How Does Acceptance and Commitment Therapy Work?
Have you ever found yourself lying awake at night desperately trying to turn down the internal noise in your head? It can be difficult to make the transition into the calmer state needed to be able to drift effortlessly into sleep, and waking feeling rested before the morning mayhem can feel unachievable. Instead, perhaps you eventually fall asleep in the early hours, not long before your alarm, or you find yourself waking repeatedly throughout the night to start a new day feeling tired, frazzled, even a little lost in your own life or finding it exhausting and unfulfilling.
Many of us can perhaps identify a time in our life when we felt as though we were somehow operating on automatic pilot, like someone else was in the driving seat.
In such times acceptance and commitment therapy (ACT) can offer support and bring about an inner empowerment to enable you to take charge of your life and live it each day, as you choose, moment by moment.
Clients often embrace this approach much quicker than other strategies because it makes no attempt to label problems and symptoms or to analyse the origin and offer up strict protocol of ‘how to solve’ these symptoms. ACT focuses on values, forgiveness, acceptance, compassion, living in the present moment, and accessing a higher sense of self.
It aims to transform your relationship with those difficult thoughts and feelings and to learn to perceive them as harmless and transient, albeit uncomfortable at times. There is no attempt to try to reduce, change, repress, suppress, avoid or control. Instead, you learn to reduce the impact and influence of your unwanted thoughts and feelings through the use of mindfulness and defusion.
ACT demonstrates that it is actually our emotional control strategies that are largely responsible for our ‘problems’. How often do we spend time trying to control how we feel by stopping it, repressing it, getting angry, sad or feeling guilty about our emotions?
Do you ever perhaps try to avoid them by eating too much of the wrong foods, drinking too much, blaming others or external factors?
As long as you are fixated on trying to control how you feel, you are trapped in a vicious cycle of increasing suffering. ACT uses metaphors such as the quicksand metaphor to highlight such scenarios: Imagine for a moment that you are stuck in quicksand. The more you struggle, the faster it sucks you under. To survive you must lay flat. Spread out in order to rise to the surface. Instinct, however, tells you to struggle to get out, but if you did it would have the reverse effect and you would very quickly sink.
Another example used is the “struggle switch”. This strategy proposes that whatever the emotion - no matter how unpleasant - if we switch off the struggle the emotions may run high, low or even be absent but what we are doing is actively not wasting resources struggling.
ACT defines this as “clean discomfort”. “Dirty discomfort” is when the struggle switch is on and acts like an amplifier bringing about anger or guilt about the emotion, or avoiding them with alcohol or food, projection – blaming others, ruminating or berating yourself.
Jill, a mother of young children who had recently divorced found herself at a cross roads. She felt lost and was tired of life controlling her. After completing a ‘mindset-reset’ course based on ACT approaches, she described feeling empowered. She had the time, space and strategies to be able to step back, pause to assess the situation, accept (however stressful it was), and continue committing to her goals of living a value led life. She was also surprised at her increased energy levels, at a time when she was actually doing more. By learning the techniques - mindfulness and acceptance; and by committing to acting on her values and embedding them into her daily life, Jill achieved this mindset-reset.
ACT has huge benefits for therapists too – it does not presuppose that the therapist is more knowledgeable, rather that they sit side by side with the client. It is not about 'getting rid' of symptoms, but about assisting the client to live a more enriched, fulfilling and meaningful life. It has evidence based results in reducing therapist burnout and greater therapist effectiveness.
ACT has proven effectiveness with depression, chronic pain, anxiety, PTSD, anorexia, workplace stress, living with terminal cancer, drug addiction and schizophrenia.