Posted Aug 08, 2020
In the grand scheme of therapy, Acceptance and Commitment Therapy (ACT) is new on the scene. Often mistaken for coming from the Buddhist tradition, ACT is actually based on the modern science of Relational Frame Theory (RFT). RFT explores how human language creates associations made in the human mind. The same language that lets me determine that an NBA basketball player is “taller” than me also allows me to make less factually based associations such as that person is “better” than me. ACT takes this theory and applies it to psychological phenomena, creating a new paradigm from which to examine and treat such associations. It may be a fact that one person is “taller” than me based on height but the association than another person is “better” than me may not be as accurate.
Despite being new on the scene, ACT has been empirically validated by the APA Division of Clinical Psychology for five different conditions, second only to the much more established Cognitive Behavioral Therapy. It has been validated to treat anxiety, depression, chronic pain, psychosis, and OCD. These are wide-ranging categories of psychological distress and upcoming research should add to that list.
My own packaging of ACT is called “Learning to Let Go.” We often tell others and ourselves to just “let go” of some issue, memory, or distress. While this action would indeed help us, it is easier said than done. Therapy is often required to sort through the nuances of each particular person and the unique obstacles to achieving a state of “letting go,” but the framework for each case is the same three steps.
- Notice and allow the present moment experience to be there
- Assess if it is useful or not useful
- If useful then Change; if not useful Let Go
This is a very simple paradigm that clients can easily grasp even if putting it into practice is much more difficult. I often use a personal fitness metaphor: everyone knows if you want to be physically healthy it requires some amount of proper nutrition and exercise. Yet actually achieving those simple conditions is incredibly difficult (hence the large number of failed New Year’s Resolutions every year). Learning to Let Go is no different for your mind than exercise is for reshaping your body.
Let’s break the system down further and detail what each step requires.
Letting go of thoughts is much like letting of balloonsSource: Photo by Sirirak Boonruangjak from Pexels
Step 1: Notice and allow the present moment experience to be there.
The first step basically says if you don’t know what you’re experiencing then you will have no ability to control it and end up acting like a pre-programmed robot. The programming comes from previous associations learned from family, friends, or society at large.
This is similar to the beginning stages of CBT that help clients mindfully notice their thoughts, feelings, or behavioral urges. However, the two systems differ in that CBT tries to dispute and argue against these experiences whereas ACT teaches people to build a tolerance and openness to them; essentially changing the relationship to the stimulus. I refer to it as imagining putting your arm around the experience and befriending it rather than trying to get rid of it.
There are really two parts to this step. First I have to build mindfulness skills to notice what the heck is going on with me. We are often “hooked” by these experiences in the moment and only later are we able to reflect on what happened. With practice, we catch them earlier and earlier, and thus we engage in less problematic behaviors. Eventually, we want to run a marathon, but we have to start with a lap around the track.
Second, when I notice a difficult experience I learn to stop trying to push it away and instead open myself to allow it to be there. There are a host of “defusion” experiences (more to come in future posts) that help us achieve this state. With time I am able to just sit and exist with the thought that “people will think this post is stupid” or the feeling of anxiety in my stomach as I hit “send” to publish it. Even with this thought and feeling, I can still submit the writing.
You can learn to allow an annoying thought to just exist there instead of needing to get rid of itSource: Photo by Ketut Subiyanto from Pexels
Step 2: Assess if it is useful or not useful.
Notice this step is not “good or bad.” Thoughts and feelings are not good or bad even if they may cause us to have negative or positive reactions. Modern society has conditioned us to relate to normal human experiences and judge them in a certain way. That’s why it’s okay if women cry but not men, an arbitrary setup determined by societal rules, but babies all cry regardless of gender. Because our minds operate differently from us, the experiences they give us may not actually be useful to us. The human mind has one agenda: keep us safe and pain-free. What it comes to judge as painful or dangerous, though, differs based on our lived experiences. So one person may become fearful of talking to new people if they were bullied in school while another person has none of these problems since they came from an open and accepting support system.
When a socially anxious person approaches a new person, their mind automatically gives them the “danger” thought based on the bullying they received for years by their peers. Thus, they avoid and don’t engage with the new person. Over time, the mind’s agenda to keep the person feeling safe led to avoidance of talking to new people but it has not improved their social anxiety at all. This “danger” thought is no longer useful to the person now trying to make new relationships as it will only lead to avoidance of people.
Simply put, the mind’s short-term agenda to keep the person feeling safe is at odds with their personal value to make relationships. It would be great if the healthiest steps for us to take were naturally the easiest ones, but this is often not the case due to these dynamics of the human mind.
Step 3: Change or Let Go.
Once I stop seeing experiences as good or bad and instead as useful or not useful, I can better assess what to do when I have them. There are generally two broad, effective sets of behaviors I can engage in at any point in my life. I can engage in change behaviors (talk to the person I am worried is mad at me, ask my boss why she scheduled a meeting with me instead of worrying what it is about, set a boundary with my roommate who keeps being late with rent). I can also engage in letting go behaviors (noticing a thought/feeling/urge and not giving it any energy or power, not act on it). Humans, though, tend to go the ineffective middle route where they don’t change or let go. Instead, they think, analyze, ruminate, and worry in the hopes that some other path will make itself apparent.
In the social anxiety example from earlier, the person has a thought: “Don’t go talk to that person.” Once they mindfully note this thought, they assess if it’s useful or not and this depends on context. If that other person looks preoccupied or angry, it may actually be to our benefit not to go talk to them right away. If the person though looks perfectly fine, then one would need to let go of this thought and still go start a conversation. Once the person decides to engage in the letting go route, they then continue forward, still anxious, and start a conversation despite their mind telling them not to.
Its possible to perform a behavior even if anxious when performing itSource: Photo by cottonbro from Pexels
The person decided this experience wasn’t useful now (it may have been in the past to prevent bullying) and decides to engage in a completely different behavior that is more effective in the present day. Over time, the person may see a reduction in the intensity or amount of thoughts and feelings they have in this same situation as their mind learns there is nothing really to fear anymore.
All the time we are presented with physical transformations of people who got around to nutrition and exercise and reshaped their bodies. The Learning to Let Go system is simply the mental equivalent of this truth. It’s not very complicated, but that doesn’t mean it is easily accomplished. After all, we are trying to overcome years or decades of avoidance-based training in the opposite direction. The human mind can be re-shaped but it requires regular work and skilled practice. This is done much more in the present than spending endless hours delving into the past in traditional, dynamic therapies. The only question for you is if you are motivated to do the work.
About the Author
Nick Joyce, Ph.D., a licensed psychologist working at the University of South Florida Counseling Center. He has spent his career helping patients manage stress and anxiety with Acceptance and Commitment Therapy.Online:Personal Website