A Discourse on Dialectics: Balancing Acceptance and Change During COVID-19

By guest author, Natalie Grandy, Ph.D., clinical and forensic psychologist, of Premier Behavioral Health Services

I was recently asked to talk about how to cope emotionally with the turmoil that COVID-19 has created for so many people. Like a “good psychologist,” I explained the science behind the benefits of getting eight hours of sleep, balanced meals, and regular exercise on mood. I spoke of the need to engage the mind in meaningful distractions—hobbies, books, and visits with loved ones (albeit, remotely). I encouraged spending time outdoors, citing some research that I had recently read with excitement about the psychological benefits of being mindful of the sights and sounds of nature.

To my dismay, I found that the more I spoke about these strategies, the greater the resentment I felt oozing from my questioner. “But I’m scared,” she said. “I don’t know if I’ll have a job to go back to and my parents are life-long smokers; what if they get this?” She went on to describe her fear for the health and safety of her loved ones, her frustration with her spouse and kids from whom there was no escape, job insecurity, anger at the lack of preparedness for a pandemic of this scale, and feelings of helplessness. What she was saying to me was, in essence, “I’m telling you that I’m scared and angry and you’re telling me to brush it off and go for a walk.” She wanted her feelings accepted and validated and what I gave her were ways to change her feelings. I blundered right into the middle of a battle ground where two forces, well known to those who work in behavioral health, were coming to blows.

For a long time, psychologists struggled with this tension between the human need for acceptance and the logistical need for changes in behavior, thoughts, and feelings in order for growth to occur in our patients. The humanists said (and this is a vast simplification), “if you validate and accept patients just as they are, they will grow into the truest and best versions of themselves.” Meanwhile, the behaviorists saw problems with motivation and bad habits and sought to change the ineffective patterns of behavior—never mind the “why” or the feelings behind the behavior.

Enter Marsha Linehan, a psychologist who developed what is now one of the most widely researched and efficacious therapy modalities for treating a host of mental illnesses, including mood, anxiety, and personality disorders: Dialectical Behavior Therapy (or DBT). DBT is a skilled-based approach of helping patients identify and manage their emotions effectively. Although the term “DBT” has broken into popular discourse, nearly at the ranks of its popular predecessor, CBT (or cognitive-behavioral therapy), I am often struck by the number of people—even those who have benefited from the therapy—who are unfamiliar with what “dialectics” really means.

Dialectics, in a nutshell, is the idea that we can hold seemingly opposed truths together at the exact same time. Linehan has explained dialectics by posing this seemingly straight-forward question:

What do you get if you combine black and white?

You would be right if you felt that the answer, “gray,” was too simple. As Linehan explained, from a dialectical approach, when you combine black and white, you get plaid. Rather than black and white coming together to form some third, discrete category of hue (i.e., gray), the black and the white remain unchanged while they come together into the same space.

The idea of holding opposing truths together is uncomfortable for human beings. We have evolved to view ambiguity as inherently threatening. In particular, those of us who might tend to be more highly anxious in general like for things to be one way or another. Therefore, we like to make statements such as:

“I’m not a morning person”

“I hate my job”

“I can’t get along with my mother”

“I can’t stand my husband right now.”

While these kinds of categorical statements aren’t “pleasant” per se, they create a sense of certainty about the world—a road map of what we can expect from ourselves and others. To be fair, most of the time viewing the world in these overly simplistic terms is expedient and not a major hindrance to our overall well-being. But it is vital to recognize that they do not reflect the full, dynamic nature of reality. Consider the following dialectical modifications to the statements above:

“I tend to be more alert in the evenings and I am able to get up and get moving in the mornings when I need to.”

“I hate my job and I am grateful to have a job.”

“I don’t agree with my mother on most things and I understand why she feels the way she does.”

“I love my husband and I can’t stand him right now.”

Using dialectics is less of a skill, per se, and more of a learned way of thinking, which admittedly takes some effort at first. But learning to be dialectical can provide a sense of freedom as it can help us dislodge ourselves from false dichotomies. I can both be furious with you and want you to comfort me. I can accept that I have a lot of shortcomings and work to improve those aspects of myself. I can be irritated that my spouse is never on time while also accepting that this is a long-standing part of his personality that probably won’t change. I can be angry at my mother and recognize that she did not intend to harm me. We all hold within us enough room for multiple truths and emotions to co-exist.

I have been thinking about dialectics quite a bit in recent weeks. In working (remotely) with my patients and listening to their reactions to the very real struggles of daily life in the wake of COVID-19, I find that at least once a day I am having discussions about how adopting a more dialectical attitude can be useful in managing relationships and building compassion for themselves and those around them. The following are some general examples of what I mean here.

You can both be thankful to have a job, recognizing that many people have lost theirs, and hate having to work from home.

You can be grateful that your family is safe and be frustrated by them.

You can hate that this pandemic is happening and recognize that some positive changes may arise from it.

You can be angry because you see someone not wearing a mask and accept that they may have a valid reason for it.

You can be frustrated that your favorite bars and restaurants are closed and be in support of social distancing measures.

You can grieve that you had to reschedule your wedding and also find meaningful ways to commemorate the would-be date.

You can hate that this pandemic is happening—you can be angry and scared and have all of the other unpleasant and completely valid emotions that go along with this kind of uncertainty—and you can take control of those things over which you have some power. I urge all of you taking the time to read this: Allow yourself to be scared and get daily exercise. Recognize your anger and start reading a new book. Grieve the experiences you are losing out on right now and have a game night with whoever you have in your household. You have enough room within you for acceptance and for change.

*If you would like help in managing your emotional well-being, please contact Premier Behavioral Health Services at 440-266-0770 for a same-week remote appointment.