What is Acceptance and Commitment Therapy (ACT)?

Acceptance and Commitment Therapy (ACT) is one of the major evidence-based psychotherapies. Over the past several decades, a significant number of scientific studies have demonstrated its effectiveness in helping people alleviate suffering and live a fulfilling life. From doctors or online, you may have heard that ACT is very useful in coping with issues like depression, anxiety, bipolar, obsessive-compulsive disorder, panic, psychosis, insomnia, trauma (PTSD), chronic pain, medical illnesses, the meaning of life, and life transitions, etc.

What to expect from Acceptance and Commitment Therapy (ACT)?

First of all, the ultimate goal of ACT is to help you live a meaningful/fulfilling life, and everything ACT therapists will do with you serves this goal.

Second, ACT particularly focuses on your relationship with your experiences. For example, you are very anxious about an upcoming job interview, and rationally, you know that you are well-qualified and well-prepared for the interview. However, you just can’t stop the anxiety anyway. From ACT’s perspective, rational analysis can’t help you that much because you already know you are good at that job and the interview. It is your relationship with your anxiety that needs intervention. The relationship means that you are constantly fighting with the anxiety, wanting to get rid of it, but you can’t win, so you are getting caught up with the anxiety, and you don’t have extra energy to do other things. ACT will help you learn how to manage your relationship with your anxiety by making space for them and keeping your distance from them (also known as acceptance, mindfulness, and defusion). At the end of the day, your anxiety may still be there, but they lose the debilitating effect. That being said, your relationship with your anxiety will be changed to that you are living with it instead of getting caught up with it. Therefore, you will be able to do things that matter to you (e.g., do the job interview).

Third, ACT is time-limited, and it usually takes between 8 and 20 sessions. Most of the time, it will be weekly sessions.

Fourth, ACT therapists will explore the cause of your concerns, which may or may not involve childhood experiences. It is crucial to understand how the past impact the present. ACT therapists put relatively more emphasis on here and now because understanding the past doesn’t always bring meaningful change. For example, understanding why you get angry easily doesn’t mean you can automatically manage it well, although that is a critical step.

Fourth, ACT therapists will ask you to do practices during and in between sessions. Like cognitive behavioural therapy (CBT), you will still talk a lot with ACT therapists because it is extremely important to share your experiences with professionals and get validation and understanding. However, from ACT’s perspective, talking is not enough in many situations if you want to make more changes. You need to intentionally practice various techniques (e.g., mindfulness, values exploration, etc.) and behaviorally step out of your comfort zone to do things that matter to you.

Fifth, ACT therapists are highly collaborative. It means that they will constantly check in with you to make sure you are on the same page.

How can Acceptance and Commitment Therapy (ACT) help you?

From ACT’s perspective, human beings’ desire to pursue happiness all the time is the fundamental reason why people are suffering. ACT thinks that people should pursue fulfillment/meaning in life instead of happiness, because human life is full of pain and uncertainty; if people want to be always happy in a painful and uncertain life, they inevitably will feel more pain. But if people pursue meaning in life, they may or may not feel happy all the time; they will feel complete or fulfilled at the end of the day. A good example is raising children or completing higher education; many people often complain frequently when bringing up kids or studying in a demanding academic program. But if you ask them how they really feel at the end of the day, most of them will be grateful that they did it; raising a family or getting a degree made their life more meaningful, despite so much pain along the way. Therefore, ACT always cares about what can be done to help you live a meaningful life.

Another fundamental reason for human suffering is, from ACT’s perspective, people tend to avoid all negative/painful experiences (e.g., thoughts, memories and emotions), even if that means sometimes, they need to pay a high price. Therefore, the fear of painful experiences drives people’s lives instead of living a meaningful life. For example, when a person wants to take the initiative (can be anything), they worry about failure because they think they are not capable if they fail. So, to avoid the pain of feeling incapable, they would instead not start that initiative or procrastinate repeatedly. As time goes by, they may feel that their life is very limiting or boring, but they can’t change anything. Therefore, ACT aims at helping people approach life from the perspective of making it more meaningful instead of just avoiding painful experiences. For the painful experiences, ACT will help people learn some perspectives and skills to better cope with them and not let them get in the way of living a fulfilling life.

When many people hear the word “acceptance,” they immediately associate it with being passive, doing nothing, and being defeated by negative experiences. That is not the case in ACT; acceptance only means allowing the existence of painful experiences (e.g., thoughts, memories, and emotions); you don’t need to like them or hate them; they do not defeat you. ACT can offer many perspectives and skills to help you better make space for those experiences. Additionally, “acceptance” is only one part of ACT; the other part (i.e., commitment) is the opposite of being passive and doing nothing; it helps you live a meaningful life instead.

The process of ACT looks like this: therapists usually will help you explore/identify important things in your life; we call it “life values.” Then, ACT therapists will help you set specific goals. After the goals are set, you and the therapist need to find out what gets in the way. There are 3 ways to tackle the barriers between your values and goals and your current situation: problem-solving, accepting them, and reducing their power. The final step is to live a fulfilling life. For example, say self-growth is extremely important to you (one of the life values). One of the specific goals is becoming more emotionally stable. What gets in the way is that you usually can’t tolerate negative emotions well; it is easy for you to act out on your friends, partner, or parents. Ways to tackle that barrier may include learning strategies to calm down, soothe yourself, better understand your negative emotions, regulate emotions, express them, communicate more effectively with your friends and partner, etc. As you gradually become better at coping with negative emotions, you are fulfilling the life value of self-growth.

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