Thursday, March 30, 2006

Acceptance of what?

Acceptance may be the single most-overlooked helpful  strategy in psychotherapy. I started this blog two months ago mainly to talk about therapeutic acceptance — and other issues raised by Steve Hayes's acceptance and commitment therapy (which I cottoned onto a couple years ago, before it was cool).

When I was deep into my expensive, destructive, “neo-Freudian” psychoanalysis, I said, after a lot of thought on the subject, that the ultimate goal of therapy could only be having a different attitude toward the things that come up within yourself. My analyst surprised me when he agreed.

Therapeutic acceptance is, I think, the acceptance of those things that come up within yourself: the thoughts and feelings and other occurences that are sort of in between that seem to surface (or bob near the surface) like from a deep, deep well you have no control over and can't possibly see into. It's not so much, in my expression to my analyst or in Hayes's literature, acceptance of things outside yourself, like environmental conditions or other people's behavior.

I think maybe that's where initial interest in this therapy approach can get derailed a little, even as presented by Hayes & friends. Because “acceptance”, as commonly used, usually refers to acceptance of factors outside yourself, not to, well, YOU. I've seen what looks like a complete lack of interest in acceptance as a approach on a psychotherapy consumer board I go to, for example.

Albert Ellis's “Unconditional Self-Acceptance” and “Unconditional Other-Acceptance” also paint with a little bit broader brush than I use in this area. I think the distinction is that you don't have to accept that you have a big nose, but you can accept the feelings that come up from your unfathomable inner well about  your big nose. And unlike Ellis, I would allow conditions on that acceptance, at least insofar as something like, “I'm ashamed to feel this way, but I hate my big nose.”

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