The Business of Practice

Radical Acceptance with DBT

Dialectical Behavioral Therapy (DBT) helps consumers tolerate and regulate their emotions.
It comprises behavior therapy, cognitive behavior therapy (CBT), and mindfulness.
For more information, see our post What is DBT and How Does it Work?


The act of learning to observe and experience things you didn’t expect or didn’t want -- without judging
or rejecting -- is a large part of DBT mindfulness. This type of acceptance frees us from
unnecessary sadness, frustration, and self-criticism and has been termed Radical Acceptance.
DBT’s radical acceptance helps us sit with where and who we are in the present moment
without judging ourselves or becoming too upset. It is a mindset used when individuals
cannot keep painful events and emotions from coming their way.

Radical Acceptance can be defined as accepting life events that are out of your control
and not resisting what you cannot change. Accepting situations without judging them
is an essential part of radical acceptance as it reduces suffering.

Radical Acceptance with DBT

What is Radical Acceptance?

Radical acceptance is completely accepting reality as it is in that precise moment. The skill is used when someone has trouble “getting over” something or someone or “moving on from” a painful or traumatic experience.  

Radical means, all the way. You totally and completely accept reality in your mind, body, and emotions. Radical acceptance is when you stop fighting reality because reality is not the way you want it and let go of bitterness. It helps people learn how to accept painful events, individuals, or aspects of their life. It is not approval, compassion, love, passivity, or against change. It is a decision to accept reality, acknowledging that all of the painful situations or events happened (or are happening). Coming to terms with the aspects of the problems that we cannot change will liberate the energy we are using to fight reality, and then if needed, we can use that energy to make a plan to change the situation for the better. 

How Does Radical Acceptance in DBT Help?

DBT asserts that rejecting reality usually turns pain into suffering. However, when you radically accept, you embrace facts. In turn, you cope with reality and live your life. Radical acceptance reduces the impact of the painful emotions associated with the event. 

Why Accept Reality?

1. Rejecting reality does not change it

2. To change reality, we must first accept it.

3. Pain cannot be avoided – it is nature's way of letting us know something is wrong.

4. Refusing to accept reality can keep an individual stuck in painful emotions – such as bitterness, anger, sadness, or shame. 

5. Deep calmness usually follows acceptance. 

How Do You Radically Accept?

Radical acceptance is a difficult skill. It challenges you to accept something painful about life. Watch Tara Brach explain why it is so hard for us to practice radical acceptance with ourselves in less than two minutes. 

Individuals who don’t have the skills for acceptance usually do not know how to accept painful events and facts. In addition, sometimes people may believe that if you accept a painful event that you are making light of it, or you are approving of it and that in the future, nothing will be done to change or prevent future painful events. Lastly, emotions can get in the way of radical acceptances (sadness, anger, rage, shame, guilt). DBT’s radical acceptance helps consumers overcome these interfering factors. It provides skills and education for tolerating distress and practicing radical acceptance step by step. 

Step-by-Step for Radical Acceptance

1. Observe that you are questioning or fighting reality.

2. Remind yourself that the unpleasant truth is just as it is and cannot be changed. 

3. Remind yourself there are causes for the reality (acknowledge history led up to the moment, consider how a series of factors have shaped people lives).

4. Practice accepting with the whole self. Be creative! Use acceptance self-talk, consider using relaxation, mindfulness, half-smile, willing hands, or other skills learned throughout the distress tolerance module of DBT. 

5. Practice opposite action! Act as if you have already accepted the event/situation. Then, engage in the behavior you would do if you had accepted it. 

6. Cope head. Imagine believing what you don’t want to accept. Then, rehearse what you would do if you accepted what seems unacceptable. 

7. Attend to your body’s sensations as you think about what needs accepting.

8. Allow disappointment, sadness, or grief to arise within you. 

9. Acknowledge that life can be worth living even when there is pain. 

10. Do pros and cons if you find yourself resisting practicing acceptance.

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