A Guide to Acceptance and Commitment Therapy

“I use ACT as a creative, often funny, methodology to help my clients learn emotional intelligence and reorient how they relate to their emotional/physical pain, thereby relieving suffering,” says Christine Carville, an LCSW-R and professor at the Columbia School of Social Work. “Using lots of amusing, memorable metaphor, and practical exercises to guide the experience, ACT emphasizes being open, mindful, centered, and actively pursuing values.”

“ACT is founded on acceptance-based principles, which promote individuals to actively receive, accept, and mindfully engage with all of their thoughts, feelings, behavioral urges, and bodily sensations instead of reflexively avoiding, running from, altering, or defending against what is disfavored or dreaded,” Carville explains.

Rather than trying to get to the root of one’s emotions, this type of therapy instead teaches clients to accept the inevitability of difficult emotions, “while stymieing their ability to detract oneself from creating a meaningful, vital life,” says Powell. In this way, Powell says the approach encourages people to befriend pain since it will always be a part of their life, and in doing so, it releases them from the struggle of trying to remove internal discomfort from their lived experience. “The basic premise of ACT is to accept what cannot be controlled, i.e. your thoughts, feelings, and certain particulars of an external experience and to continuously commit to taking actions that are aligned with your values.”

How does ACT work?

The mission of ACT is not symptom reduction or to change how someone feels about something, rather it is meant to shift how an individual relates to their thoughts and feelings. In this way, you are pursuing what Powell calls a “value-congruent” lifestyle, or a fancy way of saying matching one’s behaviors to their values. “Anytime we try to change something about our experience, we are protesting reality — ACT is about accepting and engaging with reality just as it is,” Powell offers. When we can accept and engage with our reality, even when it’s painful, we can ultimately mitigate any psychological suffering.

While symptom reduction can occur over the course of treatment, Powell says it’s not the primary objective of this approach. “According to ACT, ‘suffering’ is our struggle against and our attempts to change our thoughts and emotions,” she explains. Under this philosophy, the goal is to reframe the experience of pain as normal, so clients do not experience it as suffering.

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