Acceptance and Commitment Therapy

Cape Town Psychiatrist Dr Kerryn Armstrong
Psychiatrist Newlands | Dr Kerryn Armstrong

Acceptance and Commitment Therapy (ACT) is a type of psychotherapy that helps you accept the difficulties that come with life. ACT has been around for a long time, but seems to be gaining media attention lately. Categorically speaking, ACT is a form of mindfulness based therapy, theorizing that greater well-being can be attained by overcoming negative thoughts and feelings.

Essentially, ACT looks at your character traits and behaviors to assist you in reducing avoidant coping styles. ACT also addresses your commitment to making changes, and what to do about it when you can't stick to your goals.

ACT focuses on 3 areas:

Accept your reactions and be present

Choose a valued direction

Take action.

Whether it be a situation you cannot control, a personality trait that is hard to change or an emotion that overwhelms, accepting it can allow you to move forward. Obsessing, worrying and playing things over and over keep you stuck. In this sense, asking why can leave you helpless. ACT invites you to accept the reality and work with what you have.

Some acceptance strategies include:

  1. Letting feelings or thoughts happen without the impulse to act on them.
  2. Observe your weaknesses but take note of your strengths.
  3. Give yourself permission to not be good at everything.
  4. Acknowledge the difficulty in your life without escaping from it or avoiding it.
  5. Realize that you can be in control of how you react, think and feel.

Another aspect of ACT is the skill-set of learning how to cognitively defuse psychologically heightened experiences. Defusion involves realizing thoughts and feelings for what they really are, like passing sensations or irrational things that we tell ourselves - instead of what we think they are like feelings that will never end or factual truths. The goal of defusion is not to help you avoid the experience, but to make it more manageable for you.

Some defusion strategies include:

  1. Observe what you are feeling. What are the physical sensations?
  2. Notice the way you are talking to yourself as these feelings are experienced.
  3. What interpretations are you making about your experience? Are they based in reality?
  4. Grab onto the strands of your negative self-talk and counter them with realistic ones.
  5. Now re-evaluate your experience with your new-found outlook.

Acceptance and Commitment Therapy is not a long term treatment. The ACT experience of reworking your verbal connections to thoughts and feelings, known as comprehensive distancing, can be extremely helpful in the treatment of depression, anxiety and many other psychological disorders.