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What is Acceptance and Commitment Therapy?

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Acceptance and Commitment Therapy (ACT) is a behavioral therapy all about creating a rich, full and meaningful life whilst accepting the pain that inevitably goes with it. Officially, when written as ACT, the ACT is said as the word “act” and not as the initials A-C-T.

I knew nothing of ACT until earlier this year, when I began attending a support group called ‘ACT for Anxiety’. It sought to apply the core principles of ACT to those of us afflicted with an anxiety disorder. Since then, I’ve found ways to apply some of the mindfulness techniques I’ve learned into various aspects of my life, sometimes subconsciously, to make coping with life’s challenges a much simpler beast.

act-therapy

ACT in a Nutshell…

The core principle of ACT can be described by using a simple (and unsurprising) acronym:

A = Accept your thoughts and feelings, and be present

C = Choose a valued direction

T = Take action

Or through an exercise known as The ACT in a Nutshell Metaphor, which I have adapted below:

ME: Okay, so this week we’re going to be taking a journey through Acceptance and Commitment Therapy (ACT)…but for us to do this, I’m going to need to explain what ACT is, and the easiest way to do that is with a bit of role-play. So, I want you to scamper off and find yourself a sheet of A4 paper.

YOU: Lined, coloured or just any old piece?

ME: Any old piece would be fine, whatever you can get your hands on.

(You scamper away and find yourself sheet of paper before returning eagerly to the computer.)

ME: Excellent. Alright, now I want you to imagine that the piece of paper you’re holding represents all of your difficult, unpleasant, uncomfortable, painful and downright horrible thoughts, feelings and memories. Everything that you’ve been struggling with for so long – be it depression, anxiety, whatever – are all represented by the piece of paper you are holding. Now I want you to take that piece of paper and hold it tight up against your face. Touch it to the tip of your cute little nose so that you can’t see me anymore.

(You hold the piece of paper against your cute little nose and realize that you can’t see anything, let alone me.)

ME: Now, what’s it like having a conversation with me whilst you’re caught up in all those horrible thoughts, feelings and unpleasant memories?

YOU: Very difficult.

ME: Do you feel connected with me in any way? Are you able to read the expressions on my face or interpret my body language? If I was doing the Hokey-Pokey or making faces at you right now, would you be able to see me?

YOU: No.

ME: And what about what’s going on in the rest of the room?

YOU: I can’t see anything apart from the sheet of paper.

ME: Nothing?

YOU: Nothing.

ME: So you’re missing out on an awful lot. You’re missing the sunset that’s blazing out the window as well as the dancing bear behind me. You’re disconnected from me, from the world, from everything. Now, whilst you’re holding onto that piece of paper, I want you to imagine me asking you to hug your children, or cook a healthy meal, or type a blog post on a key board, or give your loved one a surreptitious bum squeeze. Would you be able to do those things whilst holding on so tightly?

YOU: I don’t think so. No.

ME: So when you’re caught up in all your difficult, unpleasant, uncomfortable, painful and downright horrible thoughts, you lose contact with the world around you, including your relationships? You’re also incapable of doing the things you need to do, the things that make your heart sing?

YOU: Yes.

ME: Okay. Now let’s try something else. I want you to take that piece of paper and place it on your lap.

YOU: Alrighty.

(You take the piece of paper and place it on your lap.)

ME: Now, how’s that? Can you see me?

YOU: You’re not doing the hokey-pokey any more.

ME: I’m not. But you can see me. You can see my facial expressions, interact with me.

YOU: And the sunset’s really pretty.

ME: So you can interact with the world as well?

YOU: Yes.

ME: So if I were to ask you to hug your children, cook a healthy meal, type a blog post or give your loved one a surreptitious bum squeeze, could you do any of those things now?

YOU: I could. But they’re still here; all my horrible thoughts and emotions. I don’t want them here.

ME: I know. Absolutely. It’s all still there, and of course you don’t want it, who would? But it’s not having so much of an impact on you now, is it? I’m sure you’ve tried so many things over the years to get rid of all those painful thoughts, haven’t you? Drugs…alcohol…

YOU: …self-help books, therapy, isolating myself, criticizing the crap out of me…

ME: …exactly. And you’ve clearly put a lot of time and energy into all that, but they’re still showing up. They’re still here, no matter what you’ve tried over the years. They might go away for a short while, but they always come back, yes? And sometimes bigger and heavier and more painful than ever before, yes?

YOU: Yeah.

ME: So even though every atom and instinct in your body is telling you to get rid of these thoughts and feelings completely, it’s not having the effect you wanted, is it?

YOU: No. It just makes everything worse. I want to do something that works.

ME: Okay. This is where ACT comes in. We’re going to learn about a whole range of mindfulness skills that will help you handful painful thoughts and feelings. So instead of living life with them all up in your face…you can learn to live with them sitting comfortably alongside you. They won’t be stopping you from interacting with people or affecting the way you live anymore, but they will still be there, only in ways that are more manageable and more controllable. So you can put more energy into the things you love, like cooking healthy meals…

YOU: …and giving my partner’s bum a squeeze every now and then?

ME: Exactly. How does that sound to you?

YOU: Sounds good.

Alternatively, this video sees Dr Russ Harris (author of The Happiness Trap) explaining  The ACT in a Nutshell Metaphor:

Throughout the rest of this week I will be taking a closer look at some of the strategies involved with Acceptance and Commitment Therapy and sharing with you various activities that can be undertaken to help you live a life more in tune with your strengths and values.

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5 thoughts on “What is Acceptance and Commitment Therapy?

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