What is this thing called “ACT - Acceptance & Commitment Therapy”?
ACT - Acceptance and Commitment Therapy is a technique designed to help to accept the difficulties that come with life. The aim of ACT is to help people create a rich, full and meaningful life, while effectively handling the pain and stress that life inevitably brings.
ACT focuses on 3 areas:
Accept your reactions and be present.
Choose a valued direction.
Get out of your mind and into your life. Acceptance and Commitment Therapy is not a long-term treatment. The ACT experience of reworking the verbal connections to thoughts and feelings, known as comprehensive distancing, can be extremely helpful in the treatment of e.g. depression, anxiety, addiction and many other psychological problems.
The Six Processes of ACT [Graphic]. Retrieved from https://headsted.co.uk/static/img/act/act-processes.jpg
The goal of ACT
The goal of ACT is to create a rich and meaningful life, while accepting the pain that inevitably goes with it. ‘ACT’ is a good abbreviation, because this therapy is about taking effective action guided by our deepest values and in which we are fully present and engaged. It is only through mindful action that we can create a meaningful life. Of course, as we attempt to create such a life, we will encounter all sorts of barriers, in the form of unpleasant and unwanted ‘private experiences’ (thoughts, images, feelings, sensations, urges, and memories). ACT teaches mindfulness skills as an effective way to handle these private experiences.
What is mindfulness?
When I discuss mindfulness with clients, I define it as: ‘Consciously bringing awareness to your here-and-now experience with openness, interest and receptiveness.’ There are many facets to mindfulness, including living in the present moment; engaging fully in what you are doing rather than ‘getting lost’ in your thoughts; and allowing your feelings to be as they are, letting them come and go rather than trying to control them. When we observe our private experiences with openness and receptiveness, even the most painful thoughts, feelings, sensations and memories can seem less threatening or unbearable. In this way mindfulness can help us to transform our relationship with painful thoughts and feelings, in a way that reduces their impact and influence over our life.
What is unique to ACT?
In stark contrast to most Western psychotherapy, ACT does not have symptom reduction as a goal. This is based on the view that the ongoing attempt to get rid of ‘symptoms’ actually creates a clinical disorder in the first place. As soon as a private experience is labeled a ‘symptom’, it immediately sets up a struggle with it because a ‘symptom’ is by definition something ‘pathological’; something we should try to get rid of. In ACT, the aim is to transform our relationship with our difficult thoughts and feelings, so that we no longer perceive them as ‘symptoms’. Instead, we learn to perceive them as harmless, even if uncomfortable, transient psychological events. Ironically, it is through this process that ACT actually achieves symptom reduction—but as a byproduct and not the goal.
ACT assumes that the psychological processes of a normal human mind are often destructive, and create psychological suffering for us all, sooner or later. Furthermore, ACT postulates that the root of this suffering is human language itself. Human language is a highly complex system of symbols, which includes words, images, sounds, facial expressions and physical gestures. We use this language in two domains: public and private. The public use of language includes speaking, talking, miming, gesturing, writing, painting, singing, dancing and so on. The private use of language includes thinking, imagining, daydreaming, planning, visualizing and so on. A more technical term for the private use of language is ‘cognition’. Now clearly the mind is not a ‘thing’ or an ‘object’. Rather, it is a complex set of cognitive processes—such as analyzing, comparing, evaluating, planning, remembering, visualizing—and all of these processes rely on human language. Thus in ACT, the word ‘mind’ is used as a metaphor for human language itself. Unfortunately, human language is a double-edged sword. On the positive it helps us make maps and models of the world; predict and plan for the future; share knowledge; learn from the past; imagine things that have never existed, and go on to create them; develop rules that guide our behavior effectively, and help us to thrive as a community; communicate with people who are far away; and learn from people who are no longer alive. The dark side of language is that we use it to lie, manipulate and deceive; to spread libel, slander and ignorance; to incite hatred, prejudice and violence; to make weapons of mass destruction, and industries of mass pollution; to dwell on and ‘relive’ painful events from the past; to scare ourselves by imagining unpleasant futures; to compare, judge, criticize and condemn both ourselves and others; and to create rules for ourselves that can often be life-constricting or destructive.
ACT rests on the assumption that human language naturally creates psychological suffering for us all. One way it does this is through setting us up for a struggle with our own thoughts and feelings, through a process called experiential avoidance. Probably the single biggest evolutionary advantage of human language was the ability to anticipate and solve problems. This has enabled us not only to change the face of the planet, but also to travel outside of it. The essence of problem solving is this: Problem = something we don’t want. Solution = figure out how to get rid of it, or avoid it. This approach obviously works well in the material world. A wolf outside your door? Get rid of it. Throw rocks at it, or spears, or shoot it. Snow, rain, hail? Well, you can’t get rid of those things, but you can avoid them, by hiding in a cave, or building a shelter. Dry, arid ground? You can get rid of it, by irrigation and fertilization, or you can avoid it, by moving to a better location. Problem solving strategies are therefore highly adaptive for us as humans (and indeed, teaching such skills has proven to be effective in the treatment of depression). Given this problem solving approach works well in the outside world, it’s only natural that we would tend to apply it to our interior world; the psychological world of thoughts, feelings, memories, sensations, and urges. Unfortunately, all too often when we try to avoid or get rid of unwanted private experiences, we simply create extra suffering for ourselves. For example, virtually every addiction known to mankind begins as an attempt to avoid or get rid of unwanted thoughts and feelings, such as boredom, loneliness, anxiety, depression and so on. Then addictive behavior then becomes self-sustaining, because it provides a quick and easy way to get rid of cravings or withdrawal symptoms. The more time and energy we spend trying to avoid or get rid of unwanted private experiences the more we are likely to suffer psychologically in the long term. Anxiety disorders provide a good example. It is not the presence of anxiety that comprises the essence of an anxiety disorder. After all, anxiety is a normal human emotion that we all experience. At the core of any anxiety disorder lies a major preoccupation with trying to avoid or get rid of anxiety.
Of course, not all forms of experiential avoidance are unhealthy. For example, drinking a glass of wine to unwind at night is experiential avoidance, but it’s not likely to be harmful. However, drinking an entire bottle of wine a night is likely to be extremely harmful, in the long term. ACT targets experiential avoidance strategies only when clients use them costly, life distorting, or harmful. ACT calls these ‘emotional control strategies’, because they are attempts to directly control how we feel. Many of the emotional control strategies that clients use to try to feel good (or to feel ‘less bad’) may work in the short term, but frequently they are costly and self-destructive in the long term. For example, depressed clients often withdraw from socializing in order to avoid uncomfortable thoughts—‘I’m a burden’, ‘I have nothing to say’, ‘I won’t enjoy myself ’—and unpleasant feelings such as anxiety, fatigue, fear of rejection. In the short term, canceling a social engagement may give rise to a short-lived sense of relief, but in the long term, the increasing social isolation makes them more depressed.
In general, clients come to therapy with an agenda of emotional control. They want to get rid of their depression, anxiety, urges to drink, traumatic memories, low self-esteem, fear of rejection, anger, grief and so on. In ACT, there is no attempt to try to reduce, change, avoid, suppress, or control these private experiences. Instead, clients learn to reduce the impact and influence of unwanted thoughts and feelings, through the effective use of mindfulness. Clients learn to stop fighting with their private experiences—to open up to them, make room for them, and allow them to come and go without a struggle. The time, energy, and money that they wasted previously on trying to control how they feel is then invested in taking effective action (guided by their values) to change their life for the better.
Thus ACT interventions focus around two main processes:
developing acceptance of unwanted private experiences which are out of personal control,
commitment and action towards living a valued life.
1. Cognitive Defusion: learning to perceive thoughts, images, memories and other cognitions as what they are—nothing more than bits of language, words and pictures—as opposed to what they can appear to be—threatening events, rules that must be obeyed, objective truths and facts.
2. Acceptance: making room for unpleasant feelings, sensations, urges, and other private experiences; allowing them to come and go without struggling with them, running from them, or giving them undue attention.
3. Contact with the present moment: bringing full awareness to you’re here-and-now experience, with openness, interest, and receptiveness; focusing on, and engaging fully in whatever you are doing.
4. The Observing Self: accessing a transcendent sense of self; a continuity of consciousness that is unchanging, ever-present, and impervious to harm. From this perspective, it is possible to experience directly that you are not your thoughts, feelings, memories, urges, sensations, images, roles, or physical body. These phenomena change constantly and are peripheral aspects of you, but they are not the essence of who you are.
5. Values: clarifying what is most important, deep in your heart; what sort of person you want to be; what is significant and meaningful to you; and what you want to stand for in this life.
6. Committed Action: setting goals, guided by your values, and taking effective action to achieve them.
The experience of doing therapy becomes vastly different with ACT. It is no longer about getting rid of bad feelings or getting over old trauma. Instead it is about creating a rich, full and meaningful life.
source: Embracing Your Demons an Overview of Acceptance and Commitment Therapy; Russel Harris; Published in Psychotherapy in Australia (2006). 12, 4.
The Guest House
This being human is a guest house. Every morning a new arrival.
A joy, a depression, a meanness, some momentary awareness comes as an unexpected visitor.
Welcome and entertain them all! Even if they are a crowd of sorrows, who violently sweep your house empty of its furniture, still, treat each guest honorably. He may be clearing you out for some new delight.
The dark thought, the shame, the malice. meet them at the door laughing and invite them in. Be grateful for whatever comes. because each has been sent as a guide from beyond.
"The mystery of life is not a problem to be solved, but a reality to be experienced." -Zen Saying-
"We cannot change anything until we accept it. Condemnation does not liberate, it oppresses." -Carl Jung-
"I used to think that the brain was the most wonderful organ in my body. Then I realized who was telling me this." -Emo Phillips-
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