A look at ‘Radical Acceptance’ and Defining Help in the Human Services

A look at ‘Radical Acceptance’ and Defining Help in the Human Services



Has life gone to shit? More importantly, are therapists saying ‘be okay’ with your situation regardless? As Dr. Phil would say: ‘How is that working for you?’

I am a little snarky when posing this question. Nevertheless, 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, therapists, peers, and mental health professionals need to ‘help’ their consumers self-soothe and be at greater peace with their situation. The only issue is what constitutes ‘help’Professionals in mental health cant agree.

Misapplication of techniques and misdiagnosis complicates everything further. Without the right treatment fit, how is anyone supposed to track recovery progress accurately? Another skill people in mental health grossly misapply (which makes the treatment fit challenging to decipher) is called radical acceptance. Misuse of this skill can be just as disabling, if not more harmful, than someone losing behavioral control.

There is a fine line here before helpful becomes harmful. In the mental health realm, practitioners are too clumsy when paying attention to crossing this line. In doing so, therapists can harm when it could have avoided with more practice.

Researchers are hoping to explore this line and make it visible to the mental health worker, so therapists are more aware of it. The research is revealing that people practicing radical acceptance are too often clumsy in their approach. For example, when working with limited information in practice and providing therapy, the technique backfires, and the session isn’t therapeutic. 

So, let us get right to it. Depending on how radical acceptance is conceptualized from theory and applied to practice, interventions will impact session outcomes. Theoretically, all of us in mental health want the best for our fellow people suffering or in distress.

Indeed, the climate in the rooms at mental health seminars, retreats, and the next team meeting at a local agency is never on the same page. Even when it comes down to our very intentions of helping folks in distress, how to do so has become a bit nebulous lately in the field. 

The blip in the agreement between practitioners on best practices makes the helping process even more beguiling. When the helping profession cannot agree on what help means?!

Unfortunately, there is no consensus (not even close!) through care systems in Eurocentric expressions of 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.

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) will differ. Even for folks on the other end of the spectrum (and it is just that, a range of stances), the real issue at hand continues to fascinate people in mental health.

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 us evaluate the different sides and various in-between areas of intersecting help, mental health, and 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 problematic “symptoms.” These symptoms complicate our social lives. Well, for starters, let us take a look at depressive symptoms. When someone is feeling sad, they may choose to isolate, among other possible behaviors.

If we were to step inside the therapy room and observe this therapist practice radical acceptance, how might it approach? As a practicing therapist, this theoretical therapist could have several possible inroads to suggesting to his or her consumer that sometimes it is okay to be sad. 

Now, isolating is normal behavior for many folks (maladaptive but normal) when we are sad. Well, a piece of accepting landing in a tough spot means possessing a level of self-awareness. Ask questions and check-in with the status of personal wellbeing. A step forward to enacting self-actualization is self-awareness. 

Other insight-oriented cognitive processes make us think more about our behavior. Thinking about our actions and behaviors does not mean guarantee making a. healthy decision. After all, at this point, sadness and knowing things are going well. Being more aware does not mean choosing to do the right thing in every situation.

Holding on to the belief solving a problem is futile is an even bigger problem. Therapists cannot gauge where people are in terms of the intensity of the symptom and its persistence/chronicity when it comes to patient safety. The risk of potential harm is even more dangerous. Now, this is just one symptom in a giant galaxy of human behavior. More expressions and twice, many outcomes exist depending on the contributing factors we discussed earlier.

Now, this writer thinks very highly of himself and his colleagues. Despite these lofty beliefs, this writer is also a realist and needs to be pragmatic at work as a therapist. Not even the most skilled and calculating clinician or peer can predict or calculate every outcome (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, there are always incidents in this line of work. Despite what we know, an element of unpredictability enmeshed into the exact web of how we practice radical acceptance in therapy and during peer centric relationships.

Now, let us delve into more peer centric interventions with the same need addressed: sadness, loneliness, or something similar. One great tested way of helping someone sad is not therapy or medication.

Sometimes, just plain old fashioned fun is needed. Whether connecting with friends or feeling more connected to the community, socialization is a great way to reduce sadness. A full “recovery” or experiencing relief for people experiencing sadness can be 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 we feel sad, do you want to go out into the world head-on? Probably not. 

Peer relationships, friendships can suffer tremendous interpersonal failure in the wake of behaviors that are not prosocial. As a friend or a peer, how many figurative slaps in the face with untoward behavior will you take before dropping a disordered peer? Radical acceptance of a sad person’s feeling comes with the peer’s mutual responsibility to accept these persons where they are at with life, right?

I mean, how can we practice mutuality and not be realistic about a sad person’s potential behaviors when he or she does not feel well?

Some friends may claim to be supportive. Some reality testing here. Let us be real if this were in the context of a job situation. Even within family systems, some behaviors warrant immediate police intervention beyond a friend’s support.

Threatening an ally and put them at risk of harm, this friend must call the authorities. There are so many symptoms that truly make prosocial interaction far too complex to practice radical acceptance without sitting on a vast litany of other interventions.

Knowing the therapy craft will determine the practitioner’s or peers’ ability to identify this line and select an appropriate intervention congruent with a client’s clinical picture’s shifting nature. Increasingly tricky as old symptoms can manifest unpredictably. Understanding this will go a long way in reducing possible resentment and anger from allies regarding unexplainable behaviors or symptoms.

When practicing radical acceptance, making decisions about safety may not be mutual. Instead, how comfortable a friend is with active symptoms and how adequate friends obtain support. 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 recovery journeys. 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.

J. Peters

J. Peters

Max Guttman '08, MSW '12, is the owner of Recovery Now, a private mental health practice. Through his work as a Licensed Clinical Social Worker, therapist and disability rights advocate, Max fights for those without a voice in various New York City care systems. He received a 2020 Bearcats of the Last Decade 10 Under 10 award from the Binghamton University Alumni Association. Guttman treats clients with anxiety and depression, but specializes in issues related to psychosis or schizoaffective spectrum disorders. He frequently writes on his lived experiences with schizophrenia. "I knew my illness was so complex that I’d need a professional understanding of its treatment to gain any real momentum in recovery," Guttman says. "After undergraduate school and the onset of my illness, I evaluated different graduate programs that could serve as a career and mechanism to guide and direct my self-care. After experiencing the helping hand of my social worker and therapist right after my 'break,' I chose social work education because of its robust skill set and foundation of knowledge I needed to heal and help others." "In a world of increasing tragedy, we should help people learn from our lived experiences. My experience brings humility, authenticity and candidness to my practice. People genuinely appreciate candidness when it comes to their health and recovery. Humility provides space for mistakes and appraisal of progress. I thank my lived experience for contributing to a more egalitarian therapeutic experience for my clients."
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