Acceptance and Commitment Therapy Part 1: Acceptance and Willingness

Kelsey Schraufnagel Anxiety, Best Practices, Major Depression, Treatments of Depression

Acceptance and Commitment Therapy (or ACT, pronounced as the word, not A-C-T) is a comprehensive, empirically driven model developed by Steve Hayes, PhD and colleagues with nearly 200 randomized controlled trials (methodologically sound studies) supporting its efficacy for numerous problems and concerns.

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I recently attended the Anxiety and Depression Association of America conference in Philadelphia, where I offered a two-hour workshop on deepening experiential practices in ACT sessions (largely based on the book The Big Book of ACT Metaphors: A Practitioner’s Guide to Experiential Exercises and Metaphors in Acceptance and Commitment Therapy*). This post is Part 1 of a 6 part series to–experientially–introduce ACT’s 6 core processes.

But first, a bit more on ACT…

Whereas many therapies aim to help someone feel better by changing the content of their internal experiences (such as unhelpful thoughts and uncomfortable feelings), ACT aims to help people learn how to change their relationship to these experiences. In other words, ACT is not in the service of helping folks learn to change their internal experiences, but to enhance their ability to make space for their experience as it is (not as their minds say it is– “intolerable!”). Once we learn to shift our relationship to our painful thoughts or feelings–to an allowing and accepting stance (because really, pain is a very normal and expected part of being human!)–then we can live more fully, richly, and bravely, without tip-toeing around in an attempt to avoid having these normal experiences.  People come to us to help them feel better and I say that my focus isn’t helping them feel better, but I can help them feel better.  As you can imagine, this can be a hard sell for folks!  As such, ACT de-emphasizes didactic teaching and explaining through language and encourages folks to learn through their direct experience, so if you’re willing, I hope you will take a few minutes and give this exercise* a try:

I’d like you to lean back against the chair you are sitting in (or couch, etc) and notice the sensations of your back touching the chair.

For 1 to 3 minutes (maybe set a timer), I would like you to do your best to resist against these sensations. Mentally say “No” to the sensations, as well as to the thoughts and emotions related to the sensations, or this exercise in general. “No!” (Do this before reading on.)

After the 1 to 3 minutes have passed, take a moment to check in with yourself. What sensations are you noticing in your body? What thoughts are going through your mind? What emotions are you feeling in this moment?  (Do this before reading on.)

Now, for 1 to 3 minutes, I would like you to do your best to welcome the sensations of your back touching the chair. Create space for them, and mentally say “Yes” to the sensations, as well as the thoughts and feelings related to the sensations and this exercise. “Yes!” (Do this before reading on.)

After the 1 to 3 minutes have passed, take another moment to check in with yourself. What about now….what sensations are you noticing in your body? What thoughts are going through your mind? What emotions are present for you in this moment?   (Do this before reading on.)

How was your experience different between the two trials, one of resisting and one of accepting?  What did you learn or take from this exercise?  

It might be interesting to note that although your experience might have changed from “No” to “Yes,” the sensations of your back against the chair, did not. Same sensations, you just responded to them differently.

ACT promotes creating psychological flexibility, or the ability to participate in your life in the present moment and engage and persist in values-consistent behaviors, while modifying behaviors that lead you astray.  Psychological Flexibility is encouraged through 6 core processes, one of which is Acceptance and Willingness (to have the full range of our internal experiences).  Other ACT processes include: present-moment awareness, defusion, self-as-context, values, and committed action.  Stay tuned for Part 2 on defusion!

By: Kelsey E. Schraufnagel, PsyD

*A similar exercise was introduced by Tara Brach in her book, Radical Acceptance; this  was modified to this version by Robyn Walser and Niloofar Afari in 2012 and presented in The Big Book of ACT Metaphors (Stoddard & Afari, 2014).

*Stoddard, J., & Afari, N. (2014). The Big Book of ACT Metaphors: A Practitioner’s Guide to Experiential Exercises and Metaphors in Acceptance and Commitment Therapy. Oakland: New Harbinger Publications, Inc.

 

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