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Acceptance and Commitment Therapy, or ACT, is a form of therapy that draws from mindfulness practice and cognitive behavioral psychotherapy. It is also known as a contextual psychotherapy because it encourages patients to exhibit values-based positive behaviors even if they are experiencing negative sensations, emotions, or thoughts. In other words, it helps patients increase their psychological flexibility.

As a third wave Cognitive Behavioral Therapy (CBT), ACT (said as one word) is strongly connected to the power of behavioral change. However, ACT differs from CBT. It can change the relationship you have with your thoughts rather than change them directly. ACT promotes the notion that you don’t have to do anything with your thoughts to push change in your behavior.

ACT focuses on mindfulness, diffusion of challenging thoughts, and acceptance of unpleasant emotions. With ACT, your efforts are concentrated on moving you towards a momentous life by helping you learn to separate yourself from your thoughts. Your efforts are based on your committed action towards establishing your values.

It doesn’t come as a surprise then that the outcome and effects of these therapies that brings about change in an individual have been studied on both social and psychological levels. Changes in social functioning, personality, psychological abilities, and symptoms were carefully measured. These changes are in a way, brain mechanisms.

One of several strands of Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT) is a unique way of treating a wide range of symptoms. This approach looks for non- physical causes of mental disorders, understanding that experiences such as depression, addictions, obsessive-compulsive disorder, and schizophrenia arise out of multiple complex factors. It considers genetic, epigenetic (not inherited through DNA), psychological, and cultural conditions. As a syndrome strategy, it identifies sets of symptoms as syndromes related to sets of conditions (Hayes and Lillis 2012, 5).

Conceived by Steven Hayes in 1980, ACT was developed into a fully-fledged therapy model by his students and colleagues, especially Kirk Strohal and Kelly Wilson in 1999 (ibid, xv). These researchers were concerned with finding a more successful way to ease human suffering and help people address problems within relationships and daily living. They were puzzled as to why people often suffer even in conditions of affluence. They see human suffering as common despite the high-level accomplishments that any individual may make. Hayes and his students and colleagues thought it best to examine the root causes more than the symptoms. Considering the context of each case, this approach is inductive and process-oriented for comprehending human misery and failure (ibid, 6).

Very few therapists practiced ACT until the new millennium (ibid, 15). That may be because Cognitive Behavioral Therapy (CBT) was in vogue until the end of the 20th century. As CBT declined, ACT carried on and grew.

As behavioral therapy based on empiricism rose throughout the 1960s, there was little research on psychological intervention methods. Empirical results were easily measured, and theoretical foundations tended to be weak, according to Hayes and Lillis (2012, 16), based on humanism and psychoanalysis. Misdiagnosis frequently occurred, they say, citing some of Freud’s cases where analytical symbolism, revolving around things like defecation and sex, went too far.

Perhaps in a backlash to analytical psychology, reliance spread on clearly measurable empirical evidence observed in controlled conditions. Behavioral principles were rigidly set, and the application of technologies rigidly tested. ACT arose out of behavioral therapy but made concessions to psychoanalytical and humanist approaches. It, thus, began as a less conventional approach which demanded direct and overt modifications to the behavior of the treated person (ibid, 18). Acceptance and commitment therapists want to see behavioral changes, but they also want to explore the underlying human issues to problem behavior. They view social conditions as deep, rich and complex (ibid.).

Behaviorism set great stimulus-response training and behavior choices. But it is inadequate because it does not take into consideration language and higher-level cognitive processes – meaning, conceptualization, and symbolism (ibid .). In laboratory experiments, only the external factors that the scientist can manipulate can be altered. Cognition, the internal processes of the mind, were harder to decipher. Cognition psychology was likewise insufficient. Models sprouted up, but the evidence for them was lacking. Achieving practical results from cognitive therapy seemed too difficult. By holding conversations with patients, however, Cognitive Behavioral Therapy began to develop, teaching clients to acknowledge and self-direct themselves to correct “behavioral errors” (ibid, 20) while tending to abandon evidence-based treatments in the beginning. Alternative approaches started to be put forward.

The concept of human suffering as a natural and unavoidable aspect of humanity is a fundamental assumption of ACT. It also revolves around the attempt of people to take control of or avoid their own experiences that could lead to human suffering and other areas that are not working in our lives. ACT can help people learn effective ways of managing pain, practicing mindfulness, obtaining clarity on what is really important, and seeking a life with more meaning. The objective of ACT is not to get rid of pain, but instead to learn how to experience life without too much struggle.

ACT is regarded as an empirical psychotherapy because its researchers and practitioners are committed to the progress of science and the empirical assessment of its causes and effects.

As of 2014, ACT has been scrutinized in more than 80 randomized clinical trials for different concerns in studies with more than 5,000 subjects. This form of CBT has also been used to build a non-therapeutic version of the same processes known as Acceptance and Commitment Training, which is focused on the development of values skills, acceptance, and mindfulness.

Understanding language is crucial in psychotherapy. Many of us use language in private when we think or in public when we speak with the people around us. We use language to think about, read about, write about, talk about, evaluate, relate, categorize, and describe everything around us.

Language is a useful tool in our existence as human beings, and without it we may never have had the chance to build our civilizations. For example, without language, we could not develop laws and societal rules to regulate our behavior.

While human language offers a lot of benefits, it can also have negative aspects. It’s like the yin and yang – it has a powerful dark side and a powerful bright side. And based on RFT, language plays a critical role in human suffering. Language is a tool we use to form prejudiced and hateful assumptions about people around us, construct negative thoughts, obsess over things, and revisit events that caused us trauma in the past. Too much use of language and thinking can also make it hard to keep in touch with the present moment. We can spend so much time thinking about our past and worrying about our future that we end up being unable to enjoy the present.

Through a deeper understanding of human language and its mechanism, we can better harness its bright side to minimize the effects of the dark side. This form of understanding is what RFT is trying to provide through ACT.

It is easy to understand symbolism as language is used to refer to an object or an idea. For example, the word “tree” refers to a type of plant with a trunk that supports branches, leaves, and may or may not bear flowers or fruits. Language is used to symbolize things. When you gain a better understanding of a specific word, then you can understand its meaning.

Meanwhile, generativity refers to our ability to create and understand an endless number of sentences with meaning. It is also known as productivity. Every language has a specific number of basic letters, sounds, and words. However, each one of us can produce an endless number of totally unique sentences with these words, letters, and sounds.

Various theories have been developed to explore these features and usually describe the important properties or concentrate on various concerns. For instance, linguists believe that the novelty and complexity and generativity of language are mainly due to genetic factors. However, cognitive psychologists believe that our brain is responsible for how we process and store information, including symbols.

In spite of the differences in focus, most language studies are based on the similar idea that language is used to express information that is developed by our brains. Basically, language is a system of symbols that will allow us to express our ideas that can be understood by other people. These theories often concentrate on what are deemed to be the important processes of language.

Researchers and practitioners of RFT take a different method of exploring language and cognition. Instead of explaining language as a means of communicating ideas from one person to another, RFT focuses on how humans obtain language through interaction with people and their environment. This is framed to provide a useful and practical language analysis and cognition and not just a description of a concept.

ACT is considered as the applied technology of RFT as it tries to help people use language as a way to resolve specific psychological issues. This can be done through the psychological flexibility model that is distinct in ACT.

The main objective when undergoing ACT is to enhance our psychological flexibility, which refers to our capacity to keep in touch with the present as a fully aware human being, and depending on what the circumstances call for, persisting or changing in behavior to serve preferred values.

Emotions and thoughts tend to be shaky indicators for long-term values. It’s not easy to control them, and they have the tendency to go to extremes. When we allow our emotions and thoughts to influence our behavior, we might overlook the more significant, emerging trends of action and fail to grasp genuine meaning in our lives, or experience life’s richness.

At present, psychological flexibility is measured through the Acceptance and Action Questionnaire, which is used by psychotherapists and ACT specialists to predict the following psychological concerns:

There are six fundamental ACT processes that establish psychological flexibility, and these will be discussed in detail in the next chapter. Take note that each process is considered as a positive psychological skill and not a special technique to resolve psychological concerns.

The journey that is life, just like your ACT odyssey, is filled with starts and stops, ups and downs, progress and setbacks. Here are four pitfalls that people sometimes encounter while living the ACT life. Understanding them will help keep you from becoming discouraged.

If you’ve ever watched a preschooler learning to tie their shoes, then you know what impatience looks like. In Acceptance and Commitment Therapy, too, people sometimes get frustrated and feel that they’re not achieving “the outcome” quickly enough. Remember, though, that ACT is an odyssey, not a quick fix for your problems. It’s a process, just like learning to tie your shoes. Being patient with yourself will go a long way toward helping you develop a values-driven life over the long term.

Beginning your odyssey of creating and living a high-quality life is exciting. But sometimes people try to go too fast, and they set goals that are not achievable in the short term. If you take the time you need to learn about the ACT concepts and how to work with them, and if you complete all the exercises in this book, you’ll be able to take more and more effective action as your journey unfolds. You don’t want to be like the kid who quickly wads their shoelaces into a loose lump and then takes off running, only to trip and fall when the laces come undone.

Just as you don’t want to create goals and attempt actions that are too big for this stage of your journey, you don’t want your goals and actions to be so small that you don’t experience any progress. But it can be difficult and scary to make changes, even when you know you’re ready for a different kind of life. What if you don’t like the results? What if you fail? Those are uncomfortable questions, and people sometimes try to avoid them by setting goals that are too easy or too small to create any forward movement. But remember when you were a child and knew that you needed to learn how to tie your shoes? What would have happened if you’d just left them in your closet and thought about learning to tie them someday? To sidestep the pitfall of hesitation, never set a goal without asking yourself how its achievement will help you move ahead.