What is Acceptance and Commitment Therapy?

Acceptance and Commitment Therapy (ACT) encourages people to accept their thoughts and feelings rather than fight them. The basic idea behind this theory is that the first step to solving a problem is facing it, not running away.

The ACT theory attempts to move away from defining emotional experiences as symptoms, but rather as a common part of the shared human experience. Instead of waiting to first change or eliminate feelings, ACT encourages individuals to take action while simultaneously accepting whatever it is they feel.

Core Processes for Improving Emotional Experiences

Unlike Cognitive Behavioral Therapy (CBT), ACT does not directly attempt to evaluate and change unwanted thoughts and feelings so much as it tries to release individuals from attempting to control their own experiences. The theory behind this is that suppression of negative feelings leads ultimately to more distress and should instead be replaced by acceptance of what is outside one’s control.

ACT, however, should not be confused for an attitude of complacency. On the contrary, ACT contends that there are valid and more worthwhile alternatives for improving emotional experiences, which are based on a series of core processes. 

These processes are:

• Acceptance – Permitting unpleasant internal and external experiences without trying to alter or change them.
• Being present – Closely connected with Mindfulness-Based Theory, this concept carries with it the idea of maintaining intentional contact with the present rather than experiencing life aimlessly.
• Cognitive diffusion – The attempt to alter the way individuals relate to “negative” thoughts by creating contexts where their deconstructive function is diminished. For example, an individual struggling with thoughts of worthlessness may remove himself or herself from the situation to examine their thoughts dispassionately. They may attempt to view their thought process as an external object, rather than a subjective experience. The goal of this type of thinking is to reduce the literal quality of a thought by approaching it with an observer’s perspective.
• Self-as-context – This is the concept that people are not the content of their thoughts and feelings, but are better described as the consciousness which is experiencing those thoughts and feelings. The opposite of this is self-as-content, which focuses on a conceptual self that is centered around objective facts, subjective details, and social roles. An example of this type of thinking would be saying, “Although I would like to, I’m not the type of person who would do __.” Instead, ACT encourages adaptability and flexibility of thinking through a self-as-context approach which recognizes that individuals are more than the sum of their experiences.
• Values – Clarifying what is most important and determining to live life according to those principles.
• Taking action – The ultimate goal of ACT is in the name—action. This means that an individual walks away from therapy ready to make tangible changes in behavior that are consistent with their values.

How ACT Works

ACT is closely related to the Relational Frame Theory (RFT), a psychology theory that focuses on how language and cognition impact the way we perceive psychological pain. These two theories share in the basic idea that language and thought largely direct our internal experiences.

RFT describes our ability to relate or form bidirectional links between separate objects as fundamental to the ability to communicate. Unfortunately, this propensity to relate even neutral words and ideas with meaning can become destructive. For example, a person who has begun to feel that they are being trapped in their relationships, work, or personal responsibilities may transfer that concept of “entrapment” to claustrophobia when they find themselves in small, enclosed spaces.¹ In this situation, the fear of small spaces has little to do with their actual experience and more to do with their heightened significance through relation of the concept of being trapped.

ACT works by teaching individuals to acknowledge and to move on from this propensity to relate objects or situations with negative meaning. For instance, rather than relating a messy home and a late dinner to “being a terrible mother,” clients are encouraged to focus on identifying what they can change and what they should accept. When change is necessary, it is always important to keep action tied to values and independent from how a person defines himself / herself.

When is ACT used?

ACT has been used to treat conditions that include:

• Anxiety
• Depression
• Obsessive compulsive disorder (OCD)
• Addictions
• Eating disorders
• Psychosis
• Substance abuse

What are the benefits of ACT?

ACT is thought to encourage psychological adaptability while incorporating Mindfulness-Based Therapy with self-acceptance. This form of therapy teaches individuals to accept the full range of their emotions, rather than attempt to suppress unpleasant feelings. In this way, ACT encourages people to come to peace with what is outside of their control while remaining committed to proactivity in their attitudes and actions.

References

1.         McEnteggart C. A Brief Tutorial on Acceptance and Commitment Therapy as Seen Through the Lens of Derived Stimulus Relations. Perspectives on Behavior Science. 2018/06/01 2018;41(1):215-227. doi:10.1007/s40614-018-0149-6