Acceptance and Commitment Therapy (ACT)

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Definition

Acceptance and commitment therapy (ACT) is a form of psychotherapy that aims to help you learn not just to bear your difficulties more effectively, but also to use them to guide your actions and decisions. By learning to bring mindful awareness to everyday experiences, you gradually train your brain to deal with life's inevitable, unwanted stressors in new ways so you can be free to live fully in each moment.

ACT is not about fighting your pain; it’s about developing a willingness to embrace every experience life has to offer. It’s not about resisting your emotions; it’s about feeling them completely and yet not turning your choices over to them. ACT is about making active and committed choices to live according to your values even when you feel an uncomfortable emotion or are distressed.

Pronunciation:
Unlike other therapies that go by their initials, ACT is just pronounced as a word, not A-C-T.

ACT is commonly used for treating:

  • Anxiety
  • Depression
  • OCD
  • Eating Disorders
  • Substance Use Disorders
  • Stress

Key Things to Know About ACT

Clinical trials suggest that ACT is very effective for a whole range of psychological problems. In addition, it has been shown to be effective in the treatment of chronic pain and even tinnitus!

Patricia Patric, one of the founders of ACT, says overcoming suffering is not about fighting our pain—it’s about finding a willingness to embrace every experience life has to offer, no matter what it is.

As the Dread Pirate Roberts said in The Princess Bride,

"Life is pain highness, anyone who says differently is selling something."

Pain is inevitable but how we relate to our pain makes all the difference. Fighting and rejecting pain causes suffering, allowing pain and choosing life and your values anyway, creates meaning.

ACT vs. CBT

ACT is completely different from Cognitive Behavioral Therapy (CBT). In CBT, the focus is on changing your thoughts to change your emotions. ACT approaches uncomfortable thoughts as a hazard of life and with the theory that spending time changing them does not work. Uncomfortable thoughts, even if you can change them in the short term, will always come back—either the same or in a new form. ACT works to change your relationship to your thoughts, so you no longer feel as reactive to them. You can thank your brain for its contribution (even when the contribution is hurtful and unnecessary) and live according to your values anyway.

How ACT is Used in Mental Health Wellness

Many people get stuck in the trap of “I will be happy when....” Happiness and mental well-being is treated as a far-off destination you must suffer to “earn.”

I will be happy when…

  • I graduate
  • I get my own place
  • I meet someone special
  • I get a new job
  • I get married

Unfortunately, this mindset often leads to people pushing happiness farther and farther away—and then being disappointed when all their suffering doesn’t completely disappear after the milestone. So, they push it back again. I guess what I needed to be happy wasn’t graduation, it must be a good job that will make me happy.

But this poses the question somewhat backwards. Why do you need that next thing to be happy? What will be different when you graduate or get that new job? What will you be able to do then that you can’t do now and is it really going to make you happy? Why not engage in behaviors and activities now that will move you in that direction regardless of those life milestones?

The question should not be, “What needs to happen for me to be happy in the future?” But rather, “How can I act according to what is important to me right now?” Am I standing in my own way? How can I do things that I feel good about right now, not in some far away nebulous future? Building a life according to your values brings joy and fulfillment, and you don’t have to wait.

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