Dialectical Cognitive Therapy: A Path to Inner Acceptance

Close up of smiling manMost of you as clinicians, and likely some among you as prospective clients and curious readers, have heard of dialectical behavioral therapy (DBT). In a nutshell, this is a psychotherapeutic modality focusing on behaviors that are not helpful in getting one’s needs met in relationships and life at large and are often destructive. My sense is that the focus in this form of therapy is not the cognitive component, or core beliefs, that drive these behaviors but rather the behaviors that are negatively impacting a client’s life. It is my intention, and my passion and heart’s desire as a psychotherapist, to bring attention to these underlying core beliefs that unconsciously drive our conditioned responses to ourselves in the form of “the inner critic” and to our loved ones in relationship. It is my sense, and experience, that beginning to isolate and see through these beliefs little by little acts as a fundamental linchpin toward unlocking our inner stuckness and being less and less controlled by these beliefs.

As with DBT, what I am calling dialectical cognitive therapy (DCT) utilizes mindfulness or raw awareness as a space from which to meet our inner world and its myriad beliefs. From this “centerless center” of raw awareness it is much easier to truly hold the tension of this fundamental Dialectic. Some of you may be wondering at this point, “Well, what is this dialectic with a capital D that you’re talking about?” It is the dialectic of acceptance and change. It is my strong sense and experience that we are traditionally taught, both implicitly and explicitly, that the very act of acceptance of something we want to change will never lead to change. I see this, however, as a common and unfortunate misunderstanding, or more accurately a projection onto the very meaning of the word and embodiment of “acceptance.” Acceptance does not have to include unconscious indulgence of what is being accepted nor the often associated powerlessness that comes with it. Acceptance is nothing more or less than absolute opening to “what is” and does not in and of itself include nonaction.

Deep, radical, full-on inner acceptance is the very stuff that love and transformation are made of. Thus, my deep interest is in applying full, heartfelt attention to touching our deepest emotional pain and stuckness with this spacious and ever-present awareness that is, quite simply, our Self. Therapists, clients, all of us as human beings have the innate capacity to be and embody this radical acceptance that is both full and empty; we are that raw awareness that is not separate and has no need to separate from whatever our internal experience may be. What I’m calling here “not separating” from our internal, felt experience is not at all the same as getting lost in it. Rather, diving into the felt, physical sense of the feeling, at this point, and setting aside the isolated belief-thought that created the feeling and literally becoming that feeling 100%, consciously, seems to be what heals and resolves these core beliefs and the feelings that they create or copy into our bodies. A few examples of these beliefs and the accompanying feelings are “I’m not enough” = shame or despair, or “There’s something wrong with me” = shame or rage. The feeling of shame seems to pretty much always be a byproduct of these core beliefs and could even be its core counterpart in the feeling realm. I think we all know what it’s like to feel shame. Again, contrary to what we are taught, when this acceptance is embodied at the very core of our being, change, whether in the form of observable action or not, seems to follow. Truth and transformation seem to thrive via the expression and embodiment of apparent paradox.

Finally, I just want to point to the therapeutic relationship itself as a vehicle through which this radical acceptance can be realized. I believe that these core beliefs are created in relationship with our primary caregivers when we are very young children, so it only makes sense that the therapeutic relationship would optimally serve to work through and resolve these beliefs. There seems to be some alchemy that happens, just like when we were young with these negative beliefs, when we are met, deeply accepted, and opened to just as we are. Just like not being met, dropped, rejected, and/or criticized or shut down creates these core beliefs that we’ve internalized, these same beliefs and the accompanying feelings can be worn away by being processed and met with openness and a vital curiosity of spirit. Over time, including moments of powerful bursts of epiphany, the openness and loving attention of the therapist are invited to be internalized and infused into the client’s experience of self and of living. More accurately, I would even say that what is being internalized is actually already there in the client as unconditioned presence, simply buried or obscured in moments of stress by these conditioned beliefs.

Related articles:
What is Mindfulness? What is “Mindfulness Based Stress Reduction”?
Know Thyself: The Role of Awareness in Psychotherapy
Dialectical Behavior Therapy (DBT): Core Mindfulness

© Copyright 2012 GoodTherapy.org. All rights reserved. Permission to publish granted by Tom Rhodes, MFT, therapist in Nashville, Tennessee

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Walker

    Walker

    April 10th, 2012 at 3:37 PM

    proof positive that we are our own worst enemies
    but there are things that we can do to change that
    positive things like this that can make a powerful place in our lives
    it is now all a matter of seeking that change and taking the necessary steps to achieve just that

  • Tom Rhodes MFT

    Tom Rhodes MFT

    April 10th, 2012 at 8:40 PM

    Yes! thanks for responding and I’m happy to hear your passion and embracing of this acceptance which can lead to lasting, true and fundamental change. In my experience, when we do truly accept, those necessary steps eventually become starkly obvious.

  • Iris

    Iris

    April 11th, 2012 at 4:13 AM

    It is all about working it out from the inside out

  • Tom Rhodes MFT

    Tom Rhodes MFT

    April 11th, 2012 at 7:33 AM

    Nice. That should’ve been the title!

  • Jodie

    Jodie

    April 13th, 2012 at 6:50 AM

    The thing about accepting what is present and needs to be changed really made an impression. I never thought about things this way. Always wanted to assume the thing(or situation) that needs to be changed doesn’t exist.

    you’re right. With that mindset we will not be in a great position to actually bring about a change. Very nice reading this.

  • Tom Rhodes MFT

    Tom Rhodes MFT

    April 13th, 2012 at 10:04 AM

    Jodie, I’m very happy to hear that this was nourishing and enlightening for you to read. We are taught the opposite, but the secret is out!

  • Woodrow

    Woodrow

    April 19th, 2012 at 3:36 AM

    When I first read this, I was a bit dumbfounded & wasn’t clear on all that you were trying to convey. I accepted that in the present moment for what it was (and with no negative self-labeling/inner critic activation…nor associated feelings). A second reading helped me have a better understanding. Persistence, or moving away from “nonaction,” was my follow-up to your facilitated cognitive reframe. Thanks for a great & elaborate example of “thinking outside the box.”

  • Tom Rhodes MFT

    Tom Rhodes MFT

    April 19th, 2012 at 10:53 AM

    I’m glad this was helpful for you, Woodrow. We’re not boxes are we?! So thinking and living outside of the ones we create to try to protect ourselves, when we may not need that as we used to, tends to feel good! and is of course liberating..

  • Debra

    Debra

    March 7th, 2014 at 2:42 AM

    I’m sorry, but what in the heck are you trying to say? alot of big words and abstract concepts; but not a clear message of what it is you want to relay!

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