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You may have never heard of Acceptance and Commitment Therapy (ACT), which wouldn’t be surprising since it’s only started to grow in prominence over the past 5-10 years. ACT is a type of therapy that helps you change your relationship with negative thoughts and feelings, so you can engage in meaningful actions that line up with your values.

That’s a lot of words to basically say, “do important things even when you feel like crap!”

Of course, it’s not quite that easy, because why would you need a therapist if they were just going to tell you to do the things you want? That’s almost as bad as the hilarious “STOP IT!” Bob Newhart therapist video.

In reality, there are many skills that help to make engaging in value-congruent action possible. I’m going to focus on the acceptance aspect in this blog, but it might be helpful to introduce the other concepts as well.

Acceptance and Commitment Therapy Skills

During ACT treatment, you will learn about the utility of acceptance, present moment awareness, observer self, cognitive defusion, values, and committed action.

• Mindfulness – The basis of ACT treatment is present moment awareness, or mindfulness. That is learning to be in the present moment and recognizing your own thoughts, feelings, and sensations. So many of us spend our mental time worrying about something in the future or focusing on something in the past, rather than engaging with what is happening right now. 
• Observer Self – This is basically recognizing that you are aware of your own thinking. 
• Cognitive Defusion – Helping you create space between your thoughts and emotions instead of being fully hooked, or fused, with them. 
• Values – You need to identify the things that are important to you, so they can serve as your compass and help guide you when making decisions.
• Committed Action – Taking action to engage in behaviors that are consistent with your values, even when you are experiencing distress.

My ACT Experience

Acceptance is the final skill of ACT treatment, and can be a challenging one to understand. My own personal experience even had me questioning this idea, but the proof is in the pudding and it was ultimately very helpful.

Anybody who has ever gone through graduate school can tell you just how stressful the experience is. You’re around a bunch of highly intelligent, driven people, and you’re constantly being evaluated. Sure, you were a great student in high school and undergrad, but grad school is different, and you might not be good at it, your mind tells you. As you can imagine, this pressure and negative thinking leads to high rates of anxiety and depression.

That was pretty much me in grad school. And I was having trouble dealing with it despite learning all sorts of cognitive behavioral therapy (CBT) skills to help others overcome their own mental health concerns. It just wasn’t working for me at that time in my life.

In comes ACT.

When I heard about this “new” treatment called acceptance and commitment therapy from a friend, I spent a lot of time reading about it. I immediately found it appealing, and also found myself applying what I was learning to my own depressed, anxious self… and starting to feel better.

I couldn’t talk myself out of the negative thoughts, but I could adjust how I reacted to them through the ACT skills I briefly outlined earlier.

Long story short, thanks to ACT, I ended up being very successful in graduate school and have been able to help many clients who didn’t find CBT helpful.

The Importance of Acceptance

When you feel terrible, it makes sense that you’d want to not feel terrible. If you always got sprayed with water when you walked past a certain house, chances are you’d begin avoiding that house.

Avoidance is useful in the short-term to not experience negative thoughts or feelings, but it actually promotes a rebound effect that makes those thoughts and feelings come on even stronger and more persistently. Which then makes us try to avoid them more and results in a vicious cycle called, “the control agenda.”

The truth is ,we can’t control what we think or feel. If I told you not to think of a purple banana for 30-seconds, chances are that very image popped into your head. 

So, if we can’t make ourselves not think negative thoughts or feel negative emotions, what do we do?

We learn to allow those thoughts and feelings to exist without capturing our full attention.

An illustration I like to use in therapy comes from “ACT Made Simple” by Russ Harris. I have a clipboard and my patient presses on one side while I press from the other side. The clipboard represents the patient’s negative thoughts and feelings.

When they try to push away, I push back and the clipboard doesn’t move. They can’t look around very well because the clipboard is in front of their face. They can’t do much of anything because they’re holding the clipboard up with their hands.

Then we have them set the clipboard down in their lap. Those negative thoughts and feelings still exist, but now they’re able to look around more clearly and their hands are free to do things.

They have accepted the presence of the things they previously tried to control by pushing them away, and it allows them to engage in meaningful activities.

In real-life terms, this might be going to a child’s soccer game even though being around crowds makes you feel anxiety. It could be taking a shower even though depression has you wanting to stay in bed.

You may not be able to stop negative thoughts and feelings, but you do not need to let them control your behaviors. Learning not to struggle with your challenging thoughts and emotions can be the first step on the road to a more meaningful life.

Dr. Kevin Hyde is a Psychologist in Palm Harbor, FL.
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