What is Acceptance and Commitment Therapy?
Acceptance and Commitment Therapy (ACT) is an evidence-based approach to therapy that's rooted in helping people find freedom to make real, whole-hearted choices rather than being stuck in a state of reactivity, fear or rigidity.
ACT is what's called a "transdiagnostic" approach to therapy—it's helpful across a wide range of struggles and challenges.
This is so because, instead of problem-solving each of your struggles one-by-one, ACT supports people in approaching life itself from a freer, more flexible posture. Many of us get stuck in certain ways of living, down to the very way we think and relate to our feelings. We can develop habits in our lives that unintentionally lead us down a path in which our time, energy and attention are swept up by anxious or avoidant patterns that have little to do with what we truly care about. ACT offers a journey towards getting to the core of who you are and resetting how you relate to your mind, feelings and self such that you can more fully embrace and pursue what matters to you most.
Kathleen Taylor is a therapist in Northwest, Philadelphia who practices ACT therapy.
What is the goal of ACT?
The goal of ACT is to help people develop what's called "psychological flexibility." This is a fancy way of saying—you're free.
Most of us get so caught up in certain ways of living, thinking and being that we live life in really limited "behavior loops," not even noticing that our rigid ways of thinking and emotional avoidance patterns are like the glue in our unhappiness. ACT breaks all this down and helps people return to something closer to a childlike approach to life, an open-handed posture. Instead of trying to grip life and control everything about yourself, your thoughts and your emotions, you untangle pent up tension and learn how to let go. This is transformative because it's actually an illusion that we can control our minds and our emotions in many of the ways we try to. Instead of trying to control your thoughts, emotions and by extension yourself, you start to hold everything that comes across your experience lightly because you're not driven by fear or avoidance anymore. You can just let your mind do what it does and pour your energy into what you care about instead of all your mind's layered attempts at control that don't actually work.
It's a holistic shift in your posture at the deepest level towards a more mindful, open and even trusting way of being.
When people talk about the goal of ACT, they also often talk about the six processes in psychological flexibility: willingness, cognitive defusion, present-moment awareness, self-as-context, values, and committed action. Each of these is a component of psychological flexibility. But it's not that learning each of these equals being psychologically flexible per se, it's more like when you've made this whole-person pivot towards flexibility, you'll discover that you're doing all these things in a way that you intuitively understand but you couldn't quite *feel* before. That deeper shift is what we're working towards in ACT. And one of the beautiful things about ACT is that because it's working with how you're approaching life at the most fundamental level—your relationship with your thoughts and feelings—making shifts in one area of your life often leads to whole patterns of change and growth across your life.
What is ACT therapy like?
At the simplest level, ACT therapy will feel like a fairly normal conversation that's focused on you! You'll be invited to slow down, check in with yourself, and we'll likely focus our conversation either specifically on one of your therapy goals or we'll begin with something that feels "raw" or unsettled and work our way from there towards your goals.
The majority of what I do is listen and support you as you find your own way to your own answers. Part of this, and a part that makes it "ACT" specifically is that I also try to help you get you out of your own way. I seek to help you relate to your thoughts, feelings and framework for interpreting the world in new, more flexible ways that help you make little shifts in how you're living that add up to significant changes over time. For example, I might guide you towards a certain feeling that seems to flit in and out of your awareness but that holds a lot of sway over how you've been living lately. Or, I might invite you to notice a certain thought you're having from a new angle that shows you more of how it's functioning in your life, for example using a metaphor that we can both draw from as we move forward. Or, we might explore a fear
that underlies certain behaviors you've felt stuck in lately, making our way through the fear rather than continuing in futile efforts to work around it.
These are just examples, but overall it should feel like you're being truly listened to and like I'm helping you go deeper—not cognitively into deeper intellectual understanding, but deeper in the sense that you experience yourself, your feelings and your thoughts in new ways that help you get "unstuck" and freed up to try out new ways of being you.
There's a wide range in how different therapists do ACT, and here I only attempt to speak to what ACT might be like with me. If you're interested in more nerdy detail about what this all means and how it works at a deeper level, just ask. There are layers upon layers. An interesting truth is that ACT isn't meant to be an approach that sounds incredible when you hear about it because it's meant to help people with problems they can't quite figure out how to name and thus can't quite figure out how to work through—that's precisely why people are stuck in the first place!
What can ACT help with?
From a diagnostic point of view, ACT is evidence-based for a huge number of struggles and diagnoses including anxiety, depression, chronic pain, OCD, and many more. The essence of what ACT helps people with is the ability to slow down, let go of futile efforts at controlling your way through life, connect with what matters to you and start living in a way that reflects your values rather than your fears.
That being said, not all struggles fit neatly into diagnostic categories. And, ACT can be deeply helpful for people who are managing on one level but who are struggling deeply at another level, either emotionally, behaviorally or just feeling lost inside a busy mind. Because of this, below I name a few of these types of simply-human-struggles that I see ACT help people with on a consistent basis.
Some specific examples include:
"I just can't break this cycle."
The quintessential struggle ACT helps with is when people feel stuck in certain ways of thinking or "being" that never seem to change despite how hard they try to escape. ACT helps people get off their hamster wheels and make real forward progress.
"Why do I keep acting this way?"
Just like we get stuck in patterns within our own minds and behaviors, our relationships can get stuck in grooves because we each have certain "modes" we use when we relate to each other. ACT helps people actually break out of these modes into open, thoughtful ways of relating to others that are rooted in their values.
"I wish I was more disciplined."
ACT helps people break through avoidance by gently guiding them towards the underlying "engine" holding their avoidance in place in their life. Oftentimes, this is fear. We face fears together and experience how facing fears loosens their grip and frees you up to quit avoiding in many areas of life.
"My mind is unrelentingly harsh."
Inner critics can be loud, powerful and feel incredibly hard to stand up to. ACT can help you approach your inner critic in a new way that takes away it's "fangs" and helps you out from the trap of living too often according to what the inner critic says of you.
"Who am I? How can I just be me?"
Many people feel a vague sense of being lost or not themselves. This can happen when you grew up being told very specifically how to be and haven't gotten the chance to experience yourself free of internalized "shoulds." ACT can help you navigate this confusion and find your way to just being you.
"I'm exhausted from trying so hard."
If you feel exhausted from trying so hard to be a certain way or not be a certain way, there's a chance you're trying to control parts of your life, mind and feelings that are simply not in your control. ACT helps people find their way out of these energy traps into a more open, flexible way of being.
