Acceptance And Commitment Therapy: What It Is, Techniques And Exercises

Acceptance and commitment therapy (ACT) is a set of psychological intervention techniques and processes whose main objectives are accept emotions, thoughts and events that are experienced and commit to one’s own values.

What is ACT? Acceptance and commitment therapy is the most complete of the third generation therapies. It is framed in a functional philosophical position and is based on a new theory of language and cognition. ACT defends a new vision of psychopathology in which many disorders are understood as a consequence derived from the unconscious desire not to feel pain.

ACT is a treatment oriented to the values ​​of each person, it defends discomfort as something normal and aims to reveal the paradox of behavior: the more one tries to avoid it, the more suffering one obtains. He affirms that what produces suffering is the resistance to discomfort and that the objective must be tolerate discomfort in order to generate flexibility in the regulation of behavior and direct the person’s life towards the goals they consider valuable.

Acceptance and commitment therapy is included in a type of therapies called Third Generation Therapies. According to Steven C. Hayes, we find three generations of therapies with scientific evidence:

• First generation: classic behavior therapy. They were useful, but the need to address the cognitive part was revealed.
• Second generation: cognitive-behavioral therapy. These are aimed at changing thoughts and emotions as well as changing actions. They have been widely studied and applied and their effectiveness is proven.
• Third generation: dialectical therapy, functional analytical psychotherapy and acceptance and commitment therapy, among others. What are contextual or third generation therapies? Third generation therapies are oriented towards the responsibility of the person’s choice and not their symptoms. They focus on altering the context that makes symptoms problematic. For this reason, they are also called contextual therapies.

Acceptance and commitment therapy postulates that the above therapies propose techniques to solve symptoms that are sometimes natural, as long as they are human.

Acceptance and commitment therapy is based on the approach that the more effort is dedicated to solving or putting aside something that bothers us, the more present it becomes. How does acceptance and commitment therapy work? The following principles explain acceptance and commitment therapy:

• The human condition: both the experience of pleasure and suffering are part of being human. It is as inevitable to enjoy as it is to have unpleasant sensations.
• What guides behavior: behavior can be guided by the most basic, the search for pleasure, or by ideals or values ​​such as honesty and respect.
• Experiential non-avoidance: against the tendency to flee from pain and eliminate discomfort with all possible resources, experiential non-avoidance is born, arguing that when we try to prevent or avoid thoughts and emotions that are unpleasant, what is achieved is that they increase. Experiential avoidance is an inflexible and limiting pattern of functioning and is one of the components of affective disorders, anxiety, addictions, eating behavior, impulse control, psychotics, and coping with illnesses.
• Cognitive fusion: consists of the error of taking as true what is thought without it being so.

The goal of acceptance and commitment therapy is May life have greater meaning. Since the problems will still be there and negative thoughts and unpleasant emotions will continue to be experienced, however, the actions will be aligned with the values ​​and will have greater meaning. Acceptance and commitment therapy aims to help people live a full life which does not free us from unpleasant experiences, through the provision of meaning.

Acceptance and commitment therapy is made up of the following components. The 6 components that make up ACT are:

1. Mindfulness: be present here and now, paying attention to the current moment.
2. cognitive defusion: cognitive defusion or thought defusion consists of the separation between internal events and identity. The person is not his thoughts or his emotions, these are products of the mind. It is about observing one’s own sensations, thoughts and emotions as passengers in the mind.
3. Acceptance: acceptance is the abandonment of the fighting attitude. Stop fighting unpleasant sensations, allow them to occur and observe them with curiosity.
4. contextual self: not identifying with thoughts, since these are events that occur in the mind and the self can perceive and observe them. You can contemplate what happens in the mind and who observes is really the Self.
5. Values: values ​​are what is really important to each person. It is important to identify them and keep them in mind so that they guide behavior.
6. Action: carry out actions aligned with the values. The acts that must be aligned with the objectives based on values.

The techniques used in therapy are the following:

Meditation

Meditation is full consciousness. It consists of being present and aware of sensations, impulses, thoughts and emotions. It serves to realize that you have a thought or an emotion, knowing that you are much more than that. Observe with curiosity what happens inside, releasing fears and prejudices. In the following article, you will find several mindfulness meditation exercises.

Regulation augmenting

From a behavioral perspective, it would be necessary to reinforce a behavior so that it has a greater probability of occurring again. For example, giving a prize after a passed exam for a person to study. What the ACT proposes through regulation augmenting is that a behavior acquires meaning with a reinforcing function. For example, if the title (which will mean applying for the desired job position) is related to studying today for tomorrow’s exam, the behavior is reinforced due to the meaning given to it.

The exercise, in this case, consists of reflecting, detecting socially established associations and redefining some concepts.

Non-avoidance of unpleasant emotions

If emotions such as fear or sadness are identified as “bad”, the tendency is to want to avoid them and escape from them, something that increases discomfort. It can even go to the extreme of total avoidance, which would be suicide.

However, from experiential non-avoidance, suffering is reduced. To do this, one of the techniques of acceptance and commitment consists of contextualizing pain, emotions and unpleasant sensations as something normal and human from which it is not necessary to escape, but rather from which we can learn.

One of the exercises in acceptance and commitment therapy consists of the predisposition to perceive and feel emotions, sensations, thoughts, etc.

Acceptance and normalization of discomfort

Currently, the functioning of society has no place for discomfort and pain, associating well-being with immediate pleasure and linking pain with something abnormal.

How to work on acceptance in therapy? Acceptance is about stopping fighting unpleasant sensations, allowing them to occur and observing them with curiosity. Tolerance to discomfort is worked on by being willing to experiment without resisting thoughts and emotions.

No control of the uncontrollable

The thoughts and emotions that run through the mind cannot be avoided or controlled. Trying to control internal events such as memories or sensations is not possible, and it reduces the ability to live fully. It can lead to destructive experiential avoidance, which involves the need to control or avoid thoughts, memories, sensations and the circumstances that generate them.

The technique proposed by ACT is to avoid controlling what cannot be controlled.

Observation of thought

It is about becoming aware of thoughts and differentiating ourselves from them. Distance ourselves from our cognitive events by understanding them as products of the mind. You can practice, for example, observation of thinking to achieve cognitive defusion. It is about understanding that the person is not the thought, but that the person is behind it and can observe the thoughts, sensations and any cognitive content.

By observing thought, you can choose how to act on it.

Values ​​Clarification

It is about finding what is truly important to you, the objective is to clarify what the person wants for their life and the reason for their choice. The exercise to achieve this consists of reflecting on questions such as:

• What would you be doing every day if you could dedicate yourself to something other than trying to take away your suffering?
• If you could spend an afternoon with anyone you wanted, who would it be? And if it were your last afternoon, would it be the same person?
• What would you give to the person you love most for their birthday if you had infinite money? And if it were his last birthday, would you give him the same gift?

Commitment

Commitment translates into acting responsibly towards the chosen direction. Set objectives based on the values, place the person in charge of their actions, create a strategy to direct the action towards the values ​​and act based on the values.

Use of metaphors

Metaphors, comparisons and examples are very useful to illustrate the paradoxes of psychological functioning and, therefore, are a widely used strategy in acceptance and commitment therapy. Next, we will look at several metaphors for acceptance and commitment therapy.

Some of the metaphors used in acceptance and commitment therapy are the following:

Chess metaphor

The black tiles can be negative thoughts while the white tiles can be positive thoughts. While the self is the pieces, but the board. This metaphor used in acceptance and commitment therapy allows understand the mind as a space in which things occur that we can perceive and observe without being those things.

wall metaphor

When there is no acceptance, the person finds themselves lamenting in front of a huge wall that cannot be crossed. However, when it is accepted that this wall exists, we begin to look for tools and ways to go to the other side of the wall or even look for a new path.

garden metaphor

Imagine that for a gardener the most important thing is the plants. He plants them in the best place and takes care of them. One day he starts to see weeds growing and goes to pull them out. As soon as he starts to grow a weed he pulls it off running. But he cannot eliminate them completely, but weeds continue to grow.

What do you think will happen if the gardener puts all his effort into eliminating weeds? He will not be able to spend time taking care of the plants, watering them, pruning them, fertilizing them… Do you think if the gardener is always attentive to pulling out the weeds Will you be able to enjoy the plants in your garden? What would plants say if they could talk?

stone metaphor

“The distracted man tripped over it. The violent man used it as a projectile. The entrepreneur built with it. The tired peasant used it as a seat. For the children it was a toy. David killed Goliath and Michelangelo took the most beautiful sculpture from him. In all cases, The difference was not in the stone, but in the man “

Metaphor of man in the hole with a shovel

“A man was walking through the field, carrying a blindfold and a small bag of tools. He had been told that his task was to run through that field blindfolded. The man did not know that there were large holes on the farm and very deep, he completely ignored it. So he started running through the field and fell into one of those big holes. He started feeling the walls of the hole and realized that he couldn’t jump out and that there were no other ways to get out. escape. He looked in the tool bag they had given him, to see if there was anything he could use to escape from the hole, and he found a shovel. That’s all he had. So he began diligently, but very soon he realized that there was no. I came out of the hole. I tried to dig harder and faster and faster, but I was still in the hole. I tried with big shovels and with small ones, throwing the dirt away or throwing it close… but it was still in the hole. work, and the only thing it achieved was that the hole became deeper and deeper. Then he realized that Digging was not the solution, it was not the way to get out of the hole, on the contrary, digging is how the holes get bigger. Then he began to think that perhaps the whole plan he had was wrong and that it had no solution, since by digging he couldn’t get an escape, all he did was sink deeper.

Acceptance and commitment therapy is not structured in sessions nor does it follow a closed protocol. The therapist offers explanations and exercises aimed at the patient’s reflection on himself/herself and his/her problem, emphasizes the role of the patient in his/her life and the ability he/she has to face discomfort and redirect his/her life. Through examples and exercises, the therapist shows the patient that controlling and avoiding are strategies that do not work and are accompanied by normalizing and tolerating discomfort.

If you want more information, you can consult the following books:

• Acceptance and Commitment Therapy (ACT): A values-oriented behavioral treatment by Kelly G. Wilson and M. Carmen Luciano Soriano.
• Acceptance and commitment therapy: Process and practice of conscious change (Mindfulness) by Steven C. Hayes, Kirk Strosahl, and Kelly G. Wilson.
• Get out of your mind and into your life . The new acceptance and commitment therapy by Steven C. Hayes.
• A liberated mind: The Essential Guide to Acceptance and Commitment Therapy (ACT) by Steven C. Hayes.
• The happiness trap: Stop suffering, start living by Russ Harris.
• Trying with…acceptance and commitment therapy: Core therapeutic skills for effective application by Francisco Montesinos Marín.
• Act according to values: Basic Manual of Interventions based on Acceptance and Commitment Therapy by Juan Aníbal González-Rivera.

This article is merely informative, at PsychologyFor we do not have the power to make a diagnosis or recommend a treatment. We invite you to go to a psychologist to treat your particular case.

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