Acceptance and Commitment Therapy (ACT) provides a ground-breaking, evidence-based psychotherapy that targets the development of psychological flexibility.The intention of ACT is not to remove the difficult internal experiences we have—thoughts, feelings, and sensations—but rather to develop the willingness to accept them.
In many respects, ACT does not teach people to immediately fight against discomfort, but instead allows people to create space for these difficult internal states and behaviours without controlling their actions. This paradigm shift prepares individuals to be able to engage in the present moment and move toward a life that is consistent with our most deeply held values, even in the face of distress.
The theoretical origins of ACT can be traced to researchers such as Dr. Steven C. Hayes during the late 1980s and early 1990s. ACT evolved from Relational Frame Theory (RFT), a complex behavioural theory that describes how humans learn language and cognition. RFT serves as the scientific explanation of how our minds can inadvertently create psychological suffering through verbal processes such as rumination or self-recrimination. ACT is generally thought of as a “third wave” of behaviour therapies, as it grew developmentally from traditional behaviourism and cognitive approaches.
Its method completely differs from traditional cognitive-behavioural therapies (CBT) in how it approaches problematic thoughts. Many CBTs aim to challenge, dispute, or reframe or negative thoughts to reduce the frequency of uncontrollable thoughts or the intensity of emotions.
ACT does not do this, instead, it encourages acceptance and defusion. Acceptance means experiencing thoughts and feelings willingly without trying to change or control them.
The Essence of acceptance and commitment therapy (ACT)
Acceptance and Commitment Therapy, pronounced like the word “act,” is an evidence-based psychotherapeutic approach developed by psychologist Steven C. Hayes in the late 1980s. Whereas traditional cognitive-behavioural methods typically focus on alleviation of symptoms, ACT aims to boost psychological flexibility. This means being able to fully engage with the present moment and consistently act in ways that align with your deepest values.
ACT is based on a modern behavioural psychology framework, complemented by Relational Frame Theory (RFT), which analyses how language and cognition sometimes create barriers to psychological well-being. Rather than seeking to remove uncomfortable thoughts and feelings, ACT teaches us that we can change the way we relate to our thoughts, feelings and memories.
The Goal: Psychological Flexibility
Instead of pursuing an illusion of everlasting happiness, ACT’s true objective is to cultivate psychological flexibility, enabling individuals to adapt gracefully to life’s inevitable challenges while simultaneously committing to purposeful actions aligned with their most profound personal values. It recognises that pain/struggle is a part of living, but that we add to suffering by trying to avoid it or control it.
The Six Core Processes of ACT
ACT utilises six interrelated processes, which are frequently presented in a hexagon or “hexaflex.” You can improve these processes to cultivate psychological flexibility:
1. Acceptance
Acceptance willfully allowing internal experiences (e.g., thoughts, feelings, sensations) to be present without attempting to change or eliminate them. Acceptance does not mean giving in or conceding defeat, but rather it allows us to be uncomfortable when opening up the possibility of moving in the direction of our values.
Example: Letting your feelings of being nervous before a job interview be present without suppressing them or allowing them to control your actions.
2. Cognitive Defusion
Our minds generate thoughts constantly, and though they can feel and seem truthful, they simply don’t always come from the same place. Defusion techniques allow us to move our thoughts away from a concrete place in our mind, rather, to see our thoughts for what they are, mental events rather than realities.
Example: Where you previously engaged with the thought “I’m not good enough.” Now, you shift to your thought, “I’m having the thought that I am not good enough.” This simple and small change creates distance between you and the thought.
3. Being Present
Being present means discerning the past and fretting the future, and being aware of the present involves paying attention to the Here and Now so we can be completely engaged in our experience and be less reactive.
Example: engaging in a family dinner instead of mentally rehashing your to-do list.
4. Self-as-Context
We sometimes refer to this perspective as the ‘observing self,’ which acknowledges we are not just our thoughts, feelings, and experiences. We can notice our thoughts, feelings, and experiences, and we can recognise them without being defined by them.
Example: You may notice that you feel anxious in social situations, but that does not mean you are “an anxious person.” Anxiety is simply something you experience, not who you are!
5. Values
Values are our most cherished desires about how we want to act and what we want to represent in our lives. They are not completed goals, they are ongoing directions in which we want to live.
Example: One might consider ‘being present for my children’ a value that informs parenting decisions.
6. Committed Action
Committed Action means engaging in meaningful ways in line with our values, even when we have difficult thoughts and feelings. It is about changing our behaviour in a way that more fully reflects a life worth living.
Example: You are afraid of being rejected, and you still reach out to a friend to reconnect because you value the close relationships you experience.
The ACT Process in Action
ACT does not typically follow a set order through the six processes; they work together in a mutually reinforcing way to develop psychological flexibility. The process usually starts by acknowledging that our attempts to control unwanted experiences internally, setting limits for how we live our lives (creative hopelessness). Then, ACT provides in its approach to teach you acceptance and defusion skills, providing breathing space to utilise another way of being. Mindfulness allows us to contact the present moment more fully and enables us to access our observing self. With awareness of the present and we clarify our values we engage in action; this is known as committed action, living a rich life regardless of the discomforts we experience.
Is ACT Effective?
Evidence supports the effectiveness of ACT for a wide range of psychological issues, including:
- Anxiety disorders
- Depression
- Chronic pain
- Substance abuse
- Occupational stress
- Eating disorders
The distinction of ACT is its transdiagnostic model—not symptom specifically—and the identification of psychological skills that enhance mental health and well-being overall.
ACT in Daily Life
The beauty of ACT is that it can be applied to everyday situations. Here are some examples of how you can take ACT principles into everyday life.
- When difficult emotions arise, try not to immediately address them; practice making room for them.
- Notice when you are fused with thoughts, and gently create some space.
- When mindful, choose to practice being present, and, if possible, take on a mindfulness practice.
- Reflect on your values regularly and how they align with your actions.
- Create small, value-based goals, and take committed action towards them.
The Paradox of Acceptance
One of the most impactful insights of ACT is something some have referred to as the “acceptance paradox”: that sometimes the more we try to avoid, or control, our inner experiences, the more they control us – conversely, the more we open ourselves up to experiencing discomfort with willingness and self-compassion, the more space we have to create our own freedom and choices for new experiences.
As Hayes points out, ‘If you don’t accept it, it will control you. We create the most energy for changing those things we can, by first accepting those things we cannot change, especially living towards a rich, full, and meaningful life that is aligned with our deepest values.
Conclusion
Acceptance and Commitment Therapy serves as a refreshing alternative to our culture’s demand for unfettered and unqualified feeling good. Instead of continually fighting against sometimes intolerable thoughts and feelings, ACT teaches us to hold difficult thoughts and feelings lightly while moving in the direction of a valued life. ACT is such a radical approach because our culture is obsessed with finding ways to emotionally avoid (to feel good) through quick fixes. Perhaps having a meaningful life is not about feeling better, but becoming better at feeling—all while taking steps in the directions that matter to us.
Whether you are dealing with specific mental health or emotional difficulties or simply want to live a more authentic life, ACT provides opportunities to develop the psychological and emotional flexibility needed to make living meaningful. The journey starts with not trying to control the internal emotional and psychological weather, but opening up to it (accepting) and then choosing the direction to walk in, rain or shine.
