Extreme Acceptance

Not everything that happens to us in life is something we signed up for.

There are some things in the past we desperately wish never happened to us.

There are other things in the present we desperately wish we could change. In fact, there are even people we desperately wish we could change.

Extreme Acceptance means accepting something that you emphatically do not like. Extreme Acceptance does not mean that you approve of or agree with the situation—but it does mean that you will acknowledge and embrace the situation anyway. Extreme Acceptance is the exact opposite of denial. Denial is adaptive when we are still in shock and the brain needs to protect us from information that we cannot handle yet. But denial is no longer adaptive when we constantly have blinders on that prevent us from seeing realty how it really is. Long-term, ongoing denial is basically when we lie to ourselves—and then believe our own lie!

Extreme Acceptance, in contrast, means we see reality exactly how it is—no better, and no worse. 


Why should we learn to practice Extreme Acceptance? Well, here are a few reasons to consider:

First- Just because you deny reality does not mean that problems just go away. In fact, the opposite is true: The more we make an
ongoing habit of denying reality, the worse our problems get—not better!

Second Another reason to practice Extreme Acceptance is because pain cannot be avoided anyway. Pain is simply a fact of life. We all have pain. A baby’s first emotional response to life is to cry. Why? Because coming into this world is painful…just ask the mother! And even death is sometimes painful. And then there’s plenty of pain in between. So in short, it’s not possible to avoid all that pain, no matter how hard we try.

Third- A third reason to practice Extreme Acceptance is that we must accept reality before we can change it! Accepting reality is indeed painful, since we are becoming more aware of painful things that we would prefer to ignore. But eventually, Extreme Acceptance leads to peace and freedom. Why? Because Extreme Acceptance puts us in a better position to deal with reality (*Linehan, 2015).


Since Extreme Acceptance can be such a difficult idea to grasp, here are two formulas that help explain this concept better:
Pain + Extreme Acceptance = Healing 


Pain – Extreme Acceptance = Suffering

 Both of these equations include pain.  However, our response to pain is what determines the outcome of this equation. If we demonstrate Extreme Acceptance of the pain, we are now on the path to healing. But when we do not practice Extreme Acceptance, that pain only gets worse! When pain gets worse instead of better, we will experience suffering rather than healing. Something else we can learn from these two formulas is that pain is required, but suffering is optional. I do not mean that everything you have suffered in your life is your fault. However, now that you are learning new skills and new insights in this blog series, the pain in your life does not have to keep piling up or getting worse. By demonstrating Extreme Acceptance, you really can start to turn the tide on your suffering. You can switch from the path that leads to suffering—to the path that leads to healing. Both paths will still have pain. But the pain on the healing path is bearable, while the pain on the suffering path is not. And that’s an important difference!

          For practical exercises to learn more about Extreme Acceptance, please refer to my new workbook: DBT Skills Workbook for PTSD: Practical Exercises for Overcoming Trauma and Post-Traumatic Stress Disorder

Coming soon in 2019!








*Linehan, M. M. 2015. DBT® Skills Training Manual, second ed. New York,: Guilford Press.
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Restoring Balance with Better Coping

In the previous blog series, we learned all about mindfulness.  In particular, we learned that applied mindfulness involves a three-step sequence: Awareness, Acceptance, Action. First we need to become more aware of what’s happening in the moment.  Then we need to become more accepting of what’s happening in the moment. And then, once we are both more aware and more accepting, we are in a much better position to finally take action:  In other words, to deal with the situation.


When we experience trauma, however, we are not using the part of the brain that guides us through awareness, acceptance, and action.  We are using a different part of the brain which is more concerned about our immediate survival. We are using the part of the brain that causes us to alter awareness, activate judgments—and jump straight to action as soon as possible.  But there are only three main options for action with this part of the brain: Fight, flight, or freeze.


The fight response means we become hostile or belligerent (whether physically, emotionally, or verbally).  

The flight response means we either physically leave or emotionally avoid a situation.  

And the freeze response means we just shut down altogether.  An extreme example of the freeze response is fainting.        


So what happens when you are in a situation in which it is not safe to fight back and it’s also not possible to escape?  That’s precisely why many trauma survivors learn to freeze—and then escape in their own minds. This is a process that psychologists call dissociation.  Dissociation is a combination of the freeze and flight response; this happens when you mentally freeze and then mentally escape, even if your body is still fully functioning and fully present in the situation.

All of these responses to danger or crisis are extremely helpful when we are experiencing a traumatic situation.  Awareness is altered because you need to focus only on survival. Judgments are activated because you need to make quick snappy decisions about life-and-death matters.  And you certainly do not have the luxury of consulting with a panel of experts on the best course of action. That’s why your brain limits your choices to the three options most likely to help you survive: fight, flight, freeze (which, as we saw, includes dissociation).


But here’s the problem…


When we have been traumatized enough, we learn to execute these responses to everything in life—even if we are not in immediate danger or crisis! In other words, our brains over-learn these responses.  Do you see the problem with that?

Let’s assume your coworker responds to you in a tone that you did not expect.  Now let’s assume your awareness is altered (you only notice her stressed tone, not her baggy eyes from not sleeping last night)…and then your judgments are activated instead of acceptance (“I can’t believe I have to work with scum that give me no respect)…and then you jump straight to fight, flight, to freeze.  I will let your own imagination take over from there. But here’s my point: Are you off to a good start at work? Did your trauma response just make things better—or a whole lot worse?


Remember that DBT is all about restoring balance?  DBT has entire set of skills called Distress Tolerance which are designed to provide temporary “quick fixes” to help us quickly restore balance in the moment, when we are triggered.  In other words, the purpose of these skills is to give us alternatives to replace our instinctive fight/flight/freeze reactions, and to get us back into our Balanced Mind as soon as possible.  


One of my favorite definitions of Distress Tolerance is “how to survive the moment without making it worse.”  In short, Distress Tolerance is all about healthier and more effective ways of coping—as opposed to unhealthy or ineffective coping, in which you hurt yourself, hurt someone else, or somehow make the problem worse than it already was. Another definition of Distress Tolerance that I really like is “turning unbearable pain into bearable pain.” Notice that Distress Tolerance does not take away pain—but it does help you deal with painful situations in ways that do not cause the pain to become even worse.


Ultimately, Distress Tolerance skills will help you with both acceptance and action.  That’s why the first Distress Tolerance skill you will learn is called Extreme Acceptance.  As you will see, Extreme Acceptance is a special kind of acceptance that we need to apply to both trauma and its consequences. However, after you learn about Extreme Acceptance, you will next learn a series of coping skills that will help you take action; in other words, learn how to react in more effective ways.

Notice that effective coping involves both acceptance and action. This is another one of the great balancing acts of DBT!

For practical exercises to learn more about your

fight, flight, freeze response, please refer to my new workbook: 

DBT Skills Workbook for PTSD: Practical Exercises for Overcoming Trauma

and Post-Traumatic Stress Disorder

Coming soon in 2019!

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