Acceptance and Commitment Therapy: Principles and Uses

The expressions we just listed are harmful and don’t help you solve your problems.  All they do is put conditions on things and stop you from moving forward if those conditions aren’t met. You’re giving an obvious cause-based value to whatever your thoughts and feelings are about, and pointing out that some of those things are negative.

Acceptance and commitment therapy (ACT) isn’t a new technology, it’s actually a third-wave therapy practice. People have been developing it for almost twenty five years, but its popularity is definitely more recent.

Acceptance and commitment therapy is a kind of cognitive-behavioral psychotherapy based on the relational frame theory of language and human cognition. It’s a perspective on psychopathology that emphasizes the role of the experiential avoidance, cognitive fusion, lack or loss of values, and behavioral rigidity or ineffectiveness that come along with the territory.

According to Acceptance and commitment therapy, one issue with these patients is that they mix up the solution and the problem. They follow a pattern in their life where they intentionally avoid private events (thoughts and feelings) with negative verbal functions (things like suffering, discomfort, anxiety, depression, etc). But all that does is make the symptoms worse.

What does all that mean? Readers familiar with psychology won’t have a hard time understanding those terms, but that might not be true for everyone else. So we’re going to try and clear up these terms as best we can. 

The principles of acceptance and commitment therapy

Experiential avoidance

Pain is an unavoidable part of human life, but suffering is “a whole different ball game.” Feeling bad is something every one of us would want to avoid, or get away from, if we’re already feeling it. So what you do is get down to work to get rid of all your negative emotions and feelings as fast as you can.

We all try to avoid suffering, some people more and some people less (except when there are really powerful rewards: someone might want to be “a little sick” to get attention). That makes perfect sense. But there are times when the price you pay to get that, if you do it the wrong way, can be extremely high. 

What’s important is to stop and realize when this avoidance of suffering isn’t a proper solution. Once you’ve done that, you’ll be ready to learn how to make a “psychological opening” for any private reactions that seem negative if they can bring you to something you value in life. In other words, once you understand that it doesn’t help you much to go through life putting all your effort into avoiding suffering (which doesn’t mean you have to go looking for it), you can just accept it when you feel it.

Cognitive fusion

Cognitive fusion is the most abstract concept we’ll go into in this article. If you want to understand it just  think about your mind (your train of thought) as a radio. It’s like a radio that tells you how you feel or whether what you are or aren’t doing to reach a specific goal is actually enough. It can also knock down your self-esteem by saying that you’re not good enough for anyone to like you. And there are plenty of us with radios that send these kinds of messages.

The problem comes up when you “fuse” these kinds of messages with reality. It’s when you give them a high status. It’s when you think that everything your radio says is true. And that’s why it’s so important to work on meta-thinking, which means thinking about how you think and adjusting it. You have to understand that whatever your inner voice says, it’s still just a voice, like just another voice in a radio debate.

On the other hand, this radio can be useful for you when it comes to giving you information (there aren’t just opinion shows on the radio, there are also informative ones, and it’s the same in your mind). The radio can tell you if it’s going to be hot out, or even tell you if it thinks it’s worth going out in that heat or not. But it’s still just a recommendation you can choose to follow or not. Getting back to psychology, your radio can tell you there will be tension at a party, and even suggest you don’t go. But in the end you’re the one who decides. And that’s why during therapy it’s so important to separate the fusion that’s happened between what your radio says and what you decide to do.

Values

Acceptance and commitment therapy puts a special importance on people’s values. For example, someone might see some specific object as either beautiful or ugly. And that’s mostly a question of that person’s background in whatever culture they’re from. 

We can see changes in these evaluations, and that’s true across different cultures and as time has gone by. It makes sense that you’d start to realize a lot of your judgment-based responses (beautiful/ugly, good/bad, fun/boring, etc) might have been completely different if you had been born in a different time or place. The same thing happens with your values. And that’s especially true when you examine them really closely or are faced with a moral dilemma.

Behavioral rigidity

This term is easier to define. What it means is that you always do the same things because you don’t have any other responses. That is, there are plenty of times when you turn the same problem over and over and never find a good solution. Acceptance and commitment therapy says this is because you don’t have enough “solutions” to confront problems with, and that you don’t go looking for any either. 

The disorders that come up from trying to avoid suffering

Earlier on we defined experiential avoidance. There are a lot of people who try to avoid anything that makes them feel chronic, widespread discomfort. But as a result of that they live a very limited life. This pattern of behavior ends up bringing the suffering into a lot of other parts of their life.

These people get wrapped up in a pattern of avoidance that has a huge personal cost. For example, it might stop them from reaching a lot of their goals. And that’s when you’re dealing with a true experiential avoidance disorder. 

Western culture and its main broadcasters (families), always drive you to have  “proper” or “correct” private events (thoughts, feelings, or sensations) in your life. For example, they encourage the idea that you need to be in some specific motivational or emotional state, or have some specific way of thinking about yourself to be functional and successful.

Are you successful and don’t realize it?

The problem comes when you’re successful and still go looking for those private states that they’ve taught you are the only way to get something that you already have. It’s a bit extreme, but think of a man who’s just won the lottery. Ever since he weas little people taught him that you get money from working, and that if you want to be rich you have to work really hard. Well, even though he’s rich now, he still breaks his back every day to try and fulfill that first part of what they taught him.

So it’s almost like the success that a lot of people are looking for is only true success if they suffered for it. And that means when they reach that point, they’ll just go on looking for it. Avoidance, on the other hand, gets you into an entirely different cycle. In this scenario you want to be successful except that you haven’t won the lottery. But you’ll see work as a suffering that you want to get away from, so you’ll reject success because you think that working (suffering) is the only way to reach it. And then you’ll just get stuck with another kind of suffering: not getting the things you want.

The solution is actually the problem

But sadly, all the facts say that the outcome is the exact opposite of what you were going for. It doesn’t matter how hard you try to avoid it, you’ll keep on suffering. That’s how this pattern of avoidance becomes a total paradox. 

In that case the solution to everything is actually the problem. Here’s the real issue: you have a pattern in your life that involves intentionally running away from discomfort,  suffering, and anxiety. And all that does is make you feel more discomfort, suffering, and anxiety.

The root of experiential avoidance disorder

Experiential avoidance disorder comes around when you aren’t ready to make contact with your negatively charged private experiences (whether these are thoughts, memories, or even states and feelings in your body). A more concrete example of a negative private experience would be those “undesirable” emotions like anger or sadness.

So people with experiential avoidance disorder try to change the root, the shape, or the frequency of those experiences so they’ll stop happening. For example, think of someone who’s in an especially sad emotional state. One big way people try to deal with their sadness is to treat it like a fly: they try to wave it off. But when you use this impulsive, inaccurate strategy, the fly will keep on coming. Well, the exact same thing happens with sadness.

You basically give yourself permission to feel that way. A lot of us forget that we’re “supposed” to feel sad every once in a while because that’s just the way humans are. When you avoid this experience, it only gets worse because whatever you try to avoid or push away will just stick around.

Helpful in the short term, terrible in the long term

A lot of the time this behavioral pattern will seem effective in the short term because it relieves the negative experience. But when it comes up as a chronic, widespread thing, all the negative experiences spread into other places and become a limitation in your life.

To put it another way, you’ll end up going against what’s good for you, with suicide being the extreme side of experiential avoidance. The paradoxical part of experiential avoidance disorder comes from the fact that the person with it is trying to do what they think they’re supposed to do to get rid of their suffering (and they put time and effort into that goal). 

But all that does for them in the long term is lead whatever makes them suffer to be more and more present in their more and more closed off life. They have no way to move forward with their goals and the things that are important to them.

Uses for acceptance and commitment therapy

A look at the studies published about acceptance and commitment therapy will show you which disorders have the most scientific backing with it. And they are, in this order:

• Anxiety disorders
• Addictions
• Mood disorders
• Psychotic episodes

It’s entirely possible that the what makes ACT so effective has something to do with the focus it puts on acceptance. That’s absolutely necessary when it comes to experiences linked with emotional pain (anxiety, depression, pain, posttraumatic stress, etc). But it also comes from ACT’s encouragement of personal commitment. This part seems crucial for treating disorders that put people’s health at risk (sexual risk practice, alcohol and drug consumption, etc).

On top of that, getting the patient to step back and start questioning their thoughts and ideas can be a key way to help when it comes to treating a psychotic break. We should also point out that based on research the only people who can benefit from this therapy are verbally competent adults. 

Bibliography

Steven C. Hayes, Kirk D. Strosahl, Kelly G. Wilson. Acceptance and Commitment Therapy: The Process and Practice of Mindful Change. New York. Guilford Press