Acceptance and Commitment Therapy

Acceptance and commitment therapy (ACT) is a scientific based and empirically supported type of behavioral therapy that provides a basis for living your life according to your values while also accepting instead of fighting change. It has primarily been used to treat depression and anxiety, but I find that it can be useful for many different situations and challenges.

In ACT there is a concept of “psychological flexibility” which allows for increased satisfaction with your life and decreased anxiety, stress, and depression. As your psychological flexibility increases, you will find that you can handle difficult thoughts and feelings, focus on what you choose to versus repetitive unhelpful thoughts, and see relationships, friendships, and yourself in a clearer and more balanced way. Let’s start with defining what psychological flexibility means.

Psychological Flexibility Has Two Components

Component #1 Mindfulness

The first component of psychological flexibility is the ability to be present in a non-judgmental way. To learn more about mindfulness you can look here. The basic idea behind mindfulness is that you are present in the moment and not worrying about the past or the future. You are open to what might happen without the worry or judgment attached to it. You are fully engaged in what you are doing. By being present you limit the amount of fear about the future and painful thoughts and feelings about the past.

Component #2 Action Based on Your Values

The second component is making decisions that are deliberate and helpful rather than based on past unhelpful or hurtful behaviors. These actions are in direct relation to your core values and they adapt to the situation. Only you can decide what your values are and how and in what ways you would like to live by them.

Values are an essential part of ACT but they are often confused with goals. I believe that both are essential to developing cognitive flexibility, but it is important to understand the difference. According to ACT physician and therapist Russ Harris,

“A Goal is a desired outcome that can be achieved or completed. For example, the desire to get married is a goal. Once achieved it’s done and you can cross it off the list. A value is like heading West. No matter how far you travel, there’s always farther West you can go…If you want a better job, that’s a goal. Once you’ve gotten it the goal is achieved. But if you want to apply yourself fully at work , be attentive to detail, support your colleagues, be friendly to customers, and engaged in what you are doing, those are values” (Harris, 2008).

The reason that values are so emphasized in ACT is that we create values as the foundation to our life. When a difficult thought or decision arises we can always check back to our own values and this gives meaning and purpose in our lives. For example, if I was questioning to move across the country away from my family but towards a high paying job I only need to scan my values. Family is the top value for me and money isn’t. In that situation I would evaluate my values and make a decision based on them. Since for me family is a component that makes my life worth living, I live within my value system by staying true to them. If I didn’t know or understand what my values were, challenging thoughts, situations, or decisions would be difficult to navigate through. Another example is if I had intrusive anxious thoughts that were making it difficult to navigate certain situations. One of my values is metal health and so I would move away from those intrusive thoughts and towards an action or thought that better aligned with my values.

What Are Your Values?

Dr. Harris uses a great example to get a start on understanding your values. He asks that if you are 80 years old and looking back on your life as it is today how would you finish the next three sentences:

1.) I spent too much time worrying about…

2.) I spent too little time doing things such as…

3.) If I could go back in time, then what I would be differently from today onwards is…

ACT also uses principles that help to better identify some of the thoughts and feelings that often get in the way of happiness and living a balanced life. We challenge these thoughts and learn how not to associate with them, rather than learning to “control” or “ignore” them. Painful thoughts and feelings aren’t something we can control but rather we can learn to see them for what they are and then not allow them to take residency in our mind.

One of the aspects of ACT that I like best is that you don’t have to do all of these things to improve your psychological flexibility. You may choose the ones that work best for you and leave the rest. You can use them when you need to and leave them when you don’t. There aren’t many hard and fast rules. The most important aspect of ACT and really any therapeutic modality is to just start trying it. See if it fits your personality and take action.

I hope this article has helped explain some facets of acceptance and commitment therapy. Please keep in mind this article is not intended as professional therapy or clinical advice. If you need help with a mental health issue you are facing, please contact a licensed mental health clinician.

I wish you well.

-Dr. Zaleski

Dr. Katrina Zaleski is a licensed clinical psychologist providing therapy in the state of California. One of her specialties is working with those looking for help with depression and anxiety. Learn more about Dr. Zaleski’s services for Depression Counseling and Anxiety Counseling.

Reference

Harris, R. (2008). The happiness trap. How to stop struggling and start living. Shambhala books.