ACT Therapy Guide
VIDEO: Psychological Flexibility with ACT founder Steven C. Hayes
What can we do to prosper when facing pain and suffering in our lives? More than a thousand studies suggest that a major part of the answer is learning psychological flexibility. Steven C. Hayes is one of the researchers who first identified that process and put it into action in the form of a popular acceptance and mindfulness method called Acceptance and Commitment Therapy. In this emotional talk, Hayes distills the essence of psychological flexibility down into a few easy to understand sentences. He takes viewers through a harrowing journey into his own panic disorder, to the very moment in his life when he made this life changing choice: I will not run from me. Hayes shows how making that choice allows us to connect with our own deep sense of meaning and purpose, arguing that taking a loving stance to your own pain allows you to bring love and contribution into the world. For more information visit: stevenhayes.com
GUIDE SUMMARY:
ACT is Acceptance and Commitment Therapy, which focuses on accepting your private experiences — such as your thoughts, emotions, and memories — while committing to actively live life according to your own values.
We all have that inner voice. Sometimes it’s like a cheerleader or coach, motivating us to reach our goals or helping us get through tough times. And, sometimes that inner voice is like a devil on our shoulder who plays on our deepest fears and convinces us to believe things that aren’t true. The more we try to ignore those fears and negative beliefs, the more they seem to take control of our thoughts and emotions.
ACT helps us get more comfortable with and accept our thoughts and feelings whenever they arise; developing “psychological flexibility” or the ability to stay centred when nasty thoughts, feelings and bodily sensations begin affecting us. ACT helps us learn healthier ways to relate to our thoughts and feelings, providing them with the room to come and go as they please while remaining connected to the present moment. ACT helps us identify the things that matter to us most in areas such as work, relationships, spirituality, and wellbeing, helping us design and commit to specific goals which will help us lead more fulfilling lives.
ACT therapy is used to address:
Anxiety
Chronic pain
Depression
Performance anxiety
Phobias
PTSD and other trauma and stress-related issues
Substance abuse and addiction
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PART 1: THE HISTORY OF ACT THERAPY
STEVEN C. HAYES
Steven C. Hayes is a psychology professor at the University of Nevada whose work began with how language and thought influence our internal experiences. This work laid the foundation of what developed into Acceptance Commitment Therapy in 1986.
Hayes disagreed that suffering and pain are to be avoided whenever possible. Instead he saw suffering as an inevitable and essential part of being human, and if we do not flee from what scares us, it could also be a source of fulfillment.
Central to this concept is acceptance and self-compassion, which Hayes drew from his own experiences with pain. He terms it as ‘psychological flexibility’ and it forms the foundation for his psychological exploration of ACT.
In 1992 Hayes was listed by the Institute for Scientific Information as the 30th “highest impact” psychologist in the world and Google Scholar data ranks him among the top 1,100 most cited scholars in all areas of study, living and dead.
WANT TO KNOW MORE? VISIT STEVEN HAYES.COM
PART 2: COGNITION AND THE BRAIN
Our brains tend to see patterns that aren’t there that can make it difficult for us to control our reactions when overwhelmed with strong emotions.
Evolution over thousands of years has hard-wired us humans to respond in predictable, yet unskillful ways when we feel threatened. Humans have a built in ‘negativity bias’ where we tend to recognize and focus more readily to negative events, moments and situations in our lives, than positive ones. Although this negativity bias has served a purpose in the past by helping us stay alive - by noticing dangerous things in our environment - now that same bias can start getting bigger and bigger, not alerting us to real dangers, but derailing our ability to function day to day.
Dr. Dan Siegel, a clinical professor of psychiatry at the UCLA School of Medicine developed a “hand model of the brain” to explain how our brain reacts to these dangers.
The Hand Model of the Brain
1.The Brain Stem
At the base of your brain, represented here by your wrist, is the brain stem. It’s responsible for basic functions like breathing and keeping your heart pumping.
2.The Amygdala
Your thumb, folded in sits in the middle, just like the amygdala in the brain. The amygdala is responsible for sensing danger and telling the brain and body.
3.The Pre-Frontal Cortex
Your fingers are like your pre-frontal cortex which is the part of the brain that helps us manage emotions and make complex decisions.
4.Brain Overwhelm
When fear, danger or intense emotion overwhelm our amygdala our pre-frontal cortex goes ‘offline’ and we ‘flip our lid’. When brains are in overwhelm like this, we’re stuck in ‘alarm mode’.
PART 3: HOW ACT THERAPY AFFECTS THE BRAIN
ACT therapy helps calm your brain so our fear responses don’t take over.
As we reviewed, the amygdala is responsible for keeping us safe so think of it as a barking dog. Whenever the dog feels unsafe, it will either run, attack, or simply stand still barking. When it feels safe again, the barking stops. In this way, when we learn to calm our ‘barking dog’ we give control back to our pre-frontal cortex which helps us manage our emotions and think beyond our fear.
BEFORE ACT THERAPY
‘ Flipping your Lid ’
When too much information is coming in for the upper brain to process, it disconnects. You ‘flip your lid’ and can no longer access the functions provided by your upper brain. The upper and lower parts of your brain are no longer connected and talking. As a result, logic no longer influences emotions and you get stuck in “survival mode.” You don’t have to be in ‘real danger’ to flip your lid. Any stressful situation can cause cortisol levels to rise and shut down your thinking brain.
AFTER ACT THERAPY
The Brain ‘ in harmony ‘
When your brain is working efficiently both your upper and mid brain are communicating effectively. Information comes in and is processed logically. Your brain is working in harmony. All parts are connected and talking. The upper part of your brain can now be accessed for logic, socializing and reasoning even in the midst of a stressful situation. Your upper brain is hugging your mid brain, making you feel safe.
PART 4: HOW ACT THERAPY WORKS
ACT therapy is all about being present in the moment and accepting our thoughts and feelings instead of fighting or feeling guilty for them.
Running away from any problem only increases the distance from the solution. The easiest way to escape from the problem is to solve it. A core principle of ACT therapy is to create and live a life with meaning, which includes the pain that comes along with it. ACT acknowledges that there is pain in life that cannot be avoided — negative thoughts and feelings are an innate part of the human experience — but we can work with our experience of that pain so that it does not create more suffering. ACT therapy is really less about stopping or fighting these negative experiences and emotions, and more about learning to objectively deal with them so they don’t derail us from living a life with meaning and intent.
The way you talk to yourself matters.
ACT places a lot of emphasis on language and how it can contribute to or relieve the suffering that you may experience due to your private experiences. An example of this in action is through cognitive defusion, and one way to create some distance between your thoughts is by changing your language. Instead of saying “I am anxious,” try to say, “I am having the thought that I am anxious.” Just this simple act of changing the language to distance yourself from your thoughts can lead to a change in the impact of the thought and space to work with it.
Stop living on autopilot.
Simply put, ACT therapy helps us to stop living with the weight of our past experiences that start to rule our actions through fear and uncertainty. We start playing it ‘safe’ to avoid uncomfortable feelings and end up feeling like our life is on ‘autopilot’, stuck in behaviours that do not allow us to reach our fullest potential. Instead, ACT promotes psychological flexibility, to stay in and adapt to the present moment while choosing how you want to behave based on your values. Values in this context are the qualities we choose to work towards in any given moment. We all hold values, consciously or unconsciously, that direct our steps. In ACT, tools and techniques are used that help you live your life in accordance with the values that you hold dear.
Embrace your emotions to control them.
We do not have to let our lives be controlled by depression, anxiety, or other mood disorders, we can choose to live according to our values and ACT helps make this possible. The more we commit to bringing mindfulness to ourselves, the more activity there will be in our prefrontal cortex or “thinking brain” which acts like a “brake” on our emotional reactivity, and the less there will be in our amygdala or “emotional brain”, which acts as an accelerator. With regular use of simple techniques, we can learn to distract, self-soothe, and emotionally regulate ourselves.
Boldly grow forward.
Psychological flexibility is the ultimate goal of ACT therapy. The capacity to be in the present moment, to be aware of thoughts and emotions, without trying to change or be controlled by them. With planning, repetition and practice, we can develop new and more helpful ways of responding to stress and danger. Using these skills can help us gain time to choose new responses, or if we have already reacted with fear or anger, to quickly repair any behaviours which have caused harm to ourselves or others. Most importantly, these skills can help us to consistently refine our behaviour and actions in the pursuit of our personal values or goals.
IMAGE/CONCEPT SOURCES: The Happiness Trap by Dr. Russ Harris and Illustrations by Louise Gardner
WANT TO LEARN MORE? ‘THE HAPPINESS TRAP’
PART 5: HOW ACT COMPARES TO OTHER TYPES OF THERAPY
ACT is effective for a wide range of mental health issues, and promotes a life-affirming perspective of self-determination. It is considered to be one of a few “third wave” behavioural therapies which places importance on living in the present, and uses various skills to promote mindfulness.
As a mental health intervention, ACT therapy has been empirically proven as a well-established part of applied positive psychology in recent decades. ACT therapy is known to be an effective treatment for people dealing with depression, psychosis, chronic pain, substance abuse, and all sorts of anxiety disorders such as PTSD, OCD, panic disorder and social phobias. ACT therapy also works for specific issues such as helping people be more focused at the workplace, and performing better at school or in sports. In addition, ACT therapy has become a popular treatment method to find personal contentment, increase quality of life, and the commitment to live life on purpose.
In comparison to other behavioural psychological approaches, you determine the actions you will take to resolve your challenges. ACT allows a lot of space for your therapist to tailor exercises unique to you as you collaborate on what you value most and what goals you want to achieve.
A good candidate for ACT therapy is someone who wants to learn to work with their experience, gain more self-awareness, and live according to their values. When we look at it this way, ACT isn’t a therapeutic approach that targets one particular issue, it helps to address the human condition. ACT helps people who are suffering and we all suffer from time to time in our lives.
ACT THERAPY BENEFITS
Process-based, client-driven, self-directed;
Non-toxic, non-invasive and does not require medication;
Can be used within a wide population of people because it is not targeting one particular issue;
Does not require talking in detail about the distressing issues, nor does it require a specific traumatic event to have occurred;
Can be brief or longer term therapy;
Challenges thoughts by practicing mindfulness, being present in the moment, building distress tolerance and emotional self-regulation.
PART 6: WHAT TO EXPECT DURING ACT THERAPY
ACT is aimed at increasing one’s psychological flexibility through mindful behaviour, attention to personal values and commitment to action.
Through six central ‘processes’ — think of them as phases — your ACT therapist will work with you to facilitate growth in specific areas. This facilitation is done through tailored exercises, worksheets and interactions with your therapist. These phases are designed to help you to learn to listen to your self-talk, specifically about traumatic events, anxiety, or any other stressful issues. You can then decide if this issue requires immediate action and change or if it can be accepted for what it is.
Your ACT therapist serves as your guide — to help you look at what hasn’t worked for you in past, to help you stop repeating negative thought patterns and behaviour , so you can learn to make those behavioral changes that serve you in a better, healthier way. Once you are able to face and accept your current issues, you can make a true commitment and set realistic goals. By the end of ACT therapy, you will be able to stop fighting your past and your emotions and, start practicing more confident and optimistic behavior, based on your personal values and goals.
1.Being present
The process of focusing on the here and now. The practice of being aware of the present moment - experiencing what is happening to you - without judgment by trying to predict or change what is happening. This ability will help you to develop a level of awareness - a crucial foundation - for the exercises in ACT.
2.Values
The process of defining what is most important to you in your life. Through connecting to a deeper sense of what matters to you, it is possible to define purpose, direction and decision making, for a richer and more vibrant future. Your values also refer to recognizing qualities of behaviour you would like to live in line with.
You will be asked to explore the following questions:
Who and what are important to me? Why? When? How? Where?
What inner stuff shows up and gets in the way? How am I responding to that experience? If I had to be a person who experienced suffering, in what way would I like to hold onto it? Why? Where? With whom?
What can I be seen doing when this stuff shows up? Why? Where? When? How do I feel about that? How do I treat myself when that happens? How would I like to treat myself in these moments? Why? Where? When? With who?
What could I be seen doing to move toward what matters to me? How? Why? Where? When? With who? What do I make of that? What does it mean that I am capable of this? How do I treat myself when I do these things?
How am I relating to what matters to me? How am I relating to my inner experience? How am I relating to my behaviors, both workable and unworkable? How am I relating to my self as a conscious self-directed human being?
WANT TO LEARN MORE? Visit The ACT Value Matrix
3.Committed action
The process of taking steps towards your valued goals. Once you have identified what matters most to you - in areas such as work, relationships, spirituality, and well-being — it’s time to design and commit to specific goals that will help you live you want… even while experiencing uncomfortable feelings and thoughts. Committing to action is essential to achieve your long-term goals to live a life consistent with your values.
4.Self as context
The process of ‘observing your self’ objectively in the moment. You are not only the sum of your experiences, thoughts or emotions. By learning how to contact your ‘observing self’, a part of you is able to mindfully witness your thoughts, feelings and actions at any moment. In being mindful, it is possible to free yourself from previously tightly held (negative and harmful) beliefs about yourself. Positive behavior changes cannot occur without awareness of how a given behavior affects us.
5.Defusion
The process of learning techniques intended to change how you react to your thoughts and feelings. Instead of getting caught up in the content of a experience or emotion, you can observe the process of your thinking, without getting fixated on them to the point of significant distress.
6. Acceptance
The process of practicing non-judgemental self-awareness during internal and external experiences. Acceptance is not the goal of ACT therapy but a method of encouraging action that will lead to positive results. Acceptance is the opposite of our natural instinct to avoid thinking about negative experiences. It is the active choice to allow unpleasant experiences and things that are out of your control exist, without trying to deny or change them. Once you let go of the struggle, you can now make decisions about the part you do have control over - your actions.
PART 7: STARTING ACT THERAPY
We know it takes a great amount of courage to examine your life and to decide that there are things you would like to change. And, it takes more courage to do something about it. We can help. We offer free consultations for anyone in Ontario considering ACT therapy at The Dot. We will go through any of your questions and concerns to help you decide whether ACT therapy is the right choice for you.
Melynda Thompson, RP (Qualifying)
Now accepting ACT therapy clients.
Melynda Thompson is a Registered Psychotherapist (Qualifying) with a Master's in Counselling Psychology from McMaster University. She specializes in Acceptance and Commitment Therapy, Cognitive Behavioral Therapy, and Interpersonal Therapy. Melynda supports clients facing anxiety, depression, school struggles, social anxiety, life transitions, stress, and low self-esteem.
