Stress Less, Live More: An Introduction to Acceptance and Commitment Therapy
- lichitaindrawork
- 3 hours ago
- 6 min read
Most people would agree that stress is part of life, something that everyone will eventually experience at least once in their lives. Stress is a natural body's reaction to pressure and threats, for instance, when dealing with life changes or challenges such as money worries, work issues, or relationship problems. Whilst short-term stress would be helpful to motivate us in getting things done, long-term stress could be detrimental to both our physical and mental health. As stress and life changes are mostly inevitable, finding a more sustainable healthy way to deal with these challenges would be the best way forward.
What is Acceptance and Commitment Therapy (ACT)?
In 1980s, psychologist Steven C. Hayes, inspired by his promise to stop running away from himself and his negative experiences, came up with the idea of developing what is now known as acceptance and commitment therapy, or ACT. The underlying principle of ACT is to accept one's own experience as part of life instead of fighting and trying to fix anything that is deemed 'negative' by the society.
ACT is a third-wave cognitive behavioural therapy (CBT) that seeks to alter the context and function of thoughts and emotions, rather than change the form and content of those thoughts and feelings. Essentially, it is a type of psychotherapy that uses acceptance and mindfulness strategies to help people to accept their thoughts, feelings, and experiences, both positive and negative. Hence, the primary goal of ACT is to direct one's attention from the 'negatives' they could not fix to stay focus on the present moment, and find a way forward by committing to do things they can do that are aligned with their values.
In the long-term, ACT will improve psychological flexibility, an ability to be present in the moment, being fully aware of one's situation and condition, and to be able to pursue a behaviour that is aligned with one's chosen values. By learning to tolerate and accept the 'negatives' and discomfort, rather than avoiding or trying to fix it, one would develop awareness to be here and now.
How Does Acceptance and Commitment Therapy Work?
Developing psychological flexibility through ACT could be done through six steps or core processes, which are conceptualised as positive psychological skills:
Acceptance (Open Up)
Acceptance is taught as an alternative to avoidance, mainly by acknowledging and fully embracing one's thoughts, experiences, and emotions, without unnecessarily trying to deny, change, or alter them.
In the case of experiencing stress or worries over life changes, one is supposed to fully embrace their stress and worries as a feeling, without trying to avoid, deny, or fix them. By accepting these 'negatives' one could better increase their motivation to engage with values-based actions to move forward.
Cognitive Defusion (Watch Your Thinking!)
Cognitive defusion is aimed to change the way one interacts with or relates to experiences, thoughts, and emotions by removing unhelpful contexts to mitigate harmful effects. This involves distancing oneself from their thoughts and feelings and changing the way one relates with them. The aim of cognitive defusion is to lower the 'believability" and the attachment to the experiences, thoughts, or emotions. This can be many ways, for instance by observing the thought without judging, repeating the thought out loud ("I am having the thought that I am no good"), or 'watching' the thoughts in an 'outsider' perspectives without judging.
For example, when worrying about not being able to pay the bill for next month's rent, rather than thinking "I will not be able to make it", try to voice out your thought that, "I am thinking or I am having the thought that I will not be able to make it".
Being Present (Be Here and Now)
Being present is done by being mindfully present in the moment. This is where ACT uses a blend of acceptance and mindfulness strategies to improve awareness. To be present, one must try to be aware and observe their thoughts and feelings without denying, judging, or changing them. Try to experience events clearly and directly as part of reality that can be linked with one's values and what one would like to do and can do.
Self as Context (Pure Awareness)
Self as context is an idea that encourages one to be aware of the distinction between the human's mind aspects of "the thinking self" and "the observing self." The whole notion of the "thinking" self and the "observing" self is that as a human, the part of us that is aware of what we are thinking, feeling, sensing, or doing at any moment is different from the part of us that is aware of noticing and observing those things. To put it simply, the part of us that is "experiencing" the stress is different or separate from the part of us that is "aware" that we are experiencing or feeling stress. The notion of "self as context" is to asserts that people are more than their thoughts, emotions, or experiences. That the thoughts, feelings, and experiences that are happening 'inside' us is different or separate from us as a 'self'.
Values (Know What Matters)
Values encompass determining one's chosen directions in various domains of life, e.g. family, career, spirituality, etc. The idea of this process is to realise what one values, what matters to them, what they want to achieve, and strive to achieve them. By realising and acknowledging one's values, actions taken to move forward from one's negative experiences, thoughts, or feelings will not be driven by the desire to avoid the 'negatives' or unpleasant things nor to meet other people's expectations.
Committed Action (Do What It Takes)
Committed action represents the 'commitment' part of ACT. This involves creating concrete goals and committing time to take actions that would help to achieve those goals. In this step, one could expect to set their own goals in relevance to own's difficult thoughts or experiences, and to build the skills to carry out and maintain behaviour changes that are aligned to those goals and one's personal values.
Why Choose Acceptance and Commitment Therapy?
Many studies have proven the usefulness of ACT as a transdiagnostic (applies to more than one condition) intervention, such as anxiety disorders, depression, addictions, psychosis, obsessive-compulsive disorders, and physical health problems such as headache, insomnia, or chronic pain. ACT has also been proven to be effective in reducing workplace stress and burnout.
Previous studies have found ACT to be a promising intervention for chronic and long-term conditions management, for example in supporting the parenting or caregiving of people with long-term conditions, seizure-control in epilepsy, and disease self-management. Research to wider fields have also been conducted, for instance, in assessing the usefulness of ACT in supporting smoking cessation or supporting individuals in autism spectrum.
ACT is also highly adaptable and can be delivered in various manner that suit the unique needs of people struggling with both mental health and physical health conditions. Apart from being delivered in a normal clinical setting, ACT has also been delivered in the format of a 1-day group workshops, online and smartphone applications, and telehealth.
The Caveat
ACT is an inclusive psychotherapy that anyone can do without special pre-requisite or preparation, apart from having the ability to think abstractly (understanding things or ideas that are not physical objects or experiences). Thus, ACT might not be suitable for children as abstract thinking might be challenging for children to understand.
Participating in ACT is generally safe without serious adverse effects or implications. However, professional supervision will still be necessary for people who are more vulnerability and at higher risk thoughts of suicide or self-harm. Additionally, as typical with other types of psychotherapy, ACT requires certain level of openness that might cause vulnerability and make some people uncomfortable. It might be difficult and requires some mental effort. Nevertheless, ACT teaches lifelong skills and sustainable cognitive and behavioural changes that brings long-term benefits to anyone who practice it.
In a world where stress is inevitable, ACT offers a sustainable path forward—inviting you to embrace difficult thoughts and feelings with openness, clarify what truly matters, and take committed action toward a life that is rich, meaningful, and uniquely yours.
References:
Stress: Every Mind Matters - NHS
https://www.nhs.uk/every-mind-matters/mental-health-issues/stress/
Acceptance and Commitment Therapy - Psychology Today
https://www.psychologytoday.com/gb/therapy-types/acceptance-and-commitment-therapy
Acceptance and Commitment Therapy - Mayo Clinic
https://my.clevelandclinic.org/health/treatments/acceptance-and-commitment-therapy-act-therapy
Acceptance and Commitment Therapy - Contextual Science
ACT Made Simple
https://www.actmindfully.com.au/upimages/ACT_Made_Simple_Introduction_and_first_two_chapters.pdf
Acceptance and Commitment Therapy: Model, processes and outcomes
Acceptance and Commitment Therapy: A Transdiagnostic Behavioural Intervention for Mental Health and Medical Conditions
Effectiveness of Acceptance and Commitment Therapy on Mental Health Issues: A Systematic Review
A meta-analysis of the efficacy of acceptance and commitment therapy for clinically relevant mental and physical health problems
A systematic review of the use of Acceptance and Commitment Therapy (ACT) in chronic disease and long-term conditions
Acceptance and commitment therapy (ACT) for professional staff burnout: a systematic review and narrative synthesis of controlled trials
Picture source: https://www.counselling-directory.org.uk/articles/mindfulness-based-stress-reduction-for-inner-peace-and-resilience
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