Lessons from ACT
I have written about Acceptance Commitment Therapy or ACT in previous articles but now revisit the topic from another perspective.
Psychotherapy or talking therapy in layman’s parlance has evolved over the years. Starting from the days of classical psychoanalysis of Sigmund Freud we are now in what is called the third wave of behaviour therapy. One such third generation therapy is Acceptance Commitment Therapy or ACT, conceived and developed by psychologist Steven Hayes, a clinical psychologist from the University of Nevada, and popularized by Russ Harris, an Australian GP who is now a fulltime ACT therapist and coach. The second edition of his book ACT Made Simple is now published and is truly a masterpiece. Though meant for therapists the unique lessons from this book are useful for any reader.
A fundamental difference between ACT and other therapies is that ACT does not attempt to get rid of our bad thoughts or feelings. Based on evolutionary evidence, anxiety, and by extension unhappiness, is the default state of the human mind. (A bit similar to the Buddhist concept of suffering as the lot of human beings and the Christian concept of sin). In the African savanna 200,000 years ago, humans had to be in a state of constant vigilance lest they be eaten by a sabre-toothed tiger. Those who survived were the humans who were the most vigilant not the happy go lucky ones who were soon eaten up by the hungry predators whom they had optimistically mistaken for a rock! In the modern world, there are no dangerous tigers but evolution is slow and we still have an anxious savanna brain. This is the most fundamental point in ACT and the main difference from other therapies. In all other therapies, we look at how we can get rid of our anxieties, depressions and other unpleasant thoughts and feelings. ACT turns it around and teaches you how to live a rich and fulfilling life while living with your unpleasant feelings and thoughts.
Let us see some of the techniques for achieving this jugglery of the mind. We, humans, are doing something all our waking lives. We are walking, talking, working and even if we are sitting on a chair and staring at a wall we are thinking and feeling. In psychology, thoughts and feelings are also labelled as behaviours or doing. Some of the things we do are productive, enrich our lives and help us to move forward to a better life. These are called ‘towards moves.’ The problem is we sometimes or often do things that have the opposite effect and make our lives miserable. These are called ‘away moves.’ Both away moves and towards moves originate from our feelings and thoughts in different situations. This in ACT jargon is a choice point. We can decide to do an away move or a towards move. When life is going well, we are happy with what we are doing, and people are nice to us it is easier to choose towards moves. But then life never goes swimmingly all the time. There are the invariable let downs, disappointments, and frustrations and our mood take a turn for the worst. In such a state we are more likely to do away moves.
For humans the default setting is to get hooked by these negative thoughts and feelings. Like fish caught in a line we are reeled in and jerked around by these unhappy thoughts and feelings. Many psychological problems such as depression, anxiety and addictions are due to this hooked state. ACT gives us specific skills to unhook from our unhelpful thoughts and behaviours. The four core skills of unhooking are based on mindfulness and diffusion, acceptance, self as context and contacting the present. Let me show you some tools from these skills.
Let us take one from diffusion. Diffusion is the opposite of fusion. Note that in ACT the objective is not to get rid of our unpleasant thoughts. Our futile attempts to do so or in other words fusion is the problem, not the thoughts or feelings themselves. Here is a quick and simple exercise in diffusion. Say you have a negative thought about yourself. Put it in the form of a sentence “I am X.” For example. I am a boring person, I am not clever enough. Now get hooked with the thought. Fuse with it, believe it, really get caught up in it for a few seconds. Now replay your thought with this phrase in front: “I having the thought that…” For example, I am having the thought that I am a boring person or I am having the thought that I am stupid. Now replay the thought once more but this time add the phrase “I notice I am having the thought that…” For example, I notice I am having the thought that I am stupid.You would notice a sense of separation from the thought. Try it with different unpleasant thoughts or feelings. You have just learnt a useful tool from ACT.
Sometimes we are overwhelmed by difficult thoughts and emotions and it is helpful to have a quick method of regaining our composure and balance. Dropping anchor is such a technique. When a ship meets a storm, she will head for the nearest port and drop anchor and likewise, this technique helps you weather the storm. There are three steps to dropping anchor which you can remember with the acronym ACE. A is for acknowledging your experiences, C is for coming back into your body, and E is for engaging with your world. Let us see how it works in practice.
First, acknowledge your inner experience by naming your thoughts, feelings or sensations. For example, you can say, I am noticing painful memories or I am having a feeling of sadness. Second, come back in your body by focusing on a physical action. For example, if you are seated you can push your feet into the floor, straighten your spine and slow your breathing. Third, engage with the world by looking around the room and noticing things. Note five things you can see, four things you can hear and one or two things you can feel or smell. You can cycle through this exercise until you feel calmer and able to focus on the present and take control of what you are doing.
Here is another tool from self-as-context also known as the noticing self or observing self. This is connected with diffusion as the first step in diffusion is to notice your thoughts. The Leaves on a Stream exercise is a form of noticing your thoughts. It is quite simple. Visualise a gently flowing stream with leaves on the surface of the water. Place your thoughts onto the leaves and allow them to float on by. The aim of this exercise is to learn how to step back from your thoughts by watching the flow of your thoughts. Note that the objective is not to make your thoughts go away but to place all your thoughts, positive and negative, happy and sad on to the floating leaves. The skill we are learning is how to observe our thought stream without getting hooked onto any of the thoughts.
Now you have learnt three powerful but simple exercises for managing your troublesome thoughts and feelings. If you are keen to learn more about ACT you can visit Dr Russ Harris’s website https://www.actmindfully.com.au where you will find a number of free as well as paid resource material.
I have now been contributing to Mediscene for seven years each month without a break. I thank all my loyal readers for inspiring me to continue my writing. May I wish you all a very Happy Christmas and a Happy New Year.