Learning the Paradoxical Power of Acceptance while Living with Rheumatoid Arthritis

Accepting my situation felt like giving up. But I’ve learned how to use acceptance therapy to live with more joy and optimism despite my pain.

When my therapist first mentioned acceptance therapy, I was a huge skeptic. At the time, I was a new mom who had been living with rheumatoid arthritis (RA) and generalized anxiety disorder for over a decade. I was also an occupational therapist, focused on improving the quality of life for people living with health challenges.

Acceptance sounded like the opposite of what I should be striving for. I was supposed to be “fighting” my RA and anxiety to make them go away and have a better life.

What kind of therapist would encourage people to accept discomfort in their life?

Well, in the immortal words of Gloria Steinem: “The truth will set you free, but first it will piss you off.”

I soon learned that acceptance-based approaches would paradoxically lead to a more profound sense of connection with my life. It has allowed me to live with joy in the present moment.

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What does acceptance really mean?

My therapist used an approach called Acceptance and Commitment Therapy (ACT).

ACT encourages you to stop avoiding or denying unwanted feelings, thoughts, or physical sensations. But this doesn’t mean resigning to your fate or giving up. It means practicing nonjudgmental awareness of the present moment, and actively embracing experiences as they occur.

Dr. Russ Harris, ACT expert and author of “The Happiness Trap: How To Stop Struggling and Start Living: A Guide to ACT,” explains that ACT can be simplified into a three-part process:

1. A = Accept your thoughts and feelings and be present.
2. C = Connect with your values.
3. T = Take effective action.

Harris writes “First you make room for your feelings and allow them to be exactly as they are. Then you ask, ‘What can I do right now that is truly meaningful or important?’ This is very different from asking, ‘How can I feel better?’ Then, once you’ve identified an activity you truly value, go ahead and take action.”

Sometimes my problems aren’t solvable

As someone living with chronic pain, allowing myself to be present in every possibly painful moment was very unintuitive. Before practicing ACT, my thought process was as follows:

1. Bring awareness to the present moment.
2. Notice that the present moment is painful or uncomfortable.
3. Try to fix the pain, distract myself, or do anything to avoid the pain or anxiety.

As my therapist pointed out, this is a “problem-solving” mindset, which is helpful in some contexts, particularly if the problem you’re experiencing can be solved.

But there’s a blunt truth about my RA and anxiety: my pain and symptoms can rarely be solved in the moment. And trying to solve an unsolvable problem is a recipe for frustration and a depletion of my already precious energy.

My therapist urged me to consider a different approach. Could I learn to accept the existence of some discomfort in the present moment, instead of fighting it?

My a-ha moment

After opening up and allowing the present moment, my therapist encouraged me to connect to my values and commit to doing what matters in my life.

This sparked a truly “a-ha” moment for me. I realized I had been operating under a faulty premise. I assumed discomfort needed to go away for me to have a good or meaningful life. It turns out this isn’t necessarily true. I can have a good life even alongside my pain from RA and anxiety.

I realized that my habit of running away from my pain and anxiety reinforced a subconscious narrative that told me “I can’t handle this pain and discomfort.” This meant I was held hostage by pain and discomfort whenever they inevitably arose. So, I was actually creating even more suffering for myself.

Learning to thrive with discomfort

By unburdening myself from the pressure to “fight” or fix my discomfort, I was left with more energy to put toward my life in the here and now.

After practicing ACT, my thought process on a given day might look more like this:

1. Bring awareness to the present moment.
2. Notice that the present moment is painful or uncomfortable.
3. Expand and allow for whatever I’m feeling. This might be a mixture of comfortable and uncomfortable feelings and sensations.
4. Turn my attention to what’s still possible and meaningful in my life despite my potentially uncomfortable feelings.
5. Take actions that enrich my life and the lives of those around me despite any underlying discomfort.

A strange new optimism

ACT is full of paradoxes. At first, I assumed that giving attention to uncomfortable experiences would make me feel worse or pessimistic. But ultimately, I discovered a strange form of optimism.

If we presume that we must eliminate all stress, suffering, and discomfort from our lives to be happy, we’re doomed unless we can solve all our problems. And this isn’t happening any time soon.

ACT posits that it’s possible to be completely aware of your pain and suffering, and still work toward what’s important and valuable in your life.

I’ve learned to gracefully accept what life is offering and make the best of it.

For example, if you’ve recently been diagnosed with RA, that is what life is offering you.

You could put 100% of your energy into distracting yourself, denying it, or rushing to fix your RA. However, I urge you to consider what might happen if you put even just 10% of that energy toward the question: What kind of vibrant and rich existence might still be available to me even with the inevitable discomfort of RA? What might that open up for you?

I fought against ACT at first, even going so far as to jokingly call my therapist a “sadist.” But eventually, I realized that my previous attitude was fundamentally flawed. I felt relieved when I realized I didn’t have to constantly try to fix everything.

Life involves a degree of suffering no matter what I do. Suffering was not a personal failing on my part but rather an inevitable part of being human that I can tolerate and even learn to thrive with.

ACT has fundamentally changed my perspective on living with RA for the better. It’s often used as a therapy for anxiety, chronic stress, and depression. But studies also show that it can be a useful therapy for chronic pain. In a randomized controlled trial, 28% of participants with chronic pain who used ACT showed clinical improvement in pain interference, pain intensity, and depression.

Acceptance of the present can coexist with hope

If you’re a recovering control freak like I am, acceptance might still be a bit confusing or unintuitive for you.

It was instrumental for me to work with a mental health professional who was trained in ACT to help me apply these principles to my life.

At first, it felt like acceptance was letting go of hope. This was one of my biggest stumbling blocks. However, I’ve learned that making space for the present moment does not preclude hopes for a potentially brighter future.

For example, I can honor my present RA flare-up, and the pain and uncertainty it brings, while still holding hope for remission or better disease control in the future. But if I only focus on a potentially better future, I will miss out on all that’s available to me now.

Although I fought against acceptance at first ⁠— and honestly still fight against it during my harder moments ⁠— it has opened up a more rich and joyful existence. I encourage you to consider what it could do for you as well.