Acceptance and Commitment Therapy (ACT) offers a slightly different way of understanding psychological distress, holding that some pain and upset is part of living, but it is how we respond to this that causes problems.
For example, we might worry about saying the right thing to people, but this anxiety then starts to make us feel self-conscious, and we then find ourselves being forced and awkward with people. Now the original worry has come to pass – things have become more difficult – but probably only because we worried about it so much in the first place. We get trapped in a kind of psychological quicksand – the more we struggle with problems, the more we end up being trapped by them.
ACT teaches strategies for acceptance of our difficulties. We don’t need to be completely free of anxiety or sadness to live life to the full. Having negative thoughts or feelings is part of living. Much of ACT draws on Mindfulness techniques – if we can find ways of tolerating the external world as it is, perhaps we can learn to tolerate our internal feelings and emotions too.
The second part of ACT – the ‘Commitment’ part – emphasizes ‘valued living’. We notice that, in times of difficulty, we often lose sight of our values – so a person obsessing about saying the right thing may have lost sight of why they wanted to connect with people in the first place, as part of leading a fulfilling life. By reconnecting with our values, we can find the motivation to confront some of the doubts and feelings that seem to be getting in the way of this.
ACT has a different feel to it from CBT or psychotherapy. We are not directly trying to change or eliminate difficult thoughts or feelings, we are trying to live better with them. In so doing, we might find that internal problems start to drop away anyway, but this is not the thing that ACT sets out to do deliberately.