In Tune with Your Thoughts and Feelings: An Introduction to Acceptance and Commitment Therapy

There is an abundance of psychological disciplines and approaches to therapy.

One such approach that has gained much attention is acceptance and commitment therapy (ACT). This therapeutic model, pronounced as a single word “act” (not a-c-t, but act), is a form of behavioural therapy that uses acceptance and mindfulness strategies and commitment and behaviour change strategies to increase psychological flexibility. The goal of ACT is not to avoid suffering but to accept discomfort as a part of the human experience. So, instead of reframing, avoiding, or coping, clients are encouraged to face the discomfort and see it as a passenger on our ride towards our goals.

Act is a value-driven approach that incorporates techniques from different disciplines, such as classical cognitive behavioural therapy and mindfulness, which makes it incredibly flexible and dynamic.

In this article, we will delve into the theory behind ACT, provide a case example of how ACT treatment works, contrast it with traditional cognitive behavioural therapy (CBT), and offer practical tips for incorporating ACT strategies into your daily life.

Understanding ACT: The Six Core Processes

At its core, ACT is based on the belief that suffering is a normal and unavoidable part of the human experience and that we attempt to control or avoid psychological experiences that cause true suffering. ACT doesn’t aim to change or stop unwanted thoughts or feelings directly but to alter our relationship to such experiences, allowing us to live a more values-driven life.

ACT is built around six core processes:

• Cognitive Defusion: Learning to perceive thoughts, images, emotions, and memories as what they are—just bits of language, words, and pictures—and not what they seem to be (dire predictions, threats, mandates). In my course, I learned that Instead of “I am angry,” “I am experiencing anger.”. There is always the observing self; we are not our emotions and sensations.
• Acceptance: Actively embracing the experience of thoughts, feelings, and sensations without trying to change them.
• Contact with the Present Moment: Being psychologically present, engaging fully with here-and-now experiences, with openness, interest, and receptiveness. Think of mindfulness here. Instead of resisting an urge and trying to escape from it, individuals are invited to sit with the urge and be curious about the experience. How do we feel the urge, the craving, or the sensation that is coming up? Where do we feel it?
• The Observing Self: Accessing a transcendent sense of self; a continuity of consciousness that is unchanging, ever-present, and impervious to harm.
• Values: Discovering what is most important to one’s true self, what one wants to stand for in life. This is crucial, as our values navigate our life, and can serve as the driving force.
• Committed Action: Setting goals according to values and carrying them out responsibly, in the service of a meaningful life. I highly encourage you to integrate a journaling practice that will help you keep track of your actions (and to self-reflect on the different life areas you have improved on already)

A Case Example of ACT in Practice

If we want to see real progress, we must get away from abstract concepts and put them into practice. That’s why I love case studies, and I’d like to introduce you to one such case:

Imagine Sarah, a 35-year-old woman who struggles with social anxiety. She often has thoughts like “I’m going to embarrass myself” or “People will think I’m stupid” before social events, leading her to avoid them altogether. In an ACT framework, Sarah’s therapist would help her identify and clarify her values around friendship and community. Through cognitive defusion, she would learn to see her thoughts as just thoughts—not absolute truths that must dictate her behaviour.

Sarah’s therapist might use mindfulness exercises to help her become more present and aware of her anxiety without trying to change it (this is the acceptance part). She would practice observing her thoughts and feelings from the perspective of the observing self, realising that they do not define her.

Over time, Sarah would commit to taking small, manageable steps that align with her values, such as initiating a conversation with a colleague, despite feeling anxious.

ACT vs. Traditional Cognitive Behavioural Therapy (CBT)

While both ACT and traditional CBT are evidence-based therapies that focus on the interplay between thoughts, feelings, and behaviours, key differences exist.

Traditional CBT typically involves identifying and challenging distorted or maladaptive thoughts and beliefs to bring about change in emotions and behaviours.

In contrast, ACT does not aim to change the content of thoughts but to change one’s relationship to them, fostering acceptance and mindfulness.

CBT typically aims to reduce symptoms, while ACT emphasises living a life aligned with personal values, which may or may not result in symptom reduction. ACT suggests that it’s the struggle with “symptoms” that often worsens suffering, rather than the symptoms themselves.

Implementing ACT Strategies in Daily Life

Although it might be helpful to have someone assist you in identifying a life in alignment with your values, you don’t have to be in therapy to begin applying the principles of ACT to your life. You might not have the availability of a therapist to assist you, or you might want to tackle your daily struggles all on your own, and that’s perfectly valid. If you want to implement some of the ACT principles into your daily life, then here are some tips to get you started:

• Practice Mindfulness: Engage in daily mindfulness exercises. This could be as simple as spending a few minutes focusing on your breath or engaging fully with routine activities like washing dishes, doing the laundry, or eating potato chips (or a salad).
• Identify Your Values: Reflect on what truly matters to you. What do you want your life to stand for? Values include family, career, health, education, spirituality, creativity, or community service. Don’t hesitate to write down your values and sit with yourself to identify what is important to you. How do you want to live? What person would you like to be? What is important to you? Be completely honest and reflect on if you were the one who created these values, or if they came from your family or society as such.
• Accept Your Feelings: When difficult emotions arise, practice allowing them to be there without trying to push them away. Remember, acceptance is not about liking or wanting these experiences; it’s about acknowledging their presence.
• Take Committed Action: Start small by setting goals aligned with your values. Then, take steps towards these goals, even if it means facing discomfort.
• Use Defusion Techniques: When caught up in unhelpful thoughts, create some distance by imagining the thoughts on a movie screen or leaves floating down a stream. The aim is not to eliminate the thoughts, but to see them for what they are—simply thoughts.

Acceptance and Commitment Therapy (ACT) is a helpful approach that can assist people in living a happier life. It doesn’t aim to get rid of challenging emotions or difficult situations, but instead encourages individuals to face life’s challenges directly and stay true to their personal values. Whether dealing with a specific mental health concern or looking for personal development, ACT provides a caring and empowering way to bring about positive change.

Want to read more about ACT? Here are some great books to deepen your understanding

1. “Acceptance and Commitment Therapy: An Experiential Approach to Behaviour Change” by Steven C. Hayes, Kirk D. Strosahl, and Kelly G. Wilson
   • As one of the seminal texts on ACT, this book thoroughly introduces the core concepts of the therapy. Written by the founders of ACT, it outlines the theoretical foundations and includes detailed descriptions of techniques and strategies for practitioners.
2. “The Happiness Trap: How to Stop Struggling and Start Living: A Guide to ACT” by Russ Harris
   • This accessible, self-help-oriented book uses simple language to explain how ACT can help everyone lead a more fulfilling life. Russ Harris presents the core principles of ACT and offers practical exercises to help readers learn how to manage painful thoughts and feelings effectively.
3. “Get Out of Your Mind and Into Your Life: The New Acceptance and Commitment Therapy” by Steven C. Hayes with Spencer Smith
   • Another work by one of the founders of ACT, this book is aimed at a general audience and provides a step-by-step plan for creating a full, vibrant, and meaningful life. The book contains worksheets and exercises for personal self-reflection and practice.
4. “ACT Made Simple: An Easy-To-Read Primer on Acceptance and Commitment Therapy” by Russ Harris
   • Designed for therapists new to ACT, this book breaks down the complexities of the therapy into easy-to-understand language. It includes metaphors, tips, and real-life case studies to help therapists apply the techniques in their practice.
5. “The Big Book of ACT Metaphors: A Practitioner’s Guide to Experiential Exercises and Metaphors in Acceptance and Commitment Therapy” by Jill A. Stoddard and Niloofar Afari
   • This book is an invaluable resource for therapists who want to enhance their sessions with engaging exercises and metaphors that help clients understand and apply the principles of ACT in their lives.
6. “Learning ACT: An Acceptance and Commitment Therapy Skills-Training Manual for Therapists” by Jason B. Luoma, Steven C. Hayes, and Robyn D. Walser
   • This is a comprehensive guide for clinicians that provides a detailed curriculum for conducting ACT workshops or individual therapy sessions. It includes a DVD that demonstrates ACT in action with a real client.
7. “The ACT Approach: A Comprehensive Guide for Acceptance and Commitment Therapy” by Timothy Gordon and Jessica Borushok
   • This book offers a fresh perspective on ACT, integrating it with other therapeutic approaches and presenting innovative strategies for practice. It includes case studies and scripts to illustrate how to apply ACT principles in therapy.
8. “The Reality Slap: Finding Peace and Fulfillment When Life Hurts” by Russ Harris
   • Russ Harris addresses the ‘reality slap’—the moment when life deals a painful blow—and how ACT can help individuals cope with the aftermath. This book is especially helpful for those dealing with grief, loss, or unexpected life changes.
9. “A Liberated Mind: How to Pivot Toward What Matters” by Steven C. Hayes
   • In this book, Steven C. Hayes shares the latest research and developments in ACT, illustrating how the therapy can be applied to a wide range of psychological issues. It is written for both therapists and individuals looking to deepen their understanding of ACT.
10. “The Mindfulness and Acceptance Workbook for Anxiety: A Guide to Breaking Free from Anxiety, Phobias, and Worry Using Acceptance and Commitment Therapy” by John P. Forsyth and Georg H. Eifert
    • This workbook offers a plan for overcoming anxiety using ACT and mindfulness techniques. It is filled with exercises, self-assessments, and guided meditations to help readers work through anxiety and build a life based on their values.