When acceptance is misused

I’ve heard complaints from colleagues about recommending mindfulness and Acceptance and Commitment Therapy to individuals recovering from stroke, chronic pain, etc. Basically, things were some aspects of life and activities have been affected in a long-term way.

The issue is with the idea of acceptance. They say that they are uncomfortable with the idea of encouraging their patients to “accept” their level of functioning and not to strive to get better.

This is a terrible misunderstanding of acceptance.

The idea of acceptance is to be able to determine, in this context, what you are capable of, what you aren’t capable of, and setting realistic goals of what you could achieve. The alternative that is being suggested by colleagues is that it is appropriate to set unrealistic goals so as not to smash the hopes of their clients.

I don’t even think that this is ethical!

Setting unrealistic goals will only lead to failure and hopelessness and reduce desire in the future to set any goals.

If you have been impacted by such a thing as stroke, you need to be realistic. If a full recovery, in time, is realistic, then fine, but if it is not you need to have the metacognitive awareness to determine what you can and cannot do, and work within these limits. It might not be nice, it might be hard to admit that you will never reach your previous levels of function, but deluding yourself, and allowing your clinicians to delude you, into thinking you can is unrealistic and, quite frankly, unethical.

This is what happens when people “dabble” in an area and attempt to use the tools without understanding the basic theory or rationale for why they are being used. Therapies can have negative effects, especially when they are used inappropriately or by someone without training.

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