Matthew asked about Acceptance and Commitment Therapy (ACT) in relation to my recent posts on acceptance.
I heard about ACT roughly two years ago, as an emerging alternative to Cognitive Behavioural Therapy (CBT). Here an article about ACT helpfully describes the differences between CBT, psychotherapy, and ACT:
Imagine the situation for the client who says, “I feel so anxious about going out on a date. I’m so afraid that I won’t have anything to say, or that I’ll say something really dumb.” Through the use of CBT techniques we, as counsellors, could help the client dispute the negative beliefs that she is a poor conversationalist or a boring date, replacing her anxious thoughts with positive, affirming ones, such as that she is interesting, good at conversation, or a worthy social companion.
Through longer, psychotherapeutic processes, we could help her to discover the experiences in her past (probably early childhood) which created the sense of her as socially inept. Psychotherapy takes a long time, however, and even when the effect of past history on present experience becomes known, there is still the “war of words” as the various voices within her – the critical ones and the affirming ones – clamour for attention.
The ACT principle of expansion/acceptance works differently. It would ask the client to imagine that she is about to go out on a date. She would then be instructed to scan her body, observing where she felt the anxiety most intensely. Let’s say that she reports that she experiences a huge lump in her throat. She might be then asked to observe the sensation of the lump as if she were a scientist who had never seen anything like it before: to notice the shape, weight, vibration, temperature, pulsation, and other aspects of it. She would be invited to breathe into the lump, making room for it, allowing it to be there (even though we would be highly empathetic in understanding that she did not like it or want it there!).
There’s more to ACT than just the acceptance component, but from descriptions such as those above I suspect it is aiming at the same kind of practice I’ve described as acceptance.
I haven’t undergone ACT, so I’m not in a position to recommend it, or criticise it. But I wonder how it manages the paradox of acceptance and change. On a therapeutic level, ACT must promise certain beneficial outcomes for its patients. In my experience, such promises are the biggest obstacle to practicing acceptance.
I tried acceptance and mindfulness techniques in the past, but with the benefit of hindsight I can see that those efforts were fixated on change rather than acceptance. The net result was that despite repeated efforts to ‘accept’ reality, I was still motivated by the desire for change, for a different reality. For example, the article above states:
By opening up and allowing them [unpleasant thoughts and feelings] to come and go without struggling with them, running from them, or giving them undue attention, we find that they bother us much less. They also move on more quickly, instead of hanging around and bothering us
This is precisely the kind of promise I would have clung to in the past, and attempts to ‘accept’ in such a way would be rendered fruitless by the underlying desire for change.
Perhaps this is a personal quirk, or I may be an extreme case. Or maybe an astute ACT therapist would recognise the contradiction in my efforts.
I can only speak for my own experience, and in that case the therapeutic aspect of acceptance seems accidental. The more significant motive for accepting my reality is simply that there is nothing else I can do about it.
Going a little deeper, I am my reality and my reality is me. Somehow, my reality has begun to shift in a way that is best described as acceptance. And the more I accept my reality, the more evident it becomes that nothing has really changed except my reaction to it.
Take the simplest example: people often tell me that I think too much, and in the beginning I struggled to think less. Later I struggled to understand the causes of my overthinking. Later still I tried to justify my overthinking in some terms that would be meaningful to normal people (‘underthinkers’?).
Now, as this acceptance thing slowly takes root in my mind, I’m gradually realising I can simply say “yes, I overthink everything.” I can accept it, without that acceptance implying any obligation to change, any further shame or humiliation, any loss of self.
Of course, if I’d sought that outcome in the beginning I’d have turned it into a struggle.