Radical Acceptance

Radical Acceptance means complete and total acceptance of something, accepting reality. It is a key component of Dialectical Behavioral Therapy (DBT) and a key aspect of Ritual Humanism.®

There are basically four ways to deal with a problem:

  1. We can fix the problem when possible.
  2. Change how you feel about the problem.
  3. We can learn to accept the problem as it is.
  4. Continue to be miserable

One of my friends was congratulating me on finding my happy ending since I had found a partner that made life easier rather than more difficult.  Truth is there is no happy ending. Not for anyone. We all grow old and weak and weary and eventually die. Sometimes, the unhappiness waits until the end of our lives. Sometimes it stretches out through the last few years. Often it hits intermittently throughout our lives.

(Warning: this essay contains explicit information about lady parts and functions and you may not find it appropriate for your younger children)

My pap-smears had always been clear and this last one was no exception. So when I found that sexual intercourse was too painful to perform, my first thought was to find out if there was anything that could be done to fix the problem. I went to the gynecologist and learned that this was not an uncommon problem among post-menopausal women and all that was required was a cream and some pills. The cream and pills are estrogen and estrogen can cause endometrial (uterine) cancer.

Fortunately, I saw a commercial on TV for the cream that said to watch for a bloody discharge and if you see one, see your doctor right away.

Two weeks later, I began to have a bloody discharge.

I made an appointment with a gynecologist right away. She seemed relatively confident that I had a pallup that was causing the bleeding. She thought it was fairly harmless. I was referred for surgery to remove it.

Now, I didn’t want to have surgery, but my only other choice was to continue bleeding and face whatever consequences that would lead to. I couldn’t completely fix the problem, but I could come to accept that radical surgery would be better than continuing to bleed, so I made the appointment.

This points out the second choice when things don’t go your way. Change the way you feel about the problem. I didn’t like the idea of surgery, but it was better than the alternative. So I accepted it.

So into and outpatient surgical process I went. The surgeon thought things looked good but said that he would call me with any information yielded from the biopsy that automatically follows this type of operation.

About four days later, my surgeon called with the bad news that I would need some more surgery. He said that my uterus was “a mess”. I asked if it was just a mess because of polyps - or if it was cancer. “It’s cancer.” He said it as if he didn’t want to tell me.

Have you ever noticed that sometimes when you try to correct a problem, it just becomes a more complicated problem? You still have the same choices about what to do. Again, my choice was to try to bend the world to my desires. I went back to the doctor to see if there was a solution to the problem. This time, it would take a major surgery. I didn’t want a major surgery. More specifically, I didn’t want to lose my lady parts. And yet, the alternative was to keep my uterus and all the accompanying paraphernalia and die. So, this time, I had to change the way I felt about the problem.

Instead of “I can’t stand surgery.” “This is not fair”. “Why did this happen to me?”

I had to change my attitude about having major surgery. Points in favor: I have a specialist. A surgeon who does nothing but cancer surgery on reproductive parts. One, as a matter of fact, who has had cancer, herself. These facts make my chances pretty good. Especially considering that there is no cure for endometrial cancer except for cutting it out or burning it out. You must kill every cancerous cell. So my attitude is changing. Surgery is sounding doable.

Clearly, I wasn’t going to be able to bend the world to my way. There was still a chance that I could accept another surgery and the problem would go away. So again, I made the appointment. I was sad and even afraid, but the quickest way to get this resolved – one way or another – was to get on with it.

It is difficult to accept what you don’t want to be true, but it is more difficult still to just wallow in the pain and not take whatever action you can. At that point, the pain becomes suffering.

One thing I have learned is that cancer doesn’t play fair. In fact, when one looks closely, the whole universe is unfair. We just have to learn not to let it make us suffer. Some people think that not accepting the truth, makes it go away. Others think that if we do accept the truth, it means that we agree with it. Well, I accepted that I have cancer, but I can tell you that I don’t like it, or agree with it, or in any way think that it is a good idea.

It’s exhausting to fight reality and it doesn’t work. Refusing to accept that you didn’t get that apartment that you wanted or that person that you were so passionate about didn’t feel that way about you. Or any number of things that don’t go along with what you thought your life should be like is more than a waste of time. It doesn’t change a thing and it takes the pain and discomfort you feel and turns it into true suffering.

Accepting reality is difficult when life is painful. No one wants to experience pain, disappointment, sadness or loss. Still, those experiences are a part of life. When you attempt to avoid or resist those emotions, you add suffering to your pain. You may build the emotion bigger with your thoughts or create more misery by attempting to avoid the painful emotions. You can stop suffering by practicing acceptance.

Back to the results of my second surgery. They removed everything I didn’t need to live, including my appendix. Still, the cancer had spread a tiny bit – and remember, you have to get every single cell.

Let me say that waking up from that surgery was the worst thing that has ever happened to me. I know what it must be like to be stabbed repeatedly by some murderer. I had four wounds and the pain was so bad I could barely breathe. You see, I am on pain medication all of the time because of a chronic pain condition and I think the anesthesiologist forgot that I was on a base dose. I could barely moan with pain just because I couldn’t get enough air in my lungs.

I did not want this surgery. My mother had this surgery and it was horrible for her too. I would have done anything to change reality, but there was nothing I could do.

I could live with the cancer and eventually die from it. About 8000 women do die from endometrial cancer every year. It certainly was a choice.

I changed the way I felt about the surgery and had it and now I find that I must still make more adjustments.

More than not wanting major surgery, I did not want radiation. I had already been in the hospital for second degree burns just from an hour and a half in the sun. I have very sensitive tissue. Yet, here I am with the next option being radiation. They will apply radiation to the surrounding cells to make sure the cancer is as dead as it can be.  The radiation will bring the chance of recurrence down to three percent – not zero. Now to be clear, that means that there is a three percent chance that the cancer will come back – not that I will die from it. But that starts the problem solving all over again. A situation, I would undoubtedly like to avoid. But if it comes back, I will go back through the process. I don’t want cancer to get me.

When things go wrong, no matter how wrong, there are only four ways to deal with the problem:

  1. We can fix the problem when possible.
  2. Change how you feel about the problem.
  3. We can learn to accept the problem as it is.
  4. Continue to be miserable.

I have provided you your list of choices. You can decide to allow the problem to stand and be miserable or you can go through whatever problems it will take to resolve your situation.

Another problem you may find is that you will need to keep changing your mind. About the time you have your mind set to go through with whatever process you must endure, you will wake up in the morning realizing that you have gone back to not wanting to go through whatever drastic solution that is required to prevent your suffering, and you must change your mind once again. You may need to keep changing your mind. Every time you decide that the solution is not worth the problem you need to stop and turn your mind again. I can’t tell you how many times I laid in bed crying and wishing for some alternative to the surgery or the radiation. I still have to go through the radiation and the symptoms include burning during urination, violent diarrhea, nausea, not being able to eat roughage and a half a dozen other ugly things. It will go on for about three or four weeks. But I have to keep turning my mind to the solution instead of fighting with reality. Whenever you fight with reality, reality wins.

Radical Acceptance is a skill that requires practice. Practicing acceptance that traffic gets heavy, that it’s raining on the day you wanted to go to the beach, that you didn’t get that job that looked so promising or that little bit of vaginal discharge is actually stage II cancer is important for coping well and living a more contented life. When you practice acceptance, you are still disappointed, sad and perhaps even fearful, but you won’t add the pain of non-acceptance to those emotions and make the situations worse. Practicing acceptance in smaller situations also helps you prepare for acceptance in more difficult circumstances.

Let me be clear. I’m not saying that every bad thing needs to be accepted. Remember, there are cases where the situation can be changed. Look hard for a way to do that.

When the situation can’t be changed, you must either accept the situation. It may make you sad, you don’t have to like it, but to avoid suffering you must accept that it is what it is, or live with the suffering.

Good Luck and I wish you the best!



The concepts of Radical Acceptance has been around for centuries. In 300 A.D. it was called Stoicism.