Life hands out a lot of lemons and, more often than not, lemonade isn’t enough. We turn to stronger drinks, unhealthier foods, and more bitter attitudes. As individuals, we approach and cope with traumatic events differently, but rarely are we able to move past them without conscious effort. Sometimes, conscious efforts to move past them can even make it more difficult to do so.
Acceptance and Commitment Therapy (ACT) is a relatively new practice that is targeted at victims of these traumatic events, such as sexual abuse, childhood abuse, and/or substance abuse. ACT is also an effective tool for individuals diagnosed with mood disorders or obsessive behaviors, and/or clients of familial and couples therapy. Rather than being symptom reduction based like most forms of treatment, ACT believes that attempting to reduce symptoms can create its own disorder in and of itself. “Symptoms” themselves have negative connotations and can create further anxiety or negative feelings. Although relatively new, ACT has been proven effective across a broad audience. Here’s why:
ACT derives from Relational Frame Theory (RFT). RFT is the idea that problem solving not an effective way to aid the healing process for psychological pain. In other words, we cannot use rationality to cope with negative emotions. ACT was developed with the intention to overcome psychological pain through accepting it as it is. ACT became popularly used for substance abuse therapy, psychosis, anxiety, depression, and eating disorders as a mindfulness-based form of therapy. Rather than attempting to change negative thoughts and feelings like Cognitive Behavioral Therapy (CBT), ACT encourages accepting these thoughts as they come.
ACT’s foundation lies in 6 strategies: defusion, acceptance, contact with the present moment, observing the self, reassessing values, and committing to an action plan. Each strategy involves its own set of exercises and techniques. Defusion and acceptance requires that we observe our thoughts and feelings from a distance, without absorbing ourselves in them. Contact with the present moment is relatively self-explanatory – it requires focusing all of your energy on what you are doing and feeling in that specific moment. Observing the self is the awareness that your emotions (both positive and negative) are a part of you, but they do not define you. Reassessing values involves clarifying what is meaningful to you, and committing to an action plan takes these values and uses them to set and achieve goals.
How are these principles put into action?
ACT uses mindfulness and behavioral adjustment to change one’s mindset according to different values. ACT has three goals: accept your reactions and be present, choose a positive direction, and take action. Let’s break them down.
- Accept your reactions. It’s tempting to shove negative emotions under the rug. Society finds discomfort in sadness and vulnerability, and putting up a front is a more acceptable defense mechanism than giving in and breaking down. Sadness, anger, guilt, and other “bad” emotions have negative connotations that make us inclined to try to suppress them. On the flip side, obsessing over or holding onto negative emotions is equally detrimental. ACT focuses on accepting. It encourages you to forgive yourself for “failures” – every mistake is a learning process
- ACT is values based. It encourages individuals to adjust his or her behavior according to values identified by a series of exercises. Patients adjust their responses to negative emotions according to how they feed into their personal values, rather than clouding them. They are encouraged to accept those past events cannot be changed, and that acceptance and strategy development for moving forward is the only thing that can be done now.
- We tend to have feelings about our feelings. When we are sad, we criticize ourselves for being sad. When we are anxious, we often get angry at ourselves for feeling anxious.This only perpetrates the negative feelings. ACT looks at previously failed strategies for moving past an event, and develop new, more effective approaches. ACT, metaphors, paradoxes, and experiential exercises as well as acceptance techniques are conducted each session until the individual is able to view themselves as separate from his or her negative experience.
If you practice yoga or meditation, ACT theory might sound familiar by now. ACT is essentially clinical mindfulness. Mindfulness is nonjudgmental awareness of passing thoughts and feelings. It’s centering yourself in the present rather than worrying about the future. Mindfulness encourages noticing negative feelings, allowing them to exist, and approaching them differently. More or less the three steps for ACT listed above.
ACT, however, differs from other mindfulness practices in that it can be applied to a larger population and is less manualized. Treatment is personalized to the client, and strategies are developed together rather than outlined by the therapist.
ACT is an attempt to redefine normal. Although we are significantly more accepting of mental disorders than we were twenty or thirty years ago, they are still perceived as exactly that: a disorder. The reality is that 30% of the United States adult population struggle with mental illnesses every year. Rather than continuing to perceive psychological struggling as a handicap, ACT encourages looking wholistically at mental suffering as a part of the human experience. It is personalized to the client because it is a practice rooted in personal acceptance and growth. Rather than encouraging change, it emphasizes accepting yourself as you are, negative emotions and all.
How Can I Practice ACT?
ACT does not require a separate certification. Therapists who practice other types of therapy, such as CBT or MSRT also practice ACT. Here is how to get in contact:
- Visit the United States-based website of the Association for Behavioral and Cognitive Therapy, which has a long list of behavioral therapists who either practice ACT themselves or can refer you to another individual
- Talk to your doctor who can refer you to a psychiatrist to help find a local ACT therapist
- Check out some of the most popular books explaining ACT in depth: