Where did Acceptance and Commitment Therapy come from?
ACT was created in the mid 1990s by Steven C. Hayes, Kelly G. Wilson, and Kirk D. Strosahl, and is based on Relational Frame Theory (RFT). Basically, RFT is based on the idea that relating one concept to another is the foundation of all human language.
Relational Frame Theory is a theory of human language and cognition which states that the rational skills the human mind has learned to solve problems with might work for some things, but don’t necessarily work for psychological problems.
In other words, your rational skills might solve how to handle your car breaking down on the highway, but can’t solve your heart breaking down after a relationship falls apart. When it comes to mental and emotional suffering, a new approach is needed.
Acceptance and commitment therapy is part of what is called the “third wave” of cognitive behaviour therapies which include dialectical behavioural therapy, mindfulness-based cognitive therapy, and then the very popular cognitive behavioural therapy (CBT).
What is Acceptance and Commitment Therapy?
Psychologist Steven C. Hayes developed ACT in the 1980s—but it’s important to note that it is under the umbrella of talk therapy or cognitive-behavioural therapy (CBT).
All CBT therapies are evidence-based and share the following characteristics:
- They aim to shape/change behaviour towards more adaptability/workability (i.e. be able to effectively respond to different situations in adaptive ways)
- They increase psychological flexibility (which has been proven to be correlated with psychological well-being)
- They aim to help individuals see the world accurately/realistically
- They help regulate emotions
ACT in particular emphasizes observing negative thoughts, feelings, or impulses without trying to “fix” them.
Other forms of CBT include dialectical behavioral therapy (DBT), behavioral activation (BA), compassion-focused therapy (CFT), among several more.
What’s the difference between ACT and CBT?
The difference between ACT and CBT is simply that CBT is a family of therapies—one of which is ACT. All CBTs use behavioural science;
ACT uses behavioural science in concert with mindfulness to “help build the lives we want even in the presence of pain,”
This is where we can see echoes of Zen Buddhism: both philosophies accept and even embrace the fact that pain is a necessary part of living.
Most times when we are experiencing pain or discomfort, we believe that we must rid ourselves of it before we begin to build the life we want for ourselves. Sadly, we then end up spending our time trying to fix our pain without attending to what gives us meaning, fulfillment, or contentment.
Part of this acceptance requires the patient to identify their values. Then they can “learn to take steps to engage in behaviors that are aligned with our values—even when we are experiencing pain or discomfort.”
Let’s say treating others with tolerance is valuable to you. With ACT, it would follow that you would practice remaining patient and calm when you’re being yelled at by your neighbour for playing the radio too loud.
How is Mindfulness related to ACT?
Mindfulness is very much central to ACT. Mindfulness is “the practice of turning the mind back to the present moment and paying attention to and experiencing the present moment as it is.”
If we are unaware, we don’t have the opportunity to recognize our negative feelings for what they are; if we are mindful in the moment of the feeling, we are able to accept that the negative feelings are there—and indeed that negative feelings will crop up from time to time.
“Most times when we are experiencing pain or discomfort, we believe that we must rid ourselves of it before we begin to build the life we want for ourselves. Sadly, we then end up spending our time trying to fix our pain without attending to what gives us meaning, fulfilment, or contentment.”
It’s not easy! Some moments are uncomfortable or unpleasant or downright painful. The natural human impulse is to “engage in behaviours that are aimed at fixing/ridding ourselves of discomfort as opposed to choosing behaviours that are aligned with our values and what we want our lives to be about,”
“When we are able to cultivate the ability to experience the moment as it is (even when it is unpleasant), we create space and the opportunity to flexibly choose how we want to behave in the present moment.
The present moment is the only place where we have agency over our own behaviour—we can’t go back and change the past and we can’t control the outcome of the future. We can decide what we do in this moment, including making choices that are aligned with our own values.”
What is ACT Therapy used for?
ACT has been used to treat a wide diversity of conditions, including
- Depression
- Obsessive compulsive disorder (OCD)
- Addiction and substance abuse
- Chronic pain
Because of its relative newness, there is less hard-nosed research on the subject as one might want. But broadly speaking, those feeling stuck, lost, or dominated by emotional stress are good candidates for ACT. Sound familiar? Of course it does.
When it comes down to it, pretty much everyone can benefit from some ACT practice. We can all benefit from learning how to become more behaviourally and psychologically flexible while simultaneously learning how to clarify what they want their lives to be about and taking steps in those directions.
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