Acceptance and Commitment Therapy (ACT) is at the heart of a lot of the work I do with people who see me about anxiety and intrusive thoughts. It’s a way of learning to deal more effectively not just with unwanted thoughts and feelings, but also with difficult situations.
Where Acceptance and Commitment Therapy differs from Cognitive Behavioural Therapy (CBT) is in the way that it teaches people to deal with their thoughts.
The CBT model can be seen as a conveyor belt or production line. Thoughts are generated and then examined as they come down the line for their accuracy, relevance or usefulness, and if necessary rejected and replaced with a new thought.
Instead of this engagement with every thought Acceptance and Commitment Therapy teaches people to see their thoughts as passing by them, but more like leaves in a stream or clouds passing by a window. Instead of examining the thought people learn simply to notice it, without judging or testing it. In this way Acceptance and Commitment Therapy moves people from saying “I am anxious” to “I am having those anxious thoughts”. The underlying principle here is, as Jon Kabat-Zinn said, that “you are not your thoughts”, and it’s at this point that Acceptance and Commitment Therapy’s links to mindfulness are most obvious.
Our thoughts aren’t always right, and neither are they always helpful or healthy. What we all have the tendency to do though is not just to treat our thoughts as true but to regard them as if they were factual and real in the outside world. Acceptance and Commitment Therapy teaches practical methods to reduce this tendency, and to reduce the mental distress that can accompany it.
As well as mindfulness techniques Acceptance and Commitment Therapy is also based on addressing “experiential avoidance”. Avoiding unpleasant situations or emotions is ultimately self-defeating, as the distress and suffering that we cause for ourselves increases our overall discomfort. Avoidance also keeps us trapped in patterns of thought and behaviour that become more and more restricting over time. The Acceptance in Acceptance and Commitment Therapy is this acceptance of our thoughts and our experiences, as opposed to their avoidance.
The Commitment in Acceptance and Commitment Therapy is the commitment to identify our values – what is important to us? how do we decide if we are successful? – and as importantly the commitment to live by our values. It’s through living in accordance with our values, as well as creating a more settled and mindful mind-set, that Acceptance and Commitment Therapy improves mental wellbeing and quality of life.
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