Acceptance and Commitment Therapy (ACT)

by Darby Christopher, LMSW

A new wave of well researched and effective therapies has emerged in recent years. Examples include Eye Movement Desensitization Reprocessing (EMDR), Emotional Freedom Technique (EFT), Dialectical Behavior Therapy (DBT), Acceptance and Commitment Therapy (ACT), and others. This article will focus on the process and benefits of ACT, which primarily provides tools that can be applied to everyday life, with or without the help of an ACT therapist.

Overview

The primary goal of Acceptance and Commitment Therapy, according to Dr. Russell Harris, is the attainment of “psychological flexibility.” This refers to an ability to be open to the present moment, a perhaps deceptively simple yet powerful concept. When we are psychologically flexible, we are able to feel and to observe what shows up in our lives, without clinging to it too tightly.

If much our suffering results from how we respond to sadness, a depressed mood, anxiety or anger, then ACT provides the tools necessary to not worsen the situation by reacting to it or fighting with it. The result is greater self acceptance, less time focused on negative possibilities, and more time invested in valued action.

ACT often uses metaphors to convey its ideas, and a metaphor is helpful here. Suppose  that a certain set of circumstances triggers a depressed reaction in me, and let’s say that this depressed reaction is like a branch that is floating down a stream. Any of the ways that I fight with this depression – whether by feeling badly about it, denying it or trying to avoid it by destructive means – are ways that I am damning up the stream that will not allow the branch to flow through. ACT provides the tools that will help keep me from doing this, so that I will be more able to watch the branch come, flow through and float by.

Acceptance and Commitment Therapy falls under the broad category of Cognitive-Behavioral Therapy (CBT). However, it also follows a current trend in CBT to avoid counteracting symptoms, and to instead embrace the stance and practice of mindfulness.

ACT Tools

What are these tools? Acceptance and Commitment Therapy focuses on 6 core processes that work together. Each one requires effort, and will probably not be mastered over the course of a life time. The goal is to get better at them and experience more freedom, rather than perfection. Let’s look at each one individually.

• Defusion. This refers to an ability to watch and observe our thoughts and emotions, and to create a little distance between our selves and the thought or feeling. This step is not easy because we often tend not to be aware of our thoughts. With defusion, we slow down and observe ourselves having thoughts and feelings. Next, if appropriate and helpful, a step can be taken to see the thought as perhaps a part of me, but not attached to my deepest identity, and therefore capable of change. 

• Acceptance. This refers to how I relate to the thoughts and feelings that show up in me. Am I mad at them? Do I hate them and wish they would go away? Do I treat them like unwanted guests? Or, conversely, do I welcome even the painful thoughts and feelings that show up in me, knowing they could have some useful information for me? Do I love these parts and treat them with compassion? Loving what shows up in us leads to relaxation and an ability to listen to ourselves.

• Contact With The Present Moment. To make contact with the present moment is to experience some sense of vitality right now. The requirements for this may shift as our moments shift. When we engage our observing self, we may pay attention to our sense of sight, smell, hearing, sound or touch, we may look inward and pay attention to our inner sensations, and we might do both of these at once. If we are dealing with a painful experience from our past, we will pay attention to our bodies and feeling experience, rather than ruminating over the facts of the past. Staying focused on the feeling sensations in our bodies allows us to be informed by them, as opposed to diverting our attention and missing out on the message they may offer us. Contact with the present moment often involves slowing down to be present with others, nature, and our own selves.

• Self-As-Context. This refers to an ability to be in touch with the deeper part of me that is doing all of this observing. When we build our “self-as-context” muscle, we are able to know that there is a part of us that endures and stays steady through the day to day and even moment to moment changes in our lives. Why is this important? Knowing ourselves in this way facilitates the goal of psychological flexibility. If I know that I am so much more than my thoughts and feelings, then I won’t get too attached to them. (However I will still know and honor them as important, and give them their proper place in my life.)

• Values. This refers to an ability to know what is important to me, and to allow myself to be guided and instructed by this knowledge. We are all given a certain amount of time on this earth to live in this life time. How do I want to spend it? What matters to me? What do I wish to leave behind? Getting in touch with my values both gives me a compass and a sense of deeper meaning.

• Committed Action. Once I know what my values are, what do I want to do to act on them? What possibilities am I willing to try out? How could my life take on more vitality by my action(s)? 

Conclusion

Acceptance and Commitment Therapy provides useful tools to stay open and present to the moment. There are times when using these tools may seem difficult, if not impossible. With practice, however, they can be useful in even the most difficult situations. ACT does not take the place of other types of important work that also help us be more present to our lives, such as grief work, trauma work, and understanding how our past experiences affect us. ACT can stand on its own as a useful and healing therapy, and can be used in powerful ways in conjunction with other types of therapies.

Resources

The Happiness Trap: How To Stop Struggling And Start Living, by Russ Harris, 2008

Act Made Simple, by Russ Harris, 2009 (Note: This book is written primarily for therapists, though anyone may benefit from reading it.)