Acceptance Allows Change

There is nothing to celebrate about morally distressing experiences. Yet? When we can’t acknowledge the truth of what actually happened and how it affects us, we add suffering to our situation. Giving voice to painful situations and their consequences can initially be very painful, as feelings, unmet needs, and violated values we have tried to hide, deny or repress come to life. The alternative is to keep these painful aspects of your moral distress hidden. What is the cost?

What is acceptance?

Actively embracing the present moment just as it is (Hayes et al., 2011)
Letting go of the struggle to avoid or get rid of painful thoughts and feelings
Not the same as liking the situation, agreeing with it, or judging it as fair
Not resignation or giving up on change

Why is acceptance important?

Fighting against psychological pain often intensifies suffering and keeps us stuck
Accepting reality frees up energy to focus on what we can control in the present
Crucial first step in making meaningful changes and moving forward. "The curious paradox is that when I accept myself just as I am, then I can change.”--Dr. Carl Rogers

How to practice acceptance:

One way to think of yourself is as an expanding balloon (Hayes, 2019). At the edge of the balloon is a zone of growth where the same questions keep being asked; Are you big enough to have this? No matter how big you get, you can always get bigger. When an issue presents itself, the same question keeps being asked and you say yes or no. If you say no, you get smaller. If you say yes, you get bigger. If you keep on answering yes, it doesn’t necessarily get any easier because the issues that show up may seem just as difficult as earlier ones. Saying yes does become more of habit however, and your experience provides a reservoir of strength for you and those you love.

Remember: Acceptance takes practice, especially with intense moral distress. Be patient and compassionate with yourself in the process.

In the words of the serenity prayer: "Grant me the serenity to accept the things I cannot change, The courage to change the things I can, And the wisdom to know the difference." (Wilson & Cohen, 2015)

Onto a Vast Plain
Rainer Maria Rilke
You are not surprised at the force of the storm—
you have seen it growing.
The trees flee. Their flight
sets the boulevards streaming. And you know:
The one whom they flee is the one
you move toward. All your senses
Sing to them as you stand at the window.
The weeks stood still in summer.
The trees’ blood rose. Now you feel
it wants to sink back
into the source of everything.
You thought
you could trust that power
when you plucked the fruit:
now it becomes a riddle again
and you again a stranger.
Summer was like your house: you know
where each thing stood.
Now you must go out into your heart
as onto a vast plain. Now
the immense loneliness begins.
The days go numb, the wind
sucks the world from your senses like withered leaves.
Through the empty branches the sky remains.
It is what you have.
Be earth now, and evensong.
Be the ground lying under that sky.
Be modest now, like a thing
ripened until it is real,
so that the one who began it all
can feel you when they reach for you.

For Further Exploration:

Struggle Switch--Russ Harris

https://www.tarabrach.com/books/radical-acceptance/

https://stevenchayes.com/the-bittersweet-art-of-acceptance-2/

Chodron, P. (2000). When things fall apart: Heart advice for difficult times. Shambhala

References:

Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2011). Acceptance and commitment therapy: The process and practice of mindful change. New York, NY: Guilford Press.

Hayes, S. (2019). A Liberated Mind: How to Pivot Toward What Matters. New York: Avery.

Smith-MacDonald L., Lusk J., Lee-Baggley D., Bright K., Laidlaw A., Voth M., Spencer S., Cruikshank E., Pike A., Jones C., Bremault-Phillips S. (2022). Companions in the Abyss: A Feasibility and Acceptability Study of an Online Therapy Group for Healthcare Providers Working During the COVID-19 Pandemic. Frontiers in Psychiatry, 12: 801680.

Wilson, B., & Cohen, B. (2015). The big book of Alcoholics Anonymous. Courier Dover Publications.

Acceptance is NOT Resignation!