Using ACT to manage life’s problems
Life is uncertain. One moment it is going swimmingly well and the next moment, disaster strikes and we are floundering and drowning. The disasters can take many forms from road accidents, serious illnesses, a breakdown in relationships to the death of a loved one. This month I will discuss a new therapy based on the principles of mindfulness (last month’s theme) which might be useful in dealing with such situations.
The therapy called Acceptance Commitment Therapy or ACT (pronounced as the word “act” rather than A-C-T) is the creation of psychologist Steven Hayes who spent two decades refining the therapy before writing a book on the subject. ACT is a third-generation cognitive therapy but is revolutionary in that it challenges the premises of traditional psychological therapies.
As implied in the name, ACT has two components: acceptance and commitment. Let us look at the first component, acceptance. To understand acceptance let me ask you a question. Is a state of happiness or positive feelings normal or abnormal? Do you remember those childhood fairy tales? Don’t they all end with the line,“and they lived happily ever after?” Perhaps because of this teaching we grew up to believe that real life too should be like that. We have come to believe that happiness is the normal state of human existence. But unfortunately, that is a myth. Aside from the diagnosed psychiatric illnesses that can afflict us such as depression and anxiety, there are many other causes of unhappiness or negative states of mind. Relationship problems, illness, work stresses, prejudice, low self-esteem, chronic anger, lack of meaning in life and loneliness are some of the many things that can affect our mind negatively day in and day out. So lasting happiness is actually quite a rare event. Yet many of us believe that everyone is happy except I, a belief that creates even more unhappiness.
How did this state come about? To understand that we need to go back in time and see how our minds evolved. Our ancestors were hunter gatherers and they had a few basic needs: food, water, shelter, sex. Their greatest priority was survival; ‘do not get killed’ was their motto. The better they were at anticipating and avoiding danger the greater were their chances of survival. Unfortunately, in our modern suburban jungles, there are no sabre tooth tigers. But evolution is a slow process and we still have hypervigilant brains ever on the lookout for danger. So, in reality, the normal state of the human mind is not contentment or happiness but a sense of danger and threat perhaps not to our lives but to our self-esteem and position in society.
How does ACT differ from the traditional methods of psychotherapy in dealing with negative thoughts and feelings? Psychotherapy or most self-help programmes would look to challenging and changing or replacing such negative states with more positive ones. One such method would be positive affirmations and saying to yourself that you are actually a worthy person and a wonderful human being. Another would be to create positive images of a confident happy you dealing effortlessly with life’s problems. Unfortunately, our threat sensitive brains are always fighting back and though it may be possible to attain a positive state of mind when life is going well, under stress negative thoughts creep back. The constant battle to hold back these thoughts will exhaust you and will lead to even more stress.
ACT deals with negative states differently. First, we learn to accept our negative states and not fight them. We do so with the techniques of mindfulness which consists of three steps: diffusion, expansion and connection.
Diffusion is the opposite of fusion. Let me explain what fusion means with a metaphor. Let us imagine that you have written down all your worrying thoughts on a large cardboard. Now hold on tightly to this board with both hands. Try doing your day to day activities all the while gripping this board. I am sure you will find it quite a chore. That is fusion. Now tuck that piece of board under your arm and you will find it much easier to function. That is diffusion. There are many techniques in ACT to help you diffuse from your thoughts. I will demonstrate one. Choose an upsetting thought you are having and silently repeat this thought with the words “I am thinking that ….” Now replace that with “I notice that I am having the thought….” Do you notice the difference? In the second phrase, you have distanced yourself from the thought and become an observer. You have diffused rather than fused with the thought. Try it with any thought and the thought will lose some of its impact.
The next step is expansion. Let me explain what expansion is with a little experiment. Imagine that the magazine in your hands is the total of all your troubling thoughts and emotions. Now hold it tightly with both your hands and bring it close to your face almost wrapping around your face and obstructing your view. Hold for 20 seconds. What did you feel? Did you feel that the emotions are overwhelming you and cutting you off from the rest of the world? Now let the magazine fall gently to your lap and wait for 20 seconds. Stretch your hands, look around the room, notice what you can hear, see and smell. That is expansion. Expansion is not tolerating or putting up with your emotions. It means opening up and creating space for your emotions letting them come and go in their own good time.
The third step is connection. Connection is being fully aware of the present and giving full attention to what is happening in the here and the now. This, if you remember from my previous article is one of the key components of mindfulness. The breathing exercise I taught you is a simple way to connect with your surroundings.
The second component of ACT is commitment. Commitment means aligning to your values rather than goals. If I were to ask you what you really want in life you might say, you want to be happy, rich, successful, have a great job, find a loving partner and have children. But these are all goals,not values. The problem with goals is that once they are achieved it is done and can be ticked off the list. If you don’t achieve them you have failed and are left with a feeling of disappointment. Values are different. It is a way of life, a set of behaviours you believe in and subscribe to, a direction you want to move in, a lifelong process with no end.
Take a moment to sit down and write down your values. You should write them down for each major area of your life: health, leisure, work and education, and relationships. For example, we may value a healthy body, being a loving and caring parent or an inspiring and compassionate teacher. Committing and connecting with our values also motivates us to put in the hard work necessary to keep aligned to our values.
There it is, ACT in a nutshell. If you are keen to know more I would recommend the book by Dr Russ Harris, a student of Steven Hayes, the pioneer of ACT. It is called The Happiness Trap and spells out in clear language how you can apply the principles of ACT to your life.