Finding Freedom and a Fulfilling Life with Acceptance and Commitment Therapy

Here is an explanation of Acceptance and Commitment Therapy for anxiety:

If you are struggling with anxiety, you may feel overwhelmed by constant worry, nervousness, and unease. This can significantly impact your life, making it difficult to pursue goals and dreams. You might find yourself stuck in rigid patterns of avoiding situations, people, or even internal experiences like thoughts and feelings that trigger anxiety. These avoidance strategies, while perhaps offering temporary relief, often end up limiting your life.

Many traditional approaches and self-help methods for anxiety have focused on trying to eliminate, manage, or control anxiety symptoms. The idea is often that if you can just get rid of the anxiety, you will be able to live the life you want. However, constantly trying to control or get rid of unwanted thoughts and feelings is incredibly difficult and often doesn’t work as a lasting solution. In fact, this struggle against anxiety and the efforts to avoid it can become the primary problem, exacerbating your suffering. If trying to suppress or avoid anxiety was a workable solution, you likely wouldn’t be seeking help.

Acceptance and Commitment Therapy (ACT) offers a different perspective. ACT, pronounced as one word to emphasize the action component, is an empirically grounded process approach. Instead of focusing on eliminating anxiety symptoms, ACT aims to help you create a life worth living, even if there is some anxiety that comes along for the ride. The central idea is to stop waging war against your own inner life.

Why ACT might be more effective for you:

• ACT views rigid and inflexible patterns of experiential avoidance (trying to avoid difficult thoughts, feelings, and sensations) as a core issue underlying anxiety disorders. It directly targets this avoidance.
• It helps you see that your anxiety is not necessarily the enemy, but rather a normal, albeit sometimes uncomfortable, part of the human experience. Attempts to teach you to suppress or avoid it are unlikely to work long-term.
• ACT is about loosening the hold that emotion regulation has on your life, particularly when those regulation efforts are unworkable and unnecessary.
• It focuses on fostering psychological flexibility, which is the ability to be present with your experiences and take action guided by your values.
• Instead of seeing thoughts and feelings as the cause of your problems, ACT helps you see them as simply experiences to be observed, without getting entangled in them. Language itself can sometimes trap us by fusing evaluations with experiences.
• ACT incorporates techniques like exposure, which is known to be effective for anxiety, but recontextualizes it. The goal of exposure in ACT is not primarily to reduce anxiety, but to help you become better at feeling and to engage in these experiences in the service of your values. You are practicing willingness to experience, rather than seeking mastery or control over the feeling.
• ACT helps you clarify what is truly important to you – your values. These values provide the motivation to face uncomfortable feelings and take action.
• The ultimate goal is not merely symptom reduction, but helping you live a full, rich, and meaningful life. Anxiety reduction may occur as a consequence, but it is not the explicit target.
• ACT is more of an approach to understanding and treating suffering than just a collection of techniques. It can incorporate various evidence-based interventions within its framework.

What you can do to help yourself:

• Read and learn about ACT principles: Many resources, including workbooks, are available. Understanding the underlying framework and rationale is crucial.
• Identify and clarify your values: Spend time reflecting on what truly matters to you in life. This gives purpose to the challenging work of facing anxiety.
• Analyse your past attempts to control or avoid anxiety: Understand how these strategies may have backfired or limited your life in the long run. Ask yourself if these solutions have moved you closer to or further away from your values.
• Practice acceptance and mindfulness exercises: These help you make contact with your present experience, including thoughts, feelings, and sensations, without judgment or trying to change them. Remember, the aim is acceptance, not control or relaxation.
• Practice cognitive defusion: Learn techniques to observe your thoughts as just words or sounds, rather than getting hooked by their literal meaning. This helps you respond to thoughts more flexibly.
• Commit to taking action aligned with your values: This is the core of ACT. Decide on specific steps you can take that move you in the direction of a life you value, even if anxiety shows up. Willingness is a choice and an action, not a feeling.
• Engage in “willingness workouts” or “FEEL exercises”: These are essentially exposure exercises framed within ACT. Intentionally approach situations you’ve been avoiding, not to eliminate anxiety, but to practice experiencing it while doing what matters.
• Be compassionate towards yourself: Recognize that it’s natural to struggle with anxiety given how the human brain works. Practice self-compassion as you navigate difficult experiences. Give yourself credit for taking action in the face of fear.
• Be honest with yourself: Identify and acknowledge difficult emotions like shame, embarrassment, or humiliation that may fuel avoidance, rather than suppressing them.

When professional support is wise:

While self-help resources can be incredibly valuable, seeking support from a trained professional is highly recommended, especially when:

• Your anxiety is severe, pervasive, or significantly impacting your life.
• You are struggling to implement the concepts and exercises effectively on your own.
• You are dealing with complex issues or past traumatic experiences. A therapist can guide you through difficult emotional material, sometimes even without needing you to disclose specific details (“content-free” work).
• You need help tailoring the ACT approach to your unique circumstances and responses.
• Learning ACT involves concepts that can be counterintuitive (like willingly experiencing anxiety). A therapist can help you grapple with these ideas and provide guidance.
• Experiential learning is crucial in ACT, and navigating this can be challenging alone. A therapist can guide experiential exercises and exposure techniques safely and effectively, ensuring you are engaging with them as opportunities for willingness, not control.
• You find yourself getting stuck in old patterns of avoidance or treating ACT techniques as new ways to control anxiety. A therapist can recognize this and help you return to the core processes.
• You need help clarifying your values and translating them into concrete, committed actions.
• You are using medication for anxiety. While medication can reduce symptoms, it may interfere with the experiential processes central to ACT. Discussing this with a therapist trained in ACT can help navigate this complexity.
• You need help navigating the reactions of friends and family who may not understand your new approach.
• You need a compassionate guide and “coach” to encourage you to take action and not enable avoidance.

A good therapeutic relationship is crucial for success in any therapy. If you choose to work with a professional, look for someone with experience treating anxiety who can explain ACT in a way that resonates with you and with whom you feel a connection.

Summary of ACT for Anxiety:

Acceptance and Commitment Therapy (ACT) for anxiety is an approach that shifts the focus from trying to eliminate or control anxiety symptoms to living a full and meaningful life with anxiety present. It helps you identify how your attempts to avoid uncomfortable internal experiences (thoughts, feelings, sensations) may be limiting your life. Through acceptance, mindfulness, cognitive defusion, clarifying your values, and committing to value-guided action, ACT helps you build psychological flexibility. The goal is to drop the unworkable struggle against anxiety and instead take action that matters to you, allowing your experiences to be as they are.