Acceptance and Commitment Therapy

Acceptance and commitment therapy (ACT) is a recent therapeutic approach and part of the third wave of cognitive behavioural therapy. While the conceptual basis of Cognitive Behavioural Therapy (CBT) lies in modifying one’s maladaptive and ineffective belief systems, thoughts and behaviour, ACT focuses on accepting them. How many times have you noticed that you are simply not able to fall asleep when you are actively trying to fall asleep? Or what if I say, don’t think of a white elephant? all you can think of now is likely a white elephant. so our efforts to front our thoughts and emotions can sometimes have a paradoxical effect. Hence, Acceptance and commitment therapy (ACT) focuses on accepting these maladaptive thoughts and behaviours rather than avoiding them.

Acceptance and commitment therapy (ACT) was developed by Stevens C. Hayes and colleagues in the 1980s, and it’s based on the theoretical foundations of Relational Frame Theory (RFT). RFT posits that humans create relationships between thought and the world around them through language. A young child, for instance, might favour a nickel over a dime because it is bigger, but as they get older, they might decide that a dime is better “because it is bigger.”

This example reflects how our relational thinking can develop over time and can also affect our behaviours, such as our decision-making. In other words, according to RFT, our human cognition is shaped by how we relate to the world and how we create and manipulate our relational frameworks. These relational frameworks are learned and used arbitrarily which makes it quite challenging to control or avoid them. For example, a child might have developed a self-critical thought that they are unloveable based on arbitrary cues, which influence their behaviour, thus making it difficult to change. so ACT can help you deal with these relational frameworks more effectively and assist you in accepting and making space for your thoughts and behaviours rather than engaging in a futile battle against them.

Processes of Acceptance and Commitment Therapy (ACT)

Acceptance and Commitment Therapy (ACT) consists of six major processes that allow you to reshape your thinking and set you up for the path of accepting your thoughts and behaviours rather than fighting them.

A. Acceptance

The concept of psychological flexibility is quite central to ACT. Psychological flexibility allows you to be present with your thoughts and feelings without feeling dominated by them. Rather than fighting these thoughts and behaviours, you should fully experience them without trying to change or avoid them. The aim here is not to get rid of these thoughts, feelings and behaviours but to change the way you relate to them. By learning to accept and experience these thoughts and emotions fully, you reduce the power they hold over you.

When you create space for these thoughts and behaviours to exist you are less likely to be overwhelmed by them. When you accept your uncomfortable experiences, you can clearly identify and commit to actions and experiences that align with your core value system. For example, once you start accepting your feelings of insecurity, you might be able to pursue meaningful interpersonal relationships despite the challenges or the uncomfortable feelings.

B. Cognitive Defusion

Whenever a maladaptive or ineffective thought arises, CBT aims to change the content of the thought or reconstruct those thoughts. However, ACT focuses on changing the unpleasant function of the thought. In other words, cog diffusion aims to change how to relate to a particular thought or the relational framework. In other words, you can perceive these thoughts as reality and as the truth that you must believe and act according to it; rather, it allows you to perceive it as just an externally observable event.

This helps to take away the unhelpful and ineffective function of the thought. So if you get a thought that “I am a failure” rather than identifying with the thought you can say that “I am having a thought that I am a failure”, or you can thank your mind for having a compelling thought or you can inspect the historical context in which this thought occurred, maybe it occurred when you were taking an exam or made a mistake at work or maybe you felt some emotion such as shame guilt or sadness. By doing this you are creating distance between self and the thought. This can also make the thought less believable hence reducing the ineffective function that they serve.

C. Being Present

This refers to being completely aware of your physical and psychological events and also observing them in a non-judgemental manner and not labelling them as good or bad. This allows you to observe the external or internal events directly rather than colouring them with your judgements. This direct observation allows you to build psychological flexibility; rather than believing according to the avoidant or habitual responses, you can behave and respond with alignment to your core values.

If you are experiencing anxiety when you are about to give a presentation, rather than labelling this psychological event as good or bad, you can simply observe it and accept it as a natural part of the experience. and this direct overstated allows you to access the situation and you may decide to move forward with the presentation which aligns with your professional or academic values and also fosters psychological flexibility.

D. Self as Context

Human language through a relational framework helps individuals to develop a sense of self. This sense of self is often referred to as context, this self as context provides you with a solid perspective to observe internal and external events without becoming overly attached to them. So it’s not about the specific thoughts and emotions but rather what perspective you observe these thoughts and emotions from. Self as context is important as it facilitates psychological flexibility.

It helps you to view your experiences, thoughts and emotions from a detached and observer stance without being overly attached to them. Developing this perspective also sets you up for the journey towards acceptance. You are able to readily accept your experiences because you are not attached to them and not overwhelmed by these experiences, which leads to better processing of these experiences.

You can develop the self as context through various practices such as mindfulness, metaphors and experiential learning. In mindfulness, you can practise observing your thoughts and emotions without judging them and without putting them in categories. This allows you to observe your mental and environmental events pass by as your sense of self remains constant. Another way to cultivate self as context is by using metaphors. A very common metaphor used by therapists is the “sky and weather”.

Imagine yourself as the sky, which is constant and static and imagine your psychological and physical events as the weather, which is dynamic and ever-changing. like the sky, your sense of self is stable and static while your thoughts, feelings and events, just like the weather, are dynamic and eventually pass away. Last, experiential processes or activities can be used to develop a self of self. recall all the different emotions you have felt throughout this week or recall some memories from your past.

By doing this you will notice how these emotions, thoughts and events pass through while the sense of self or “I” remains constant and unchanged. These exercises and activities help you create that space to experience your mental and environmental events without judging them and also without getting overwhelmed by them.

E. Values

This process of ACT involves taking actions and behaviours which align with your values. One of the goals of ACT is to help you identify what is truly important in your life. However, trying to find and identify your values can be a daunting task as it is different to separate what you want and what truly matters to use and what’s actually societal expectations and external pressure. Finding your true values requires self-exploration. These values and value systems are not something static or achievement or sort, but something that you can express through your behaviours and your actions.

society imposes various constraints on individuals. Usually, individuals may adopt behavioural patterns which align with society’s expectations or to avoid rejection and feelings of inadequacy. For example, you might feel like you “should” choose a certain career because it’s prestigious or because of family expectations. three kinds of behavioural patterns and thinking can be extremely detrimental to a person. Hence ACT aims at eliminating these patterns and also to facilitate the growth of an authentic self, a self that realises its values.

F. Committed Action

Committed actions mean creating a wider pattern of consistent value-oriented actions. In this sense, you can integrate various cognitive and behavioural therapy approaches, such as skill acquisition, shaping methods and goal setting. Sometimes taking committed actions towards your goals can be tough as you may experience a lot of obstacles. When you are trying to take committed action toward something, you might get thoughts like “What is the point of this”, during times like these you can implement a cognitive diffusion strategy. It can help you to realise that what you are experiencing is a thought or a mental event which will eventually pass. This helps you to strengthen your psychological flexibility.

All these ACT processes are interrelated to each other and tend to complement one another. All these processes together promote psychological flexibility. all these six processes can be categorised into two parts. One, is the mindfulness and acceptance process, which includes acceptance, cognitive defusion, being present and self as context. all these processes together help you to achieve mindfulness. and for the second part, behavioural change processes which include self as context values and committed actions.

How Acceptance and Commitment Therapy (ACT) Differs From Traditional Therapies

Acceptance and commitment therapy (ACT) and Cognitive Behavioural Therapy (CBT) are both evidence-based therapeutic approaches and they do have some commonalities between them, however, they are different from each other in their main goals and the methods that they use. CBT is based on the assumption that your negative and maladaptive thought patterns lead to negative emotions and behaviours. and Identifying and eliminating these negative thought patterns is essential for the reduction of psychological distress. ACT focuses on acceptance and mindfulness rather than controlling or contradicting negative thought patterns. It allows us to look at our psychological and environmental events as mere experiences and urges us to detach from them.

As CBT emerged out of behavioural and cognitive paradigms, CBT offers a more mechanistic view of the mind and the goal is to alter the maladaptive patterns to relieve stress and enhance emotional well-being. whereas ACT is based on functional contextualism and Relational Frame Theory (RFT) which emphasizes psychological flexibility. the aim here is to accept and commit to taking meaningful and value-oriented actions rather than falling into the avoidance pattern of behaviour.

Criticisms and Challenges of Acceptance and Commitment Therapy (ACT)

Acceptance and Commitment Therapy (ACT) has gained prominence in the field of psychotherapy, however, it’s not without its criticisms and challenges. One of the major criticisms of ACT is that its techniques can be quite complex. Processes or techniques such as cognitive diffusion and self as context can be very complex and abstract even. These techniques are also hard to master for the client and even for the therapist, it requires consistent practice. The main goal of ACT is to increase one’s psychological flexibility but it can be very different for individuals who have or are experiencing great psychological distress and/or cognitive impairments.

ACT might also run into some problems during its implementation. Many therapies that are accustomed to more structured interventions and therapeutic models such as CBT may find the experimental nature of ACT a bit difficult to adapt to. The lack of a step-by-step procedure may cause difficulties. Most of the clients desire and sometimes may also need symptom reduction at a particular moment and ACT orientation towards value-based actions rather than focus on symptom reduction can cause significant distress to the client.

Some clients may face difficulties in engaging in acceptance due to painful emotions and the daunting process. However, this might lead to clients experiencing resistance which can significantly impact the engagement of the client in therapy. In non-Western societies, the self is understood in relation to family community social roles etc. ACT’s focus on personal values and self as context may clash with cultural norms. therapists can be more culturally sensitive when applying ACT, and one can adapt the processes in order to make it more culturally appropriate.

Conclusion

So Acceptance and Commitment Therapy (ACT) provides us with a unique approach towards psychological well-being. It emphasises acceptance, mindfulness and committed actions rather than only focusing on symptom reduction. It can be very useful for people who find it challenging to control or eliminate their negative thought patterns as suggested in CBT. ACT has its philosophical foundations in Relational Frame Theory (RFT), which suggests that human cognition, though language, is shaped by how we relate to the world around us and our experiences.

The main aim of ACT is to increase the psychological flexibility of the individual. Psychological flexibility in ACT refers to the ability to stay present and non-judgement towards one’s own thoughts and emotions. It also refers to the ability to observe your thoughts and experiences without feeling overwhelmed by them. ACT emphasizes being according to your core values and not reacting based on avoidance or distress.

However, like any other therapeutic model, Acceptance and Commitment Therapy (ACT) too has some criticism and challenges. ACT is very complex and abstract which might be difficult for some clients to comprehend and sometimes even for the therapist. therapists who are accustomed to CBT or other structured therapeutic models might face difficulties in adapting to a model which is abstract in nature and does not have step-by-step procedures.

Last, its overemphasis on personal values and self as context might clash with some cultures that understand self in relation to the family and community. This highlights a need for a more cultural adaptation of ACT. In essence, Acceptance and Commitment Therapy (ACT) is a very useful tool for promoting well-being by allowing individuals to accept their mental and physical experiences and commit to living a life which aligns with their core values. This can lead to increased fulfilment in life and make you more recent and adaptive in a world that is constantly changing.