Acceptance and commitment therapy explained.

Jason Brien.

     Acceptance and commitment therapy (ACT) is a relatively new psychotherapeutic approach. ACT is sometimes referred to as a humanistic cognitive behaviour therapy. The goal of ACT is to help people to create rich and meaningful lives whilst accepting the inevitability of pain and suffering. If you understand the old Buddhism saying “Suffering is inevitable” then you will understand the basis of ACT. Acceptance and commitment therapy can help people to recognise and understand that suffering is inevitable and so they must learn to recognise the value in accepting (rather than supressing or denying) painful and distressing emotional and cognitive experiences. There are 6 core principles of ACT which we will now explore.

1. Cognitive defusion; 

Cognitive defusion is about creating space between ourselves and our cognitions (thoughts, memories, mental images, etc) so that they have less of a hold over us. Imagine standing with your nose pressed firmly against a wall. When you try and look outwards, all you can see is the wall directly in front of you right? You may see some objects in your periphery but they will be blurred and unrecognisable. The more space you create between the wall and yourself, by stepping increasingly backwards, the more you can begin to recognise the peripheral objects and so the less hyper focused on the wall you become. To put it simply, the more that you hyperfocus on exclusively negative/distressing thoughts, images, memories, etc, the less you can focus on other types of memories, thoughts, etc, including neutral and positive ones.

2. Expansion or acceptance;

This refers to making room for all that is swirling around in your mind (positives, neutrals and negatives) without paying them undue attention or becoming overly attached to them. By opening up and allowing all of the thoughts, memories, feelings, etc, to come and go freely (even those which cause you the most distress), you will find that they will eventually bother you less. Think of it this way… When you are watching a scary movie and a particular scene is freaking you out, do you constantly replay and re-watch the scary/gruesome part so you can freak yourself out even more or do you cover your eyes until the scene ends and so continue to watch the rest of the movie? What happens to people who become hyper focused on trauma, negative experiences, social anxiety, etc is that rather than allowing the distressing thoughts, feelings, etc associated with the trauma, social anxiety, etc, to come and go freely, they replay and re-watch the trauma, etc repeatedly thus distressing themselves repeatedly.

3. Connection to the present moment; 

Rather than dwelling too much on the past or worrying too much about what might happen in the future, ACT suggests spending the vast majority of your time in the present moment. Yes, there is value in short trips to the past or the future but those trips shouldn’t become so long that you become detached from the now. You always need to maintain contact with the present moment so you don’t become completely lost and detached. Think of it like the difference between being asleep and being awake. What happens when you wake up? The act of waking up reattaches you to the present moment, right? Waking up reaffirms that you are here and not wherever you just were. Have you ever noticed that when you are sleeping it is really difficult to control what you are thinking or feeling but as soon as you wake up you regain that control? That is what bringing your attention back to the present moment does for you. It gives you back control.

4. The observing self; 

To connect to our observing self is to access our transcendental self – a continuity of consciousness that is unchanging, ever present and immune to harm. From this transcendental place, we are able to experience our thoughts, feelings, memories, etc as peripheral aspects of ourselves and although these thoughts, feelings, etc, are always changing, they are not the essence of who we are. The observing self doesn’t struggle with reality. The thinking self perceives life and reality as hard, unfair, unjust, etc, whereas the observing transcendental self simply perceives life and reality as an unfolding series of probabilistic outcomes which have no malevolent intentions towards us or others and so should be observed with openness, interest and receptiveness. Stress is the result of the struggle between the thinking self and observing self. The thinking self always wants to attach undue significance to events and if that undue significance is negatively biased, a stress response will occur.

5. Clarifying values; 

This ACT principle involves clarifying that which means the most to us such as family, friends, relationships, spirituality, morality, etc. It also requires us to look deep within ourselves and ask the hard questions like “What type of person do I want to be or become”? or “What are my values and morals and what should I stand up for and against”? Our values and morals give our life direction and purpose and motivates us to make significant personal and interpersonal changes. Values are not the same as goals. Goals are once off time limited events whereas values are kept within us consistently and they are of great importance to us. Likewise, morals give us strength of character. A person without morals is a person without scruples. Any goes regardless of the impact upon oneself and others.

6. Committed action; 

Like the old sayings “Talk is cheap” and ‘Actions speak louder than words”, ACT encourages committed, effective and purposeful action. Think of it this way. You can plan a luxurious overseas trip. You can book the flight tickets and hotel rooms and even plan an itinerary but if you don’t get off the lounge, get to the airport and board the plane, nothing of significance has really occurred (besides wasting a bunch of money). You alone can provide the motivation to get up off the lounge and to the airport if you want your overseas holiday to come to fruition. Any action that we take must have productive value. Anxiety for example is purely unproductive. Five hours of anxiety contributes nothing of meaning or value to our life whereas just 5 minutes of cognitive restructuring for example provides immense value and meaning as it has the potential to alleviate that which is/was stopping us. Before you take any action, ask yourself “What is the value of this action? Is this action productive or unproductive”?

References

https://link.springer.com/chapter/10.1007/978-0-387-23369-7_1

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5769281/

https://www.psychotherapy.net/article/Acceptance-and-Commitment-Therapy-ACT