ACT: What’s up with all the acronyms?
Therapists can make therapy pretty confusing.
To be fair, we’re just working with what’s out there - but there are a lot of confusing things out there! How do you know what kind of therapy you need? How do I find a therapist I vibe with? And seriously, what’s up with all the acronyms?
Let’s demystify some of these things together. Today, we’ll take a look at Acceptance & Commitment Therapy, or ACT. We’ll explore what it is, where it comes from, and look at some of the key themes to see what might resonate with you.
What is it and where did it come from?
Acceptance & Commitment Therapy is a part of what’s called the “third wave” of behavioral therapies. Along with a more traditional focus on behavioral interventions, these therapeutic approaches also bring attention to acceptance, mindfulness, and compassion. ACT guides us to navigate painful events with acceptance, while committing to take values-driven actions to create the kind of life we want to live - hence, the name. It was developed by Dr. Steven Hayes in the 1980’s with the goal of building what Dr. Hayes refers to as “psychological flexibility”.
Psychological flexibility refers to our ability to stay in the present moment, even when the moment is painful, and choose to act based on our values. We learn how to do this by engaging in the six core processes of ACT: acceptance, defusion, contact with the present moment, self-as-context, values, and committed action. Let’s dig into each of these a bit further.
Acceptance
In the context of ACT, acceptance refers to the act of “opening up and making room for unwanted private experiences: thoughts, feelings, emotions, memories, urges, images, impulses, and sensations.” Through acceptance, we learn to spend less energy and effort on fighting off these things that we may deem as “bad” or “wrong”. Instead, we learn to exist alongside them. We make room for these unpleasant experiences without trying to rid ourselves of them.
Some techniques that may be used to move towards acceptance include first noticing the experience and allowing it to be there. You can try to normalize the feeling by reminding yourself that feeling something means you’re human. You might also use visualizations: imagining what shape an emotion may take, imagining that you’re opening space inside of you to hold the feeling, or imagining your breath flowing into and around it.
Defusion
Defusion, also called cognitive defusion, is the process of gaining some distance between ourselves and our thoughts. ACT presents the idea that many of us are “fused” with our thoughts - that we often automatically accept them as truth, or grant them a lot more weight than they deserve. Therefore, when we “defuse” ourselves from our thoughts, we’re able to acknowledge that a thought is just a thought. No more, no less. This distance gives us back control of our lives.
There are a ton of approaches we can take here: simply stating that we notice we’re having a thought about (insert topic here), singing the thought or saying it in a silly voice, imagining that it’s written out on a computer screen and turning it into clip art. Other techniques involve talking to your brain and thanking it for its thoughts, identifying that your brain is just trying to solve a problem, or naming the story your brain is telling you. These techniques all work towards the same purpose: giving us the ability to notice our thoughts and gain a little distance so that they don’t feel quite so heavy.
Contact with the Present Moment
Contact with the present moment is all about being where you are. Rather than getting caught up in anxieties about the future or regrets from the past, we center ourselves in the here and now. We observe everything nonjudgmentally: our internal experiences, the physical world around us, whatever the moment calls for. That psychological flexibility allows us to adapt to what is needed or most useful in the present moment.
ACT places a lot of emphasis on the flexibility here, because there are significant costs to being inflexible. When we can’t be flexible, we can’t be fully present. Getting hooked by our thoughts and feelings steals our ability to be flexible, and we miss out on experiences, connection, and doing our work with excellence.
To build this flexibility, we can practice skills to engage more fully with the activities of the present moment, to really lean in and enjoy the current moment, and to focus in fully on whatever we’re doing. It doesn’t have to all be about meditation - we can practice this mindful awareness throughout our day with just about anything we find ourselves doing.
Self-as-Context
Self-as-context is less about a specific process and more about who we are. ACT suggests that there are two elements to our mind: the thinking part and the noticing part. We generally talk a lot more about the thinking part. Our mind is constantly generating thoughts, so naturally that tends to call more attention. However, there’s also a part of our mind that is always noticing what’s going on. We can “step back” and notice that we’re thinking. Self-as-context is that noticing self, always quietly aware of what’s going on within us.
A helpful metaphor here that’s often used is to think about the weather vs. the sky. Your noticing self is like the sky - it’s always there. Your thoughts and feelings are like the weather - it’s constantly changing. No matter what kind of terrible weather passes through, the sky itself is unharmed. The sky always has room for it, and sooner or later, the weather will pass.
Values
Values are the qualities and characteristics that describe what we want our lives to look like. When you think about who you are, what your character is like, what kind of person do you want to be? When we’re not living in alignment with our values, we often notice a lot of tension and discomfort. In order to live a better life, ACT says that we need to know what direction we’re heading. By identifying and clarifying our values, we now have a compass pointing us in that direction.
Values are different from goals in that we can live out our values here and now, in one way or another. Sometimes, our values conflict. We may want two seemingly opposing things, and then we have to prioritize which values we choose to act on. We don’t have to do it “perfectly” - we just want our values to guide us towards a meaningful life.
Committed Action
As the “commitment” part of ACT, committed action refers to the action steps we take, guided by our values, to live the lives we want to live. It refers to physical and psychological action. It’s great to know our values, but they don’t do us a lot of good if we’re not putting in the work to live them out. Committed action can relate to a wide variety of skills and tools that we may need to apply in order to bring us closer to living out our values.
Sometimes, this looks like learning how to problem-solve to navigate a difficult situation. Maybe we need to set a goal for ourselves to drive us to action. Additionally, we might have to practice accepting that some things are outside of our control so that our attention can be directed to the things within our control. As uncomfortable as it might be to make these changes, we know that they will ultimately serve to bring us closer to a meaningful life.
Resources
ACT provides us with a ton of useful tools and concepts. It acknowledges our very human tendency to avoid uncomfortable experiences, often at the cost of our own best interests. By challenging us to accept that these experiences are a part of life, acknowledge that we have a choice to make, and commit to moving towards a more meaningful life, ACT can be an incredibly helpful framework to facilitate growth and change.
If you’re interested in learning more about ACT, here are some recommended resources for further reading:
Get Out of Your Head and Into Your Life by Steven Hayes, PhD (a workbook created by the founder of ACT)
ACT Made Simple by Russ Harris (great for clinicians!)
The Happiness Trap by Russ Harris (great for anyone!)
Russ Harris’s YouTube channel (clear explanations of concepts and metaphors used in ACT)