Acceptance and Commitment Therapy: An Introduction
Acceptance and Commitment Therapy (ACT) is a “transdiagnostic” therapy, which means it is effective at targeting underlying causes found in maintaining mental health difficulties, across a spectrum of diagnoses. It is also an evidence based supported treatment for mood disorders, mixed anxiety disorders, psychosis, chronic pain, and obsessive-compulsive disorder. See here.
Below is a bit more of breakdown for what ACT involves and how it might benefit you:
Acceptance: This part of ACT encourages you to acknowledge your thoughts and emotions that are present rather than to fight or avoid them. It’s about recognizing that all feelings, even difficult ones, are a normal part of life. By accepting that these feelings exist, whether we like it or not, you can reduce their power over you.
Now, acceptance does not mean agreeing with or liking every thought or emotion, but caring for ourselves through non-judgmental curiosity for what is showing up. Some emotions are reflections of a need. Other thoughts and emotions can be trauma reactions —our mind and body automatically responding to something in the present from a state of mind that showed up when we were surviving a past event. If we get halted at guilt or shame about what we are thinking or feeling, for example, we do not get to address and move through what is underneath that thought or feeling that is showing up. We can then get stuck in the mud at judgment, which can eventually fuel avoidance if whatever we are feeling/thinking is not going away with how we are currently handling it or not handing it. Whatever the cause, if we cannot in the least acknowledge a disturbing emotion/thought is present, it can be difficult to intentionally figure out what to do with it, and it may keep coming up, or entrench very rigid coping strategies that limit how we get to live our life.
Commitment: In ACT, commitment refers to setting and working toward goals that align with your values. It’s about taking action that reflects what’s truly important to you, even when faced with obstacles or uncomfortable feelings. So often the advice from others is reflective of what has worked for them, or is overly simplified. For example, some common advice for depression may be “work out, drink more water, eat more whole foods.” These are great sentiments, with truth behind them because all of these things do help regulate our mood for the better, but so often they’re missing a component on how to move towards these things. If you did want to prioritize working on being more active to help manage depression symptoms, for example, but cannot get out of bed, there may be feelings of shame for not being able to simply cognitively will yourself into action. So, the commitment component is less about “Just get out there and do it,” and more about using mechanisms within ACT to make action more accessible for where you are at in your process, towards how you want to be.
Values: Values helps clarify what matters most to you in life. So much in our society is geared towards an emphasis on satisfaction from getting to the outcome of a goal like reaching a milestone, or getting to the end of our week so we can enjoy our weekend. An overemphasis on contentment coming from reaching the outcome, however, can block our motivation when goals feel so out of reach. Shifting towards a values based perspective allows us to savour the process and find motivation within the moments between getting from point A to B. Much like we may have a New Years resolution which involves a radical habit change. When we’re fixated on goals, the moment we fall off from maintaining that change, we can feel like a failure and reinforce a sense of hopelessness. A focus on your values allows for far more flexibility around how we approach growth, providing multiple avenues for us to develop the person you want to become.
Contact with the Present: A key component of ACT is mindfulness, which involves being present in the moment. So often distress can be all consuming. Having access to connecting with our present moment can ground us in more than just that distress, or pull us back from rumination about anticipating what will go wrong in the future, or things that have gone wrong in the past. Connecting with the present allows us to come back into this moment we are existing in, which has more to offer than just the feelings and thoughts we are hooked by. Working on this mental muscle helps you become more aware of your inner experiences and less overwhelmed by them.
Cognitive Defusion: This technique helps you distance yourself from your thoughts through observing them so they have less impact on your behaviour. Instead of being controlled by your thoughts, you learn to see them as just thoughts, not as truths. Values then come in and help us determine what we do with these thoughts. First, however, we have to notice the thoughts and feelings that are jerking us around. It’s kind of like recognizing what lens in filtering our perspective as it is occurring versus looking back and being able to recognize that lens only after we’ve changed to a different filter.
Self-as-Context: Combining all these aspects of ACT together, we are better able to access the part of our selves that can be a neutral observer. A self that is able to hold nuance about ourselves. We are not just our feelings, or thoughts, or experiences. We can have thoughts we don’t like and thoughts we do like, same with emotion, and within all of us is this capacity to notice our experience and feel more empowered to act in ways that matters to us.
Overall, ACT is a practical, flexible approach that can be adapted to many contexts. It doesn’t see various emotions or thoughts as inherently good or bad, but contextual to how they interact with your actions and values. It sees most people’s difficulties coming from either fusing so deeply with a thought or emotion, or it being something that we avoid so deeply, that our resulting reactions do not take us in the direction we want for our lives.
