Acceptance and Commitment Therapy (ACT) is a third-wave Cognitive-Behaviorual Therapy (CBT), centred on the idea of acceptance, presence, and values-focused life as an approach to managing mental health problems. ACT assumes the idea that the human brain is an outdated machine which sooner or later will cause psychological distress for everyone. As such, it is assumed that the brain will inevitably cause pain. With this in consideration, ACT aims for people to live a meaningful and values-oriented life while learning to accept the pain that unavoidably comes with it. Rather than see the pain in life as something to avoid at all costs, it teaches us to view it as the price of admission for a rich life.
To achieve its aims, ACT is based on the ACT Hexaflex Model, a model that includes six essential therapeutical processes that are covered within therapy.
Contacting the present moment
Contacting the present moment means being fully present moment by moment, becoming aware of whatever is happening in the here and now, and connecting with it fully. As humans, we find it difficult to be present, because the mind tends to think of the regrets of the past or the worries of the future, failing to fully engage with what is unfolding now. We often operate on automatic pilot while life passes by unnoticed.
The irony is that the here and now is all there is. Living in the past or future prevents us from becoming aware of the sound of birds, the smell of coffee in the morning, or the improved mood after exercising.
In the study “A wandering mind is an unhappy mind”, psychologists Matthew A. Killingsworth and Daniel T. Gilbert of Harvard University, discovered that “The ability to think about what is not happening is a cognitive achievement that comes at an emotional cost.” The scientists discovered that people are unhappier when their mind is wandering, and happier when they are present in the current activity, even if that activity is washing the dishes.
Now, they also uncovered that the brain tends to wander in other matters, other than the present moment. The reality is that, although difficult, with a purposeful effort we can learn to become more present and override the automatic pilot more often. And this is one of the core elements of the ACT hexaflex model: practising presence.
You can start by setting up one or several alarms in your phone to remind you to focus on your physical sensations (are your warm or cold, is your body in a comfortable position, is there any part of your body tense, can you notice the smells around you, etc.). Here you have some examples of grounding techniques that can help you become more present.
Not only do we tend to wander around thoughts of the past or the present, but the mind also is inclined to easily identify with these thoughts (fusion). For example, if you have the thought “I am stupid”, the brain inclines to take that as true. Similarly, if you feel shame or guilt, your brain is likely to take this as if you have done something wrong, or you are bad in any way. However, we know that just because we have a thought or feeling, it doesn’t mean it is true.
We all have hundreds of thoughts daily, and some of them can be quite strange or far from the truth. People can have random thoughts about slapping someone in the face or even jumping out of a window. Just because you had a similar thought, it doesn’t indicate you mean it, or you are going to act on it. In other words, many of your thoughts, not to say most of them, are not true, accurate or helpful. And still, many of the most distressing thoughts feel as if they were.
ACT argues that because we have a brain, we will think numerous daily thoughts, and there is not much we can do about it. Instead of trying not to think the distressing thoughts, it encourages people to better relate to those thoughts by detaching from them. In ACT we learn to step back, separate ourselves from these thoughts, images, memories, or feelings, and see them as what they are: just brain activity.
The practice involves first becoming aware of the times when we are fused with our thoughts, and second learning techniques to step back and watch those thoughts as if we were an observer.
Because we are humans and we have the brain we have, we are going to feel pain and unpleasant emotions, there is no escape. This is the price of admission to a rich life.
The propensity of the brain, however, is to avoid unpleasantness, which leads us to all sorts of unhelpful behaviours (e.g., avoiding going to places, people or events). This resistance to painful emotions, and all the behaviours we do to avoid them, paradoxically increases the intensity and duration of these emotions, creating long-lasting suffering, and often mental disorders.
An alternative approach is the one offered by ACT: by accepting the painful emotions and not running away from them, we allow these feelings to come and go naturally, without increasing their intensity or duration, while learning to endure and live with them. We can’t get rid of the emotion, but we can learn to live with it more skilfully, in ways that allow us to live a rich life, and still have unpleasant feelings.
The ACT hexaflex model includes self-as-context as another core process. ACT differentiate two distinct elements of the mind: the thinking self and the observing self. The thinking self is part of our brains that does all the thinking. Worries about the future, regrets about the past, etc. The observing self is the part of us that is aware of all this thinking.
Self-as-context can be a difficult concept to understand, but think about it, your thoughts, feelings, body sensations, and life roles, all this change constantly. The only part of you that never changes is the awareness element, the aspect of you that observes all these changes.
In order to create a meaningful life, we have to clarify what are our values, so we can start behaving accordingly to them. Values act as chosen life directions. They are our guide in life and help us follow a direction that aligns with the type of human being we want to be.
What honestly matters to you, what do you want your existence to be about, and what do you stand for?
Acceptance and Commitment Therapy is also about commitment, the commitment to behave according to one’s values. Finding clarity on what your values are is not enough for creating a meaningful life. This rich life will only be created once you start acting from those values.
Commitment is about doing what it takes, even if sometimes this is unpleasant, to live by our values. This can sometimes mean confronting someone or facing a difficult job interview or an exam.
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