Acceptance Commitment Therapy (ACT): An Effective Approach

When a new client comes to my office, her/his first question is: “What type of therapy do you do?” followed by a second: “How long will it take?” Answering the second is easier.It depends on previous experiences in therapy, changes wanted, defense mechanisms at play, and how removed someone is from feelings and sensations. The answer to the first varies with the client just as my therapeutic response differs for each client.I work collaboratively with each person to develop personal goals and an effective way of working together. I do not have — and never expect to have — a one-style-fits-all approach.

Over the past year I have seen the efficacy of combining cognitive behavioral therapy (CBT) with acceptance, commitment, take-action therapy, called ACT. Because ACT, sometimes called the third wave of CBT, is not as well known, here is a brief explication of the approach that I find increasingly effective.

We are all shaped by our past experiences.Some of us have mothers or fathers who left us at an early age. Others may have been taunted, verbally or physically mistreated, or grown up in a divisive household affected by alcoholism, mental illness, or anger avoidance. Or we may feel we grew up unscathed by anything unusual. But we all have memories stored in portions of the brain. These can be automatically triggered which activates our “flight or fight” response releasing cortisol causing us to feel continually “stressed out”, depressed, and/or anxious. Current research into the workings of the brain has shown how these automatic thoughts can cause physical illness and also cellular changes in the brain. Struggling to rid ourselves of the memories or voices usually makes the battle worse and maintains the stress.

Here is where acceptance comes in. By accepting these as part of us but not reacting to them, we can diffuse our triggers and deactivate the autonomic responses. We can allow them to come and go, but ignore them. You can learn to drive your metaphorical bus ahead allowing annoying passengers to go along for the ride. You can choose or COMMIT yourself to proceeding in your direction not theirs. It sounds simple and it can be depending on how much you can learn to be mindful of where you are in any given moment. Is your mind causing an automatic response to a situation? Is your mind creating the reality or is your experience creating it? Can you become an observer of your thoughts without getting entangled in them?

The Acceptance part of ACT helps you reframe your current situation. What will you believe: your mind or your experience? It is very present oriented and mindfulness based. Awareness of your senses is critical and some of us gallop through life paying little attention to what we truly see and experience in the moment. We fuse what our mind tells us with our feelings for and about ourselves. The voice in your mind, which may sound like your father’s, tells you “you’re incompetent”, but your experience, if you really observed it and were mindful of it, will tell you that your work colleagues see you as completely competent.

I see my role as helping clients deconstruct past patterns, gain insight into triggers, learn to stay in the present, commit to acting on their values, and most importantly to become an observer of themselves and their thoughts.

For most of us, our current mainstream culture traps us into taking our own thoughts literally even though they are not based in our actual experience. We may suffer deeply and feel abandoned when an adult relationship falters or feel as though we are miserable failures at what we do professionally. So we THINK the answer is to keep searching for someone new or for that perfect job. But our mind keeps “looping around” telling us “you can’t do it”. But what does our actual experience tell us? Doesn’t the answer lie within each of us as we continue our journey into feeling whole and alive? Going to therapy can help you gain insight into your past experiences and give you hope that you can live in the present moment without framing everything through the filters of your past.

For a deeper understanding of ACT, consult The Worry Trap: How to Free Yourself from Worry and Anxiety Using ACT. New Harbinger, 2007. Get this book on Amazon. See also Steven Hayes, PdD, University of Nevada, the originator of ACT, posts research studies and maintains the site.

See also Emotional Alchemy: How the Mind Can Heal the Heart, Random House (2002) for information on common emotional/thought patterns or schemas. Get this book from