ACT stands for “Acceptance and Commitment Therapy.”
ACT is a behavioral treatment that is based in the idea that suffering comes not from the experience of emotional pain, but from our attempted avoidance of that pain. It is used as a treatment for PTSD and other mental health disorders.
Its overarching goal is to help people be open to and willing to have their inner experiences while focusing attention not on trying to escape or avoid pain (because this is impossible to do) but instead, on living a meaningful life.
ACT can be broken down into five goals:
Recognising that trying to escape emotional pain will never work.
ACT therapists refer to this goal as creative hopelessness. This goal is met when a patient sees that all the things they have been trying to do to avoid emotional pain do not work, and there likely will never be an effective way of completely eliminating emotional pain from one’s life.
Control is the problem.
The realisation that problems come not from the emotional pain itself but from attempts to control or avoid that emotional pain is the second goal of ACT. The patient may realise that trying to avoid emotional pain is counter-productive. In addition to the pain potentially getting worse, so much time and energy is often placed into trying to avoid emotional pain that there is no time for the pursuit of positive things in one’s life.
Viewing yourself as separate from your thoughts.
Our thoughts are very believable. A person who has experienced a traumatic event may have thoughts that they are a bad person or that they are “broken” or “damaged.” However, while these thoughts may feel true, they are only thoughts and not a reflection of what is real. The third goal in ACT is to help the patient “take a step back” from their thoughts and not buy into them as truth. A thought is just a thought and not a reflection of who you really are.
Stopping the struggle.
At this stage in ACT, patients are encouraged to stop their tug-of-war with their thoughts and feelings. The patient is to let go of attempts to avoid or control thoughts and feelings and instead practice being open to and willing to experience thoughts and feelings for what they are and not what we think they are (for example, bad or dangerous).
Commitment to action
Avoidance can consume one’s life. It takes a tremendous amount of energy, especially for a person who has experienced a traumatic event. As a result, the person may not be placing much time or energy into living a meaningful and rewarding life. Therefore, the final goal of ACT is the identification of areas of importance in a person’s life (referred to as “values” in ACT) and increasing the extent with which a person is doing things that are consistent with those values, regardless of what emotions or thoughts may come up.
For example, a person who has experienced a sexual assault may fear or have anxiety about getting into relationships again despite the fact that they may value closeness and intimacy.
In ACT, the person would be encouraged to engage in behaviours consistent with those values (for example, reconnecting with an old friend) while being willing and open to have whatever anxiety may come up as a result. By not avoiding that anxiety, it will not get worse and will be less likely to get in the way of the pursuit of a meaningful life.