Acceptance and Commitment Therapy has gained lots of momentum in recent years, and with very good reason! As a Clinical Psychologist it is one of my favourite forms of therapy to do with clients! And “doing it” rather than just talking about it, is often the key to its success! It’s an action-focused experiential therapy, whereby the aim is to help people uncover what direction they want to go in, to stop running from uncomfortable experiences, and to instead start making concrete changes to improve their life!
It’s commonly referred to as ACT (pronounced like the word “Act” rather than the separate letters A.C.T) and it’s what’s known as a trans-diagnostic therapy. This means it can be applied to all sorts of problems. It’s not just suitable for one particular diagnosis or issue! In fact, many therapists would argue that the processes and skills are helpful for all of us as we navigate our way through life’s challenges!
As the name suggests, ACT is based around Acceptance (of things which are out of our control) and Commitment (towards actions which build a meaningful life). It is a practical therapy founded on six core processes which make up its ultimate goal of increased “Psychological Flexibility”.
These inter-related processes are as follows:
Contact with the Present Moment
This is about being truly present. Being mindful or aware of exactly what is occurring in the moment as it unfolds. This includes awareness of our internal thoughts and feelings as well as awareness of external stimuli and experiences. Without this awareness (and the information it gives us) most of us instead get caught up in ruminating about things that have already happened or worrying about the future. This makes it much harder to live the kind of lives we want. We’re stuck focusing our attention on things that are out of our control because either they’ve already happened and we can’t change that, or they’re not actually happening yet (and might never actually occur!)
Acceptance
This is a crucial principle that people often struggle with. ACT teaches us to stop denying, running away from, or trying to get rid of our internal experiences (thoughts, feelings, memories etc). It also teaches us that we cannot always avoid painful experiences or prevent bad things from happening to us. Acceptance of both these things frees us up to start living our lives the way we want to, even with the discomfort or pain in our life. This acceptance is not about liking or wanting these things to happen, but it is about acknowledging reality as it is, and accepting that these things are often out of our control. The more we struggle with fighting against reality (or fighting the feelings or thoughts we don’t want to have) the more stuck we feel.
Defusion
This is about “unhooking” or defusing from any unhelpful thoughts or feelings that arise, rather than letting them control us. It’s about creating some distance from them. Learning how to notice and make room for the thoughts or feelings without becoming attached to them!
The default for most of us is to treat our thoughts as facts. We then feel and behave in accordance with this. In contrast, Defusion is the process of observing our thoughts as just words or language that our mind has churned out. Recognising that we have a choice about how to respond. For example, a common thought that pops up for most of us from time to time might be the thought that we aren’t good enough. What happens next is we automatically get hooked by that thought, believe it must be true, and then we experience a variety of feelings in response - perhaps insecurity, sadness, anxiety, or shame. Being hooked by these feelings then triggers even more thoughts or painful memories along a similar theme. We might then overtly avoid doing certain things or hold ourselves back from pursuing the things we want to do. Or maybe we get so caught up inside our own heads we miss out on actually living. Defusion instead teaches us to notice or observe these thoughts, but to create enough space that we don’t have to let them dictate out actions.
Values
This is about uncovering what's truly important to us, deep in our hearts, so that these principles can guide our actions. A common metaphor is that values are a bit like a compass in that they can guide us to move in a certain direction. In ACT, values are freely chosen. This means letting go of rules, expectations, or “shoulds”, and instead, figuring out what really brings us a sense of meaning, vitality or fulfilment; even if it’s different to the way we’ve been conditioned to believe we should be living!
Committed Action
This is all about turning our values into goals, and then translating these goals into action.
Without values underpinning them, goals will often be hard to achieve. This is because without any clarity around the “Why?” our motivation will soon wane. Or even if we do achieve our goals, they will often feel unfulfilling if we have only pursued them because of a sense of obligation rather than because they are actually important to us. On the flip side though, values without any committed action can often lead to living a life that feels frustrating, depressing, or inauthentic. This is because we are stuck knowing that we want to live our lives differently but are struggling to do what it takes to achieve it. ACT helps people to make a real difference in the way they live their lives, by setting goals which are underpinned by their values, and translating them into actions they can actually implement in an effective and realistic manner.
Self-As-Context
This is often the hardest concept for people to truly grasp. Ultimately, it’s about recognising that we are not who we think we are. We are not all the things we tell ourselves. Those labels or ways we define ourselves are just powerful stories we have created about ourselves or our lives, based upon our brain interpreting our experiences a certain way. The reality is that we are so much more than our thoughts and feelings. We are the person that is having the thoughts or feelings, but we are not defined by them. We are an observer who can notice the experiences, and who can act differently under different circumstances, learning to respond with flexibility rather than assuming that what has happened before will inevitably follow again.
For example, instead of being hooked by the belief “I’m an anxious person” we would learn through ACT that we are instead a person who sometimes feels anxious, and who therefore sometimes acts accordingly. We would learn that this is not set in stone. It is dependent upon the context. There will be times we don’t feel anxious, or times we don’t behave the same way. Under different circumstances we may behave differently. We might feel different feelings, we might think different thoughts, and we might see ourselves or our lives differently. Yes, there may be repetitive thoughts or patterns we engage in, but we are still separate from these things whether good or bad. We can notice and experience our thoughts and feelings, but we are not the content of what they tell us!
There’s lots of self-help information out there which draws upon ACT’s processes, as well as a body of ever-increasing research into its effectiveness!
But if you would like to explore learning more about ACT and how it can help you build a truly meaningful life, then engaging in Acceptance and Commitment Therapy with a Psychologist or Clinical Psychologist may be a great option!