Acceptance and commitment therapy | MHT

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Acceptance and commitment therapy | MHT

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Should therapy help individuals manage, rather than eradicate, negative thoughts and feelings? Dr. Nic Hooper, psychology lecturer and co-author of ‘The Acceptance and Commitment Therapy 2020 Diary’, argues you can live a full life while experiencing enduring psychological adversity.

I remember reading the original Acceptance and Commitment Therapy (ACT) book, written by Steven Hayes, Kelly Wilson and Kirk Strosahl and published in 1999. I was sat in the library of Swansea University circa 2005. Up to that point, to be quite frank, my Psychology degree had done little to inspire me. But this book changed my life. 

Let me tell you a little about ACT, before I tell you about why it was so powerful for me…

ACT takes the position that trying to avoid our unwanted thoughts and feelings (called experiential avoidance) will generally lead us away from the sort of lives we’d like to be living. As an example, if you are feeling a little down then chances are that you will want to avoid feeling that way. Consequently, your mind will feed you thoughts that are designed to make you feel better. Those thoughts could be something like: ‘stay in bed, it is safe here’, or ‘open that bottle of gin, that will numb the pain’. Now, acting on those thoughts may well solve your first problem (you may begin to feel better in the short-term) but it will create a second bigger problem (avoidance will restrict your life and may lead to harm in the long-term).

‘Core processes’

Given this position, the main aim of ACT is to improve psychological flexibility, which involves giving people the tools to experience their thoughts and feelings in such a way that they do not stop them from moving in personally meaningful directions. Let’s dig at this a little. As a practitioner you would draw upon one of six core processes in an attempt to improve psychological flexibility:

Willingness: commonly called acceptance – the practitioner trains the client to embrace their unwanted thoughts and feelings, rather than run away from them.

Contact with the present moment: commonly called mindfulness – the practitioner trains the client to return their attention to the present moment when it has wandered to the past and to the future.  

Self-as-context: over time we build stories about who we are but often those stories can imprison us – the practitioner trains the client to see themselves not as their self-stories but as a container for them.

Defusion: in some contexts our minds feed us helpful thoughts and in other contexts they do not – the practitioner trains the client to distance themselves from their thoughts so that they can choose their behaviour more carefully.

Values: in order to decide which thoughts are helpful and which are not, we need to know what domains in our life are important, and what qualities we would like to bring to our daily interactions – the practitioner helps the client to clarify their values.

Committed action: values mean nothing if they do not result in behaviour – the practitioner helps the client to create and complete goals (short-term and long-term) that are in line with their values.

So, in short, ACT helps people to relate more skillfully to their thoughts and feelings so that they can move their feet in valued directions, and the approach impacted my life because it gave me a different answer to the following question: do human beings have to struggle with and defeat their unwanted thoughts and feelings in order to achieve good psychological health?

A colourful metaphor illustrates the epiphany that ACT gave me.

Imagine you are in a tug-of-war contest with a big, ugly monster. Between you is a large and seemingly bottomless hole. If you lose the contest you will surely die. So you start pulling. You look up to see the monster holding the rope with one hand. After a while the monster decides to take the contest a bit more seriously. He begins pulling and you find yourself moving closer and closer to the hole of death. As you pull harder and harder you realize that this approach is not working. Struggling with our unwanted thoughts and feelings sometimes leads nowhere. ACT taught me that we have another option: we can simply acknowledge their existence and get on with the act of living a life that is in line with our values. ACT taught me that I don’t have to fight with my monsters; I can simply drop the rope.

How liberating a moment it was, in the library of Swansea University. To live a life where my unwanted thoughts and feelings were no longer the enemy, where they instead came to play like a radio in the background; always present but not at the centre of my existence. ACT, to me, is an approach like no other. It freed me to pursue daunting challenges that have since brought meaning to my life.

Dr. Nic Hooper is Senior Lecturer of Psychology at University of the West of England and Co-author of ‘The Acceptance and Commitment Therapy 2020 Diary’.

This content was originally published here.

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