Acceptance and Commitment Therapy

Acceptance and Commitment Therapy London ACT

ACT (Acceptance and Commitment Therapy) differs from CBT in that it is less interested in the content of the thoughts and more interested in the process of how we respond to the thoughts we have. If we get caught up with negative thoughts regardless of what those thoughts say and start worrying and ruminating about them, we will lose ourselves in our minds and will not be present in the moment.

ACT is based on the idea that, generally, trying to get rid of pain and difficult emotions or thoughts actually feeds into them and makes them worse. If instead we are able to accept them, we can focus on our values and goals. Acceptance doesn’t mean resignation but an acknowledgement of and a willingness to experience difficult emotions so that we can focus our energy on dealing with situations in a constructive way in line with our values for life.

Through ACT we learn to make room for painful feelings, thoughts, and body sensations – allowing them to be there, coming and going without us struggling against them. One of the main ‘ingredients’ of ACT is Mindfulness.

ACT is often seen as part of what’s called ‘Third wave CBT’.

“Third-wave CBT” refers to a newer generation of cognitive-behavioral therapies that go beyond traditional cognitive-behavioral therapy (CBT) techniques. While traditional CBT focuses on changing maladaptive thoughts and behaviors directly, third-wave CBT emphasizes acceptance, mindfulness, and the broader context of psychological processes.

The “waves” in CBT refer to different stages of development in the field:

1. First Wave: This initial stage was dominated by behavioral therapies that focused on directly modifying observable behaviors through conditioning techniques.

2. Second Wave: This stage introduced cognitive therapies that focused on identifying and challenging distorted or irrational thoughts to change emotions and behaviors. Traditional CBT is a hallmark of the second wave.

3. Third Wave: This latest stage includes therapies like Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy (DBT), Mindfulness-Based Cognitive Therapy (MBCT), and others. These therapies emphasize concepts like acceptance, mindfulness, and values-based living rather than simply trying to change thoughts or behaviors.

Third-wave CBT acknowledges that trying to eliminate or control unpleasant thoughts and emotions can sometimes be counterproductive. Instead, these therapies encourage individuals to observe their thoughts and feelings without judgment, accept them, and commit to actions that are aligned with their values and goals, even in the presence of discomfort.

It incorporates mindfulness strategies to increase psychological flexibility, which is the ability to stay in the present moment and choose behaviors that align with one’s values despite challenging internal experiences. The goal of ACT is to help individuals lead a rich, fulfilling life by embracing their thoughts and emotions while pursuing their goals.

Acceptance and Commitment Therapy (ACT) frequently uses metaphors as a key therapeutic tool. Metaphors in ACT help clients understand complex psychological concepts in a more relatable and tangible way. They serve to illustrate ideas like acceptance, mindfulness, and cognitive defusion, making them easier to grasp and apply in daily life.

Some common metaphors used in ACT include:

1. Passengers on the Bus: This metaphor illustrates the idea that our thoughts, emotions, and urges are like passengers on a bus we are driving. While these passengers might be loud, demanding, or even threatening, we are still in control of the bus and can choose where it goes, rather than being controlled by the passengers.

2. The Struggle Switch: This metaphor compares the mind to a switch that can be turned on or off. When the switch is on, we struggle against our thoughts and feelings, which often makes them worse. Turning the switch off represents accepting these thoughts and feelings without trying to fight them, which can reduce their intensity and impact.

3. Quicksand: This metaphor is used to explain the concept of acceptance. Struggling against difficult thoughts and emotions is likened to fighting quicksand—the more you struggle, the deeper you sink. In contrast, by accepting the situation and not struggling, you can stay afloat.

4. Tug-of-War with a Monster: This metaphor describes the futility of fighting against our thoughts and feelings. Imagine you are in a tug-of-war with a monster over a pit. The more you pull, the more you stay engaged in the struggle. The alternative is to drop the rope, symbolizing acceptance and letting go of the struggle.

These metaphors help clients conceptualize and internalize ACT principles, making the therapeutic process more engaging and effective.

Rosa Hernando – Acceptance and Commitment Therapy London.
Accredited by the British Association of Behavioural and Cognitive Psychotherapies (BABCP).