A brief introduction to the basic principles of Acceptance & Commitment Therapy (ACT)
ACCEPT AND COMMIT
These are just a few initial thoughts about the psychological principles of Acceptance and Commitment Therapy (ACT), (say it as one word, rather than spelling out each letter). ACT encompasses mindfulness principles, but, more importantly rejects the idea of “healthy normality” so common in much of western psychology.
Four core messages are fundamental to ACT:
1. Accept what is out of our personal control, while committing to do whatever is in our personal control to improve our quality of life.
2. Create a rich full and meaningful life while effectively handling the pain and stress that life inevitably brings.
3. Deal with our painful thoughts and feelings in such a way that they have much less impact and influence over us.
4. Clarify what is truly important and meaningful to us, and use that knowledge to guide, inspire and motivate us to change our life for the better.
The emphasis is on change to allow these aims to be achieved. The psychologist, Carl Jung said, "The foundation of all mental illness is an unwillingness to experience legitimate suffering." Too many people seem to think it's good for us to never feel any sadness or anxiety. Many people take medications for situations that are supposed to make us feel sad or anxious; they would make anyone sad – or anxious.
The myth of psychological health assumes that humans are psychologically healthy, and that to not be so is a sign of abnormality. But just think about the incidence of mental illness in all its forms, high rates of divorce, sexual concerns, abuse, violence, bullying, prejudice, loneliness etc.
Suffering is inevitable. Everyone we meet in our lives will have suffered in one way or another; it is part of being human. However, continuing to struggle with our problems does not get rid of them but just makes them worse.
The answer is counterintuitive; accept what you cannot change rather than struggle to change it. There is an analogy with being caught in quicksand; if you struggle to get out, you are likely to sink. The answer is to lie flat and float on the surface, accepting what cannot be changed.
Have you ever driven a car and suddenly realised you have no memory of the last few kilometres or you are on the bus and nearly miss your stop. You have probably been daydreaming or slipped into automatic pilot.
Acting mechanically in this way and not being fully aware of what we are doing is something most of us do. We might be day dreaming in a kind of reverie where the mind just wanders off wherever it wants, which is okay in many instances. In fact, this mind state can be creative at the right time when great ideas just pop into our minds but this mind state is something to be alert for.
Being on automatic pilot is a time when we may drift into rumination. We might follow a small negative thought down a dark road into a whole series of painful memories. It can lead us into old thought patterns associated with depression and anxiety. When we are on automatic pilot we don’t see it coming. We don’t catch the thought or feeling and see it for what it is, a passing thing.
It is important to recognise when we are on automatic pilot and make a conscious effort to move away from this mind state. The more useful or preferred mind state is to be alert or awake or mindful. In this mind state we are more able to observe our thoughts and feelings in ways which allow us to choose not to get attached to them.
Language is a “double edged sword”, and can lead to experiential avoidance. The fact is that problem solving works well for “external events”, but when used for “internal experiences”, it leads to more and worse problems. The mind creates an internal conversation where you give yourself a range of negative messages; these may have their source in messages given to us when we were young.
To find happiness, we try to avoid or get rid of bad feelings - but the harder we try, the more bad feelings we create. It's important to get a sense of this for ourselves and to trust our own experience rather than simply believing what we read or are told.
With this in mind, take a moment to complete the following sentence: “The thoughts/feelings I'd most like to get rid of are ...”
Once you've got your answer, take a few minutes to write a list of every single thing you've tried in order to avoid, change or get rid of these unpleasant thoughts or feelings. Try to remember every single strategy you have ever used, whether deliberately or by default. Don't try to edit your answers. The goal is to come up with as many examples as possible, and there are no rights and no wrongs.
• avoiding situations where the feeling occurs,
• using drugs or alcohol,
• taking prescription medications,
• criticising or chastising yourself,
• going into denial,
• blaming others,
• using visualisation or self-hypnosis,
• reading self-help books,
• seeing a therapist,
• using positive affirmations,
• talking it through with friends,
• writing in your diary,
• smoking cigarettes,
• eating more or eating less,
• sleeping more or sleeping less,
• putting off important changes or decisions,
• throwing yourself into work/socialising/hobbies/exercise,
• telling yourself `It will pass.'
Once you've done that, go through your list and for each item, ask yourself:
1. Did it get rid of my painful thoughts and feelings in the long term?
2. What did it cost me in time, energy, money and health and vitality?
3. Did it bring me closer to a rich, full and meaningful life?
The Paradox Of Control
We need to understand the difference between what we can and can’t control. Humans are addicted to control. Our very large and sophisticated brains allow us to exert an amazing degree of control over our environment. Our first instinct when confronted with an unwelcome experience is to somehow try to control that experience.
In most cases, this control instinct works very well. If you spill a glass of water, you exert control by wiping it up. If you find that you’re too warm wearing that jacket, you take it off. In countless ways, every day, all day long, we are exercising control.
Control and Acceptance
Most people find that the more they want to avoid thinking about something, the more likely they are to think about it. In fact, it is only when we decide that “I must not think about X” that we begin to experience thoughts about X as intrusive and pervasive. The stronger the prohibitions against a thought, the more out of our control the thought seems to be.
Most of us have experienced this in social situations when we have told ourselves things like, “Don’t look at the bit of spinach between her teeth!” In some cases, when thoughts are especially disturbing and we believe that we absolutely, positively, must not think them, these thoughts can become obsessions.
The opposite of control is acceptance. This focuses on letting go of the struggle to control anxiety, developing mindfulness of the present moment, and increasing the willingness to experience whatever thoughts and feelings are part of that moment.
Remember, we cannot change the past. No matter how bad or distressing it may have been, the past is set and we can’t change it. What we can do is to acknowledge what has happened and, if it is unhelpful, take action so that it won’t affect our future. Many people find it easier to be a result of their past rather than be the cause of their future. Similarly, we cannot know the future, and therefore all we have is this moment, right here and now.
Acceptance requires us to accept whatever is going on completely, without any judgment. It is neither right, nor wrong, good nor bad. It just is. Accept whatever is going on to the best of your ability, whether you have just won the lottery, lost your job or are in a noisy disagreement with your partner. This does not mean you don't feel the feelings, pleasurable or painful; acceptance is key here. This allows a shift in focus from avoiding uncomfortable feelings to choosing to act in ways that add value to life. Acceptance of anxious thoughts and feelings helps us focus on today and take steps that move us closer to the life we truly want to live.
The nature of true acceptance involves being wholly willing to accept our suffering without fighting against it. Acceptance means embracing - not rejecting - our most difficult emotions and thoughts without being driven by them, and making room in our lives for negative side effects and unpleasant thoughts and feelings in order to create a meaningful life.
Defusion means relating to your thoughts in a new way so that they have less control over you. Negative thoughts come to have less and less effect on your behaviour. Defusion, like acceptance and willingness, is a behaviour that can be learned just like other skills.
Defusion is a way of changing how we respond to automatic thoughts, reasons, life stories and other troublesome activities of our minds. Fusion involves believing that what our minds tell us is literally true. Defusion allows us to treat those activities of our minds differently so that they no longer control our behaviour.
Write down two or three negative, self-judgmental thoughts. If you need help coming up with some, consider:
What does your mind say about your body when you see yourself naked in the mirror?
What does your mind tell you about your abilities when you have just had a day in which nothing went right?
Pick the thought that bothers you the most and use it to work through the following exercises.
• I’m having the thought that ... Pick a painful thought, and buy into it for a few seconds. Then replay it in your head with this phrase in front of it - and notice what happens. Then do the same again, but this time with a longer phrase: I notice I’m having the thought that …)
• Naming The Story (‘If we turned all these painful thoughts, memories, feelings into a movie or novel, and we called it ‘The Something Something Story’ – what title would you give it? If you think about a long title, see if you can cut it down to 2 or 3 words – eg the ‘loser story’ or the ‘life sucks story’. Okay, whenever any thought, feeling or memory that is connected with that story shows up, silently say to yourself, ‘Aha! Here’s the ___ ___ ___ story.’)
• Thanking your mind Treat your mind like it’s an annoying teenager trying to get a reaction from you. Whatever it says, no matter how scary or nasty, reply, with a sense of humour, Thanks mind! Then notice what happens.
Dealing with emotions
We go through a myriad of emotions everyday ranging from “Happiness”, “Sadness”, “Anger”, “Joy”, “Fear”, “Anticipation”, “Boredom” and “Jealousy” to name a few.
These emotions can be triggered by major events or even small meaningless things such as burning the toast, spilling coffee on your top. Many times our emotion can be driven by thoughts/assumptions: what’s that person looking at, he/she doesn’t like me etc. These thoughts and assumption can trigger emotional responses which affect our day.
Emotions are helpful as well as destructive. Anger for example can motivate us to strive to achieve or drive us to cause harm, to others or to ourselves. Being mindful of our emotions is important.
Aspects to mindfulness of emotions include recognition, naming, acceptance and investigation. There is no need to practice with all four each time an emotion is present. You can experiment to find out how each encourages a non-reactive awareness towards emotions.
Recognition and Naming:
A basic principle of mindfulness is that we need to recognise what is happening. Recognizing certain emotions as they arise can sometimes be difficult. We have been taught that some emotions are inappropriate, or we are afraid of them, or simply don’t like them. The more we learn to recognize he range of our emotions, including the subtlest ones, the more familiar and comfortable we become with them. As this happens, their grip on us relaxes.
A steady and relaxed mental noting, or naming of the emotion of the moment-”joy”, “anger”, “frustration”, “happiness”, “boredom”, “contentment”, “desire” and the like-encourages us to stay present with what is central in our experience. Naming is a powerful way to keep us from identifying with strong emotions. There are many ways that we are caught by emotions: we can feel justified in them, condemn them, feel ashamed of them, or enthralled with them. Naming helps us step outside of the identification to a more neutral point of observation: “it’s like this.” Folk tales tell of the dragon losing its power when it is named. Likewise, emotions can lose their power over us when they are named.
In mindfulness, we simply allow emotions to be present, whatever they may be. This does not mean condoning or justifying our feelings. Meditation offers the extraordinary opportunity to practice unconditional acceptance of our emotions. This does not mean expressing emotion, but letting emotions move through us without inhibitions, resistance, or encouragement.
To facilitate acceptance, we can try to see that the emotion has arisen because certain conditions have come together. For example, if you had a flat tire on the way to work, and your boss gave you a new assignment with a tight deadline after you finally arrived, you might feel frustrated or angry. If your boss gave you that same assignment on a morning after you’d had a good night’s sleep and heard some great news about a close friend, you might feel excited or challenged.
If we can see emotions as arising from a particular set of conditions, we can more easily accept them, and not take them personally.
In the context of our emotions, both positive and negative, acceptance recognizes you don't have to like any particular thought, feeling or sensation, want it or approve of it, you simply:
• allow it to be there - because it already is
• give it permission to be where it already is
• let go of struggling with it
• stop fighting with it
• make peace with it
• make room for it
• let it be
• breathe into it
4 Quick Steps To Emotional Acceptance
1. OBSERVE Bring awareness to the feelings in your body.
2. BREATHE Take a few deep breaths. Breathe into and around them.
3. EXPAND Make room for these feelings. Create some space for them.
4. ALLOW Allow them to be there. Make peace with them
You can do this with many different sensations. Keep going until you have a sense of no longer struggling with your feelings. As you do this, one of two things will happen: either your feelings will change - or they won't. It doesn't matter either way. This is not about changing your feelings; it's about accepting them. Some people find it helpful to silently say to themselves, 'I don't like this feeling but I have room for it, 'or 'It's unpleasant but I can accept it. '
Mostly the unpleasant feelings fall into the negative emotions of sadness, anger, fear, anxiety and guilt. When we turn away from these emotions, we usually give them a stronger hold on us. When we turn towards them, allowing ourselves to experience and know these feelings for what they are, we weaken their influence.
Thoughts, Feelings & the Observer Mind
Negative moods and accompanying thoughts restrict our ability to relate differently to experience. It is liberating to realize that our thoughts are just thoughts, even the ones that say they aren’t.
We can develop the observing mind to observe our own mental processes. We can then generate an ability to choose which thoughts are factual and useful and which are disempowering thought patterns or old stories that can perpetuate a low mood, or initiate a relapse into depression or maintain anxiety.
Identify the place in your body where intense emotions are located and surround the physical sensation with a sense of friendly interest. Don’t try to eject the sensation but make room for it and breathe into it so as to more readily accept the sensation for what it is, rather than trying to fight against it.
If we pay attention to feelings by saying, “what I am feeling right now, what’s here right at this moment, let me feel it”, we give ourselves a different place to stand and observe as opposed to being caught up in a flood of thoughts and emotions. We can see the force of the cascading thoughts and feelings without being dragged into them. We start to move towards a different quality of attention by bringing a gentle awareness to our mind’s processes and the consequent range of feelings.
Much of what I have said here is based on the paper, “Embracing Your Demons: an Overview of Acceptance and Commitment Therapy” by Russell Harris. This can be accessed at http://www.livskompass.se/wp-content/uploads/2012/11/Russ_Harris_A_Non-technical...
There is also much valuable information in “The Happiness Trap: How to Stop Struggling and Start Living”, also by Russ Harris, Exisle Publishing (2007). If you read this book, I suggest you read it through from cover to cover first, then go back and read it again, this time doing the exercises.