realm, all too often practitioners forget to be extra mindful not to cross this line and exact harm when it could have been avoided with more practice.
I hope to explore this line and make it visible to the reader. People practicing this skill are too often clumsy in their approach and are sometimes working with limited information on how to correctly implement this skill in practice when providing therapy or peer centric relationships. So, let’s get right to it. Depending on how you conceptualize the notion of a problem can be a big problem, right? It certainly seems to be for the camps in the mental health reform movement(s). I am bracketing the “s” because it isn’t one movement.
I mean theoretically, all of us in mental health want the best for our fellow people suffering or in distress. I certainly hope so, but the climate in the rooms at mental health seminars, retreats, and your next team meeting at your local agency is never on the same page. Even when it comes down to our very intentions of helping others folks in distress how to do so has become a bit nebulous lately in the field. This blip in the agreement between practitioners on best practices makes the helping process even more beguiling, doesn’t it? When the helping profession can’t agree on what help means?!
Well, unfortunately, there is no consensus (not even close!) through systems of care in Eurocentric expressions mental health treatment or the reform movement because help is far too unique to the individual. We are working with people with different cross-sections of society. And, even if we all did suffer from the same plight, the manifestation of any “disorder” or symptom (for those that lean towards DSM oriented frameworks for positing mental health issues as a constellation of illnesses requiring treatment) is going be different.
Even for folks on the other end of the spectrum (and it is just that, a spectrum of stances) understanding these issues at hand as a direct or indirect result of complex traumas or learned behaviors from environmental, discriminatory, or any number of nonorganic and codifying approaches to framing what the person needing makes it profoundly difficult to define the idea of help.
So, let’s evaluate the different sides, and various in-between areas of this spectrum of definitions intersecting help, mental health, and practicing radical acceptance. We will begin with a small survey of symptoms in the medical model of mental health treatment. There are indisputably many diagnoses that have complex “symptoms”. These symptoms complicate our social lives. Well, for starters, let’s take a look at depressive symptoms. When someone is feeling sad, they may choose to isolate among other possible behaviors. Now, let’s evaluate this symptom of sadness and the frame of isolative behaviors.
Now, take these thoughts/feelings/behaviors and tell your therapist about them. If we were to step inside the therapy room and observe this therapist practice radical acceptance, how might it approach? As a practicing therapist, I can tell you this theoretical therapist could have several possible inroads to suggesting to his or her consumer that sometimes it is okay to be sad. A safe approach (for now at least until it takes a dangerous turn, look out!) Sometimes, we all get upset, isn’t this a given truth? This therapist might say that acceptance of our sadness, grief, or negative feelings and being alright with not being okay in the moment is also very encouraging. Sometimes this is true as well. To begin to get underneath why aren’t feeling well, we first have to realize we have landed there.
Now, isolating is normal behavior for many folks (maladaptive but normal) when we are sad. Well, a piece of accepting we’ve landed in a difficult spot, and have begun possibly isolating, is also a step towards many positive steps forward like self-actualization, self-awareness, and other insight-oriented cognitive processes which make us think more about our behavior. Now, here is the line. Just thinking about our actions doesn’t mean we will choose to make healthy decisions and enact positive behaviors in the future. After all, at this point, you’ve realized your sad, accepted, and know things are going well. Just because your more aware doesn’t mean you’ll choose to do the right thing for yourself our your situation.
Holding on to a belief you cannot be helped because your problem is futile is an even bigger problem. When your therapist isn’t able to gauge where you are in terms of the intensity of the symptom and its persistence/chronicity when it comes to patient safety and risk of potential harm is even more dangerous. Now, this is just one symptom in a giant galaxy of human behavior where there are even more expressions and twice many outcomes depending on the contributing factors we discussed earlier.
Now, I think very highly of myself and my colleagues. I am also a realist and need to be pragmatic in my line of work as a therapist. I know, that not even the most skilled and calculating clinician or peer can predict or calculate these outcomes (reading the DSM backward and forwards or as an expert in human behavior) unless the therapist is supernaturally clairvoyant and can read into the future with their clinical gaze. For this very reason, there are always incidents in this line of work. Despite what we know an element of unpredictability is sewn into the very web of how we practice radical acceptance in therapy and during peer centric relationships.
Now, let’s delve into more peer centric interventions with the same need being addressed: sadness, loneliness, or something similar. One great tested way of helping someone sad isn’t therapy or medication. Sometimes, it is just plain old fashioned fun. Whether it is connecting with friends or just feeling more connected to the community socialization is a great way to reduce feelings of sadness. A full “recovery” or experiencing relief for people experiencing sadness can be discovered through establishing more meaningful friendships, time spent socializing and having plain wholesome fun with peers.
Now, that line that we talked about earlier is about to make is reemergence into this conversation. Don’t emotions like sadness sometimes make it more difficult to relate with others? When you feel sad, do you necessarily want to get out there and take the world head-on? Maybe not. Peer relationships, friendships can suffer tremendous interpersonal failure in the wake of behaviors which are not prosocial.
As a friend or a peer, how many figurative (hopefully not literal) slaps in the face with untoward behavior will you take before dropping this disordered peer (or just plain rude and inhospitable)? Radical acceptance of a sad person feeling comes with it a mutual responsibility of the peer to accept these persons where he or she is at with life, am I right? I mean, how can you practice mutuality and not be realistic about a sad person’s potential behaviors when he or she doesn’t feel well?
Some friends may claim to support you for a while. Some reality testing here. Let’s be real if this were in the context of a job situation or even within your own family some behaviors warrant immediate police intervention beyond the support of a friend. If you threaten an ally and put them at risk of harm; this friend must and should call the authorities. There are so many symptoms that truly make pro-social interaction far too complex to practice radical acceptance without sitting on a vast litany of other interventions.
Knowing your craft will determine your ability to identify this line and select a fitting intervention congruent with the shifting nature of your client’s clinical picture. This is increasingly difficult as old symptoms can manifest unpredictably. New ones may emerge during the recovery process as a direct or indirect result of those factors we discussed earlier. Understanding this will go a long way in reducing possible resentment and anger from allies that may hold you accountable for unexplainable behaviors or symptoms. Friends who simply aren’t prepared to conceptually understand these issues when practicing radical acceptance will always struggle with where the line is drawn every time.
When practicing radical acceptance the decision to work with your client may not be mutual based on how comfortable your friend is with your symptoms and how satisfied you are with the support you receive from your friend. Sometimes, like all relationships, the decision will not always be mutual. Be prepared for that sobering possibility. There is no question that friends of someone carrying a mental health diagnosis deserve our unconditional radical acceptance of their symptoms and their journey toward recovery. Unfortunately, be prepared for times when this may not always be possible due to the nature of so many things that can go wrong with our mental health.