Extant research in humanistic psychology and positive psychology emphasizes the role of human strength in personal growth and development (Bauer et al., 2015; Greene & Burke, 2007; Meyers et al., 2015; Passarelli et al., 2010). It is believed that everyone has the potential to achieve excellence, which determines their worth as an individual. As a social animal, every human being has an innate desire to be loved, respected, and approved by others. Being loved and appreciated makes people happy and adds meaning to their existence. However, failure to receive these often leads to self-doubt and despondency. In such situations, people blame time, luck, and life instead of recognizing and appreciating their unique individuality. Furthermore, people tend to compare their lives with others which can be detrimental to one’s experience of worthiness and wellbeing. Often, individuals set their standards for success and failure in a way that imitates the glamorous world in which they live and refuse to accept mediocrity. As a result, the average has become a new standard of failure. Furthermore, when people fail to meet their self-set standard of success, they start questioning their self-worth instead of accepting reality and improving their condition. In this context, Manson (2016) has suggested that great and successful people have accepted mediocrity and worked tirelessly to improve themselves and their lives (p. 62). Accepting reality may appear challenging at first, but it is a precursor to self-improvement and emotional wellbeing (Hayes et al., 2004; Roger, 1959).

With the changing world, academics’ attention has shifted to the phenomena that contribute to promoting wellbeing. Wellbeing is a combination of positive emotions, engagement, relationships, meaning, and accomplishments (Seligman, 2002). In this paper, wellbeing refers to the presence of healthy emotions, the ability to recognize one’s potential, the ability to manage difficult life events, and a sense of purpose. Unlike conventional psychology, contemporary psychologists are increasingly interested in investigating the importance of human strengths in maintaining wellbeing. In psychological research, several constructs are considered predictors of psychological health and wellbeing. Self-esteem (Awan & Sitwat, 2014; Paradise and Kernis, 2002), spirituality (Awan & Sitwat, 2014), and resilience (Kumar & Singh, 2014; Vinayak & Judge, 2018) are some of the frequently studied constructs. Unconditional self-acceptance (USA) is one of the least studied constructs that determines wellbeing. Self-acceptance is an age-old concept used as an intervention technique for treating patients with borderline personality disorders during the Buddhist period (Bernard, 2013). Modern psychologists have investigated the Buddhist notion of radical self-acceptance further, emphasizing the significance of self-acceptance in leading a happy and tranquil life. In addition, it is a well-known concept in humanistic psychology. Humanistic psychology is the first branch of psychology that emphasizes the value of human nature and believes that humans are fundamentally good. Eminent humanistic psychologists such as Maslow and Roger have mentioned self-acceptance in their theories and discussed its importance. According to Maslow’s theory, radical self-acceptance helps individuals move beyond self-actualization or selfless-actualization. It is marked by selflessness, expanding beyond oneself, and caring for others and society (Greene & Burke, 2007). Similarly, according to Roger (1995) self-acceptance helps in realizing one’s full potential. Given the importance of self-acceptance in self-development, it is worthwhile to gain a thorough understanding of it. We begin this article by discussing the concept of self-acceptance as it is reflected in Buddhism and humanistic psychology. Then we investigate self-acceptance as a predictor of psychological functioning and overall well-being.

Buddhist Perspective on Self and Self-Acceptance

In Buddhism, the term atman indicates the self, which has been considered illusory (Maya) in nature. It refers to one’s soul (Rāhula, 1974, p. 63). It believes that there is no such separate self. The self or atman is a derivation of five aggregates or skandhas, which include a person’s form, sensations and feelings, perception and understanding, mental development and volition, and consciousness (Lu, 2022; Rāhula, 1974, P. 30). Divine energy helps to create and maintain the self (David et al., 2013b). According to karma, a self or soul is a dynamic physical or mental energy that begins a new existence in a new body after death. These karmic imprints are known as samskaras (reincarnation) in Buddhism. To avoid this karmic imprint from being passed down from one life to the next, Buddhism encourages people to achieve nirvana. Nirvana is a state of enlightenment, peace of heart and mind, end of suffering and the life cycle (David et al., 2013b). It refers to “a decentration of the self, a profound acceptance of existence, a sharpened attentiveness to all of one’s mental and physical activities, freedom from identification with states of greed, hatred, and delusion, and deep compassion for one’s fellow beings” (Segall, 2003). People in pursuit of Nirvana learn to detach themselves from the material world that they believe is illusory and work toward living a tranquil and harmonious life.

Although Nirvana is the end of suffering, people still tend to identify their existence with success and good things. According to Buddhism, labeling any event or thing as good or bad inhibits individuals from confronting and experiencing them. Fear of failure and avoidance of so-called good or bad things might limit people’s ability to live a richer life. Conversely, the ability to accept things regardless of their nature helps guide people’s responses to bad situations and makes people open to experiencing them (David et al., 2013b). In Buddhist scripture, it is always encouraged to realize that suffering is an inherent aspect of existence that can result from different aspects of one’s life or the inability to achieve nirvana itself. However, one can avoid emotional attachments and thus suffering by formulating rational and flexible desires and accepting the impermanent nature of things, including people. Radical acceptance of different life experiences helps develop a better sense of self.

Humanistic Psychology and Self-Acceptance

Unlike earlier schools of thought, which focused on the negative aspects of human life while ignoring the positive aspects, humanistic psychology focuses on human strengths. It recognizes the inherent goodness in every human being (Maslow, 1991). Maslow and Roger, two well-known humanistic psychologists, have extensively focused on the self. Although other psychologists from this school have spoken about the self, we will focus on Maslow and Roger’s perspectives on the self in this article.

Self-Acceptance in Maslow’s Theory

Abraham Maslow, one of the humanistic psychologists, has worked extensively on the hierarchy of needs. He has organized human needs into a hierarchy, at the bottom of which is the need for food, safety, and social needs. As human beings progress from basic needs to growth needs, they seek respect, appreciation, and recognition before reaching the highest need called, self-actualization. Self-actualization refers to realizing one’s full potential and making the best use of that potential to make life worthwhile. Self-actualized individuals acknowledge and respect individual differences without holding any grudge against people. It has been claimed that by reaching the peak of the pyramid, one can achieve complete acceptance of oneself through self-disclosure (Greene & Burke, 2007). Self-actualized people have a positive view of themselves, and they value their individuality. Realizing various facts about oneself, such as one’s strengths, flaws, likes, dislikes, etc., can lead to self-understanding and allow an individual to achieve radical acceptance of oneself (Hoffman et al., 2013). Radical self-acceptance enables people to develop an empathetic and compassionate attitude toward others, which further helps improve interpersonal relationships (Scherman, 1981). Additionally, it is a step toward self-transcendence or selfless actualization (Green & Burke, 2007).

Self-Acceptance in Roger’s Theory

According to Roger (1959), individuals have ingrained actualizing tendencies characterized by growth and autonomy that serve to enhance or maintain the individual. Roger termed this as fully functioning human being. He believed that positive regard is essential for being an actualized person. Positive regard refers to positive attitudes toward others, such as sympathy, acceptance, liking, and warmth. According to Roger (1959), when people receive conditional positive regard, i.e., internalizing that some experiences are rewarding and others are not, they develop conditions of worth (assessing that only some experiences are worthy of positive self-regard). In contrast, when people obtain unconditional positive regard from their significant others, it helps them to improve. Unconditional positive regard refers to accepting others for who they are, in a nonjudgmental way (p. 209). Roger believed that the more unconditional positive regard people receive, the more likely they are to be fully functioning persons. According to Roger (1959), a “fully functioning person is synonymous with optimal psychological adjustment, optimal psychological maturity, complete congruence, complete openness to experience, and complete extensionality” (p. 235). Furthermore, he claimed that a fully functioning person constantly grows and develops (Roger, 1959).

Roger (1995) believed that self-acceptance opens the door to learning about others and life. It enhances self-awareness by assisting people in comprehending their attitudes, feelings, and thoughts. Self-acceptance and acceptance of others broadened people’s mindsets and enabled them to see the reality of life. Moreover, self-understanding and self-acceptance promote constructive changes in people and make them less defensive against a threat. Additionally, accepting one’s shortcomings and mistakes can be influential and motivate others to change their attitudes and behaviors. For that reason, Roger claims that “transformation happens nearly unnoticed with self-acceptance” (Roger, 1995).

Rational Emotive Behavior Therapy (REBT) and Self-Acceptance

The importance of self-acceptance has been highlighted earlier in this paper. However, Albert Ellis, the founder of REBT, has extensively studied the construct of unconditional self-acceptance (USA). In his therapeutic approach, USA is used as an alternative solution to the irrational belief known as global self-evaluation (Ellis, 2005). Global self-evaluation is the evaluation of a person’s total being or self, which can be positive or negative. It is also known as self-esteem or self-rating. Self-esteem is an evaluative aspect of self-concept and one’s overall sense of worthiness (Blascovich & Tomaka, 1991; Rosenberg, 1965). According to Ellis (2005), self-evaluation is an ingrained human tendency in which people rate their total self (worth or value) in terms of their success, their relationship with others, and winning approval from significant people (p. 14). A positive evaluation of the self occurs when people meet their standard of success or goodness (related to different aspects of life), which results in high self-esteem.

On the other hand, when people experience failure and/or disapproval from their significant others, they engage in negative self-evaluation, leading to low self-esteem (cited in Ellis, 2005, p. 37). Empirical studies have found that high self-esteem is related to different positive life outcomes (Aboalshamat et al., 2017; Campbell & Lavallee, 1993; Mann et al., 2004). Additionally, psychologists such as Braden (1969) claimed that self-esteem is always positive, and one cannot have enough self-esteem. However, it has been argued that the value derived through self-evaluation makes one’s sense of worth conditional. In self-esteem, people regard themselves only when they succeed and condemn themselves during failure; therefore, it is also considered conditional self-acceptance (Ellis, 2005). In REBT, any level of self-esteem is considered dysfunctional and illogical, which can promote psychological dysfunctions. While low self-esteem is associated with the feeling of worthlessness, high self-esteem can increase the fear of failure, which can cause anxiety (Ellis, 2005, p.14). Furthermore, when individuals’ values depend on their accomplishments, they become less tolerant of negative feedback and criticisms (Baumeister & Tice, 1985). This happens because they consider unfavorable feedback a threat to their self-esteem, which can generate adverse reactions such as aggressive behaviors (Papps & Carroll, 1998).

Therefore, to avoid the negative consequences associated with self-evaluation and address the problems of self-worth, REBT encourages clients to practice USA. REBT primarily suggests two approaches to teaching USA. The first approach is the philosophically elegant solution to the problems of self-worth or self-esteem. According to this approach, value or worth is meaningless and invalid when applied to a person’s being or self. It believes that the human self is unique, complex, fallible, and in flux (Dryden, 2013; Ellis, 2005). Moreover, evaluating people’s worth based on their traits or actions is highly illogical because often, these traits are not stable (Ellis, 2005, p. 59). It encourages individuals to separate their global self from their deeds. Apart from this, this approach encourages clients to have no self-images, give up all self-rating ideas, and choose unconditional acceptance of one’s being and existence. It is argued that USA can protect individuals from the emotional disturbances caused when one’s self-esteem is threatened (Ellis, 2005, p. 44; Mills, 1993). According to Ellis (2005), USA is “the individual fully and unconditionally accepts himself, whether or not he behaves intelligently, correctly, or competently, and whether or not other people approve, love, and respect him.” It is a rational choice that people make based on the complexity and variability of human nature. Although REBT practitioners recommend following the elegant approach, it can be challenging to convince clients to give up their egos and believe that their self is too complex to have worth or value (David et al., 2013a; Mills, 1993). Therefore, to help clients, REBT offers another practical solution, considered an inelegant approach. Unlike the elegant solution, in this approach, clients were encouraged to evaluate their value on the basis of a safer and more stable standard, such as their existence. Through this approach, clients learn to value themselves because they exist; they are alive and human (Ellis, 2005; Mills, 1993). Thus, when clients encounter a failure in the future, they will rate only their performance instead of their total self.

Acceptance in Different Therapies

The use of acceptance in treating psychological dysfunctions is evident from the previous sections of this paper. Apart from those, different third-wave psychotherapies include acceptance in their intervention to reduce negative experiences and promote a meaningful life. In this section, we will discuss the use of acceptance in Acceptance and Commitment Therapy (ACT) and Dialectical Behavior Therapy (DBT) as well as how they are similar to or different from the acceptance used in REBT and humanistic theories.

Acceptance in Acceptance and Commitment Therapy

ACT is a mindfulness and acceptance-based intervention approach, that views human suffering as a result of psychological inflexibility, caused by cognitive fusion and experiential avoidance. Cognitive fusion refers to equating one’s thoughts with reality. Experiential avoidance on the other hand, is an attempt to avoid or escape unwanted private experiences. Private experiences are one’s thoughts, feelings, memories or physical sensations (Levin & Hayes, 2011). ACT interventions primarily aim to develop psychological flexibility and a meaningful life (Harris, 2006; Hayes et al., 2004). It refers to being fully conscious of the present moment, being aware of one’s private experiences and the ability to modify behaviors to support one’s value (Hayes et al., 2004). Acceptance is one of the six fundamental processes used to establish psychological flexibility in ACT. In ACT, acceptance is used as an alternative to experiential avoidance. It refers to the willingness to actively embrace the private experiences as they occur at the present moment without judgment or attempt to control or escape from them (Hayes et al., 2004; Twohig, 2012). In this context, acceptance refers to consciously choosing actions that align with what matters to the individual (Jeffcoat & Hayes, 2013). The ACT’s notion of acceptance and REBT’s idea of USA share some commonality in terms of being aware of reality and acknowledging it. However, the application of acceptance in both therapies is different. ACT uses acceptance to avoid the compounding harmful effect of experiential avoidance whereas REBT uses USA as an alternative for global self-rating. In REBT, the individual chooses USA because he or she acknowledges that the self is complex, unique, and fallible.

Acceptance in Dialectical Behavior Therapy (DBT)

DBT is a subset of cognitive behavior therapy (CBT), developed by Marsha Linehan. The term dialectical refers to bringing two opposites together in treatment. DBT’s dialectics are acceptance and change (Dimeff & Linehan, 2001). The concept of acceptance in DBT is derived from Roger’s client-centered therapy and the Buddhist ideas of non-attachment (Dimeff & Linehan, 2001). DBT therapists primarily employ acceptance in two ways. First, the therapists use the Rogerian idea of acceptance to convey unconditional acceptance for patients in a nonjudgmental manner (Dimeff & Linehan, 2001). In DBT, the therapist uses acceptance as a validation strategy to validate the patients’ feelings and emotional reactions (Robin & Rosenthal, 2011, p. 171). The second method is acceptance used by the patients. Acceptance used by patients is mainly inspired by the Buddhist notion of acceptance. It is used to help patients acquire greater acceptance of self, others, and life. The context acceptance used in DBT is mostly similar to that used in ACT. Both therapies practice acceptance to prevent experiential avoidance. Additionally, DBT therapists promote acceptance because the circumstances are beyond one’s control or impossible to change (Robins & Rosenthal, 2011). In the context of REBT, it encourages practicing unconditional acceptance due to the complex nature of human beings and the transient nature of life. USA is used because it considers global self-rating illogical and detrimental to wellbeing. Moreover, clients who practice USA consequently acquire unconditional other acceptance (UOA) and unconditional life acceptance (ULA).

The Rationale of the Study

We discussed the importance of USA in maintaining emotional stability earlier in the REBT section. Despite the importance of USA, there are a relatively limited number of studies available. Researchers have opined that lack of standardized instruments to assess USA could be a reason for this (Blascovich & Tomaka, 1991; Davies, 2006). We have mentioned earlier that USA is a rational belief used against global self-evaluation. Over the years, many psychometric measures of rational and irrational beliefs have been developed to understand the cause of emotional disturbances (DiGiuseppe et al., 2018; Gavit et al., 2011; Macavei & McMahon, 2010; Mogoase et al., 2013). However, most of the scales measure only the irrational side of thinking and have been criticized for ignoring the rational part of belief (Shorkey & Whiteman, 1977; Lindner et al., 1999). In order to overcome this limitation, many other scales have been developed, including both rational and irrational items (DiGiuseppe et al., 2018; Gavita & Duta, 2013; Gavita et al., 2011; Mogoase et al., 2013). Despite various measures, only a few psychometric instruments involve USA (Chamberlain & Haaga, 2001; David et al., 2013a; DiGiuseppe et al., 2018). The “unconditional self-acceptance questionnaire (USAQ)” by Chamberlain and Haaga (2001) is the most frequently mentioned scale in the literature. However, this scale has been criticized for lack of construct validity, i.e., the scale items are contaminated with self-esteem. Therefore, the findings of the studies that used USAQ are questionable.

Defining a construct is crucial for scale construction (Dawis, 1987). It not only helps to understand the construct but also helps in item generation. All the literature on USA is based on REBT theory; thus, existing measures have used Ellis’s definition of USA (see REBT section) to generate the scale items. None of these scales have given any operational definition for USA. Although Ellis’s definition seems adequate, there is a need to discuss this definition more deeply, which will add more insight, hence the construct can be better understood without any confusion. Most of the existing literature either focuses on identifying its relationship with neurotic symptoms (Chamberlain & Haaga, 2001; Cihuan & Dumitru, 2017; Scott, 2007) and other aspects of human beings (Chamberlain & Haaga, 2001; Jibeen, 2017; MacInnes, 2006) or discusses USA in relation to other theories (Hoffman et al., 2013; David et al., 2013b; Jeffcoat & Hayes, 2013; Nielsen et al., 2013). In the present study, we aim to bring more clarity to the existing definition of USA by discussing different aspects and the nature of USA.

Why a Qualitative Study?

The primary objective of qualitative studies is to understand phenomena, experiences, and concepts that have not been studied in depth (Billups, 2019; Cleland, 2017). It allows deeper understanding of different people’s experiences and perspectives on a particular topic (Hammarberg et al., 2016; Mohajan, 2018). It is a highly effective method for studying phenomena or contexts which are hard to understand through numbers. Furthermore, data collected through qualitative techniques are more authentic because they are based on firsthand observations and human experiences (Billups, 2019). Since a sound psychometric tool for conducting empirical studies on USA is yet to be developed, the present study adopted a qualitative approach to unravel the nature of USA and obtain an in-depth understanding of unconditional self-acceptance. The qualitative techniques used in the study have been discussed in the methods section of the paper.

Method of Study

Participants

Although USA is one of the rational beliefs and a key concept of REBT, individuals with proper training in REBT were limited within our reach. We approached a few academicians who are well conversant with REBT; however, they could not come on board due to the paucity of time and resources. The role of acceptance in various therapeutic approaches has been discussed earlier in this paper, and keeping the time frame in mind, we included mental health professionals (psychotherapists) in our study as the participants. The inclusion criteria involved a minimum two years of experience in psychotherapy, and participants must have a professional degree in any psychotherapy.

The participants in the current study were selected using a purposive sampling technique. Initially, we approached 21 participants; however, eleven participants declined to participate for various reasons. The remaining ten participants agreed to participate in the study (N = 10, male = 3, female = 7, Mage= 38.9 years). All of the participants in this study were Indians residing in India. Nine participants had professional degrees in psychotherapy, except for one academician with great interest in humanistic psychology. The educational qualification of the participants was a Master of Philosophy (M.Phil.) in clinical psychology, counseling psychology, and a Ph.D. in psychology. Since the present study included mental health professionals with expertise in psychotherapy, we tried to incorporate participants practicing different types of psychotherapy. The participants of the present study are practitioners of different types of cognitive behavior therapy (CBT), REBT, and humanistic psychology. Three participants in this study said they follow only one therapeutic approach, while the majority claimed to employ multiple therapeutic methods depending on the client’s problem. Five participants claimed that they predominantly use CBT along with dialectical behavior therapy (DBT), mindfulness-based therapy (MBT), and emotion focused therapy (EFT). Four of the participants said they primarily use client-centered therapy and REBT. In addition, participants mentioned that sometimes they combine different approaches to help their clients. Although the participants included in the present study are not specially trained or certified in REBT, most of them admitted that they use different techniques of the REBT approach in therapies.

Ethical Consideration

The present work was approved by the Institutional Human Ethics Committee. Before beginning the data collection, participants were debriefed about the objective of the study and the process involved. A soft copy of the research participant and informed consent form was sent to the participants prior to the data collection. All the participants read and understood the consent form. Verbal consent was obtained from all the participants. Anonymity and confidentiality of information shared by the participants were assured.

Data Collection

The current study employed the interview method to collect the data. Due to the pandemic and countrywide lockdown, telephone and online interviews were conducted. Interviews were conducted individually at the convenience of the participants. A semi-structured questionnaire was used (see Table 1) for the interviews. The first author conducted and transcribed the interviews. Each interview session lasted until data saturation, when there was a repetitive response, and no new information emerged (Polit & Beck, 2006). All the interview sessions were audio-recorded with the permission of the participants to avoid missing any important information.

Data Analysis

For data analysis, a manual coding technique was employed. Data were analyzed using content analysis and thematic analysis techniques. Different colors were used to create codes and to avoid confusion. Frequently mentioned terms, contexts, and phenomena were used as references for generating codes. In order to create the major themes, coding was performed in two stages by following the methods given by Charmaz (cited in Nyumba et al., 2018). After reading the transcripts thoroughly, a large number of codes (labels) were generated on the basis of frequently mentioned responses in the first stage. For this purpose, one question was considered at a time for the analysis. The number of words in the participants’ responses ranged from 44 to 385 (M = 178, SD = 88). The second stage of coding involved more precise and organized coding. In this stage, major themes were generated by examining the codes generated in the first stage. The relationship between different codes and possible categories in which themes could be combined was observed in the first stage. In the second stage, different codes with common properties were combined into the same themes. In this way, a total of three themes emerged.

Data Trustworthiness

Data trustworthiness of the present study was examined using member checking and peer debriefing techniques by Creswell and Miller (2000). Moreover, supportive evidence from the literature was used as a triangulation technique to validate the themes. Peer debriefing was done by providing the transcripts to the second author. Since the first author had conducted the interviews and formulated the themes, to avoid researcher bias and establish the reliability of the data, the second author analyzed and coded the transcript separately. The codes generated by both authors were discussed, and only the common themes identified by both authors were included in the final result. For member checking, after the final data analysis, major themes were discussed with the participants individually, and required changes were made.

Table 1 Semi-structured questionnaire for the interview
Full size table

Results

Three major themes emerged from the data (self-awareness, a positive attitude toward self and others, and social comparison). In this section, USA has been discussed through the themes or domains derived from the data. In other words, we tried to explain the nature of USA on the basis of the emerged themes.

Self-Awareness

From the interviews, a pattern of responses emerged that represents the consciousness of strengths, weaknesses, and an understanding of self, including thoughts, emotions, and actions. We termed this component self-awareness. A participant stated, “USA is accepting oneself as it is through self-realization (Participant:7).“ People with a high level of USA are aware of different aspects of their lives, including positive and negative aspects, and accept them without condemnation. According to one participant, “People who have USA are aware of themselves, which gives a holistic picture of themselves. They know their strengths and limitations and strive to improve them (Participant: 6).“ Self-awareness is fundamental to acceptance, followed by change. One cannot show acceptance of a mistake unless he or she recognizes the mistake. Furthermore, one cannot improve unless he or she recognizes the need for improvement. This statement is consistent with the view that change happens through USA (Dryden et al., 2013; Roger, 1995). In this way, self-awareness disproves the common misconception that USA promotes complacency and resistance to change. This component of USA also inhibits people from overidentifying themselves with their thoughts, emotions, and actions. It encourages them to work on their flaws. Conversely, a lack of self-awareness can lead to grandiose feelings. “When people have little or no self-realization (behavior, thoughts, emotions) they are more likely to feel superior to others, which leads to resistance to change (Participant:3).”

The importance of self-awareness is indeed critical for a better understanding of the self. It has been addressed by many prominent psychologists before. According to the existentialist perspective, as self-awareness helps understand the self, it plays a crucial role in channeling the evil part of the self in a constructive way (Hoffman et al., 2013). Consciously differentiating and admitting negative tendencies is a sign of authenticity toward the self. According to Diamond, this is an “invaluable blessing of freedom, vigor, inner strength, and self-acceptance (excerpted from Hoffman et al., 2013).” One of the participants confirmed this, saying, “USA is to be truthful and genuine about oneself (Participant: 9).” Additionally, self-awareness was also equated with openness to experience, a term given by Roger (1959). The term experience refers to bringing awareness to everything present in a person’s life. Openness to experience makes individuals trust their senses and instincts even when their experience contradicts their beliefs, and they accept it (Roger, 1959). Openness to experience has been considered the polar opposite of defensiveness, which is the tendency of individuals to protect themselves when things do not align with their perceived standard of worth. Awareness brings out a person’s genuineness and makes them more receptive to new experiences. Furthermore, it helps deal with hardships and sufferings without jeopardizing one’s sense of self (Roger, 1963). As a result, it can be concluded that self-awareness is a crucial component of USA.

Positive View Toward Self and Others

The second theme we found is that people who accept themselves unconditionally have a more positive view of themselves. As previously discussed, self-awareness leads to a better understanding of self; it helps in understanding the underlying causes of an individual’s behaviors and the consequences associated with them. In contrast, a lack of self-understanding accelerates feelings of inadequacy and self-rejection. A better understanding of self not only protects against critical self-judgment but also fosters a compassionate attitude toward oneself. According to a participant, “In USA, you are aware of yourself, you love, respect, and accept yourself (Participant:6).” People who have USA internalize the fact that humans are fallible, and as a result, they accept that mistakes and failures are a part of life. Understanding the unpredictability and complexity of human beings promotes acceptance and compassion. Additionally, it encourages people to learn from their mistakes and failures.

USA is associated not only with a positive attitude toward oneself but also with a positive attitude toward others. One of the participants stated, “People who have USA have an optimistic view of themselves and others (Participant: 1).” They tend to perceive negative feedback with a positive attitude. Their self-understanding fosters empathy by relating themselves to others. It replaces rudeness with kindness and conceits with humility, which helps develop healthy interpersonal relationships. According to a participant, “Empathy is an important component of USA because when people accept themselves unconditionally, they are more likely to accept others by putting themselves in others’ shoes, which promotes a stronger bond between individuals (Participant: 8).” This finding is consistent with previous results that suggest a positive relationship between attitudes toward self and others (Phillips, 1951). Furthermore, previous evidence suggests that acceptance and respect for oneself are positively related to acceptance and respect for others (Berger, 1952; Sheerer, 1957).

Social Comparison

The last pattern of response was related to social comparison. Social comparison is a phenomenon in which people judge their value by comparing themselves to others. Considering the evaluative nature and fallibility of human beings, by engaging in social comparison one can put his or her ego under risk. Social comparison and conditional acceptance are two sides of the same coin. According to a participant, “People frequently fail to accept themselves unconditionally as a result of hierarchical consciousness (Participant: 10).” In this context, hierarchical consciousness refers to a tendency to rank everything from individual to the collective level, including human existence. Furthermore, people assign a scale of positivity to negativity to categorize everything, deciding that success is positive and failure is negative, that fair is beautiful, dark is ugly, and so on. This hierarchical consciousness is often based on social comparison, in which people use previously established social standards to evaluate their worth. It often happens when people lack self-awareness and as a result, are unable to look within and understand what they value. In such a situation, people start comparing their lives with others and try to imitate others’ lives that they believe to be perfect. Social comparison not only promotes self-doubt but also limits one’s ability to appreciate the beauty of life’s uniqueness. This may further manifest in various psychological dysfunctions, leading to self-defeating behavior.

While anyone of any age group can be a victim of the consequences of social comparison, adolescents are particularly vulnerable. One of our participants who works with adolescents highlighted the possible impact of comparison from her therapeutic experience. According to her, “Adolescents often try to fit into certain groups, e.g., cool, smart, rich, intelligent, and so on, by engaging in social comparison, which many times leads to self-harming and antisocial behavior, and sometimes can lead to suicide (Participant: 4).” In contrast, acknowledgment of the self and lack of judgment are less likely to be associated with social comparison. It is noteworthy that individuals who accept themselves unconditionally may draw inspiration from others and strive towards personal growth and development rather than comparing themselves with others. They do not necessarily engage in global self-rating. According to another participant, “People who have USA are self-aware, and it occurs within oneself. Here, people are not comparing or competing with others (Participant: 2).” According to Ellis (2005), they understand that their total self is beyond their actions, thoughts, and feelings; thus, they do not seek others’ love, respect, and approval to feel worthy.

Discussion and Conclusion

USA is crucial for mental health, especially in the current competitive world, where people have a hard time understanding their value. The pressure of being successful and the fear of missing out are highly evident among people, leading to inadequate feelings and self-rejection. Given the importance of USA in the context of mental health and wellbeing, the current study began to understand the nature of USA. According to the findings of our study, we identified three major themes related to USA. First, the self-awareness aspect of USA refers to being aware of various aspects of oneself, which promotes better self-understanding and self-realization. Second, a positive attitude toward self and others helps develop empathy and fosters interpersonal relationships. Finally, we discussed USA in relation to social comparison, where people might get inspired to work toward self-growth and development. They do not necessarily engage in social comparison. Our findings support previous research evidence and Ellis’s viewpoint on USA (2005). Furthermore, based on the literature on USA and our findings, we propose the nature of USA as follows:

  • USA involves considering oneself beyond one’s accomplishments and failures. It is to understand that one’s self-worth is not dependent on the approval, love, and respect of others.

  • One’s social status, identity, race, physical appearance, failures, and achievements do not define one’s value. Every person is valuable simply because they exist.

  • USA refers to being aware of both positive and negative aspects of oneself, such as thoughts, feelings, emotions, and actions.

  • It refers to recognizing strengths and weaknesses and trying to improve them rather than being complacent about them.

  • USA acknowledges that humans are unique and prone to making mistakes; thus, rather than dwelling on flaws and failures, the best thing one can do is to accept one’s flaws and mistakes.

  • It entails respecting and accepting oneself as one is.

  • One might get inspired by others and strive toward development without giving a global self-rating.

Although a few measures of rational and irrational beliefs include self-acceptance as a subscale, the USAQ is the only instrument that exclusively measures self-acceptance. Existing instruments, including the UAQ (David et al., 2013a), the measure of rational and irrational beliefs (DiGiuseppe et al., 2018), and the USAQ (Chamberlain & Haaga, 2001) include some of the aspects of USA discussed in this study; however, none of them cover all the features of USA. For instance, the UAQ is a unidimensional scale that measures unconditional acceptance of self, others, and life. The items of this scale primarily include the second feature outlined in this paper, i.e., “Acknowledgment of one’s social status, identity, race, physical appearance, failures, and achievements.” Similarly, the measure of rational and irrational belief scale involves self-acceptance concerning achievement, affiliation, and comfort while ignoring other crucial aspects of self-acceptance such as self-awareness and a positive view toward self and others. Finally, the USAQ incorporates some features of USA discussed in the present study; however, it does not include the self-awareness component. Concepts such as the USA are often assumed to be understood and not explored, which leads to confusion in understanding and operationalizing such constructs. The present paper provides insight into those aspects of USA that have not yet been addressed in the literature. Furthermore, the findings of the current study contribute to the existing literature on USA by bringing more clarity to the construct. This may encourage future researchers to investigate more about USA and its relationship with various aspects of human life.

Despite its contributions, the present study has some limitations that need to be addressed. Firstly, although the participants of the present study mentioned that they use REBT techniques in their therapies, they were not exclusively trained in REBT. Furthermore, it is also necessary to conduct a follow-up study with a larger sample size, including theorists from all the major CBT perspectives, especially those who view acceptance as an essential component of their therapy. Secondly, to determine whether cultural disparities influence how people interpret USA, there is a need to include participants from different cultural backgrounds. Moreover, we conducted individual interviews in the present study to collect data. We believe a focus group discussion would have been a better approach for this purpose. Finally, in order to assess the internal validity, a psychometric instrument needs to be developed based on the present findings.