Are you looking for a well-researched and proven type of therapy that can help you move past anxiety? Then perhaps Acceptance and Commitment Therapy, or ACT for short, is for you. In this article we explore what ACT is, the benefits of its approach and how I used it to beat anxiety. We also learn about how you too can use it to effectively manage anxiety.
What is ACT and how does it work?
ACT is a type of therapy developed by Steven C Hayes PhD that blends cognitive behavioural therapy (CBT) and mindfulness-based therapy. I came across it in my late twenties, not long after learning about meditation and mindfulness through the work of Jon Kabat Zinn. What I discovered through ACT was a healthy way to relate to the OCD that I was experiencing at the time. It became one of my most valuable tools in dealing with anxiety and I can´t recommend it enough. ACT works by helping to identify and change negative patterns of behavior that are based around avoidance of anxiety and depression. It can be broken down into the three components of its acronym:
Accept your reactions and be present.
Choose a valued direction.
As I’ve mentioned in previous blogs, acceptance has been the cornerstone of my recovery. Without it, it´s really hard to make any headway with anxiety because uncomfortable feelings of nervousness and worry are such a normal part of everyday life. When I first started having problems with anxiety at school, I remember being angry at myself for feeling nervous. I was sitting worrying on the school bus one day as I had to give a short presentation to the class during the first lesson and was not prepared for it. I started imagining everything that might go wrong and obviously this was leading me to feel more and more uneasy. But the real problem was not this uneasy feeling, it was my refusal to allow myself to feel it. It turned out that as I was a good speaker, the presentation didn´t end up going as badly as I’d feared, but by not accepting my fears, I’d made myself feel terrible and for no good reason.
Because we live in a society where we can easily get rid of anything that bothers us, we seem to think we can apply this to our inner life too. Hayes comments in an interview with New Harbinger that “we deal with our own psychological struggles by trying to get rid of our painful feelings, difficult memories, or worrisome thoughts—as if then we’ll be happy. But it doesn’t work.” In fact, what all the research points to is that when we try to push negative thoughts away, we end up getting more of them.
Hayes goes on to say that “Psychological suffering is usually caused by running away from difficult private experiences and becoming entangled in your own thoughts”. Instead of running from these negative thoughts and emotions, ACT aims to teach the idea that we can learn to accept them and thus build a more positive relationship with them. “We teach clients how to back up from thoughts and the world structured by thought” says Hayes “and instead to focus on the process of thinking itself: how to feel feelings as feelings, fully and without needless defense, even when we don’t like them. This approach allows us to see thoughts more constructively, as passing abstractions and nothing of any real substance.” This may all sound very good in theory, but is it really all that simple in practice? I´ll be honest in my answer and say that in my experience, whilst acceptance of anxiety is definitely possible for everyone, it does take a lot of work.
Luckily for us, humanity has known all about this for thousands of years and has developed a useful tool to help us out: meditation. This ancient practice is very popular right now and with good reason. Meditation is all about learning to accept the present moment non-judgmentally. For example, when practicing a formal meditation with a focus on the breath, the practitioner is encouraged to gently focus their attention on the sensations of breathing. They try to keep their attention on the breath as they breathe in and out, but are aware that their thoughts are likely to repeatedly stray to whatever is on their mind, a hamburger, the dog, an argument or an infuriating noise outside. The idea is to accept these thoughts whenever they come up and to gently draw your attention back to the breath.
This habit of the mind, to jump from one thimg to another whilst not paying any attention to what it should be focusing on, is so common that the Buddhists came up with a name for it. They call it monkey mind, and if there was a competition for it, then I would be right up there with the world’s very best. When I first learnt about acceptance commitment therapy and started meditating, I was barely able to do it for more than a few seconds without my mind jumping from one thought to abother. But I stuck with it and was encouraged by the advice that by not getting angry and upset when I noticed that my mind had wandered and instead gently bringing my attention back to the breath, I would train my awareness and ability to focus.
This is the work of mediation and over time, as your brain literally begins to change through the process of neuorplasticity, it will become easier to accept intrusive thoughts as they come up and to learn to put your attention on something else. As Rezzan Hussey explains in the article: ‘A Guide to Practicing Acceptance, the Game-Changing Habit´“When we practice acceptance, we are deliberately choosing to slow right down to all experiences that appear on the radar. We actually welcome harder emotions and explore them with curiosity.” The meditation component of ACT is amazing as it allows you to build the muscle of acceptance and to not get too fused with negative thoughts. Part of the problem of anxiety disorders is that we get so caught up in our negative thoughts that we start to really believe in them. Something that we would have once just laughed off, seems to become real and threatening. This process is called thought fusion and can be short circuited when we learn to look at problems more mindfully.
Now for the next part of the acronym – choose a valued direction. This is all about choosing your values for life, so that you are not just stumbling along making random choices from day to day. It´s also about keeping your values in the forefront of your mind, so that if the road gets stormy, you can still find your way. Russ Harris, the brilliant ACT author of ‘The Happiness Trap’ comments that “Values are your heart’s deepest desires for how you want to behave as a human being. Values are not about what you want to get or achieve; they are about how you want to behave or act on an ongoing basis”.
The idea is that whenever you realize you are having a negative thought, you first accept it and then decide rather than continuing to worry about it, that you are going to put your attention onto something you value. The valued activity could be talking with a friend, reading a book or even cleaning the house, it doesn´t really matter what the activity is, as long as you are gently putting your attention onto something positive. It is important to not confuse values with goals, as Harris comment in his book ´Ther Cofidence Gap´: “Values are not the same as goals. Values are directions we keep moving in, whereas goals are what we want to achieve along the way. A value is like heading North; a goal is like the river or mountain or valley we aim to cross whilst traveling in that direction.” In following our values in this way, we are taking positive action and can change the automatic way in which we respond to anxiety and start to have a more positive relationship with it.
The final part of the acronym – take action, is about committing to live your values in all areas of your life and whenever adversity appears. By commitement I mean that whenever things get difficult you don´t give up. The great thing about this approach to ACT is that you now have a plan and if you stick to it, no matter what, then you are going to have a much easier time with managing the anxiety. If we want to achieve anything in our lives, then commitment is key.
How I applied acceptance commitment therapy to my life
At first this approach can seem quite difficult, but the truth is that like everything, the more you practise the easier it gets. I slowly started to apply ACT to my life in different scenarios and could see the potential. The big break through though came during a family wedding that had been looming in the background for months. I was not looking forward to it. Whilst I wanted to see my cousin get married and hoped it would be a great day for him and his fiancée, I was going through a tough period of my life and I´d been having a lot of panic attacks. They often seemed to happen in public places, especially places where I had the sensation of being trapped or where I might find it hard to leave. I couldn´t think of a better example of this kind of public place than being squashed between your father and brother on a narrow wooden bench in a small and claustrophobic church.
Just the idea of it made me squirm as I would sit there imagining everything that might go wrong. But serendipitously (or not), just a week before the wedding I came across the book I mentioned previously, ‘The Happiness Trap’. From it I learnt all about ACT and was impressed that the therapy incorporated mindfulness acceptance, which I had also recently learnt about. I found the part about values interesting and immediately came up with a list of mine, with family and connection being two of the most important. The night before the wedding I decided on how I was going to deal with the anxiety when it came up. I was going to try and focus on acceptance and even if it didn´t work I decided I would keep trying anyway. I also thought about my values for the day and made a commitment that instead of trying to avoid anxiety (like trying to push water uphill) I would try and accept it and stay present whilst connecting with my family or paying attention to the church service.
The big day came around, and while I was anxious, I was able to accept it a little more than usual. As we waited in the church I tried to laugh at my dad’s incessant jokes and relayed a few of my own. This definitely helped and I took note. As the service began I became more nervous- this was the part I had been dreading. I started thinking about how bad it would be if I had a panic attack, and how I wanted to get the hell out of there. But I quickly caught myself and realised that this type of thinking was in fact a subtle way of me not accepting the present. Each time I caught myself thinking like that (which was a lot) I tried to gently bring my attention back to something I cared about, like the church service and the fact my cousin was getting married. By doing this, I got through the service and the rest of the day without too many problems and I even managed to enjoy myself a little. From that day on I’ve been using acceptance commitment therapy to help me out in difficult situations and it really has been a lifeline for me.
How you can apply ACT to your life?
If you think that ACT has the potential to help you too, then I would highly recommend that before doing anything else you read one of these two amazing books, which go into detail about how to apply many of the techniques: ‘The Happiness Trap’ by Russ Harris and ´Get out of your mind and into your life’ by Steven Hayes. There are also lots of resources online and I have provided links to some of them below. In addition, there is now an ACT app with lots of great features to remind you to practice.
I think though, and I hate to drive it home, but the most important lesson was the one that I learnt that day at the wedding. To try and accept whatever difficult emotions come up and to repeatedly and gently put your attention onto things that you value. If you keep doing that, then over time you will start to notice a positive difference in how you relate to those difficult emotions and you will become much more accepting of them. This may lead to getting fewer of them, so that what was once a vicious circle of negativity may change into something much more positive.
I hope you have found this article helpful. In my opinion ACT really is the best therapy out there for dealing with a whole range of anxiety problems. Feel free to leave a comment or message me with any questions. If you’re interested in having coaching based on the principles of ACT, then let me know. You can contact me at firstname.lastname@example.org the first session is free.
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