Let’s Talk About: Acceptance & Commitment Therapy (ACT)

Let’s Talk About Acceptance & Commitment Therapy (ACT)

ACT, as defined by it’s founder Stephen Hayes is “an empirically based psychological intervention that uses acceptance and mindfulness strategies, together with commitment and behavior change strategies, to increase psychological flexibility”. In ACT, psychological flexibility involves 6 core processes: Defusion, Self, Acceptance, Presence, Values, and Action.

Learning how to use skills and techniques within each of the 6 core processes has been shown to be an effective practice for people dealing with a variety of difficulties including stress, anxiety, trauma, substance use, depression, grief, chronic pain, eating disorders, and obsessive-compulsive disorder, among others. A therapist who uses the ACT approach, will work with clients to help them to pivot away from rigid thinking patterns and towards a more open and flexible way of relating to their inner world, and in turn, their life. Learning ACT tools has been shown to help people to embrace their vulnerability, and live richer, more meaningful lives.

I have provided a brief introduction of one of the first skills typically learned in ACT: Defusion. Defusion requires pivoting from cognitive fusion to cognitive defusion. Cognitive fusion means buying into what your thoughts tell you and letting what they say overdetermine what you do. The flip side of fusion is seeing thoughts as they are-ongoing attempts at meaning-making, and then, choosing whether to give them power. Defusion is a flexibility skill which involves just noticing the act of thinking. With this ability to distance from our thoughts, we can begin to free ourselves from negative thought networks.

Below is an experiential exercise that is commonly used in ACT, which helps people to learn how to “defuse” from negative thinking patterns.

• Put your hands together, palms facing upwards, as if they were pages on an open book. Imagine that your hands are your thoughts. Now, slowly raise your hands up toward your face until you are covering your eyes and can only see through the gaps of your fingers.
• Take a look around and notice how this impacts your view and connection with your environment.  
• Notice it is difficult to see much other than your hands (thoughts), so what would it be like to go through your day this way? Would you be limited or miss out on things? Would it be challenging to respond to others or the world around you?
• This is a good representation of fusion. We become so entangled with our thoughts that we get disconnected from our environment and the present (here and now) experience. Similarly, our thoughts also have a big impact on our behavior and capacity to be effective.
• Notice as the distance from your hands (thoughts) and your eyes increase, you are able to take in more information and it is easier to connect with others or your environment.
• This is a good representation of defusion. Your hands (thoughts) are still there, and you can look at them without becoming entangled with them. If the thoughts are useful/workable you may use them; if they are not, you notice them and let them sit there. This aids in becoming more flexible.

“In ACT, our main interest in a thought is not whether it is true or false, but whether it is helpful; that is, if we pay attention to this thought, will it help us create the life we want”
-Russ Harris, The Happiness Trap: How to Stop Struggling and Start Living