Acceptance and Commitment Therapy (ACT)

What it Is

Psychological and physical suffering is inevitable, whether the pain comes in the form of distressing thoughts, emotions, or actual physical pain.  This is a part of the human experience.  In reality, most forms of private “aversive” experiences never fully go away, despite what we would hope. 

From the point of view of Acceptance and Commitment Therapy (ACT), pronounced “Act,” our culture has labeled human suffering using medical language.  These labels include words like Depression, Obsessive Compulsive Disorder (OCD), Post Traumatic Stress Disorder (PTSD), and the like.  These terms are completely contextual, based on language and culture.  This type of language is important, as it also influences how people seek to cope.  The methods people tend to focus on are forms of “symptom reduction.” People often infer that this logical way of thinking is the most helpful solution, to eliminate what feels “bad” and to feel “good” more frequently.  In ACT, using logic-based thinking is considered a behavioral effort to fight or avoid reality.  These attempts to find an end to our suffering often make us feel worse and often hopeless.  

How it Works

We may not realize it, but a good deal of the time, we have choices as to what we do when we experience psychological and physiological pain.  We can keep focusing on efforts to control or avoid the pain, or we can bring our specific type of suffering along with us as we attempt to live fulfilling lives.  We already do this.

In ACT, the main focus of the work is helping people to utilize certain psychological processes: Acceptance, Defusion, developing a Self as Context, Committed Action, Value driven behavior, and Contact with the Present Moment.  The goal of using these processes is not to get rid of our suffering, but to learn to accept it, and develop a different relationship with it, as it is a part of us. 

This idea is contrary to the medical model.  As a result of giving up the fight, or reducing the amount of unhelpful behaviors and attitudes that reinforce symptom reduction, people tend to feel better and their thoughts and feelings often become less relevant.  This concept is not intuitive, but is helpful to many.  This is the essence of ACT, a “Third Wave” form of CBT that involves cognitive, behavioral, and mindfulness practices (e.g. becoming aware and connected to the present moment without expressing judgement).

References:

Harris, R. (2006). Embracing your demons: An overview of acceptance and commitment therapy. Psychotherapy in Australia, 12(4), 70.

Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2009). Acceptance and commitment therapy. American Psychological Association.