3 Lessons Learned from Acceptance & Commitment Therapy
Recently, we’ve been talking about how to get the most out of your therapy sessions, and I shared with you three of the main takeaways from one of the most powerful psychological treatments – Cognitive Behavioral Therapy.
I also mentioned that a newer treatment is gaining momentum and filling in for some of CBT’s weaknesses. This treatment is called Acceptance and Commitment Therapy, and the research on it in helping people transform their thinking and find freedom from anxiety, stress, depression, and lots of other mental health problems is super impressive.
You’ve probably never heard of ACT (pronounced as the word “act” rather than by its letters), so I’m here to tell you the main takeaways from this incredible treatment approach.
THE WEAKNESSES OF COGNITIVE BEHAVIORAL THERAPY
CBT is great. I’m a big fan, and so is the research.
Over and over and over again, the research shows us that people who engage in quality cognitive-behavioral therapy get better.
Their symptoms reduce in intensity, their quality of life improves, and they have a greater sense of wellbeing.
But CBT isn’t perfect, and the research has shown that as well.
One of the main premises of CBT is that changing your thoughts helps change your feelings.
If I can change self-critical thoughts into self-compassionate thoughts, then I should feel a tiny bit warmer toward myself.
It makes sense conceptually, and for many people it really works.
CBT presumes that if you can see the evidence for and against your thought, you can develop a more reality-based thought and then reduce the intensity of the emotion attached to the thought.
And that works….kinda.
A lot of us already know that the thoughts we’re having aren’t entirely logical.
When we have the thought “No one likes me,” we can pretty much immediately call BS on the thought and generate counterexamples.
But for some reason, that thought still lingers and gets to us.
HOW ACCEPTANCE AND COMMITMENT THERAPY IS DIFFERENT FROM COGNITIVE BEHAVIORAL THERAPY
That’s where Acceptance and Commitment Therapy comes in.
ACT says, “Yep, you have some irrational thoughts sometimes…and you know they’re irrational….and you still believe them. Yep. That’s what’s happening.” ACT encourages us to acknowledge that reality.
Whereas CBT wants us to change the thoughts, ACT wants us to change our relationship to the thoughts.
So, CBT hears the thought “No one likes me,” considers that thought important, and then targets that thought for further examination.
But ACT hears the thought “No one likes me,” treats that thought as it would any other thought, and then allows that thought to pass just like any other thought.
It doesn’t treat that thought as any different than any other random thought that passes through our heads…the thoughts like
“I’m hungry,”
“I wonder where the bathroom is,”
“Huh, I got another stain on my shirt,”
“I’ve been sitting here a long time,” and on and on.
All thoughts are equal in importance, so ACT doesn’t treat any thoughts as any more important than any other thoughts. So just like all of those other random thoughts flit in and out of your head, so can the thoughts that tend to get stuck. ACT helps you get them unstuck.
ACT is kind of a wacky treatment in that it encourages us to do the exact opposite of what makes sense, so it takes a lot of time and commitment to really understand it, but it’s worth the investigation.
If you’re curious about diving deeper, I recommend reading A Liberated Mind or Get Out of Your Mind and Into Your Life, both by Steven Hayes, the psychologist who created Acceptance and Commitment Therapy.
In the meantime, here are three main takeaways from ACT.
ACCEPTANCE AND COMMITMENT THERAPY LESSON #1: SEE YOUR THOUGHTS FOR WHAT THEY ARE, NOT WHAT THEY SAY THEY ARE
Those nasty thoughts that keep getting stuck in our heads…the ones that make us so anxious or stressed or overwhelmed…they tell us that they’re important thoughts and that we really need to pay attention.
They tell us we’ll never get all this done, they tell us we’re not good enough to make it all happen, they tell us we’re broken and hopeless.
We know there are counterexamples, and we recognize these thoughts are maybe a little exaggerated, but we still think there’s something truthful about them.
But have you noticed that you have other thoughts that are equally as irrational, but in the opposite direction…and those thoughts miraculously don’t seem to get stuck?
Thoughts like, “Hey, maybe I’ll win the lottery this time!”
We have those thoughts, but they’re so ridiculous that our brain immediately flags them as unimportant, and they just pass right on through.
If we held on to them, we’d probably be buying more lottery tickets and investing in more startups.
There are reasons our brains flag the negative thoughts more than the positive ones, but it’s not because they’re any more true.
Acceptance and Commitment Therapy encourages us to take the same approach to our negative thoughts that we do to our positive thoughts…hear the thought and let it pass without grabbing on to it and treating it like it’s special.
This is called cognitive defusion, and it’s a process of creating some psychological distance between your self and your thoughts.
It’s about recognizing that you have thoughts but you aren’t your thoughts.
It’s not about determining whether your thoughts are true or false, or important or unimportant, or good or bad…it’s just about recognizing them for what they are: thoughts.
And then it’s about appreciating that you are separate from your thoughts.
ACCEPTANCE AND COMMITMENT THERAPY LESSON #2: ALLOW YOURSELF TO EXPERIENCE WHAT IS PRESENT IN THE MOMENT
Look, we work really hard to avoid our feelings. Like really, really hard…all day long, every day.
We’re in the habit of thinking that we’re supposed to feel good all the time, so we think there must be something wrong if we’re not feeling good. And whenever there’s something wrong…we want to head just as far in the opposite direction as we can.
This is true for just about anything.
Something smells wrong with the milk…we avoid it.
Something seems off with a person you just met at a party…you avoid them.
When something bothers us, we tend to change it or avoid it. And for a lot of things, that’s a reasonable approach to take. You’re uncomfortable in your chair, so you shift around or move to another one.
But a lot of the things that bother us or make us uncomfortable exist on the inside, and we can’t just easily move them or change them.
In fact, trying to take the “fix it” approach to our thoughts and feelings tends to backfire.
When it comes to psychological stuff (your thoughts and feelings, for example), the more you try to get rid of it, the more you’ll have it.
The more you try to not think about a red banana, the more thoughts about red bananas you’ll have.
Try it…count how many thoughts about red bananas you have in the next 30 seconds and compare that to the thoughts about red bananas you had before I ever mentioned red bananas.
How’d it turn out?
The same works for feelings: the more you try to not feel anxious, the more anxious you’ll feel.
Actually, we ultimately become anxious about the anxiety…or depressed about how depressed we are….or angry about how angry we are….or stressed about how stressed we are. You get it.
It’s not so much the thoughts and feelings themselves that are the problem — it’s the thoughts and feelings about the thoughts and feelings.
So that’s where this lesson comes in.
When we experience the thoughts and feelings as they are, without trying to avoid them and without trying to hang on to them…their intensity lessens.
When you allow yourself to experience what is in the present moment, with all its intensity and discomfort and pain, it somehow paradoxically is easier to manage.
It’s counterintuitive, but it works.
ACCEPTANCE AND COMMITMENT THERAPY LESSON #3: CHOOSE YOUR ACTIONS BASED ON YOUR VALUES, NOT YOUR FEELINGS
After reading the first two lessons, you might be thinking that ACT is just about doing nothing: don’t change your thoughts, just hear them….and don’t change your feelings, just feel them.
But it’s not really about doing nothing. It’s about doing the valuable things.
In this case, it’s about doing the things that matter most to you.
Acceptance and Commitment Therapy recognizes that our emotional discomfort means we spend a lot of our lives engaged in behaviors and experiences that aren’t valuable to us.
We binge watch TV to avoid uncomfortable conversations with our partners, we build our dream house on Pinterest to avoid how inadequate we feel in our actual lives, we sleep in and take naps to avoid how stressed out we feel, we drink an extra glass of wine to avoid the anxiety of talking to someone new.
We end up choosing our actions based on avoiding bad feelings rather than choosing our actions based on creating a life worth living.
After a few years of too much TV, social media, late mornings, and alcohol, just about anyone would be feeling like their life somehow got off track.
ACT encourages us to choose our actions based on our values rather than our feelings.
So if being an attentive and caring friend is valuable to you, then you might choose to arrange to see at least one friend per week…even if you’re feeling inadequate as a friend.
Or if tending to your physical health is valuable to you, then you might choose to move your body for 30 minutes a few times per week…even if you’re feeling stressed and run down.
Once we make a habit of choosing our actions based on our values rather than our feelings, we end up creating a life where we’re spending much more time engaged in meaningful activities….and not surprisingly, that tends to feel pretty good.
Like I mentioned before, ACT tends to be a very counterintuitive treatment.
Often, it has us do the exact opposite of what we would think to do or prefer to do.
But honestly, that’s what makes it so effective.
The entire reason we got into the problem we did with our anxiety and stress is because we were doing what made sense….so, it turns out that doing what doesn’t make sense can actually undo the problem.
Hopefully you’ve got a therapist on board to help you maximize using all these ideas and strategies. Make sure you grab my worksheet packet to get the most out of your therapy sessions. Grab it here.
I’ve noticed a lot of people use the words fear, panic, and anxiety interchangeably. But they’re not the same. So next week, get ready for some good ol’ education, where I’ll tell you exactly how to tell the difference. Don’t miss it.
Talk to you soon,
Dr. Finch
P.S. Remember, this is education, not treatment. Always consult with a psychologist or therapist about your mental health to determine what information and interventions are best for you. See the disclaimer for more details.
Hayden C. Finch, PhD, is a practicing psychologist in Des Moines, Iowa, dedicated to helping you master your mental health.
