Radical Acceptance practice in Borderline Personality Disorder begins as a way to learn how to tolerate emotional distress and can progress to being implemented as a very effective way of coping in healthier ways that will lead to the actual soothing of what used to be emotional distress that felt intolerable.

Borderline Personality Disorder (BPD) is a formidable personality disorder. It is a complex and multifaceted mental illness that negatively impacts efforts to build relationships. In fact, if anything, the issues that those diagnosed with BPD have, often make relationships next to impossible to manage in any way that is constructive and age-appropriate.

Dr. Marsha Linehan pioneered one of the most popular therapies for the treatment of BPD called Dialectical Skills Training (DBT) One of the central principles of DBT, housed within the Distress Tolerance Module of Linehan’s Skills Training is Radical Acceptance.

Radical Acceptance has its roots in ancient Buddhist philosophy. As it is applied by Linehan in her DBT skills training it denotes the choice that can be made by those with BPD to be “willing” as opposed to “willful”. Most borderlines, at some point or other, find themselves in what are referred to as unregulated moods in which they are not able to effectively manage their emotions. This is, in fact, an example of willfulness.

When one is willful, one is rigid and not flexible. Most borderlines are willful because they lack the emotional maturity to flow with things as they unfold, particularly relationally. Borderline willfulness has become second nature due to years of protecting and defending against pain and anxiety from within and largely is the result of the very elaborate defense mechanisms required just to feel as if one isn’t about to die or cease to exist.

Emotions overwhelm borderlines. Most with BPD feel the need to defend against emotional pain, the roots of which, or cause of which, for most is hidden deep within their unconscious and is often not even a small part of their conscious awareness – or it it is it is more often than not dissociated from because again, it brings with it too much pain. Pain, that for those with BPD, feels like it is an outside force, a monster that lurks in the dark recesses of their minds just waiting to get them, so to speak. Borderlines’ emotions feel more like they are coming from outside of self because they are often, in fact, repetition compulsions of the original core wound of abandonment – mounting discomfort, pain, stress, distress, terror, and unmet needs that were experienced at a very young age and that did not meet with nurture or were not soothed.

These are the well-worn neuronal tracks of borderline abandonment fear and abandonment depression that leave the borderline feeling out of control, helpless, and in need of rescue. The very rescue that he/she needed as a young child, didn’t get. These needs and the reactions to them of those with BPD persist and repeat as ingrained life schemas well into chronological adulthood. They become automatic responses that the borderline has very willful and protective responses to.

Learning the stance of willingness required to practice Linehan’s Distress Tolerance skills can and does produce incredible change over time when practiced. Adopting a willing attitude of radical acceptance creates change because one learns how to stop the whirlwind cycle of borderline emotional dysregulation. A dysregulation that is not only very emotionally painful but also keeps those with BPD from being able to get to know the authentic self that was lost to the narcissistic injury of the core wound of abandonment suffered or perceived by the borderline in the very early stages of psychological development, usually before the age of 2 years.

Radical Acceptance can also play an important role for those who are non borderline but have a family member or partner or ex-partner with BPD as I outline in my ebook, The Other Side of BPD – Mindfulness and Radical Acceptance For the Non Borderline - Non-Borderlines can free themselves emotionally from the chaotic and painful rollercoaster ride of loving (or having loved) someone with Borderline Personality Disorder.

Radical acceptance is the vehicle of transition between knee-jerk protective reactions that further borderline suffering and the borderline’s learning how to begin to tolerate some emotional distress that over time comes to be dreaded less, feared less, and then reacted to less.

The Radical Acceptance of DBT, when practiced, helps the borderline develop the core skills necessary to build emotional mastery and turn what has been unbearable and unmanageable suffering into manageable pain. Manageable pain when it is faced, and is no longer abandoned pain is the juncture at which a new foundation of self understanding can begin to be formed that is necessary for recovery to be a possibility.

© A.J. Mahari 2007 – All rights reserved.

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