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Acceptance and Commitment Therapy

Though acceptance and commitment therapy is a relatively new psychological therapy, numerous studies and evidence-based research have now highlighted the effectiveness of this treatment method for patients with a range of disorders and psychological problems.

Acceptance Commitment Therapy (ACT) is a mindfulness-based therapy that incorporates elements of Buddhist mindfulness meditation and newer behavioral therapy techniques. ACT differs significantly from CBT interventions in that rather than correcting negative thoughts, emotions and sensations, it teaches you to embrace and control them. This rationale is based on accepting feelings such as fear, frustration and anxiety that are a vitally necessary part of life and that allow you to be more involved in the things going on around you. By embracing these feelings so that you can more effectively reach and achieve your goals, the negativity can be reduced significantly. By trying to avoid negative feelings, the more they can persist in your life and influence it in unwanted ways. The goal is to control your reaction to these feelings in order to allow you to participate in life in an easier way. Research has shown that acceptance commitment therapy can have a dramatic impact on a whole host of problems, from anxiety and depression to chronic pain and a variety of other conditions.

There are six core principles involved in acceptance and commitment therapy that have been developed to improve psychological flexibility:

  • Cognitive defusion: These are specific learning methods that allow you to reduce your habit of ‘buying into’ ineffective or harmful thoughts, emotions, images and memories. Changing the way we think about things can be ineffective, so this method offers you the choice of simply not buying into or engaging with thoughts that could be harmful to you.
  • Acceptance: Here, you learn how to make space for your thoughts instead of spending energy trying to change them. This principle is applied to physical sensations and emotions as well as thoughts. Learning how to tolerate these thoughts allows patients to more actively pursue the things they want in life.
  • Mindfulness: By making contact with the present moment, your experience becomes clearer so that you can take interest without judgment. Mindfulness teaches you to positively interpret things that happen around you in a more grounded way without painful interpretations that can be catastrophic to your experience.
  • Self-observation: Transcendence allows you to experience an arena where positive and negative events occur but have no actual power to harm you. When we have anxiety or other painful internal experiences, it feels as though it is harmful to us if we allow it to be there. Unfortunately this results in trying to suppress or avoid these feelings, resulting in them getting more intense and unpleasant. By recognizing that these painful experiences do not actually harm us, but are just some of many internal experiences we have, it can help us to act in meaningful and not get too embroiled in managing our emotions.
  • Values: By identifying the things that are most important to your true self, you can develop values that become the compass of your life without expectation of positive experiences. Every goal that you face will have unpleasant components but by making your values clear and acting in accordance with them, you will reduce avoidance and rather create more helpful strategies to handle them.
  • Commitment: Your value-based goals can be more effectively committed to. Here, you make an effort to realize your values no matter how difficult they may be. Your life will become more meaningful when you are able to make a consistent effort towards your value-based goals.

Advice for Families

Are you a family member of a therapy patient? Whether your child, spouse, sibling, or other family member is attending therapy, chances are you have some questions. When one person in a family is struggling with an eating disorder, depression, anxiety, or other mental health issue, it affects everyone in the household. Unfortunately, a lot of family members don’t know how to act around the patient and so sometimes do more harm than good. Of course, we all have good intentions, and it makes sense to want to be involved. However, there are certain guidelines that people would do well to follow in order to best support the therapy patient.

Stop trying to “fix” them.

This seems to hold especially true for men, including fathers, brothers, therapycartoonhusbands, and boyfriends. For whatever reason (genetics, social factors, etc.) men like to look at a problem, analyze it, and decide upon the best approach for solving the problem and making it go away. Unfortunately, this often means looking at the family member in therapy as “the problem” and setting about trying to “fix” the person. The best thing you can do is recognize that their therapy is out of your control and that there is nothing you can do to make this so-called problem go away. This is often a particularly touchy subject for parents, who feel responsible for their child’s health and (understandably) think they should have a say in the treatment approach. Contrary to what people sometimes think, the best thing you can do for your family member is let go of the reins and put some trust in the therapist. After all, they are the trained professional who best knows how to deal with mental health! If there is something you can do, they or your family member will let you know. Second of all, looking at the person as “a problem” won’t help the situation. It will only damage the relationship and make the person feel shame and guilt. Everyone has their shortcomings and needs a little help. In this case, your family member will be helped by attending therapy, not, in most cases, by your input.

Patience, patience, patience. Did I mention patience?

Rome wasn’t built in a day, and you might not see improvement or change in your family member attending therapy for a while. If the patient just started seeing a therapist, drop any expectation that they are going to come home from the appointment a new person. It can take weeks or months before you start to notice anything different. Respect the process. Try not to put pressure on your family member or ask a lot of probing questions about their progress. As the therapist and patient build a relationship they will begin to accomplish more and more, but this can only be done as work over a series of appointments builds on itself. If you have patience, your family member attending therapy will undoubtedly share with you what they feel comfortable and allow you to celebrate successes with them when such milestones are reached.

Expect resistance.

Therapy is a tough process and not always fun! As your family member processes their emotions and faces difficult obstacles, there may be times when they bad mouth therapy, insist on quitting, or reject the therapist’s advice. It’s not helpful to get into an argument about it with them, but show your support for their commitment in any way you can. Whether it’s prompting a dialogue about the reasons they are struggling, sharing a story with them about a time you wanted to give up on something but persevered, or ask if there is anything you can do to help them with an assignment or make the task more bearable.

You don’t have to understand what they’re going through, just try to understand they’re going through something.

It can often be hard for families of therapy patients to deal with the depression, anxiety, eating disorder, grief, or trauma that their loved one is experiencing. Many times this is because the family member has no direct experience with the mental illness or life experience. It’s OK to not understand, and in fact you may be met with frustration if you try to act like you “get it” or know exactly what they’re going through. Faking it won’t help anything. All that’s really required of you is that you understand your child, sibling, or significant other is struggling and dealing with something very difficult for them. Don’t feel pressured to relate or tap into their exact emotions. Sometimes a simple acceptance of their struggle and a shoulder to lean on is all that is required.

Establish appropriate boundaries.

This one looks a little different for everyone and takes significant communication to agree upon limitations. Sometimes this means taking a step back if you are a person who is typically overly involved in their loved one’s life. There’s no need to attend every session or know every detail of what was discussed! On the other hand, this can also mean boundariesrelaxing the boundaries. If you are skeptical of therapy, distance yourself because it’s “not your problem,” or are frustrated with your loved one for needing help, you have probably built a brick wall between yourself and your family member attending therapy. Try to keep an open mind and participate in sessions if and when necessary. Spark a discussion regarding the boundaries that will work best for both parties.

I hope this helps! Do you have any other questions regarding this topic? If so, leave them in the comments and I’ll do my best to answer them.