Written by: Dr. Katrin Seifert, PsyD
It seems natural that a person would want to avoid discomfort, to stay in their comfort zone, to try to stay safe. Can it be that these seemingly protective behaviors can actually put a person at risk of missing out on the life they really want?
Acceptance and Commitment Therapy (ACT) provides a person with techniques to learn to tolerate and live with unavoidable discomfort in order to pursue a rich, fulfilling life. With the help of a therapist at Positive Change Counseling Center [https://www.pccounselingcenter.com/], you can put these techniques into practice, stop avoiding, and start living!
What is Acceptance and Commitment Therapy (ACT)?
Acceptance and Commitment Therapy (ACT) is an evidence-based therapy, part of the “third wave” of cognitive behavioral therapy. ACT differs from traditional cognitive behavioral therapy (CBT) in its emphasis on learning to accept that unwanted thoughts, feelings, sensations, etc. are a part of life, and on increasing one’s willingness to experience these unwanted experiences.
There is research to support that ACT can help with various psychological difficulties, including but not limited to:
Depression
Anxiety
OCD
Chronic Pain
Psychosis
If you choose to work with a Positive Change Counseling Center therapist who practices ACT, you can expect to be exposed to concepts of mindfulness (a way of observing your experience), acceptance (openness to your experience), and values (identifying what is most meaningful to you and how you want to live).
How Do You Know if You Need Therapy?
Choosing to begin on the path of therapy is a very personal decision, and there is no one way to tell if therapy is right for you. Some people seek therapy to better understand themselves, some people are seeking relief or answers, and some people even begin therapy hoping to change people or situations outside of themselves (although they quickly learn that they cannot control these external factors). Most of the time, people seek out therapy only after they have tried for some time on their own to reach their goals or solve their problems. Sometimes the very things we do to try to feel better end up making things worse - this is one of the fundamental tenets of Acceptance and Commitment Therapy.
You might find that behaviors aimed at relieving discomfort in the short-term lead to negative consequences in the long-term. Although avoidance may feel better in the short-term, it keeps us from living the life that we want.
Think about it - what have you tried doing recently to control, reduce, or suppress painful thoughts, feelings or sensations?
I’d like you to take a look at your habits - how have you been coping with discomfort and how is it working, in the short-term and the long-term?
Common avoidance and control strategies include:
Flight
Hiding/escaping
Distraction
Zoning out/numbing
Fight
Suppression
Arguing
Taking charge
Self-bullying
Although these strategies can work in the short-term, they can become problematic when you rely on them too much, or try to use them in situations where they are not effective, or they stop you from living the life you want. The goal is to create and live a full, enriching, meaningful life, and to accept the discomfort that comes along with it.
Acceptance and Commitment Therapy Techniques:
Below, you will find a description of common Acceptance and Commitment Therapy (ACT) techniques that you are likely to encounter in your work with a Positive Change Counseling Center therapist:
1. Being Mindful
Mindfulness is a core component of third wave therapies. Mindfulness in the context of ACT refers to focusing your awareness on your here-and-now experience, with openness and curiosity.
The most accessible and simplest form of mindfulness is mindful breathing. Simply breathe as you normally do, noticing the act of breathing and related sensations in your nose and chest and belly. As you become distracted by thoughts or sensations, gently bring your attention back to your breath. Allow yourself to be completely with your breath as it flows in and out. Follow the air all the way in and all the way out. Be present moment by moment with your breath.
Another way to practice mindfulness is being mindful while doing everyday activities. Instead of being on auto-pilot, with your mind focusing on another time and place, be present in this moment, aware of what is happening right now. You can mindfully shower, or wash dishes, or make tea, or walk. Simply noticing, observing, experiencing these activities as if for the very first time (think of that saying, you can tell a tourist in New York City because they are walking down the street looking up).
2. Acceptance of Emotions
I invite you to think back on early messages you received about emotions. Would you agree that you learned early on that you should be able to control your emotions? That some emotions are bad?
There is an alternative to this approach - to accept your emotions, to feel your emotions, in a gentle, loving way, so that you can fully experience this moment (the only moment we truly get to live).
Although some emotions are uncomfortable, they come and they go, and they will not be the end of you. The less we fight our emotions, the more smoothly we will experience them. Let’s explore what it is like to experience our emotions as a welcome part of who we are, and not as our enemy.
Making room for our feelings means being open to them, getting familiar with them, welcoming them. You don’t have to do anything, you don’t have to fix it, you don’t have to make it go away.
When you’re facing an uncomfortable feeling, try these 4 steps:
Observe the sensations arising in your body, scanning from head to toe, looking for any uncomfortable sensation. Focus on and observe any sensations, describing them to yourself.
Take long, deep breaths into the area where you feel the uncomfortable sensation, imagining the breath flowing into and around the sensation.
Open up and create a space around the sensation, giving it plenty of room.
Allow the sensation to be there, make peace with it, until you find yourself letting go of the sensation and emotion.
3. Cognitive Defusion from Unhealthy Thoughts
A primary strategy from ACT is “defusion” - being able to observe your thoughts simply as productions of your mind. Consider this: your mind tries to protect you from danger by ringing alarms, although sometimes these alarms are exaggerated or misguided. It is impossible to stop your mind from telling you these negative stories; in fact, the more you try to stop yourself from thinking something, the more intense the thoughts can become.
Cognitive fusion is treating your thoughts as though they are the truth, that they are important, that they are wise.
Cognitive defusion is recognizing that thoughts are merely sounds, words, stories, bits of language.
If a thought is helpful, pay attention to it. If it’s not, “defuse” from it!
Some ideas for “defusing” are:
Repeat the word over and over; for example, “loser, loser, loser, loser, loser, loser,” until the word loses its meaning and you see the word as just sounds strung together.
Tell yourself, “I’m having the thought that X.”
Leaves on a stream meditation - place your thoughts on leaves floating down a stream and watch them drift away, letting go of any engagement with them.
Sing your thought to the tune of a song; for example, sing, “what if it all goes wrong” to the tune of “Happy Birthday”.
Say the thought in a silly voice; for example, the voice of Daffy Duck.
Recognize a familiar story you tell yourself (for example, the story that no one will like me), give the story a name, and call it out each time it comes into your mind.
4. Identifying Values
Most importantly in ACT is that we learn to live in line with our values. Instead of letting fear, anxiety, insecurity, or avoidance make our life decisions, we want to make choices in line with our deepest-held values.
What are values? Values are not goals. Values are chosen life directions. Values are how we want to be, what we want to stand for, how we want to relate to the world. Values are principles that can guide and motivate us. Values describe what you want your life to be about, what sort of person you want to be, what kind of life you would be living if you were not avoiding discomfort.
5. Values Self-Assessment
Sometimes we have lived our life for so long being controlled by fear and avoidance, that we do not even know what our values are. Here are some ways to get in touch with your values:
Imagine you are attending your 80th birthday party - Imagine what someone might say about what you stood for in your life, what you cared about, the path you took. First, imagine what someone might say if you do not change how you are currently living and you continue to be controlled by fear and avoidance. Then, imagine what someone might say if you started living your life the way you truly want to live it
Think about 10 domains of life, and describe how you want to live in each domain: Intimate relationships, family, friends/social, career/employment, education/training, personal growth, recreation/leisure, spirituality, citizenship, health/well-being
Once you have defined how you want to live in the 10 domains, for each domain, assign a number 1-10 (1 being the least, 10 being the most) to describe a) how important these values in this domain are to you, and b) how much you are currently living your life in alignment with these values in each domain. Look for the areas with larger differences between how important an area is to you and how much you are living in line with the related values, and put energy into overcoming avoidance in those areas to live a more enriching, fulfilling life!
6. Committed Action
ACT is about being able to face our challenges and old patterns in order to make changes to live a more fulfilling life. Committed action reflects putting out values into action, manifesting our values in a practical way. Once you have clarified what your values are, you can create goals to move you in a valued direction, and start taking action to achieve those goals.
Goal setting:
When setting goals, think about the acronym SMART (specific, measurable, achievable, relevant, and time-bound) - try to create goals that you can easily follow and measure. For example, instead of setting a goal of “Make more friends,” a SMART goal might be, “Reach out to 2 old friends once per month, and attend 2 social groups per month, for the next 3 months.”
Once you identify your goals, think about what specific actions are needed to achieve the goal. Start with the smallest step. Thinking about our example goals above, some initial actions might be, review your list of contacts/social media friends and pick 2 to reach out to, and go to the social group website to look into available groups.
Once you know what steps you need to take, consider what psychological and behavioral barriers you are likely to face. Will fear, insecurity, avoidance creep up? For each barrier that you identify, think about what coping strategies, such as those reviewed above, you can use to help you through these barriers.
7. Workability
The ACT concept of workability refers to evaluating whether a way of thinking or behaving helps you in the long run toward creating a rich and meaningful life. It involves asking yourself, “does this help me create the life that I want?”
When it comes to thoughts, ask yourself, is this thought helpful? If so, you can engage with it. If not, you want to “defuse” from it. To determine if a thought is helpful, ask yourself, “Is this an old thought?” “Does this thought help me live a full, rich life?” “Does it help me be the person I want to be?” Instead of considering whether a thought, feeling, or behavior is right or wrong, good or bad, think about whether it helps you move in your desired direction on an ongoing basis.
Remember, avoidance of discomfort feeds patterns that accommodate your short-term desires at the expense of your long-term interests.
8. Two Sides of the Same Coin
Hold out your hands, palm down. Think about the top of your hands as all the things you’re running from, scared of, trying to avoid.
Now, flip your hands, palm up. On the palm side are all the things you want to be about in your life.
As you slowly turn your hands over and back, consider, is it possible that the flipside of things that are important to you is what you are afraid of, and the flipside of what you’re afraid of is what is important to you? Perhaps it is not possible to have one without the other, that they are like the front and back sides of a coin. No fear, no importance. No importance, no fear.
Is Therapy Worth It?
Acceptance and Commitment Therapy is a unique approach to healing human suffering. If you’ve tried a lot of things to feel better and change your life, and you’re still struggling, ACT might be the right approach for you. Contact Positive Change Counseling Center [https://www.pccounselingcenter.com/] to connect with a therapist who can guide you through the process, so you can live the rich, fulfilling life you have been seeking.
References
Bach, P. A., & Moran, D. J. (2008). ACT in practice: Case conceptualization in acceptance and commitment therapy. New Harbinger Publications.
Gloster, A.T., Walder, N., Levin, M.E., Twohig, M.P., & Karekla, M. (2020). The empirical status of acceptance and commitment therapy: A review of meta-analyses. Journal of Contextual Behavioral Science, 18, 181-192.
Harris, R. (2008). The happiness trap: How to stop struggling and start living.” Boston: Trumpeter.
Hayes, S.C. (2005). Get out of your mind and into your life: The new acceptance and commitment therapy. Oakland: New Harbinger Publications, Inc.
Strosahl, K., Robinson, P., & Gustavsson, T. (2012). Brief interventions for radical change: Principles and practice of focused acceptance and commitment therapy. Oakland, CA: New Harbinger Publications.
Swart, J., Bass, C., & van nevel, J. (2014). A comparison between dialectical behavior therapy, mode deactivation therapy, cognitive behavioral therapy, and acceptance and commitment therapy in the treatment of adolescents. International Journal of Behavioral Consultation and Therapy, 9, 4-8.