Author: Patricia O’Hare

Ring the bells that can still ring

At the age of 72, I am so blessed to be still able to work part-time at a Mental Health Care Unit nearby. Not only does this job provide me with stimulation (which I crave in this Covid dominated world), but it also allows me to interact with all the other doctors and therapists in the team. Each of them brings new ideas and suggestions which are truly invigorating.

The therapeutic modality which we follow in this ward is called Dialectic Behaviour Therapy (DBT) – a well-researched and documented therapy especially for disorders where emotional dysregulation causes negative consequences for the patient. The overall goal of the therapy is to give patients a life worth living. The programme is skills-based, and a number of the skills taught can also be invaluable to people who do not fall into the emotional dysregulation category – they are good, simple, down-to-earth life skills that can be used in various situations by a variety of individuals.

The particular skill I would like to share is called Radical Acceptance, which is defined as “complete and total acceptance, from deep within, the facts of reality. It involves acknowledging facts that are true and letting go of the fight with reality” (Linehan).

The above definition sounds obvious, yet for many people, when reality does not accord with their hoped for or expected reality, a huge mental and emotional process is unleashed. This flood of negative thoughts and emotions can be very unsettling and interferes with the individual’s coping capacity. The emotional mind goes into overdrive with intense feelings of disbelief, fear, outrage and anger, to name but a few. The emotional mind then dominates the rational mind. The result is usually poor problem-solving techniques followed by impulsive behaviour (which is generally later regretted) and the ensuing emotions of shame and regret, which add to the emotional turmoil.

To identify whether you have trouble with radical acceptance, monitor your thoughts for a while, and if you catch yourself thinking thoughts like” this shouldn’t happen, this can’t be happening, this is not fair, I don’t deserve this, I don’t believe this” you would, in all likelihood, have problems with radical acceptance. When you are unable to accept what is, all your emotional energy is used to generate more and more inflammatory thoughts and emotions. This type of behaviour will never result in acceptance because all you are doing is fanning the flames instead of trying to douse them. No matter how unpalatable the event that caused your pain, if you don’t allow yourself to accept what is, the pain will persevere and cause prolonged suffering.

To illustrate the above, a song by Leonard Cohen comes to mind (I am an unabashed devotee of his – his poetry is magic). The song is Anthem, and the chorus line is as follows:

This refrain encapsulates for me all the ideas about radical acceptance. Firstly, there is always a chance for a new beginning even though it may not be our ideal – there will always be bells that still can ring even though your preferred one is out of the equation. Secondly, forget the perfect offering because it doesn’t always guarantee the perfect outcome. Thirdly, there is a crack in everything – although perfection is highly desired, it is seldom realised. Lastly, that’s how the light gets in refers to possibilities and a new way of thinking that may not have been possible had the crack not appeared to let the light in.

Radical acceptance is a tool that you can use, not to dull the pain but to prevent long-time suffering because of your inability to say, “So be it. Amen”


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