In our teaching of DBT skills, I always say that radical acceptance is one of the hardest skills to learn. To do. To embody. I feel this way myself. As much as I talk about acceptance, I find my brain constantly wants to err on the change side of the acceptance-change continuum. It wants to deny, to refuse, to do anything it can not to accept difficult things. And difficult can mean anything from minor inconveniences to major events and crises.
When we talk about the concept of radical body acceptance, we’re talking about something incredibly challenging. We’re talking about accepting our bodies just as they are – how they look, how they function, how they age – and that’s no small task.
We have multiple systemic forces working against engaging in radical body acceptance (e.g., diet culture, ageism, healthism, ableism, among others), making this process so difficult. And yet, it’s also so important. Because what’s the alternative? Not accepting how are bodies look can lead to a lifetime of distress, eating disorders, harmful surgeries, and more. Not accepting the limitations of our bodies in terms of function or health can keep us stuck in dangerous patterns of denial and frustration and harm. Not accepting how our bodies age can set us up to fear getting older and to experience unnecessary suffering in the latter part of our lives.
When we talk about radical acceptance, we talk about reducing the struggle with what is. To be clear, acceptance doesn’t mean we have to like something. We can dislike that our bodies are in pain or aren’t able to do what we want them to do or are slowing down or even that they don’t look a certain way, but radical body acceptance means we acknowledge that this is how our bodies are. We stop saying they “should” be another way. And the radical part means that we are fully accepting – with our minds, hearts, souls, and yes, even our bodies that our bodies are as they are.
Why should we accept what we don’t like, what causes us pain, what limits us, or causes us sadness or grief? The idea is that pain is inevitable – physical pain, emotional pain, loss, distress – these are all a part of being alive. We can’t escape this. But suffering occurs when we refuse to acknowledge this pain, when we tell ourselves it “shouldn’t” be this way, or when we keep pushing for something else, other than what is.
As we age or lose function, as we experience pain, as we exist in bodies that aren’t celebrated in mainstream culture, that’s painful. While it might be challenging to feel this way, the feeling is complicated by non-acceptance. On the other side of practicing radical body acceptance is typically an experience of calm or peace, a serenity incompatible with rejecting reality. Compare that to getting stuck in patterns of bitterness, anger, and sadness when things aren’t are as you want them to be. Those experiences typically don’t shift over time.
And to be clear, acceptance isn’t anti-change. We can accept how our bodies are and also work to change some of the things that make us uncomfortable or that make living in our bodies a challenge. And we can accept how our bodies are and also work to challenge the systems that negatively impact our bodies. Acceptance and change can co-exist, but in order to change something, we first have to acknowledge its reality.
Practicing Radical Body Acceptance
Below are the steps for practicing radical body acceptance, adapted from the DBT Skills Training Handouts and Worksheets book. Let’s walk through them, focusing on the process of what body acceptance might sound like:
Observe that you are questioning or fighting reality. Here, you notice that you want your body to be different. You’re aware of thoughts, such as, “I can’t stand my stomach” or “I wish I were smaller” or “I can’t take the fact that I’m not as strong as I used to be,” as well as accompanying emotions and physical sensations.
Remind yourself that there are causes for the reality. Bodies are complex organisms. Weight has a largely genetic component but can be also be impacted by chronic dieting. There’s a wide array in how bodies experience pain and disease and ability. Some of these causes are known, some unknown; either way, there are causes. As bodies age, they lose some of their function. They slow down and experience more discomfort. This is what happens.
Practice radical body acceptance with the whole self (mind, body, soul). You accept that this is your body. You accept that this is what your body looks like, moves like, feels like. You accept that your body is aging or changing in other ways. You lean into this acceptance with a softness in your face and posture. Maybe you use other DBT skills like half-smile and willing hands to practice acceptance of your body with your body.
You try to embrace your current body with your whole being. You accept and value your body. You accept and value your body even if you don’t like the way it looks. You accept and value your body even if you struggle with illness and/or pain. You accept and value your body even if it doesn’t function the way you’d like it to. You accept and value your body even as you age.
Practice opposite action. Aloud you say, “I accept that this is my body” You write a list of everything you would do if you were accepting of your body. If you were fully accepting, what would you wear? Do? How would you think about your body, what it can do, and what it can’t? What activities would you move away from? Toward? How would you respond to pain or illness? How would you conceptualize aging? What would you tell yourself about all of this?
Cope ahead with events that seem unacceptable. You picture yourself coping with future moments of body distress, with difficult body image moments, with pain or discomfort, with disability, with aging. You mentally practice what you’ll do down the road when these moments intensify. You come up with some strategies before strong emotions arise, because its typically challenging in those moments of emotion mind to figure out what to do.
Attend to body sensations as you think about what you need to accept. You notice your breathing as you think about your body. You notice where there’s tightness. You notice when you feel the urge to clench or to move, as you focus on acceptance. You track your body for energy, temperature, stress, and other physical sensations – not necessarily trying to change anything, just noticing.
Allow disappointment, sadness, or grief to arise within. Perhaps you allow yourself to feel sad that your body doesn’t conform to a cultural ideal. Maybe you grieve that activities that used to bring you joy are now inaccessible. You might access sadness or frustration or hopelessness around chronic pain or aging. There’s likely some fear that things will get worse. You try not to suppress these feelings. You acknowledge that this is hard right now and approach yourself with kindness and compassion. If the feelings become unbearable, you access your other DBT skills, particularly those targeted at crisis survival.
Acknowledge that life can be worth living even when there is pain. Despite sadness and disappointment, frustration, fear, and even hopelessness at times, you are still able to find comfort and joy in certain things. You know that you are more than your body. You’re clear that however you experience your body and its difficulties, you are more than this. You remind yourself that everyone struggles in some way; everyone has pain. You encourage yourself, believing that you’ll find a way to cope with whatever happens. And you also know that, in addition to struggles, life offers beauty and joy and connection. It’s worth hanging around for these.
Do pros and cons if you find yourself resisting practicing radical body acceptance. You write down a list of the pros and cons of accepting your body. What are the cons of accepting your body as is? The pros? Are these short-term or long-term pros and cons? What can you make of the balance between your pros and cons?
Again, this process (and these steps) are easier said than done. Radical body acceptance might be something you come to again and again throughout your life. You might end up relying on other DBT skills to support you through those more difficult moments. The hope is that doing this work can result in reduced suffering and greater peace and comfort over time.