What is Acceptance and Commitment Therapy?
Introduction
You've most likely heard of Cognitive Behavioural Therapy (CBT). Acceptance and Commitment Therapy or ACT is a cousin of CBT. It has history rooted in behavioural therapies (1970s) and relational frame theory (80s & 90s). For a comprehensive suggested history, this article is worth exploring.
In my earlier years of practice (circa late 2000s), I have found that many clients enjoy the relatively straightforward, goal-smashing, go-getting style that CBT offers. You explore it, name it, come up with alternatives. You also set goals that are time-conscious and manageable in bite-size and you're well on your way so goes the prescription of the therapy.
As time passed, I had some clients return and report that they feel exhausted and no longer had the energy to try their well-structured and rigorous CBT methods that have served them very well.
"Even if I say don't think about a pink elephant, that's still thinking about it", is often how I describe this: What clients had discovered was that all the fighting and struggling it takes to negotiate with the depressive demon and debilitating anxieties cycle after cycle was catching up to them. There was no more fuel left in the tank because mental health is not a one-hit wonder. It requires a Backstreet Boys kind of longevity to learn and to practice.
It was around the same time I had discovered ACT through a Dr. Russ Harris - a mainstay practitioner, teacher and proponent of ACT's popularity in Australia. Sitting in a conference room filled with 200 mental health professionals, I found myself perching (uncomfortably) with my feelings just as they were. The invitation was to do so without any expectations of what would happen to them. This exercise then extended to exploring that lump in my throat and the softness of my socks against the tightness of my shoes. I watched silently as my brain pulled in different directions, grabbing at worries, incomplete tasks and self-conscious judgments in the process. At the end of it, I realised I was no worse than when I had started for just observing. I didn't need to fight. That it was okay to (learn how to) watch and let it just be that.
What's it for then?
Like in CBT, you'll explore thoughts, emotions and behaviours and how they influence each other. You'll also find out about what I like to call your relationship with these live components of what it is to be human. And this is where it feels very different from CBT which posits how we should very consciously and intentionally fight or at least change how we think, feel and behave as the solution. Alternatively, ACT champions psychological flexibility - the ability to respond to with what life has to bring in a way that is functional and aligned with personal values.
The Basics
How ACT proposes to move towards psychological flexibility are via practices/skills which build our ability to have a partnership with our thoughts and feelings - especially with those we typically come to therapy in hopes of 'fixing' or 'getting rid of".
Acceptance
The word 'acceptance' is often met with confusion and downright horror when suggested to clients. Are we to accept that we will always worry and be depressed? Yes and no.
The idea is that when we have nothing left in us to fight, that it is the actual fighting that doesn't get us any closer to getting rid of regrets of the past and uncertainty of the future. Acceptance simply means acknowledging that thoughts and emotions are a part of being human and are functional (in moderation). Burning the entire forest to get rid of a few sick trees is more harmful and sets up unrealistic expectation that could lead to deeper hopelessness and feelings of incompetence or failure.
This does not mean that we should just lay down and meditate for the rest of our lives - we will still be solving problems when they come. It just means our heads can become clearer for problem-solving if we have the ability to hold space for the worries and doubts rather than constantly trying to reject them.
Using techniques such as mindfulness and cognitive defusion, we develop the ability to give thoughts and emotions their due respect and moment in the darkness and begin to notice that they come and go anyway. In the context of being a human being in this pale blue dot we call earth (thank you Carl Sagan), we are able to have better relationships with how we think and feel.
Commitment
As we spend less and less time wrestling and tackling with thoughts and emotions, we are also freed up to put into motion behaviours/actions which actually matter to us. We rediscover what our values are as an individual within our respective communities - "What makes me tick?" "What do I actually want to do (for now)?" "How do I want to live?" "How do I want to be remembered?"
We set committed and actionable movements based on our values and turn our attention towards them. By walking alongside Sadness, Anger, Fear and friends (at the beach?), we start gearing the brain towards making meaningful memories vs. being in a perpetual mode of fight or flight.
Thinking this might be the therapy for you?
As a mental health advocate, I strongly believe in the self-practice of mental wellbeing (and acknowledge its challenging nature). ACT and its skills are part of my daily life as much as being a psychologist and coach are. I look forward to sharing more with you.
See you soon,
Helen
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"Stop struggling, stop living" - Dr. Russ Harris
