Acceptance and Commitment Therapy
Embracing Imperfect Reality
July 22, 2007
By Tanya M. Morrel, PhD
-
Email This Post
Print this article!
Digg
del.icio.us
Mahalo
StumbleUpon
YahooMyWeb
Over the years, a variety of innovative psychotherapy techniques have evolved to help people function “normally.” Most have proved to be fairly effective. Yet nearly 30 percent of Americans still suffer
from a diagnosable psychiatric disorder each year. Even more frightening, one in two people will seriously contemplate suicide at some point in their lives. Are we are in search of something unattainable? Perhaps freedom from pain and suffering is not normal or possible.
This is in fact the premise of a new type of treatment called Acceptance and Commitment Therapy, or ACT (pronounced “act”). ACT emerged partly in response to studies demonstrating that therapy techniques designed to stop or change people’s thoughts were ineffective. In contrast, ACT’s goal is to teach people to live a meaningful life while accepting unavoidable painful thoughts and feelings.
The Power of Language
ACT is based on research that demonstrates the power of our language, both external and internal. For instance, a simple word like “milk” has incredible meaning for us. I bet you can smell, taste and see the substance when you read the word. In the same way, we can relive painful experiences so vividly that we can remember the words that were said and begin to feel the feelings we had at the time. Our language can create continuing pain when we become fused with it — meaning that it begins to define who we are. Perhaps you have experienced moments in which your mother or father’s voice repeats itself in your head, telling you that you are inadequate. Do those voices begin to define your life?
Mindfulness
In ACT, you are taught to notice your thoughts and feelings by practicing mindfulness. First, you are encouraged to “make contact” with the present moment using techniques such as eating mindfully and walking mindfully. Then, your therapist will ask you to engage in activities designed to make you notice your mind’s workings: You might be asked to take your mind for a walk or to watch your thoughts float by like leaves on a stream. Practicing mindfulness every day can help you notice when your thoughts and feelings are driving your behavior.
De-Fusion from Thoughts
Once you begin to notice your thoughts, the next step is to de-fuse from them by becoming the observer. The metaphor of a game is often used: You strive to watch your struggle with negative thoughts and feelings and not be in that game. Language, such as “I am having the thought that I am inadequate,” is used to help you distance yourself from the thought, not to try to get rid of it.
Values
The other important part of ACT is its focus on values. An ACT therapist uses various exercises to help you determine what is really important to you. One compelling exercise asks you to imagine that you are attending your own funeral. What are you afraid might be said about you? What do you hope will be said? Using these exercises, the therapist can help you determine your values. The question then becomes: Can you act in accordance with your values rather than according to what your negative thoughts and feelings tell you to do?
Committed Action
Once you have determined your values, an ACT therapist helps you decide which value you are most neglecting. Then you can begin to set goals for yourself that are “values consistent.” Committing in the therapy session to very concrete, attainable goals can help you achieve them between sessions because you know your therapist will ask about them at the next session.
Therapist-Client Relationship
One of the most interesting things about ACT is the stance of the therapist toward the client. Unlike the relationship in many other therapy approaches, the ACT therapist believes that she is in the same “soup” as the client, struggling with her emotions and thoughts rather than accepting them. Consequently, you will find that your ACT therapist often uses the word “we” and engages in exercises with you during the session. ACT therapists are trained by engaging in the same exercises that they teach. They are committed to the continuing practice of these skills in their daily lives.
Applications of “ACT”
The ultimate goal of ACT is achieving psychological flexibility, meaning the ability to make contact with the present moment and then choose how to act based on your own values. Given this goal, ACT can be helpful with a variety of problems. It has been demonstrated to be effective in treating anxiety, depression, substance abuse, chronic pain, anorexia and even schizophrenia. To learn more about ACT, visit www.acceptanceandcommitmenttherapy.com
TANYA M. MORREL, PH.D, is a licensed psychologist with a psychotherapy practice in the Towson area. She specializes in the treatment of adults and adolescents with a variety of problems, including ADHD, anxiety, depression, marital and family issues and difficulties with life transitions. She has more than 40 hours of training in ACT and continues to practice the skills she teaches her clients in her own life. She can be reached at 410-832-0113, or visit her website at www.acceptandcommit.com.
