Acceptance and Commitment Therapy

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“When suffering knocks at your door and you say there is no seat for him, he tells you not to worry because he has brought his own stool.”

–Chinua Achebe



Many forms of psychological difficulties and suffering can be conceptualized as unhealthy efforts to escape, avoid, control, or suppress emotions, thoughts, memories, and other private experiences. It is our human tendency to try to avoid thinking or feeling things that are painful to us. People engage in all sorts of behaviors in an attempt to avoid coming into contact with those internally painful experiences, such as withdrawing from intimate relationships, using food in ways that are unhealthy, substance use, trying to be “perfect” enough, and sexual acting out. Unfortunately, efforts to suppress or eliminate negative thoughts or emotions often result in actually increasing the frequency and intensity of these unwanted thoughts and feelings. In essence, all those things we do to try to avoid thinking or feeling a certain way actually ends up making those unwanted experiences more central in our lives and our behavior becomes dictated by them, making them even more powerful.

Acceptance and Commitment Therapy (ACT) seeks to increase psychological acceptance, the ability to contact negatively evaluated private experience, directly, fully, and without needless defense – while at the same time engaging in behavior that is in the service of chosen values. ACT is one of a “third wave” of cognitive behavioral therapies that includes Dialectical Behavior Therapy (DBT; Linehan, 1993), mindfulness-based cognitive therapy (MBCT; Segal, Williams, & Teasdale, 2001), and Integrative Behavioral Couples Therapy (Jacobson, et al., 2000). What sets these approaches apart from traditional CBT (alá Beck or Ellis) is that rather than trying to directly change the content of thoughts, feelings, sensations, or memories, these therapies seek to change the function of those events and the individual’s relationship to them. Rather than focusing on trying to change a particular thought, feeling, or experience, in ACT the focus is on seing how trying to avoid those experiences may actually be getting in the way of you living a life that is consistent with what you would choose to value.

ACT is an empirically-based therapy and has garnered significant empirical support for treating a wide variety of psychological problems. The theory on which ACT is based is called Relational Frame Theory (RFT), and is a result of a 20 year program (80+ published studies) of basic research into the nature of language and cognition (Hayes, Barnes-Holmes, & Roche, 2001). One of the unique aspects of the ACT model is the reputed processes of change for ACT are holding up fairly well in mediational analyses, as compared to traditional cognitive-behavioral therapy. For those interested in more up-to-date research information on ACT and RFT please visit

“Would you be willing to have what you already have in terms of unpleasant thoughts/feelings, to welcome them willingly into your life, if that meant you could live the life you’ve always wanted to live, if you could be the person you would choose to be if you could write the story?” The goal of ACT is not to eliminate certain parts of one’s experience of life, but rather to learn how to experience life more fully, without as much struggle, and with vitality and commitment. Ask yourself this question… When you get to the end of your life, which would you rather have written on your tombstone?

“Here lies X, she/he worked really hard to overcome her/his anxiety/depression/body image concerns, etc.”
“Here lies X, she/he lived a life that was meaningful and of value.
Acceptance and Commitment Therapy is about helping you live the life you’d want written on your tombstone.

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