ACT 101: What is Acceptance and Commitment Therapy?

Acceptance and Commitment Therapy, or “ACT” is a psychological intervention many therapists use to help clients achieve more insight about their thoughts and feelings, encourage behavior change, and to increase psychological flexibility and distress tolerance.

While searching for a therapist, you may have come across therapist profiles that inform clients about the therapist’s style and interventions they use in sessions. Therapists often name skills and training in areas like cognitive behavioral therapy (CBT), psychodynamic therapy, Gestalt or mindfulness-based interventions. Like these, ACT is another type of therapy that teaches clients about their values, moving towards distress tolerance by accepting tough situations as being tough, and learning skills to make values-driven choices and move towards our goals. If you are interested in ACT, here are some key terms to help you understand what it is all about.

1. Cognitive Fusion

This refers to the idea that we get too caught up in our thoughts and feelings rather than the reality of what we are really experiencing. For example, we may find socialising scary because we believe it is difficult to talk to people or that people tend to be judgy. You may have flashes of that one time you embarrassed yourself in a group when no one understood your jobe. These are assumptions, beliefs, and images we have about this situation but the reality may be that the person interacting with you is very easy to talk to and interested in everything you are saying! Without bringing awareness to your surroundings and eternal experience through the 5 senses, you may be making decisions and taking actions based on your internal experience.

2. Experiential Avoidance

Here is when we do things to avoid the unfavorable thought or feeling. With the previous example, we may decide to stay home and miss opportunities to make new friends. This avoidance can lead to not asserting boundaries or asking to be included on projects, or giving speeches even if we are hunting for opportunities to grow at work or school. As a result, life narrows down and we are unable to create the life we imagine as ideal.

3. Defusion

This takes place when we learn to observe our thoughts and beliefs as they are: as products of our mind. Not all thoughts and beliefs we have need to be true. You can recognise that you have thoughts (that are sometimes true and at other times only partially true), and that you do not have to act on the thought.

4. Acceptance

Acceptance or “radical acceptance” as it is sometimes called in ACT is choosing to be open and non-judgmental towards one’s internal experiences. Sometimes it may look like acknowledging that something brings an intense feeling of shame and anxiety when we even think about it. Acceptance is realising they can arise and will arise despite being unpleasant to deal with.

5. Willingness

Willingness involves deciding and making choices about our life’s narrative or story. We may explore your Life Story and Values in ACT therapy sessions to determine where you want to be and what your goals are. Using distress tolerance skills and acceptance, we continue engaging in value and goal driven behaviors to achieve our goals.

One of the best quotes I like because it is representative of ACT is

“pain is inevitable, suffering is optional”.

If you find yourself trying to resist feelings of fear, anxiety, or sadness, it can be helpful to not only acknowledge them as inevitable and understand why they exist, but also to take committed steps to make change possible. If you are interested in exploring your goals, values, and ACT with a professional, my wonderful colleague Mark and myself (Aanchal) are trained in ACT and we are accepting clients for acceptance and commitment therapy currently!