What is Acceptance and Commitment Therapy (ACT)?
Acceptance and Commitment Therapy (ACT) is a therapeutic technique developed by Steven Hayes in the 1980s. ACT is based on Relational Frame Theory (RFT), a psychological theory suggesting that because humans have language they are able to easily and regularly evaluate nearly all of their experiences in a negative way, compare themselves to supposed ‘ideals’, identify personal ‘shortcomings’ and use these as evidence for their perceived ‘unworthiness’. It is in this way that ACT treats unpleasant thoughts as a completely normal human occurrence. In accordance with this, research demonstrates mental illness to be very prevalent amongst a range of populations, with mental illness being one of the leading causes of disability worldwide, and approximately 50% of people meet the diagnosis for a mental illness at some point in their lifetime. With the view that unpleasant thoughts are in fact normal, the aim of ACT is to teach individuals to ACCEPT the presence of such thoughts without letting them take over, and COMMIT oneself to achieving a more fulfilling life by participating in behaviours that are meaningful to them.
Six Core Principles of ACT:
The goal of ACT is for one to achieve psychological flexibility. Psychological flexibility can be defined as “the ability to fully contact the present moment and the inner experiences that are occurring without needless defence, and, depending on the context, persisting or changing in the pursuit of goals or personal values.” Put simply – this means distancing yourself from your negative thoughts; not trying to get rid of them but also not letting them take over – and – behaving as you would if those negative thoughts did not exist; therefore behaving in ways that will lead to fulfilment. ACT aims to achieve psychological flexibility through the following six core principles:
- Contact with the present moment: which as the name implies, involves being aware of the here-and-now instead of daydreaming or doing things on “autopilot”. This involves taking the time to “tune in” to things one usually wouldn’t. For example – when eating dinner – enjoying the aroma of bolognaise pasta, being aware of one’s fork and how it feels against one’s tongue, listening to the sound of each chew, feeling the warmth of the food going down one’s oesophagus, and so on. Practicing this principle will prevent one from dwelling on the past or worrying about the future, both of which can be unhelpful.
- Cognitive Defusion: involves detaching oneself from unpleasant thoughts, instead of letting them control you. Thoughts are viewed as merely bits of language or images rather than objective facts, and are treated with minimal importance. It is in this way that one’s negative thoughts become less threatening and have less impact on one’s psychological wellbeing.
- Expansion & Acceptance: refers to being okay with the presence of one’s negative thoughts. The reasoning behind this is that when someone tries to get rid of their unpleasant thoughts, paradoxically, they can actually increase in number. This can do someone more harm than good, and leave them feeling quite frustrated. When one accepts that unpleasant thoughts are in fact a normal human occurrence, does not fight against them nor engage in them, such thoughts have much less impact on an individual’s wellbeing.
- The Observing Self: is related to ones awareness and attention. It is believed that there are two parts to the human mind; the thinking self and the observing self. The thinking self includes one’s thoughts, opinions, goals, feelings, memories and so on. On the other hand, the observing self is being aware of one’s ‘thinking self’ at any point in time, and is what allows us to be unaffected by our negative thoughts. Whilst the observing self is an important part of human consciousness, it is often ignored in Western Psychology.
- Values Clarification: involves highlighting to a person what really matters to them and what they stand for. It should be noted that while one’s values and goals may align, they are different. Goals are usually associated with attainment; they can change, be completed, and be replaced with a new goal. Values are different in that they are usually associated with one’s behaviour; they are usually long lasting and consistent. For example – a football player’s goal may be to win a premiership, and values may include being a respectful and supportive team member. By clarifying a person’s values they are able to focus on what is really meaningful to them and act accordingly, instead of getting caught up in unhelpful thoughts.
- Committed Action: relates to the steps taken by an individual towards a more fulfilling life, even if such steps are challenging or uncomfortable to begin with. Committed action includes living in accordance with one’s values, and achieving goals that are value-driven. During therapy the psychologist may set homework for their client to help them achieve their short, medium and long-term behavioural goals.
When ACT is useful:
Research has shown ACT to be useful in treating children, adolescents and adults suffering from distress.
Research suggest ACT is effective in treating the following psychological conditions:
- Obsessive Compulsive Disorder
- Workplace stress
- Stress of a terminal illness
- Symptoms of chronic pain
- Post Traumatic Stress Disorder
- A Variety of Anxiety disorders
- Drug Addiction or Abuse
- Impulse control disorders
- Personality Disorders
- Parental distress
- Stigma issues
- Infertility stress
- Marriage problems