Interventions

Have the courage to change the things you can, to accept the things you cannot, and the wisdom to know the difference.

Whatever background and culture you come from, and whatever spiritual or non-spiritual approach you have to life, this principle — drawn from a well-known religious teaching — is one I have found to be a useful guide.

Sometimes the only change needed is at a cognitive (thinking) level: the acceptance of what you cannot change.

What Cannot Be Changed

Some losses are permanent. A sports injury leaving you paralysed. A degenerative eye condition. The death of a loved one. These are clear: there is no going back.

There is, however, an enormous psychological challenge in what we call "coming to terms with" such losses. Acceptance is not easy — and often therapy is very helpful in that process. But many aspects of life can be therapeutic in themselves. Losing a loved one is better borne if the relationship was good, and if family and friends can share and support one another. Contact with others who have faced similar losses can also help — hence the many self-help groups that exist.

What Gets in the Way of Acceptance

Two factors frequently impede acceptance:

• Isolation — whether through lack of support, or through feeling too ashamed to seek it
• Being stuck — unable to move through grief or loss to a new way of living

Some psychological problems are not as clear-cut as the examples above. This means a great deal of energy, time, and money can be invested in trying to change something that actually needs to be accepted.

An important part of a therapist's role is to check whether the problem you bring is something that can be changed, or something that needs to be accepted and adjusted to. Because acceptance is not easy, it can be the central aim of therapy — and sometimes the work of therapy is purely around acceptance.

Acceptance and Change Therapy is now part of mainstream NHS psychological therapy provision, known as ACT (Acceptance and Commitment Therapy).

What Can Be Changed

Many situations we struggle with are not fixed — they are ones we are actively maintaining through our response to them.

We spend a great deal of time in our culture blaming ourselves or others, imagining that if something about us — our weight, our moods, how clever we are — or about others, was different, life would be so much better. But if we stop trying to change things we probably cannot, and instead accept that this is how it is, we free ourselves up to live better now.

Acceptance is not the same as putting up with a situation. It is recognising what is within your control — and what is not.

Useful Resources

• The Compassionate Mind website offers pointers to a wide range of resources.
• Books on ACT and Acceptance and Commitment Therapy are widely available in libraries and online.