Acceptance and Commitment Therapy 11/14/2023

Written by Amanda W. and Sarah B. and reviewed by TWCCLLC counselors

In today’s edition of our Types of Therapies Series, we will discuss the type of therapy referred to as Acceptance and Commitment Therapy, or ACT (like the word, not the test). This form of therapy is used by many of our counselors here at The Well and is one that just might work for you. Let’s explore and see what you think.

ACT is in the family of cognitive behavioral therapies with CBT (Cognitive Behavioral Therapy) and DBT (Dialectical Behavioral Therapy). While they’re all in the same family, they are each unique. What makes ACT unique is that it focuses on the idea of defusion from internal experiences rather than dwelling on them and attempting to change them. Defusion is not to be confused with dissociation – the goal isn’t to escape internal experiences, just to not take them too seriously. 

The first step to defusion is learning and applying mindfulness skills (how can we defuse if we don’t notice what’s happening?). When learning mindfulness, we learn how to observe, describe, and participate in the present moment nonjudgmentally, one-mindfully, and effectively. Nonjudgment is the thing that people tend to struggle with the most because it’s an automatic impulse to categorize things as good, bad, right, or wrong. While that may be useful when selecting fruit or deciding whether or not to wear your seatbelt – it is not helpful when we make a mistake on a task or with a friend (perhaps try “I’m human and I’m learning” as a replacement for self-judgment). 

Developing mindfulness helps with another important ACT component – acceptance. Acceptance doesn’t mean that we agree with or condone anything, it just means that we accept the present moment as it is without adding to it or subtracting from it. Negative self-talk in response to mistakes is a good example of adding to reality. That’s a good way to make the present moment harder than it has to be (we call that unnecessary suffering) and why we aim for defusion of those kinds of negative automatic thoughts that interpret the emotions we feel in response to something. 

If we tell ourselves that we are bad and not good enough every time we make a mistake AND we believe it then, not only are we adding to reality, we are also maximizing our misery. On the other hand, if we can remember that a thought is just a thought and not necessarily true just because we thought it, then we have the power to defuse from that thought and shift to thoughts that are more helpful and accurate (I’m human and I’m learning) while diverting an unnecessary shame spiral. 

The ability to divert that shame spiral and shift our thinking is the ultimate goal of ACT because it leads to what we call psychological flexibility. This skill helps us shift flexibly based on the context or situation that we are in so we can respond to situations effectively. 

To tie our example together – if we make a mistake on a task and have the negative automatic thought, “I’m so bad at this, I’ll never get it right”, that will trigger feelings of shame (I’m bad) that overwhelm the body which will then trigger the behavior of giving up. However, if we make a mistake, notice the negative automatic thought, remind ourselves that a thought is just a thought and not necessarily true (defusion), and intentionally use self-talk that is encouraging (I’m human and I’m learning – then we have changed the whole process and the outcome. Mistake → a little sad → encouraging self-talk → try again and learn a little more until we reach mastery. 

Notice that we’re not trying to change or escape emotions and none of the emotions are considered “bad.” Eradicating negative emotions would be a lofty and unrealistic goal. ACT views all emotional experience as adaptive, it’s our judgment of emotion that creates unnecessary suffering, not the emotion itself. For example, anxiety is often perceived as an unwanted emotion. But, moderate amounts of anxiety are what motivates us to wear a seatbelt, pay a bill, study for a test, and look both ways before crossing the street. Feeling down motivates us to rest and recuperate after stressful events that deplete our energy. 

In other words, ACT is focused on learning to be present in the moment so we can face life’s challenges head-on and flexibly adjust to a variety of contexts effectively. It teaches how to be accepting of unpleasant feelings, not to overreact to them, and to bravely face situations where those unpleasant feelings may arise. It encourages the development of adaptive behaviors that reflect our values while dealing with challenging situations. With ACT, we learn how to shift away from unnecessary suffering and obstacles so our values can become our guide and we can create a space for growth and living a life that focuses on aligning with our values rather than avoiding what we fear. 

ACT vs CBT: Which is Best for You?
After discussing CBT in our previous blog, let’s compare it to ACT. While both methods work towards helping us overcome challenging emotions and thoughts, their approaches are very different. CBT focuses on challenging and reframing patterns of thinking that aren’t accurate or helpful, whereas ACT teaches us to accept that unwanted feelings and situations as a natural aspect of life while helping us learn that we don’t have to believe (or pay attention to) everything we think.

In general, ACT has been helpful for a broad spectrum of physical and psychological conditions. It is often used for depression, obsessive-compulsive disorder, post-traumatic stress disorder, and psychosis. Additionally, it can help with managing high levels of stress and various forms of anxiety. 

If you think this type of therapy would be beneficial to you or someone you know, please reach out to us at 816-974-7378. We would love to connect you to one of our therapists. Be watching for our next segment about Dialectical Behavioral Therapy coming soon, and as always Be Well.


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