What is Acceptance and Commitment Therapy?
I consider Acceptance and Commitment Therapy (ACT) foundational to the therapeutic process and it is by far one of my favorite modalities to draw from. ACT is considered a brief intervention, meaning it does not have to take years of therapy to start making a difference in your sense of fulfillment in life. It addresses many presenting problems such as stress, anxiety, depression, trauma, OCD, addiction, and even psychosis. In addition to mental disorders, ACT is used to treat physical pain associated with some medical conditions.
No matter where you are in your therapeutic journey, ACT is helpful and it’s concepts are simple to integrate into daily life. In fact, I utilize ACT in my own life often.
I find ACT so helpful that I wanted to introduce it in a blog in the hopes that whoever comes across my website can take some skills away with them.
Brief History
Acceptance and Commitment Therapy (ACT) is a relatively new evidence-based therapy developed in the late 1980s by Dr. Steven C. Hayes. It uses principles from mindfulness, behavioral, and cognitive-behavioral modalities to increase psychological flexibility.
A very paradoxical nature of ACT is that it does not try to change you, and yet, when you commit to practicing ACT, you notice your life changes to allow you to live more in alignment with your values, and are free of the negative thoughts that cycle in your mind.
Your Thoughts Are Separate
The idea is that your pattern of thinking directly affects your mood, which then affects your behavior. So if you change your thinking or “self-talk”, you will feel better. Sounds simple, right? But I think as we all know, it is NOT that easy to change your self-talk. Sometimes, the inability to change or control your thoughts makes you feel even worse about yourself, or more hopeless about your situation.
However, if you accept your thoughts as just stories or mental events, you realize your thoughts are just beliefs you have developed, and not the absolute truth.
ACT is all about changing how you relate to your thoughts. You don’t try to stop or control them. You just learn how to observe your thoughts and emotions, without attachment or judgement.
For example, if you use ACT with the thought:
“I am boring and no one would like to be friends with me”.
First, recognize it is just a mental event and it is okay to have thoughts like this sometimes. You are human after all. You can then create distance from this thought by labeling it “thought” or “ I am noticing I am having this thought that I am boring and no one would like to be friends with me”. Notice the difference between “I am boring” versus “I am noticing I have this thought that I am boring”. This is a technique to create space between you and your thoughts and emotions. By doing this, you can then consciously choose to believe or disregard any thought that pops into your mind.
It is also useful to evaluate your thoughts as “helpful” or “unhelpful”. To determine if a thought or emotion is helpful or not, ask yourself if believing that thought will lead you towards actions that are aligned with your values. If not, it’s probably the story-telling mind taking you for a ride. We have a tendency to hold onto thoughts and emotions that are negative because we humans are unconsciously and sometimes consciously, on the look out for danger. This is something we evolved with to simply keep us alive. However, we can see how it leads to negative self-talk and an unwillingness to engaged in the activities are aligned with our values if we rigidly believed every thought that enters our mind.
You Can Choose How to Take Action
Next, you choose to commit to socializing more because it is meaningful to you to have fulfilling connections and friends, and you are important to them too.
When people believe all the thoughts that enter their mind, their thinking becomes rigid and inflexible. As a result, they stop moving towards the things they want in life that will ultimately bring them fulfillment.
If you rigidly believed the thought, “I am boring and no one would like to be friends with me” you would probably spend a lot of time alone, which only keeps you stuck in the negative pattern that rigid thought created.
You don’t have to believe every thought that enters your mind. Humans have a story-telling mind, which is neat, but we may come up with stories that are not true.
You don’t have to let your thoughts dictate or control your actions. In the example, you can choose to ignore that thought and choose to be socially engaged and live a life with fulfilling connections.
A helpful way to remember what Acceptance and Commitment Therapy is:
Accepting your thoughts/emotions and to be fully present in the moment
Choosing a meaningful direction (or acting according to our main values)
Taking action
Passengers on the Bus
A metaphor that helps illustrate the ACT model is Passengers on the Bus. You are driving a bus. In life, you will pick up passengers along your journey. Not every passenger you pick up will be pleasant. These passengers could be shame, anger, or inadequacy. You may pick up the “you’re not good enough” passenger, or the passenger that screams from the back of the bus, “what’s the point of even trying?!” There may even be a passenger with anxiety that tells you it’s safer not to drive at all.
But the point is that they are passengers. They are not driving the bus. You are driving the bus, and you get to decide where you are going in life. The passengers on the bus do not control you or how you drive the bus. You get to decide. You may not get to choose which passengers hop on the bus, but you can choose to take them for a ride.
Core Principles of ACT
Although the process of therapy looks different for everyone, ACT has six main principles to it and I have written a brief summary of each:
Contacting the present moment: therapy does delve into the past occasionally, but to develop the skills for ACT, you must start with being in the here and now. Your therapist will guide you through and teach you the mindfulness skills needed to do this. Once you learn how, you will always have the ability to bring yourself back to the present moment.
Defusion: (not a misspelling of Diffusion) this step teaches you how to separate yourself from your thoughts and emotions and observe them as mental events that you can choose to listen to or ignore. Our thoughts come and go, and we don’t need to get tangled into them.
Acceptance: by accepting difficult thoughts and emotions, rather than avoiding them, we give ourselves a chance to observe them, and accept what we are experiencing. From there, we are free to choose to take action towards what we value in life, knowing that the stories we think about ourselves are not always true or helpful, but are just a part of the human experience.
Self-as-Context: this term is referring to a self that observes or watches it’s own thoughts with full awareness of what we are thinking and feeling.
Values: knowing what we uniquely value in life is important to ACT. Our values are our compass guiding us towards a meaningful and fulfilling life.
Committed Action: guided by our chosen values, we commit to taking the steps necessary towards our own fulfillment in life.
Besides Acceptance and Commitment Therapy being effective for many presenting concerns, I love this therapeutic approach because it is collaborative, creative, and inherently empowering for clients.
