Acceptance and Commitment Therapy

The reality slap takes many different forms. Sometimes, it’s so violent its more like a punch: the death of a loved one, a serious illness or injury…at other times the slap is somewhat gentler: that sudden flash of envy when we realize someone else has got what we want; those sharp pangs of loneliness…those painful stabs of failure, disappointment or rejection.

…In each case, we face a big gap between  the reality that we’ve got and the reality that we want. And the bigger the gap, the bigger the pain…[acceptance of this gap] doesn’t mean we deny the pain that is there, or that we try to pretend that it doesn’t hurt. Rather, it means we acknowledge that the pain is there and we also appreciate all that life has to offer.

-Russ Harris, The Reality Slap

Acceptance and commitment therapy, or ACT, aims to use mindfulness and committed actions to help clients live in more alignment with their values, accept difficult and complicated events or feelings and find meaning in the midst of pain. We learn to have psychological flexibility when we embrace the six core tenants of ACT. Here at our New York City therapy practice, we have a warm, compassionate team trained in this treatment modality and its application.

The Six Core Therapeutic Processes of Acceptance and Commitment Therapy:

1. Contacting the Present Moment

2. Thought Defusion

3. Acceptance

4. Self Awareness

5. Values

6. Committed Action

Contacting the Present Moment

It is normal and natural to get caught up in our thoughts and feelings. When we practice mindfulness, we are practicing being present in the here and now. This can be difficult when we are ruminating on the past or worrying about the future. By consciously practicing guided meditations, breathing exercises, or grounding activities, we can engage with the present moment and learn to let our thoughts pass in and out of our minds.

Thought Defusion

Certain thoughts can be very intrusive, strong, and entangled with our own identity. Through meditative exercises, we can learn to take a step back and become an observer of our thoughts. This helps us defuse those thoughts from our identity and observe them simply as words pass through our minds.

Acceptance

Acceptance means we allow ourselves to open up and make room for emotional pain, loss, disappointment, and hurt. Instead of avoiding our hurt and painful emotions, we acknowledge them and turn the struggle switch off. This doesn’t mean we like or want painful emotions or loss. It doesn’t mean we are okay with our pain. It also doesn’t mean we give up our fight to heal or improve our situation. It simply means we are acknowledging our current reality and the emotions that accompany it.

Self Awareness

Through meditation, we learn to tap into our “observing self” or perhaps our “wise mind” that is full of pure awareness. We make space to observe our thoughts, our feelings, and our emotions without judgment. We can pause in the present moment and collect data on how we are feeling in our minds and bodies.

Values

Each of us has our own unique value system. No values are better or worse than others. They simply inform us of how we are most fulfilled in this season of life if we are acting in alignment with those values. Values will change throughout the lifetime. It is important to take a values inventory in each new season of life in order to make changes toward meaning and fulfillment.

Committed Action

Committed action means we are taking clear action steps towards our goals in alignment with our values system. You may not be where you want to be in your job, your relationships, or your health journey-but, committed action allows us to take clear action steps each day to get closer to our end goal. I like to say that big changes only happen with a million tiny little things added together over time.

Values Exploration

Values are ever-changing in each new season of life. Some may remain consistent, like loyalty or service to others. Some may change with age, such as adventure or playfulness. These may still be important, but other values outweigh them due to life changes, like routine with scheduled vacations and play.

For instance, we may not value the same things in our college years and twenties as we do when we enter our thirties and forties. This is not a bad thing; it simply means you are growing, changing, and shifting your priorities throughout your lifetime. It is a normal and natural process.

Living in the Bullseye

Given that our values shift throughout different years of life, it's important to take inventory of what is important in the here and now. You will use a values inventory to assess your most important values and then look at these values in the four major realms of life with the ACT Bullseye exercise: Work and Education, Leisure, Personal Growth and Health, and Relationships.

Work and Education:

Take time to assess how your current situation aligns with your goals for your career or education.

Leisure:

Think about how your current leisure time spent resting, engaging in play or creativity, fun, and recreation line up with your ideal goals for restoration.

Personal Growth and Health:

Chronic pain and illness or postpartum depression may impact your current level of personal growth and health. Think about what stability would look like and where you are on your journey currently. Personal growth also includes mental health and spirituality.

Relationships:

Take inventory of how you are showing up in your relationships (familial, friends, romantic). What are your goals for ideal relationships and where do you stand now?

If you are not where you want to be in your journey (aka, living in the bullseye), you have an opportunity to create committed action steps to evoke change. Even in challenging situations like navigating chronic illness or postpartum challenges, you can take committed action steps towards stability.

In summary, you can think about Acceptance and Commitment Therapy (ACT) with this helpful acronym:

A= Accept your thoughts and feelings and be present

C= Choose a valued direction

T= Take action