Acceptance & Commitment Therapy challenges rules

The big difference between Acceptance & Commitment Therapy (ACT) and traditional western approaches to therapy and psychiatry is this: ACT does not focus on reduction of symptoms.

In fact, ACT contains the core belief that reducing the symptoms of emotional distress and deliberately trying to ‘cure’ the outward signs of 'mental ill-health', can make things worse. Trying to get rid of symptoms is often what can land a person in the consulting room in the first place – the development of what a traditional clinical approach would term a 'mental disorder’, springs from attempts to suppress emotional pain.

Instead, the alternative view, the one that lies at the heart of ACT, is that our difficult thoughts and feelings are not aspects of ‘illness’ but simply part of life.

The human condition

Common so-called ‘disorders’ like anxiety, depression, addiction, are a normal aspect of human life. Even if we haven’t been diagnosed with a specific condition, emotional and mental pain can make us suffer, and just about everyone will experience these at some time, at different levels, and perhaps over a long period.

For ACT, the pain is part of being human. The normal mind is not content, or happy. The normal mind has destructive qualities, and brings about its own suffering as a normal effect of being alive.

This understanding comes from a view of human language as a double-edged sword.  We have language, and as a result, we have suffering – because it’s only as a result of language that we can struggle with our thoughts and feelings, in a way that other non-humans simply cannot.

Survival with language

Language gave us the power to think and to plan, and to tackle difficulties. This was an enormously powerful survival strategy that permitted us to see a problem, recognise it as such, and then to seek a solution that enabled us to get rid of it, or avoid it. ACT therapists and theorists see this problem-solving urge translated from the material world—where we had to learn to avoid or fight predators, or other dangers, and to ensure we have sufficient water in the dry season, and enough food when the harvest fails—into our interior world of relationships, feelings, worries and fears.

As an example, addiction almost always begins as the attempt to tackle fears, sad thoughts, depression, low self-esteem and so on. People with obsessive compulsive disorder develop rituals to stave off anxiety.

Therapy and exercises

In therapy, ACT concentrates on teaching mindfulness – awareness of the here and now, and a non-judgemental acceptance of it all. This can move on to a focus on developing a similar acceptance of private, internal, experiences and feelings which may be in our past or our present. The ‘commitment’ part of the therapy supports an outlook on, and reaction to, our experiences based on sound, true-to-ourselves values, to enable a more fulfilled life and work.  

A therapist may share specific exercises with their client, to practise the skills of mindfulness and to track changes. You might begin with a ‘homework’ exercise to do when getting dressed in the morning, and be asked to concentrate on engaging with every sense involved. Or alternatively you might have to sit quietly and be aware of yourself, your body, your thoughts…without judgment or avoidance.