What is Acceptance and Commitment Therapy?

Perhaps you notice you are often consumed by unhelpful thoughts that get in the way of you doing things or experience difficult emotions that can feel intolerable sometimes; maybe you notice you feel a bit lost, dissatisfied with what you do on a day-to-day basis but are struggling to understand why or what else you could be doing.  If any of this sounds familiar, then Acceptance & Commitment Therapy (ACT, an approach developed by Steven Hayes in the USA) might be an approach that you find helpful.

Does this mean I just need to “accept” what is happening and deal with it?

In short, no! Acceptance in ACT doesn’t mean just putting up with how things are. The aim of ACT is to create a rich, full, and meaningful life while accepting the pain that inevitably goes with it. The overarching aim is to promote psychological flexibility – the ability to be in the present moment with full awareness and openness to our experience and to take action guided by our values. This helps enhance quality of life because we can respond far more effectively to the problems and challenges life inevitably brings.

ACT is more about our relationship with our thoughts and emotions rather than the content. So, it doesn’t identify thoughts/feelings as right or wrong, but instead as helpful/unhelpful depending on where we are, what we are doing etc. It uses a great analogy called ‘Passengers on the Bus’ to illustrate this:

Imagine you are driving a bus to a destination of your choice; somewhere important to you (i.e., a rich and meaningful life based on your values). On the journey with you are several passengers. These passengers have their own ideas about where the bus is going. When they are not happy about the direction, they shout and try to persuade you to do things their way. These passengers represent your thoughts, memories, emotions and physical sensations. You might have the “anxious passenger” shouting about everything you need to worry about, or everything that could go wrong; maybe there is the “angry passenger” that tells you how unfair everything is.

Now there are a few possible ways to respond to these passengers:

1. The Struggle – You (the driver) may try to get the passengers to be quiet by arguing with them or shouting over them. All your energy is spent in arguing with the passengers rather than focusing on the direction of travel (towards your values). This is exhausting!
2. Giving In – You may try to make peace with the passengers and do what they say – giving in or avoiding doing things because it’s too hard. This may make us feel safe in the short term but in the long term keeps us stuck.
3. Willingness – You acknowledge what the passengers are saying but keep hold of the steering wheel and continue driving towards your values. The passengers are still shouting, but you choose to carry on.

The willingness option accepts that we don’t have control in what thoughts and feelings show up, but we can control what we do when they do come up. We can allow them to ‘chatter’ away in the background, recognizing them for what they are –some of the hundreds of thousands of thoughts we have in a given day, a wave of one of the many emotions we experience in a given day, and continuing doing what we want to do. Although I appreciate this is easier said than done!

What does ACT involve?

ACT sessions typically incorporate a range of techniques including the following:

• Understanding different aspects of the problem and how they link together e.g., what kind of thoughts you find yourself caught up in, and how the process of being caught up in thinking leads to certain behavioral actions that can be life-draining or unhelpful in the long term; and what kinds of emotions you struggle with and why.
• The focus is on changing your relationship with your thoughts (and emotions) rather than the thoughts themselves, so we focus more on what you can do when an unhelpful thought shows up rather than the ins and outs of what it means and trying to ‘correct’ it.
• Strengthening the ability to be more present focused both practically and through mindfulness meditation
• Connecting you with your values, i.e., the key qualities that bring you meaning in life
• Planning how to take committed action towards a more value-driven lifestyle and taking this action in a helpful way

If you like the sound of the above, and think it might be helpful to you, then don’t hesitate to get in touch with professional services to help you think about next steps. Typically, you will start with an assessment to understand your needs better and agree together whether this is the right approach for you and what to expect in sessions.

Written by: Dr Gurveen Ranger
Clinical Psychologist at Sage Clinics