What Is Acceptance and Commitment Therapy (ACT)?

Acceptance and commitment therapy holds the view that the basis of a lot of your problems can be tied to FEAR. This stands for:

• Fusion – You are so tied to your thoughts that you can’t separate yourself from them. Cognitive fusion can feel rigid and like you’re being governed by your thoughts. You might see thoughts as facts without any evidence to support them and have other maladaptive thinking patterns. An example of cognitive fusion is, “I relapsed, which means I am no good, and I will never get sober.”
• Evaluation – You might find yourself evaluating your experience. This typically involves labeling thoughts and feelings as “good” or “bad.” For example, you may label thoughts around urges to drink or use drugs as “bad.”
• Avoidance – Trying to push negative thoughts or feelings away or numb them is avoidance. An example of avoidance would be drinking or using drugs when difficult feelings arise.
• Reason-giving – This is the reason or justification you give for why you can’t change your behavior. An example could be, “I can’t stop drinking because my life is too hard to cope with sober.”

A part of acceptance and commitment therapy is identifying these tendencies. Your therapist may use cards or worksheets to help you recognize when you’re engaging in FEAR.

The second part of acceptance and commitment therapy is helping you learn healthier alternatives to deal with thoughts and feelings and identify values and goals to guide your life. ACT does this through six core principles:

#1 Acceptance

You’ll learn to accept your feelings and emotions without judgement. This process involves some mindfulness training. Your therapist will teach you how to just notice thoughts and feelings as they arise instead of getting “hooked” by them and creating a story around them. You won’t judge a thought or feeling as good or bad, you’ll only acknowledge that it’s a thought or feeling you’re having. If uncomfortable emotions arise, you’ll allow yourself to feel them instead of trying to push them away or numb.

#2 Cognitive Defusion

Cognitive defusion is a way of creating space between yourself and your thoughts. Your therapist will teach you specific techniques to do so. A handful of examples:

• Giving a physical shape, texture, or size to a thought.
• Thanking your mind for producing this interesting thought.
• Labeling a thought: “I am having a thought right now that I am a bad person.”
• Repeating a thought out loud until it becomes just a sound.

These types of exercises can decrease your attachment to your thoughts and make them feel less powerful.

#3 Being Present

Being present is a key component of ACT. By being present in your current experience, you can slow down the hamster wheel of unhelpful ruminations that keep you stuck in the past or worrying about the future. Your therapist will teach you mindfulness exercises to help you do this, such as getting in touch with all of your senses or describing your internal experience in a non-judgmental way.

#4 Self as Context

Self as context is a way to be present in the now. It’s the idea of “observing self.” You’ll learn that you are not your thoughts, feelings, or experiences. You’re the core where they are produced. ACT will teach you to be aware of thoughts and private experiences without getting attached or invested in them.

#5 Values

Acceptance and commitment therapy helps you identify your core values and use these to guide central parts of your life like spirituality, family, and career. Your therapist will help you decipher if your values are coming from your true self or based on “should’s,” past influences, or outside expectations.

#6 Committed Action

You’ll determine specific goals you’d like to achieve and the psychological roadblocks that are getting in the way. These goals will be in line with the values you’ve identified. You’ll use the other ACT processes to help you work toward these goals, such as acceptance and cognitive defusion.

Acceptance and commitment therapy can be used across several therapy sessions or as a brief therapy over six 30-minute sessions, known as FACT: Focused Acceptance & Commitment Therapy.