A fellow blogger wrote a while back about creating your peace, and it got me thinkng about the relationship between non-acceptance and suffering in the context of mental illness.
Mental illness isn’t fun, that much is clear. How we relate to illness, wellness, and recovery can evolve over time depending on the individual illness, how it affects us, and how it evolves. If there is partial or full remission of symptoms in between acute flares of illness, the outlook may look quite different than for someone who’s chronically symptomatic.
Hope
I think hope can look different depending on the stage you’re at with the illness. A hopeful outlook might mean hoping to get fully better or relatively better, or maybe just not decline. Somehow, that hope has to reconcile itself with the reality of the illness. That might look like different things for different people. It may be helpful to hope for a level of recovery that may or may not be realistic. Or it might not.
I’m a very logical-minded person, and that seems to fit nicely with the fact that I’ve always tended to be a realist. Hoping for something beyond what’s realistic feels a bit like an exercise in futility, so I just don’t.
Resistance
Since mental illness sucks, I think perhaps the natural reaction is resistance. This is bad, I don’t want to feel this way, I’m useless, I hate where I am now. Resistance can be good if it can be used to bring about change that actually has a fighting chance of making things better.
But what about when there’s no reasonable prospect of things getting better? You can resist, but it’s only going to spin your wheels rather than get you anywhere. Maybe that’s where acceptance comes in.
I mentioned a while back that I’d gotten a comment on an older post about the ACT life compass from someone who seemed offended that I’ve accepted the fact that I have treatment-resistant depression. I think part of the issue may have been that this person has a different concept of what acceptance is. Acceptance, at least in the context of ACT (acceptance and commitment therapy) is the opposite of resistance. It’s not about liking where you are, giving up, or not taking actions to promote positive change. It’s about accepting that this is the way things are right now, and rather than fight it, I’m going to make the most of the hand I’ve been dealt.
Changing mindset
I’ve gone through a major shift over the last few years with my own illness and what acceptance means (there’s more on that in this post on acceptance). I used to have full remission between depressive episodes, so I was either sick or I was fully well. When I last relapsed in 2016, I figured it would continue on with the same pattern. Except it didn’t. Instead, I got worse and had a progressive decline in functioning.
It was probably 2019 when I started to have a shift in where I expected my illness to go. It didn’t come from a place of hopelessness; rather, it was just a realistic appraisal that the pattern of my illness had changed. Last year it started to become clear that wellness, at least like I had before, is off the table. As time has gone on, I’ve accepted that. Maybe some new wonder treatment will come along, but I don’t find it helpful to hold out hope for something that may or may not ever happen. In my mind, there’s no point in trying to look ahead and push myself towards a future that doesn’t exist. I would much rather accept that this is where I am now, this is where my illness is, and I’m going to work with what I’ve got to make a life that is as meaningful as it can be.
Transitioning to acceptance
I suppose there was a period of grieving, although it was spread out enough that there was never a hard hit. For me, acceptance is a good place to be. It’s comfortable, it’s realistic, and I don’t have the energy for resistance anyway. Non-acceptance would not be as good a place for me as I’m in now.
Resistance/non-acceptance probably feels like the path of least resistance, as odd as that may sound. Acceptance isn’t something that can truly happen overnight; it’s a process that can demand a lot of reflection. But I think suffering is inherent in resistance. We only have so much control over the suffering that’s directly related to the illness, but there’s more control available over acceptance.
I’m sure that, for some people, acceptance could never mean anything other than giving up, and that wouldn’t be acceptable. And if that works, that’s awesome.
But I think acceptance is an option that’s at least worth contemplating. It may or may not be the right fit, but if it could reduce suffering somewhat, that’s something to consider.
What’s your own relationship with resistance and acceptance?
Related posts
- Acceptance and Commitment Therapy Metaphors – the hub for all things ACT on MH@H
- Some Quotes on Acceptance
- Where’s the Instruction Manual for Mental Illness Life?
Thank you for your thought-provoking post. Accepting the hand you’ve been dealt — so important and so true. I too used to experience my bipolar illness in intervals and in-between intervals I was mostly asymptomatic. Now I have low to medium to high anxiety much if not most of the time with few if any breakthrough events. I too have wondered if I would return to break-through illness coupled with intermittent asymptomatic behavior. I don’t think this is in the stars for me. I too find it is important for my health to accept this as “truth” at least “truth for me.” Accepting this reality allows me to focus on current challenges like how to reduce the anxiety that rears its head daily through exercise, blogging, the right medication and other therapeutics like CBD.
I agree, accepting current reality makes it easier to shift focus to problem-solving.
I’ve struggled to accept being depressed forever, which is some ways is good, because in the last few years I have got quite a bit better. But I still need to accept that I will probably always be prone to strongly depressed days, and I need to accept my ASD diagnosis and its likely impact on my life, that I may never have a career, be financially independent of my parents, get married or have children.
Getting the ASD diagnosis definitely seems like a milestone in figuring out what direction life can go.
The arc of our lives can certainly look different than the “normal” one we see presented in the world and it is definitely hard to come to terms with that. The financial independence is a hard one for me, as well.
The government-enforced disability=poverty linkage definitely isn’t my favourite.
I think this is a really healthy way to approach things. My depressions have been more episodic lately and I notice that I suffer the most when I’m resisting and fighting back against them. When I finally get to the place of acceptance with it, the depression eases and eventually begins to life. So this makes a lot of sense.
Good to hear that helps!
If you are satisfied with the diagnosis, and even with the prognosis, then acceptance seems to be the positive way to go. Finding ways to deal with what is.
I have a degenerative condition, it will NEVER get better and I have to live with how it obstructs a lot of activity – so I have adapted, I have accepted there are things I can no longer do, things which brought me pleasure. No point in banging my head against that wall, it would simply mean adding another level of pain LOL
That’s a very good way of putting it!
Resistance creates suffering in our experience. We may have told you before that we’re struggling with acceptance as also creating suffering. So we’re trying out “allowing” as the opposite of resistance. It’s too new to say how it’s going. We try not to attach to expectations and outcomes but given how much we worry, this is also not exhibiting much success. This topic seems very useful because suffering, in theory, can be alleviated through behavioral choices. We did think we were an awful person who deserved awful things, so suffering was invited, sought. Hard change to act differently. Trying! 💕
Allowing – I like it. That, and leading with love. ❤️❤️❤️
When I first started having issues with mental health I fought against the mental health workers. I did not want to be labelled because of attempting suicide.
Then as I had a severe relapse I was resistant . My psychiatrist was wonderful and so was all the nurses and aides on the floor. I started coming around during the group sessions. I entered into the discussion and it began to feel comfortable speaking about it out loud.
In every time I have been sick and hospitalized I have just went with the flo. No sense making a nurse or anyone else uptight. So, I talk and chat with the nurses, the lab techs and just accept where I am at.
It is the same for me at this time of my life. I have accepted the fact of surgery and I will go once more with the flow of things.
I think that’s a very good approach.
Thought provoking post. I like the fact that you can integrate different points of view into a realistic whole.
Acceptance to me, doesn’t mean ” giving up” to me it means ” Making the best of a given situation” and that certainly eases suffering. At least, it does for me.
Happy Wednesday despite everything 😊🤗
There’s something very empowering about making the best of a given situation. Happy Wednesday! 💕
If you ask my psychiatrist, I haven’t accepted anything because I’m questioning my diagnosis. If you ask my therapist, she’ll tell you that not only have I accepted that I have mental illness, I’m doing everything I can to get the right diagnosis/treatment.
Acceptance doesn’t mean going along with whatever your doctor says even if you have doubts about your diagnosis. In my case, I’ve spent the last 5 years trying desperately to make bipolar fit because it seemed like it could explain what I was going through. But it never completely fit. When my therapist brought up BPD, we walked through it and we decided that I fit 6, possibly 8 of the 9 criteria.
Someone telling you that you simply haven’t accepted your diagnosis when you go to them w/ doubts about what is actually going on is horribly invalidating. No one but you can decide if you have or have not accepted something. Levels of acceptance can change over time, and you can “decide” you no longer accept something when the act of accepting causes additional emotional suffering.
Case in point: me continuing to “accept” I have Bipolar disorder when signs are pointing to BPD means I have to continue putting up with treatment that doesn’t seem to be doing a whole lot of anything while my quality of life suffers. Um. No thank you.
Good on you for pushing back against the wrong diagnosis. When I was talking about acceptance I was thinking more along the lines of internally accepting reality as it’s experienced, which in your case sounds like it probably involves BPD. Psychiatrists, or other professionals, should never expect their patients to just put up and shut up. They get it wrong sometimes, and the professional thing to do would be to own it when that happens rather than blame that patient for not accepting what’s being shoved down their throat.
Oh, thanks for mentioning that!
Yup.
Ketamine isn’t necessarily going to be a magic bullet. It might help, or it might not; only time will tell.
I enjoyed this post and the comments. Resistance and acceptance are interesting subjects. My depression is treatment resistant as well. I worried about it when I was in my twenties. I knew that each episode made the likelihood of brain rewiring to the permanent more likely. And, here we are.
Acceptance features heavily in the books I read on philosophy, religion, self-care, and recovery. I float in how well I’m doing. It’s interesting though: acceptance isn’t just for easing emotional distress. It also helps with the physical stuff. When I resist the pain, I’m tense and it gets worse. Acceptance makes us like a river. We flow. I really love and wish for flow.
Flow is very good.
“I’m going to work with what I’ve got to make a life that is as meaningful as it can be”. This is a solid philosophy. I always appreciate your thoughts, insights and strength Ashley. I would love to hear your thoughts on this process, expanded into book form. Acceptance of something we don’t want can be a life’s work.
Thank you!
Like many people, for me it’s been a roller-coaster of resistance and acceptance. Unfortunately, I still swing between them both in terms of physical and mental illness/wellness. I still find it hard to accept that I’m never going to work as a Mental Health Nurse ever again, even ten years later 🙁 Do you miss the job Ashley?
I’ve definitely got moments of missing it. I think it makes a difference that the last three years of my career were at a job I didn’t like but felt stuck in. It would have been harder if I’d had to leave while working at a job I really liked.
Yes, perhaps if I’d really disliked my job, I wouldn’t have felt such a great loss.