Acceptance and Commitment therapy: an overview

Introduction:

Acceptance and Comittment therapy (ACT) is a revolutionary new development in human psychology. Originally developed for treating anxiety and depression, the principles of ACT can be applied to a broad range of human concerns, including Marriage and Couple relationship therapy.

Developed in the USA, ACT is rapidly being embraced around the world. ACT is supported by extensive ongoing research confirming its effectiveness as a therapeutic approach.

Intriguingly, while based on principles of behavioral psychology, ACT has striking similarities with many ancient Eastern Contemplative traditions. In this respect, the approach can be described as both radically new as well drawing on some ancient approaches.

How ACT works: the power of language

ACT is primarily concerned with the way in which we, as human beings are inevitably influenced in powerful ways by the force of language as it shapes and organizes our experience and reaction in the world.

As human beings, we experience the world with language – whether we are having thoughts, judgements, opinions, images, fantasies,emotions and memories – this is all happening because of language.

In a very real sense, we are continually documenting our experience, much like a documentary film-maker documents the subject matter of her movie. We choose to notice certain features, ignoring others, much like the film-maker in the editing room.

Try it out for a moment…ready?

Okay. So what did you do today, so far..?

Take a few moments to answer this question to yourself.

Now notice what details were included and which were left out. Did you brush your teeth this morning? Did you include putting the lid back on the toothpaste tube? Did you rinse your mouth? Was this sequence included?

We are continually selecting and editing our experience and can’t include (nor is it useful) every little detail.

And most of the time we move through experiences without noticing this relentless editing process and what chunks and bits of experience gets left on the editing-room floor. The point is that we are highly selective.

Whats more, we want pleasant, enjoyable experiences and try to repeat and hold to them. We also do all we can to avoid and prevent unpleasant and painful experience.

We get entangled with our stories…

From an ACT perspective, thoughts, judgements, images, emotions and memories can becompelling. One can literally be swept away by one’s story or narrative and the accompanying feelings and reactions. In a very real sense we become entangled, pushed along by the story with which we are caught up.

ACT calls this entanglement, cognitive fusion.

As one is swept away by one’s story or narrative and the accompanying feelings and reactions, this cognitive fusion results in psychological rigidity that suffocates and restricts one’s taking the needed behavioral step in accord with one’s values.

Often entanglement with our story grows as we struggle against uncomfortable or difficult situations, trying to avoid a painful or uncomfortable experience. This happens frequently, for example, with difficult emotional states such as with the experience of Depression and Anxiety.

The more one struggles to “get away” from the “anxiety/depression experience”, the more I try to push it away, try to talk myself out of it, try to change my thinking, try to make it go away by imagining pleasant places, try to distract myself and so on, the bigger the discomfort seems to become.

From an ACT perspective, psychological suffering is usually caused by this experiential avoidance, the attempt to get away from and avoid the painful experience rather than accepting what is and deciding how best to respond in terms of what one wants.

Mindfulness skills support defusion…

ACT skill training encourages developing Mindfulness. This allows for increased Acceptance of the situation at hand and, as a consequence, a freedom to take action in support of one’s values.

In my own work with clients using ACT, I focus on six core skills which support greater psychological flexibility. These are:

1. Cognitive Defusion: In ACT one learns to look at thoughts, judgements, images, emotions and memories for what they are, not what they appear to be.

2. Acceptance: Learning to percieve thoughts, judgements, images, emotions and

memories allowing them to simply come and go, without struggling with them.

3. Contact with the present moment: Awareness of the moment to moment here and now, experienced with openness, interest and receptiveness.

4. Observing the self: Accessing a perspective of observation, noticing the shape of the river rather than simply being swept along.

5. Values: Discovering what is most important to one’s true self.

6. Committed action: Setting goals according to values and carrying them out responsibly.

Applying ACT in therapy:

ACT is a powerful approach for working with Depression, Anxiety, Social Anxiety as well as Marriage, Couple and relationship issues. ACT skills are relatively easy to learn and practiced over time.