What is Radical Acceptance and How Can it Help Me?

“The curious paradox is that when I accept myself just as I am, then I can change.” –Carl Rogers

In Dialectical Behavioral Therapy (DBT), the word “dialectic” refers to a synthesis or integration of opposites. In simpler terms, it means that two opposing things can be true at the same time (e.g., the sun and the moon, the seasons, feeling alone at the same time you are surrounded by people). In DBT, this balance is between change and acceptance.

Having originated long before Western psychology discovered it, acceptance has long been a cornerstone of many Eastern religions. Buddhism in particular teaches us that when we accept things as they are—including the pain in life—instead of wishing they were different, we experience much less suffering. In DBT, we call this Radical Acceptance—a practice first developed by Marsha Linehan of the University of Washington.

What Is Radical Acceptance?

It is difficult to accept many things that happen in life—losing loved ones, the way our family members, coworkers or even stranger treat us, illness, car accidents and other tragedies, etc. The mind does not want to allow painful thoughts into consciousness, so it avoids these thoughts—ultimately leading to denial. Unfortunately, until the pain is appropriately dealt with, it will turn into suffering.

Pain can be almost impossible to bear, but suffering is even more difficult. When you refuse to accept pain, you will suffer. A common formula that is often discussed in relation to the concept of Radical Acceptance is the idea that, “pain + non-acceptance= suffering” (suffering occurs when pain is denied, avoided or renounced). In her DBT skills manual, Marsha Linehan outlines the following:

“Freedom from suffering requires acceptance from deep within of what is. Let yourself go completely with what is. Let go of fighting reality. Acceptance is the only way out of hell.”

When we experience pain, if we allow ourselves to fully feel it and accept the reality of it, we can move on to embrace our new reality. If we refuse to accept what is, we become stuck in a persistent state of suffering. Pain and non-acceptance combine to create this suffering. Until we can break through to reality, the suffering will continue.

Radical Acceptance Is

  • Complete and total acceptance of things, just as they are.
  • Knowing where your control lies and where it doesn’t (think of the Serenity Prayer).
  • Tolerating the moment, even when it is painful or uncomfortable.
  • Looking at “just the facts” of the situation.
  • Being non-judgmental.
  • Shifting your focus away from what “should be” and towards how they are.
  • Not fighting reality or trying to change it into something that it’s not.
  • Mindfulness of our emotions and allowing ourselves to lean into the discomfort of painful emotions.

What Radical Acceptance Is Not

  • Judging an event or situation as “good” or “bad”.
  • Throwing our hands up in the air or waiving a white flag.
  • Approving or condoning behaviors.
  • Giving up your needs.
  • Embracing a person who hurt you as if nothing happened.
  • Ignoring or denying a situation.
  • Never asserting your thoughts/feelings.
  • Acceptance does not equal agreement.

An Example of Radical Acceptance

The other day I was driving on the expressway and ended up stuck in heavy traffic. I was already running behind for an important meeting—and with the traffic jam I was facing, there was no way I was going to make it on time. As I sat there, unable to move, I began to feel anxious and frustrated. Why did this have to happen to me today? It shouldn’t be this way! How unfair!

I realized quickly that these thoughts were not effective. They would do nothing to improve the situation or my mindset. I then shifted to radically accepting that there was traffic and I was going to be late. Was I happy about being late? Did I not care about it? Nope! I simply accepted that there was traffic, I was going to be late and that life would move forward with this as my reality.

Applying Radical Acceptance

What are you currently resisting? How can you actively apply Radical Acceptance toward the difficulties you are experiencing? Acceptance of your personal experience has the power to radically change the way you approach almost every aspect of your life and ultimately allow you to engage the world in a more positive, peaceful and productive way.

If you are struggling with this skill, a mental health professional can offer support and guidance. I wish you the best in your pursuit.

6 Reasons NOT to Use Your Health Insurance to Pay for Therapy

Have you ever considered paying for therapy out of pocket?

If your health insurance covers the cost of counseling services, probably not. Before I became a therapist, it never crossed my mind to pay any of my healthcare out of pocket—especially if I could take care of everything with a measly $25 co-pay. Now that I’m on the other side of the fence, I actually pay for much more of my healthcare instead of relying on my insurance (and this includes paying out of pocket for my own therapy).

If you’ve read this far, you’re probably wondering, “But I have insurance…why wouldn’t I use it? Why pay more?” I understand the allure of using your health insurance to cover the majority of the session fees, but do you realize what you give up for that co-pay? If not, allow me to shine some light on the truth. I’ve learned a lot of things throughout my career as a therapist. Things consumers don’t know. Things that I would want you to know if I were you. And so I’m here to tell you the things I want all clients to know before/when they are using insurance-approved therapists.

1. Your therapist has to diagnose you to get you reimbursed.
Insurance companies require a diagnosis so they can decide if they will pay for therapy or not. This means your therapist must give you a diagnosis that your insurance will cover even if you don’t really need a diagnosis. And these diagnoses follow you. In many cases, mental health diagnoses do not have a statute of limitations meaning they will follow your forever as “pre-existing illnesses.” As a client it is rare that you ever even know your diagnosis, so I would consider this to be one of the most motivating reasons to pay out-of-pocket because when you do, your therapist does is not required to give you a diagnosis.

2. Your records are not protected.
Your insurer can audit your records at any time they wish. This means any details that your therapist might not have included in the paperwork (perhaps for good reason) is technically open to the eyes of any “claims specialist” the company hires. Again, this might not matter to you. But if you hold high clearance for a job, or have other reasons you want your information to be held confidential- this is important to know.

3. Your care is dictated by the insurance company.
Whenever you are diagnosed, the insurance company will decide how much treatment and what type of treatment you will receive. Meaning, rather than giving you the best care possible that suits your needs, you will be designated a treatment plan based on your insurance company. Simply put, the care of the client is dictated by the insurance company, and the therapist essentially works for the insurance company, not the client. This can compromise the quality of mental health services provided.

4. Insurance almost never pays the full fee.
This means you are either going to be responsible for the remainder (which you need to clarify ahead of time) or it means your therapist is working for less than a fair market wage. Most insurance companies reimburse therapists at a very low rate, typically lower than the set fee from the clinician. It makes it hard to do good work with clients when your therapist is worrying about how he or she is going to pay their bills and sustain a practice.

5. You may end up seeing a generalist therapist, instead of one with the unique skill set you need.
While many therapists are qualified to treat common challenges such as anxiety’s or depression, if you are interested in working with a specialist to address a specific challenge, you should consider looking out-of-network. Private pay therapists often have niche practices, and if you come across a therapist whose skills speak directly to your needs—perhaps needs you didn’t even know to look for—it’s worth reaching out.

6. Less investment in the counseling process.
When people pay for therapy out of pocket, they have more emotional buy in and commitment to therapy. Paying with our own money tends to make us work harder and better appreciate the services we are paying for. Plus, therapy is very affordable. Even at a rate of $100 per hour, you could get 30 hours of therapy (which is far more than the average time needed), for less than getting your kid braces, than two months of an average mortgage payment, about the same as some people pay for one big-screen television, WAY cheaper than a divorce, etc.

So what can you do about it? There are options!

If possible, pay cash for sessions. This ensures that your records and diagnoses are entirely confidential documents. The content of your session stays entirely between you and your therapist. And your care is dictated by what you think you need, not your insurer. Many people have a Health Savings Account (HSA) or Flexible Savings Account (FSA) that will help them pay for sessions and operates just like cash- but they don’t realize it.

If you cannot afford to do that, consider a non-profit. Many areas have nonprofits that offer low fee counseling based on income or other eligibility. That takes a little digging, but often you can find it on google by looking for “low fee” or “affordable” or “nonprofit” counseling. You will likely see less experienced clinicians, but you will maintain control and confidentiality.

See if your insurance company will reimburse you for out-of-network services. This will cost you up front, and your diagnosis will be recorded, but it gives you the freedom to choose any licensed clinician and their records are more protected than if you go with an in-network therapist. Contact your insurance company directly to inquire about the out-of-network reimbursement policy specific to your plan. Your therapist will provide you with a statement/invoice, known as a “Superbill”, that you will be able to submit for reimbursement.

Therapy, especially when you are paying out-of-pocket, is always an additional expense, in more ways than one. There are travel expenses and the time commitment that it takes to make therapy effective. However, the rewards can greatly outweigh temporary monetary costs. How much is too much to pay for peace of mind, the renewal of a relationship, or finally finding freedom in an area of life that has previously seemed unattainable? $500? $1000? $5000? Some people would pay ten times that to experience the real progress and change that can happen in therapy. What is the change you are seeking worth to you?

50 Ways to Practice Self-Love this Valentine’s Day

Think about the last time you were on an airplane. Remember that spiel about oxygen masks? The flight attendant gives a safety demonstration on what to do if the oxygen masks drop. “If there is a drop in cabin pressure, oxygen masks will drop down in front of you. … Be sure to secure yours before you help anyone else.” If you put the mask on your child or neighbor first, you could potentially pass out before you are able to put on your own mask. What if you translated this example into your day-to-day life? What would that look like exactly?

Making your wellbeing a priority is not about being selfish. It is about putting yourself first so that you are better equipped to help others and gracefully handle what the day brings. It is about loving yourself so that you can offer more love to the community around you.

Valentine’s Day gives us an amazing opportunity to focus on loving and honoring ourselves, to give thanks for everything that we’ve done, everything that we are blessed to have, and all that we are able to do. Whether you’re coupled up or flying solo this year, there’s no better time than the month of love to show yourself some TLC. Here are some ideas for treating yourself like the VIP Valentine that you are:

  1. Buy yourself fresh flowers.
  2. Take a long, relaxing bath.
  3. Clean your house or apartment.
  4. Watch your favorite movie. Even if it’s for the 20th time.
  5. Make yourself breakfast in bed.
  6. Repeat the following mantra, “I love and accept myself.”
  7. Have a mini pamper session.
  8. Make a list of fun activities to do and post on your fridge.
  9. Go for a run or a long walk.
  10. Start the day with two minutes of meditation.
  11. Fill your body with food and drink that nourishes it and makes it thrive.
  12. Dress your body lovingly in a gorgeous outfit.
  13. Do something for the first time.
  14. Throw your favorite jammies in the dryer for a few minutes so they’re nice and warm and put them on as soon as you come home from work.
  15. Listen to music. Just close your eyes and listen.
  16. Read a good book.
  17. Buy something you’ve always wanted.
  18. Make a list of all the things you like about yourself.
  19. Set the mood while cooking — candles lit, music on.
  20. Give yourself a manicure.
  21. Plan a fun weekend for yourself and your partner/friends/family.
  22. Write down 10 things you feel grateful for.
  23. Get your sweat on.
  24. Smile.
  25. Write yourself a love letter.
  26. When you grocery shop say, “I am choosing this for my body because I love her.”
  27. Give yourself a massage with beautifully scented lotion.
  28. Do something creative.
  29. Stand up straight and tall.
  30. Try a new, healthy recipe.
  31. Take a nap.
  32. Call your mom and tell her you love her (or your dad, sister, etc.).
  33. Oxygenate by taking three deep breaths.
  34. Put on some music and dance away.
  35. Commit to doing your hair and makeup for a week.
  36. Play video games.
  37. Allow yourself to have that piece of chocolate and savor every minute.
  38. Plan an adventure.
  39. Shut off your email and cellphone for an hour.
  40. Use scented candles or diffuse essential oils.
  41. Complete that project or goal you started.
  42. Play board games with friends or family.
  43. Give yourself a day off.
  44. Self-love mantra: “I am enough. I have enough. I do enough.”
  45. Wear your favorite perfume.
  46. Stretch.
  47. Cuddle with your pet. Or with your human.
  48. Watch a stand-up comedy show.
  49. Host a dinner party.
  50. Hire a coach or a counselor.

Have a wonderful, love-filled Valentine’s Day! Be good to yourself.


5 Tips for Surviving Thanksgiving Post-Election

After the extremely contentious 2016 election, a peaceful Thanksgiving dinner may prove more difficult than usual. Experts say the particularly divisive election could intensify typical family squabbling this holiday season, especially among relatives on separate sides of the political fence who may be seeing each other for the first time since Donald Trump’s stunning victory on November 9th.

So, how do you get through dinner without it devolving into a shouting match? I’ve compiled a few ideas for you to try. But, remember, if all else fails, there’s always hiding in the bathroom. I am kidding. Kind of…

1. Make the dinner table a no-politics zone.

If you’re hosting an event and want to set early boundaries about what you expect from your guests, inform them ahead of time that when the group sits down to feast, all political talk is off the table. If someone else is hosting the gathering, share this idea them and have them reach out to the guests. Some people, unbelievably enough, are looking forward to talking politics with their relatives. If that’s the case, don’t subject a captive audience to it. When dinner is over, the politically minded can retreat to the den to debate, and everyone else can eat pie and watch football in another room.

2. Find common ground. 

Every American wants security, prosperity and liberty. Our political disagreements stem from different opinions of how to achieve these ends. As much as possible, remind your family of how you are similar before explaining the finer points of how you differ. For example, we all want secure borders. We all want to stop terrorism. We all want to preserve the environment for future generations. Establish these points of agreement at the outset, and you just might discover that those “unreasonable” family members aren’t so unreasonable after all. With this foundation, the same passion that might have become insults and personal attacks will be channeled into meaningful discussion.

3. Be ready to create a conversational diversion.

The best way to keep people from talking about politics is to get them talking about something else. What’s the best thing they’ve watched on TV or Netflix or in theaters this year? Inquire about their vacations, their jobs or their hobbies. Browse the news before dinner and come prepared with some interesting apolitical headlines to discuss. If the conversation starts to turn, be ready with what you’ll say next. Consider responding politely with, “You know, I’m not comfortable talking about that yet,” or, “We know we don’t agree on politics, so let’s not discuss it.”

4. Remember to STOP.

Get ready. This is an acronym that can change your life. When you start to feel annoyed or upset in any way, remember to employ this simple, yet rapid technique that will help take control of the one thing in your power: your response.

Take a breath
Observe the sensations in your body, your thoughts/emotions, your interaction with the other person
Proceed in a way that best supports you, the other person, and your relationship

In moments when we feel flustered, usually our first impulse is to act in a way we’ll come to regret. Austrian physician and concentration camp survivor Viktor Frankl once said: “Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.” Taking a moment to STOP helps us get into this gap between stimulus and response and claim the power to choose the most beneficial action.

5. Be thankful.

In my family, we go around the table and everyone has to share one thing they are grateful for before we begin eating, and that sets the tone. Remember that Thanksgiving is a time for family. It’s a time to be thankful for those you’re with…and to focus on the things that unite us rather than divide us. No families agree on everything. But at the end of the day, you’re still family. If political conversations get out of hand, affirm to the table that your relationships are deeper than the 2016 election.

Cheers to a peaceful and enjoyable Thanksgiving holiday!

Introvert, Shy, Socially Anxious: What’s the Difference?

“Introvert”, “shy”, and “socially anxious” are commonly used interchangeably to describe individuals who prefer to keep to themselves or who aren’t very outgoing and sociable. While they may have similar characteristics, the three terms mean different things. Being able to differentiate between them will allow you to develop a deeper understanding of others, helping you build a greater sensitivity towards individuals who do suffer from social anxiety in particular.

The terms introvert and extrovert were popularized by Carl Jung in the early 20th century. Introverts may only seem shy on the exterior because they are typically soft-spoken and reserved. However, not all are shy; introverts find other people and over-stimulating environments to be tiring, and regain energy by resting and being alone. They tend to prefer an evening with a good friend over attending a large party. They are thoughtful, thinking before they speak, and they also prefer to observe rather than participate in discussions.

Compared to shyness, introversion is not a characteristic that is outgrown or developed, but is rather a trait that is inherent in an individual. In contrast, extroverts are people who are energized when surrounded by others, and who enjoy social situations and interacting with others. They prefer to spend time with others than to be alone. At the same time, introversion and extraversion are on opposite ends of a spectrum; there are plenty of individuals who fall in between. Ambiversion is a term that describes people who feel comfortable with social interactions, but who may also talk less and treasure time alone.

People who are introverts often describe themselves (or are described) as shy, but shyness and introversion are not the same thing. Shyness has, at its heart, a fear of negative judgment by others. Think of the difference this way: If asked to a party, an introvert might think about whether they wanted to expend their precious supply of social energy. A shy person, however, might think about how others at the party would perceive them. As author Susan Cain explained in “Quiet,” her landmark book on introverts: “Shyness is the fear of social disapproval or humiliation, while introversion is a preference for environments that are not overstimulating.” One stays home from the party from preference, in other words, and the other from fear.

Unlike introversion, shyness is better understood as a response, rather than a state of being. It’s the social discomfort we feel whenever we worry about measuring up or appearing out of place or awkward. Nearly everyone has felt some degree of shyness at least once. However, severely shy individuals may have further issues with building relationships at school or at work, possibly leading to social anxiety.

Social Anxiety Disorder
Social anxiety disorder, also known as social phobia, does have an element of shyness to it. However, the main difference between the two, is severity.

Severity in the level of anxiety:
Mild anxiety levels in social situations is in keeping with shyness. High anxiety levels in social situations is more in keeping with social anxiety disorder.

Severity in the degree of avoidance:
Little or no avoidance of social situations, is in keeping with shyness. However, avoidance which interferes with life is characteristic of social anxiety disorder. For example, a person suffering from social anxiety may avoid going out, or meeting people, or drop out of school, or avoid careers they are capable of. It interferes with their life now, and in what they want to do in the future.

Severity in the persistence of symptoms:
Generally someone who is shy will feel uncomfortable when meeting someone for the first time. This usually gets better with time, as they become more familiar and comfortable in that social setting. However, someone with social anxiety disorder may continue to be anxious even when they get to know the other person better.

The most distinguishing feature between social anxiety disorder and shyness is that social anxiety disorder debilitates one’s functioning, and not just socially. In adults, social anxiety can impair one’s work functioning and cause conflicts in family life. In children, social anxiety can interfere with academic achievement, school attendance, social hobbies, and making friends. Furthermore, the lack of self-confidence of social anxiety sufferers tends to result in poor assertiveness skills, and often leads to other psychiatric conditions, such as depression, other anxiety disorders, and substance abuse.

Psychotherapy, particularly cognitive behavioral therapy, has been shown to be effective in treating social anxiety disorder. Anti-anxiety medications and antidepressants can also help in some cases. If you are struggling with SAD, reach out for help from your doctor or a licensed mental health professional.