What is Acceptance and Commitment Therapy (ACT)?

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by Andrea M. Darcy

Heard of ‘ACT therapy’ but not sure what it’s all about?

What is acceptance and commitment therapy?

Acceptance and Commitment Therapy (ACT) is a form of talk psychotherapy which uses mindfulness as one of its main tools.

At the heart of ACT is the goal of helping you live a more meaningful and productive life by developing what it refers to as “psychological flexibility”.

This is essentially about learning to accept what you can’t control, and then recognising and committing to taking the actions that will improve your life and moods.

ACT therapy can be offered as either a short-term therapy or long-term therapy, depending on what your requirements are.

A brief history of acceptance and commitment therapy

ACT was created in the mid 1990s by Steven C. Hayes, Kelly G. Wilson, and Kirk D. Strosahl, and is based on Relational Frame Theory (RFT). This is a theory of human language and cognition which states that the rational skills the human mind has learned to solve problems with might work for some things, but don’t necessarily work for psychological problems.

In other words, your rational skills might solve how to handle your car breaking down on the highway, but can’t solve your heart breaking down after a relationship falls apart. When it comes to mental and emotional suffering, a new approach is needed.

Acceptance and commitment therapy is part of what is called the “third wave” of cognitive behaviour therapies. This ‘wave’ includes dialectical behavioural therapy (DBT), mindfulness-based cognitive therapy (MBCT), and then the very popular cognitive behavioural therapy (CBT).

How is ACT different than CBT?

Whereas CBT works to challenge and reduce your irrational thoughts or dysfunctional feelings which cause you to suffer, ACT instead believes that suffering is a natural part of life.

Instead of trying to change your thoughts and feelings, ACT believes that experiences should not be avoided but rather accepted.

The point of ACT therapy is not to learn to change your experience of life, but to learn to change your relationship with your experience of life. Instead of trying to get rid of difficult emotions, ACT teaches you to get to know these feelings. Then helps you to learn not to act on them or choose situations that further create them.

To accomplish such radical acceptance, ACT uses metaphors and experiential exercises. These teach you to be more flexible and less reactive to your feelings, thoughts, memories, and bodily sensations that cause you emotional distress.

Psychological Flexibility – What Does It Mean?

By: Amy

ACT coined the term psychological flexibility to describe a new and different approach to the life events and emotional states that result in suffering.

Psychological flexibility involves being present here and now, fully aware of one’s self. And it means choosing responses which lead to behaviour guided by values you have recognised as meaningful to you.

Perhaps an easy way to understand what psychological flexibility is to first look at what it is not. Or at ‘inflexibility’.

The main contributors to psychological inflexibility are:

• living in the past or the future instead of the present moment
• being “stuck” and unable to let go of thoughts, beliefs, emotions, and sensations that cause suffering (called being ‘fused’ to them)
• always trying to avoid your unpleasant thoughts, memories, and feelings, hoping that they will, somehow, go away
• being addicted to an idea of yourself, or ‘self-concept‘, always telling the same stories about yourself and your life
• not being aware of your personal values
• patterns of behaviour that keep all of the above goin.g

Acceptance and commitment therapists might explain this to you in a far easier way, by using the FEAR acronym. Your problems in life can be seen as boiling down to:

• Fusion with your thoughts
• Evaluation of experience
• Avoidance of your experience
• Reason-giving for your behaviour.

And now back to psychological flexibility. How then can one become flexible and move away from the above? By being in the moment, aware and open, and taking positive actions. The acronym here becomes ACT.

• Accept your reactions and be present
• Choose a valued direction
• Take Action.

The Six Processes of Psychological Flexibility

Let’s look at this in more detail by looking at the six core processes that create flexibility.

1. Being present.

This is about being consciously connected with events, both those things that are happening in your environment and within you. It is a process of noticing what is happening around you right here and right now, without needing to judge. Meaning you don’t compare it to the past, or predict what is next (worry about the future).

2. Cognitive Defusion.

This is the opposite of identifying too strongly with your thoughts, feelings, and memories, and assuming they are the only truth or making them real when really they are just your perspective. For example, if you feel anxious and then decide it’s because you are a weak person and hold to that, it’s what ACT would call ‘fusion’.

Defusion would be to be able to take a step back and recognise that you are just anxious. So you are going to have negative thoughts that may or may not be true, an experience that doesn’t have to define you. You learn to let thoughts come and go like clouds.

By: Randy Pantouw

3. Acceptance.

This is the exact opposite of what psychologists call ‘experiential avoidance’. Aka, trying to get away from things you deem ‘negative’.

Acceptance does not imply you just ‘tolerate’ painful and unhelpful feelings and thoughts.  It means you give such difficult thoughts and feelings some space, and don’t struggle against them.

4. Self as Context (Observing the Self).

ACT makes the difference between The ‘Thinking Self’ (also known as conceptualised self) and the ‘Observing Self’ (also referred to as ‘self as context’).

Your Thinking Self is the part of your mind which thinks, analyses, produces ideas, judgements, memories, thoughts, etc. It is based on your self-description.

Your Observing Self, on the other hand, is ever-present self, unchanging, and behind all of this analysis. It appears when you take a step back and observe your thoughts, feelings, sensations, and experiences as things that are separate.

It’s easy to think that you are only the Thinking Self, but really you are much more. And when you realise that you can lessen the control of the Thinking Self on your life.

5. Values.

These are what you truly want to be in your life — what you stand for, and how you want to spend your time in the world. They are things you always strive towards, as opposed to goals which you can achieve. In fact values could be seen as the way you want to accomplish your goals. Your goal might be to be a doctor in five years, and it would be your value to help others that drives you towards it.

[Read our article on “What Are Personal Values?” for more on this subject].

6. Committed Action.

This is action driven by recognised values. Because committed action is driven by what matters to you, it means your actions will evolve in a positive way, keeping your values in mind. When you learn to act from your values it means even if something is uncomfortable or hard, you can strive forward with self-compassion and openness.

But how can you actually achieve these six things?

ACT uses mindfulness, acceptance, and commitment as the three main tools of achieving the above.

Mindfulness involves a mental state of openness and awareness, allowing you to connect with your ‘Observing Self’. In other words, it brings you fully into the present moment. And in the present moment, unhelpful thoughts and painful emotions have less impact on how you think, feel, and behave.

Acceptance is about allowing your feelings and memories to arrive and leave without alway striving to either avoid them or control them. It’s about letting things be as they are instead of always becoming addicted to the energy of struggle.

Commitment goes back to the idea of values. When you identify your true values with your therapist you then commit to living those values in your future life choices.

Psychological issues ACT is proven to work with

Acceptance and commitment therapy is one of many therapeutic approaches which is proven by research to work (so-called evidence-based methods) with particular psychological issues, such as in this 2015 research overview led by the University of Amsterdam. It found ACT to be affective for anxiety disorders, depression, and addiction.

ACT is also considered particularly affective for post-traumatic stress disorder. Other psychological issues it can aid with include:

• obsessive-compulsive disorder
• chronic pain
• eating disorders
• addiction
• psychosis

Is Commitment and Acceptance Therapy for Me?

It can be hard when deciding to start therapy. All the different types of therapy and therapists can seem overwhelming, as can the question of long term therapy vs short term therapy, or the difference between counselling and psychotherapy.

If you have a feeling ACT sounds right for you, but aren’t sure, don’t forget that therapy is not a jail sentence! You are free to choose the therapist that works right for you, and try another therapist or form of therapy if you are very certain it’s time to move on.

Seeking to try Acceptance and Commitment Therapy in London? Call us or book your assessment now using our easy online booking tool .

Andrea M. Darcy is a mental health expert and the author of now thousands of popular online articles and webpages.