Acceptance And Commitment Therapy

Written by Kate Southwell on 13th of January 2021
Clients who I’ve been in contact with recently will know the term “ACT” (short for Acceptance and Commitment Therapy). I wanted to write a little about it here as it’s become so prominent in my therapeutic style.

One major principle of ACT is to encourage people to live by their values. If we are feeling anxious or depressed, we often find we start to grow further away from behaving in the way we want to. Values aren’t defined as goals or things we feel we should be doing, but more compass bearings on how we want to live our lives. A value can relate to absolutely anything that is important to us and in therapy, I help clients to identify what matters to them personally. Rarely do people have the exact same set of values as they can be so far ranging, from a value related to being ‘fit and healthy’ or ‘treating others with respect’ to ‘considering the environment wherever possible’ or ‘being an empathic partner/friend/parent’. Once we have identified values together, we can work out how to live by them, no matter what thoughts or emotions stand in our way. For example, I might have a value of being ‘fit and healthy’ but perhaps don’t fancy engaging in healthy activity. Perhaps I feel tired or it’s cold outside so I decide I won’t do the run I’ve promised myself I’ll do. ACT is about encouraging relevant activity no matter how we feel. It suggests that it isn’t about wanting to do it, feeling in the mood for it, or even doing it because we’ll feel better afterwards (although we might!), but rather about doing it simply because it is in keeping with our values.

So, one key is defining our values – what is really important to us? What is less important? Therapy is then aimed at making changes to our behaviour to live a more content life as we align it to our value systems. Often (but definitely not always) negative emotions come from conflicts within value systems and adjustments to our actions can make a surprising difference to how we feel.

Another huge part of ACT is redefining how we see our emotions. Most people are taught through the messages we absorb in our environment that ‘hard’ emotions are bad, and generally best avoided. ACT asserts that suffering is ubiquitous – meaning that everyone will have some level of suffering in their lives. Clearly, some humans face much more suffering than others; the aim of ACT is not to dismiss that, but rather to embrace suffering as part of life. Sometimes, when we ride the waves of our emotions out, we find we feel less plagued by them. If we spend hours, days, months of our lives ‘fighting’ to feel better, we are still in the metaphorical battle field, in close proximity to the emotions we don’t want to be near. ACT employs a series of techniques (including mindfulness) which I teach in therapy, to help us to become less meshed with our sadness, anger, hopelessness etc and instead move towards our values. This does not mean that we won’t experience a full host of emotions, it just means that they can come along with us for the ride rather than immobilise us. Indeed, if we leave the battlefield, they may follow us; but at least they can watch while we do the things in life that are important to us, rather than hold us hostage and wear us down by engaging us in the fight.

One of the most powerful images I consider when I am using ACT is that of a ‘monster at the door’. I encourage clients to imagine that they are in a room with an open door; beyond that door is the path towards living a life a in keeping with our values. However, blocking the path is a monster. The monster (unwanted emotions and thoughts) keeps telling us not to bother leaving. He shouts at us to stay in the room, to keep ‘safe’, not to push ourselves as it’s so risky outside. He tells us that he only cares about our wellbeing and that he just doesn’t want us to get hurt or to feel bad. Now and again, we might argue with him, try to talk it out, saying “but maybe it’s nice out there, maybe I’ll enjoy it”, but he always has a convincing reason to keep us in the room. ACT is a series of techniques which we can use to walk past the monster and take him with us (if he must come!). He might regularly shout at us, tell us we’re doing it wrong, suggest that we were happier in the room we’ve come from – but we don’t have to listen to him, or even engage with him, and as we keep walking, he might just get a little smaller.

I have increasingly found ACT to be helpful for many clients, although it is not for everyone. If you decide to see me for therapy, I’ll fully assess your needs and we’ll work together to do what’s best for you. If you’d like to know any more about this style of therapy, I’d highly recommend the book “The Happiness Trap” by Russ Harris.
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