Acceptance and Commitment Therapy (ACT)

ACT is a mindfulness-based psychotherapy that could be summarized as the practice of accepting emotional and physical discomfort while moving towards values based actions in your life.

Unlike other models that aim to reduce symptoms or control emotions, ACT promotes the idea that people, and their psychological experience, are not a thing that's broken and needs fixing.

In sessions, this may look like exploring difficult emotions and associated sensations while building greater exposure and tolerance, also known as acceptance. Sessions may also include naming and articulating values so that one can identify which behaviors will support those values and create an upward or forward spiral of change.

ACT promotes the idea that people, and their psychological experience, are not a thing that’s broken and needs fixing.

ACT is a mindfulness-based psychotherapy that could be summarized as the practice of accepting emotional and physical discomfort while moving towards values based actions in your life. Unlike other models that aim to reduce symptoms or control emotions, ACT promotes the idea that people, and their psychological experience, are not a thing that's broken and needs fixing.

In sessions, this may look like exploring difficult emotions and associated sensations while building greater exposure and tolerance, also known as acceptance. Sessions may also include naming and articulating values so that one can identify which behaviors will support those values and create an upward or forward spiral of change.

ACT promotes the idea that people, and their psychological experience, are not a thing that’s broken and needs fixing.

Examples of Acceptance and Commitment Therapy

Let’s look at a specific topic like emotional eating.

(Please note this is not the same as disordered eating such as Bulimia or Anorexia, which both involve an addiction cycle and work differently.) Client A comes in to address what s/he refers to as eating poorly with little control over being able to change that in sustainable ways.

An ACT process would begin by understanding what values this desired change is in service of. Maybe those values are about balanced health or feeling reliable. They may even be about beauty ideals or negative body image. It’s important to unpack values and differentiate between which ones are our own and which ones we may have inherited from others or society. (This applies to many subjects, not just eating.)

Once the client has found a clear statement of values that matter to her/him, s/he can begin exploring the edges of emotion or sensation s/he would have to feel, tolerate, experience to act in accordance with those values.

For example, it’s common for loneliness or anxiety to come up in association with food craving. Eating may temporarily soothe or distract from that feeling but may also lead to reinforcing a negative self-view. The client would be asked to explore that loneliness or anxiety in session with the therapist.

Exposure to the emotion or associated sensation in the therapy room helps the client feel less alone or overwhelmed or identified with the emotion. The client finds out more about their own wiliness to feel what’s there while stepping towards values at the same time instead of waiting to feel differently first.

This same process applies to other topics. For example, procrastination, indecision, patterns in relationships, burn out, anxiety, depression.

The above example presents ACT in a very linear way, but it’s actually a very fluid and dynamic framework. In a single session the client may move from defusing (detaching) from an all consuming emotion or a story about themselves, to looking at their life history, to speaking about values, to more existential questions of self.

ACT is very flexible and has a coaching element to it, which leads clients to stay most concerned with the present moment and future acts of change.

Timeline: Flexible (6 Session Minimum)

A client can expect to see clear goals and direction within 2 sessions + some notable change in 4 more sessions. The plan depends on how many topics a client may be working on and the layered complexity inside each topic.

In the example above, emotional eating may look straight forward, but there may also be family history or family relationships involved. Also, some coping mechanisms took a long time to develop and take a long time to change. Patience with oneself and the process is paramount!

With Sarah I found a place I could be more honest and real then I had been able to be before. Her ability to listen and help me reframe my challenges allowed me to accept myself in ways I hadn’t been able to before. I was able to be vulnerable and share my messy life and shortcomings. She helped me to pick up the pieces and on a tactical and emotional level put things back together in a healthier way.

- Christine -

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