Acceptance & Commitment Therapy

Imagine a therapy that makes no attempt to reduce symptoms, but gets symptom reduction as a byproduct.  

Acceptance and Commitment Therapy, known as ‘ACT’ (pronounced as the word ‘act’) is based on a set of principles that work together to activate your potential for psychological flexibility. There is a growing body of research-based evidence that reveals higher levels of psychological flexibility correlate to greater quality of life. The term “psychological flexibility” refers to the ability to adapt to a situation with openness, awareness, and focus, and to take action guided by your values, or your heart’s deepest desires for who you want to be and what you want to stand for in life. In other words, it is the ability to be present, open up, and do what matters.* The goal for the outcome of therapy is that you will be better able to handle difficult feelings, disrupt unhelpful thought processes, rise above self-limiting beliefs, focus on and engage in what you are doing, and change ineffective or self-defeating behaviors. This goal is achieved by employing mindfulness combined with effective action. Mindfulness enables you to be fully aware of your here-and-now experience, with an attitude of openness and curiosity, and to be engaged and absorbed in what you are doing while reducing the influence and impact of painful thoughts and feelings. Effective action is conscious and deliberate, rather than impulsive or mindless; motivated, guided, and inspired by your core values; and flexible and adaptable to the demands of the situation.*

Using problem-solving skills that work well in the exterior world, we attempt to control or avoid our interior world, our thoughts and feelings, and in the process increase the unwanted thoughts and feelings and decrease our ability to live life freely. ACT claims that psychological flexibility is at the heart of healthy emotional functioning. Through six core therapeutic processes--acceptance and willingness, cognitive defusion, present-moment awareness, self-as-context, values, and committed action—we open up to and act upon actual experience rather than what the mind or body demands.
 

• Acceptance involves the action of allowing the presence of all experiences—internal and external, positive and negative—as they are in the moment, without attempting to escape, change, or control those experiences. Simply put, acceptance means gently holding whatever arises. Willingness is a closely related behavior of taking an open and aware stance that can facilitate acceptance. This stance does not mean believing your thoughts to be true, and it does not mean resignation. Rather, it is an experiential recognition that many experiences include elements that simply cannot be changed, such as spontaneous emotions, memories, external stressors, and other people’s choices or behaviors. Whereas attempts to get rid of, avoid, or control these experiences can limit our choices and lead to psychological inflexibility, acceptance and willingness allow us to experience whatever is present when doing so would foster action that aligns us with how we want to be in the world.

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• Cognitive defusion refers to the process of stepping back from thoughts and observing their presence. Thoughts are not inherently problematic, but become problematic when we fuse with them, or believe their content to be true, and react, often impulsively, in response. Defusion is disentangling from self-talk and merely observing thoughts as entities separate from self, as simply words. Cognitive defusion is the process by which we change our relationship with the content of our thoughts.

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• Present-moment awareness has been described as one aspect of mindfulness. It can be defined as a process of nonjudgmental, present-focused awareness. The human mind spends much time worrying about the future and ruminating about the past, and being dominated by thoughts about past and future can come at a cost. That cost can be giving up actions that are important to us. Present-moment awareness focuses instead on compassionate observation of internal and external stimuli, turning off the autopilot of cognitive fusion and allowing us to respond in a more flexible, nonreactive way that is consistent with how we want to be in the world.

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• Self-as-context refers to a sense of self that transcends the content of our experiences. In other words, there is a “you” that is observing and experiencing your inner and outer world and is also distinct from your thoughts, feelings, physical sensations, and roles. From this perspective, you are not your thoughts and feelings; rather, you are the context or arena in which they unfold. The perspective of self-as-content, by comparison, tends to be driven by the scripts we have about ourselves, our lives, and our histories. This becomes problematic when defining ourselves by the content of our stories then drives actions that are inconsistent with how we want to be in the world. Self-as-context aims to shift to the perspective of observer and experiencer of life as it unfolds, choosing actions based on how we want to be in the world.

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• Values are paths or directions defined by the individual as important and meaningful. Values define who we truly want to be and what we want to stand for. Traveling in valued directions makes life rich and fulfilling. Values provide the road map for making behavior changes. Values cannot be permanently achieved, but are ongoing, enduring types of behaviors that guide us to specific actions. Values are personal, an affirmative answer to the question “If no one knew I was doing this, would it still be important to me?” Acceptance, defusion, present-moment awareness, and self-as-context are practiced to promote greater flexibility in the service of living in accordance with personal values.

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• Committed action is simply walking the walk. Values provide direction, and committed action is the actual behavior change. While values are a path that is never finished, they point the way to goals, specific actions that can be completed and that are in service of values.​

The ultimate goal of ACT is psychological flexibility, which is the ability to be present, open up, and do what matters. Ultimately, being present, opening up, and doing what matters lead to a life that is rich, meaningful, and characterized by true vitality.