Applied Acceptance: Accepting Ourselves and Accepting Others in the Helping Profession

Acceptance 
The term acceptance is common across many therapeutic modalities. Acceptance is one of the 4 processes of the spirit of Motivational Interviewing (MI), it is one of the 6 core therapeutic processes of Acceptance Commitment Therapy (ACT), and radical acceptance is a key component of Dialectical Behavioral Therapy (DBT).

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​Webster Merriam defines acceptance as “an agreeing either expressly or by conduct to the act or offer of another so that a contract is concluded…” (2016). In helping roles we apply the term acceptance to life’s struggles and challenges. Hanson describes acceptance as, “making room for painful feelings, urges and sensations, and allowing them to come and go without a struggle” (Jones-Smith, 2016, p. 195). And when we apply the term acceptance to those of us who help, we often talk about acceptance in terms of accepting a client with unconditional positive regard and without judgment.
 
It is important to note that acceptance of difficult circumstances is not the same as resignation to non-action, and a helper’s acceptance of a client is not condoning harmful choices. Rather acceptance is an important first step before taking action; understanding the ways that things are is a vital starting point towards changing the way we behave or act. Acceptance and making changes are two distance yet interdependent concepts that are important to making lasting change in behaviors. The serenity prayer often quoted in AA sums this perspective up well, “God grant me the serenity to accept the things I cannot change, courage to change the things I can, and the wisdom to know the difference.”
 
Clinicians and other types of helpers often hear of the importance of accepting those we help and serve. As someone who works in the mental health field I hear phrases on a near daily basis such as: “accept the client where they are at,” or “try to accept the client, that doesn’t necessarily mean that you agree with their choices.” Clearly many of us understand that accepting those we help is important (this does not mean that we truly know how to accept others or that we are good at doing it). I hear much less talk from colleagues about the need for helpers to accept themselves. In this article I explore 3 important ways that it can be helpful to practice acceptance in the helping fields. I believe that acceptance starts with accepting ourselves, then accepting others and finally helping other in their own acceptance journeys. 

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Self-Acceptance
In our zeal to help others and change the world, helpers often fail at offering compassion and acceptance to ourselves. Practicing self-acceptance is important. If we are to help others be well, we must first be well ourselves. There are at least 3 primary ways that practicing self-reflection and self-acceptance are important for helpers to be effective. First, practicing self-acceptance is a primary step and core component in any self-care activity. Second, accepting ourselves allows us to be fully present with others. Third, practicing self-acceptance puts our words into practice for clients, effectively modeling a way of being for our clients. When we accept ourselves we are more present, less burnt out and function as authentic role models for our clients.
 
Noah Rasheta writes that acceptance is “being open to the actual feelings we’re having… [so] we can learn to simply be with our experiences” (2016).  Acceptance is actively stopping distractions, “acceptance is taught as an alternative to experiential avoidance” (Fisher, G. & Roget, N., 2008). The first step in self-acceptance is self-refection, and this is easier said than done. We often live a life of delusions and distractions, many times we will go as far as to seek out crisis in others in order to avoid the storm brewing in ourselves. Techniques such as meditation, deep conversation and even some types of focused physical activity can be helpful in taking the first step in self reflection. Once we begin to notice our inner experience, it is important to work towards nonjudgmental compassion and forgiveness of ourselves. There are many ways one could think about accepting oneself, this link has a list of 8 self-acceptance techniques from a Zen Buddhist perspective. ACT offers 3 ways to practice self-acceptance (Markway, 2013):

1. Sunset Mind: Notice critical thoughts as if you are watching a sunset – without judgment, critique or attempts at control.
2. Stand in the Hurricane: Accept the discomfort mindfully and act in a manner that honors yourself despite the hurricane.
3. Feel Your Emotions: Explore how you feel and allow yourself to fully experience that feeling, knowing that it is safe to do so.

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Accepting Others
Acceptance can sound easy, and most of us helpers want to believe that we are accepting and kind people. The type of acceptance required when working with folks who are experiencing serious problems is beyond being an “accepting and kind person.” To this end many therapeutic approaches put a heavy emphasis on the helper’s ability to accept a client despite their choices, behaviors or circumstances. DBT uses the term radical acceptance to drive this point:
 
“Radical means complete and total.  It's when you accept something from the depths of your soul. When you accept it in your mind, in your heart, and even with your body.  It's total and complete” (Moore, C., Anderson, B. & McQuivey, K., 2014, p.195).
 
Motivational Interviewing breaks acceptance down into 4 components: absolute worth, accurate empathy, affirmation and autonomy support. Absolute worth in the form of unconditional positive regard is the basis of acceptance, this is the notion that all humans deserve our respect and compassion. Accurate empathy is the practice of the helper attempting to understand what it is like to be in another's shoes, accurate understanding of the other can help to build and reinforce compassion. Affirmation refers to the searching of another’s strengths, efforts and positive traits. Affirmations lead the helper to avoid seeing clients as helpless, victims or other deficit-based perspectives. Autonomy support is an important and often forgotten part of helping others. Telling a client “this is your choice and I respect that” helps to empower the client, but more importantly this type of statement reminds the clinician of the client’s right to self-determination. The client has the ultimate say in their life and behaviors, and the helper has the ultimate say in their choice to either accept or judge the client (Miller& Rollnick, 2013).

The above 4 components of acceptance offered by MI provide us with a road map towards accepting our clients, but before we can even begin to apply these concepts to our clients we must practice self-reflection. It can be easy to accept a client with whom we easily relate to, a client who completes homework or a client who is willing to take an active role in their treatment. It can be harder to accept a client who is not willing to ask for help, a client who does not follow through with tasks, or a client who does not initially want to take an active role in their treatment. It can be even harder to accept clients who have engaged in behaviors like cruelty towards animals, violence and sexual assault. It is important that helpers practice regular self-reflection in order to have a thorough understanding of “hot button issues” that might act as barriers in accepting our clients.

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Helping Others with Acceptance
Acceptance of the self and acceptance of current circumstances are two important goals we can help our clients working towards. Increased acceptance can empower our clients, build self-efficacy and promote positive change in our clients’ lives. Self-acceptance can act as an antidote for client anxiety and judgment. Russ Harris describes self-acceptance in his book The Happiness Trap:

“Self-acceptance means you refuse to buy into the judgments your mind makes about you, whether they're good judgments or bad ones. Instead of judging yourself, recognize your strengths and weaknesses, and you can do what you can to be the person you want to be” (2008, p.155).
 
Accepting the current reality (no matter how painful or hard it may be) is a necessary first step for anyone considering making a change in their lives. Our clients need and deserve to see their situations as they are in order to move forward to make changes, but accepting that one is in a tough spot is not the same as giving up.
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“Acceptance does not mean that we agree with what is happening or that we believe it must continue… Acceptance means that we are able to gaze into the face of the present and say, ’You are in front of me, and I acknowledge you are here” (Noel, 2010).
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Acceptance is a first step towards change, and it is a deceptively big first step. The very process of acceptance it self can be a journey for both helpers and those we help. As helpers we must work towards accepting ourselves and modeling that behavior. We can then speak from experience and conviction about the virtues of acceptance. We certainly need to accept all of our clients with unconditional positive regard, and this takes continual self-reflection and assessment. Finally by making acceptance a treatment goal, the helper can guide the client towards their own acceptance.
 
While most helpers are familiar with the concept of acceptance, it is all too easy to forget to apply acceptance to our work and ourselves. Accepting ourselves, our world, and our clients lays the groundwork to establish strong helpful relationships with those we help. I believe that practice of acceptance, like most things, starts with ourselves and can then be used with others. As I continue to grow as a professional I need to continue to reflect on and assess my ability to “work the basics” of compassion and acceptance. It is my hope that this article promotes a small step in that direction for others as well.

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Works Cited​ 

     Acceptance [Def. 1] (n.d.). In Merriam Webster Online. Retrieved March 6, 2016, from http://www.merriam-webster.com/dictionary/acceptance
 
     Fisher, G. & Roget, N (2008). Encyclopedia of substance abuse preventon, treatment and recovery. Thousand Oaks, CA: Sage Publications.

     Harris, R. (2008). The happiness trap: How to stop struggling and start living: a guide to ACT. Berkley, CA: Shambhala Publications.

      Jones-Smith, E. (2016). Theories of counseling and Psychotherapy: An integrative approach, 2nd edition. Thousand Oaks, CA: Sage Publications. 

     Markway, B. (2013). The ACT approach to self-acceptance: Three suprisingly simple ways to increase self acceptance [Web log post]. Retrieved from https://www.psychologytoday.com/blog/living-the-questions/201305/the-act-approach-self-acceptance
 
     Miller, W.R., and Rollnick, S. (2013). Motivational Interviewing: Helping people change. NY: Guilford Press.

      Moore, C., Anderson, B. & McQuivey, K. (2014). The resilience breakthrough: 27 tools for turning adversity into action. Austin, TX: Green Leaf Book Group Press. 
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     Noah, R. (2016, Feb 24).  Acceptance vs. resignation [Web log post]. Retrieved from http://secularbuddhism.com/author/noahrasheta/
 
     Noel, L (2010, Oct 27). The meaning of acceptance part 1 [Web log post]. Retrieved from http://www.sandiegotherapyservices.com/blog.php?id=7214737948806716367