Acceptance and Commitment Therapy

Acceptance and Commitment Therapy (ACT) is a new-age therapy approach rooted in the science of Behavior Analysis and Relational Frame Theory.  It is based on mindful acceptance practices and values based action.  The approach has been used effectively to treat a wide variety of psychological “disorder”, ranging from struggles with adjustment and finding general direction in life, career, and family planning, to treating anxiety and mood disorders, phobias and agoraphonia, and even to treating severe illnesses such as schizophrenia.  The approach is very flexible, customizable, and highly collaborative between client and therapist, so a step-by-step description of what to expect can be pretty hard to explain as it often jumps around among 6 core processes.

Here is a description of the 6 core processes used in ACT:

Defusion:

Defusion is about noticing your emotional side as a separate entity as your core self. In observing your anxiety and your struggle, you naturally get curious and ‘get close to’ the very thing and/or that you are most often turning away from and avoiding.  By turning towards this struggle and objectifying it as something separate from you, you are shifting your relationship from being a blind sufferer to an outside observer, which can really help to lessen the threatening nature of the experience that you were once desperate to escape.  Defusion can oftentimes be the most “fun” part of ACT, your therapist will have a large selection of exercises and techniques that you can try to separate yourself from, or “defuse” from, this inner emotional experience that you are struggling with.  Everyone finds their own unique strategy here.

Acceptance:

Acceptance is about making room for this emotional experience.  By carefully getting to a safe place with your anxiety and/or depression (with the help of your therapist), your therapist may ask you some thoughtful questions such as “do you think that you can make room for your anxiety to be here in this space, if it means that can you move forward with doing XYZ?”  (XYZ being something important that you feel your symptoms are preventing you from being able to do). A large part of acceptance is self compassion, and here you can expect to learn how to talk to yourself in a much kinder way, and to also see your anxiety and depression in a much softer light than before- as something that wasn't nearly as terrible as you were making it out to be.  Your symptoms are not always what they seem to be after you get to know them a little bit more. There is often another “side” to your struggle, that is related to your values and what you care about most - and drawing this association can be really helpful with making you more willing to make space, understand, and have compassion for the kinds of symptoms/thoughts/feelings that you experience.

Contacting the Present Moment:

Check in with each of your senses, notice all that is around you.  Getting present helps you to get in touch with reality- in other words, it helps you to ‘get out of your mind, and into your life’.  When you are present, you are able to contact your self, your values, your goals, and the tangible situation that you are currently in.  Once you are here, you can be safe, and defusion and acceptance can take place.

Values:

Values are what “you” are all about. Your chosen values are who you are, what matters to you, what makes life feel good.  The thoughtful and intentional “you”. Everyone has a different set of values, but many share several common values, such as: being kind, being understanding, being open, and being authentic.  Your values are your helpers, guides, and motivators, they are your moral compass when anxiety and strong emotions are trying to push you around. When you make space for your struggles, you often make this space in service of following through with your values. An exciting part of the ACT process is working with your therapsit to discover what your values are and to start putting them front and center in your life.

Self-as-context:

There is a part of you that notices everything that happens to you.  The self-as-context is the "Observer self", from a spiritual side people may refer to this as their soul or their spirit.  When you check in with your senses to get present, there is a part of you that is noticing and naming each of your sensual and cognitive experiences.  There is a part of you that notices and reports the thoughts in your mind, and the feelings in your body when your therapist asks about it. This is the part of you that is your voice of reason and that sees the bigger picture, and the part of you that can better connect with your values when you need them the most.

Committed Action:

Now that you are present and checked in with your self-as-context, what are your values in this situation that you are in?  What do you want to be about here? What are your bigger goals, and what small actions can you take right here, right now that will bring you a little bit closer to those goals? What difficult feelings and thoughts are here, that you can make space for, so that you can continue anyway with the commitment that you have made?  Identify your preferred course of action, give yourself that encouraging self talk, make space for hard things, and go for it.

Acceptance and Commitment Therapy Results

The goal of ACT is to help you to outline and better understand your identity, core values, and goals in various areas of your life.  With this information, you will be able to see yourself from outside, bigger perspectives, separate yourself from outside disturbances such as mental health symptoms of any scale and/or situational life obstacles, and identify and commit to clear courses of action.  These courses of action will be decided on based on how well they align with what you know matters to you (your values) and whether they bring you closer to your goals or not. Research has found that rather than just decreasing negative mental health symptoms, it is engaging in a meaningful life that has better life satisfaction outcomes for people, which is precisely what ACT is striving to get for you!

While I cannot guarantee that the results of ACT will be a decrease or complete reduction in anxiety, depression, or other mental struggle- I can tell you that you are highly likely to have more clarity in your life provided that you participate in and practice all of the exercises that we do together in session.  If I were to guarantee a reduction in symptoms, then I would be sabotaging the core feature that works in ACT -- taking action to improve your life, rather than to avoid and resist the suffering and discomfort that comes with it. However, you might just find that a reduction in symptoms is a side effect of achieving a better, more fulfilling life.

For more information on what to expect with ACT, check out my blog post here.