Acceptance Commitment Therapy Part Two

At the heart of ACT is action. It could well be called Action Commitment Therapy instead and the acronym is meant to pronounced as the word, act, rather than as initials.

The actions one takes in ACT are those that help create a life, living out one’s values. Goals are seen as stepping-stones to those values. The idea is that, if one lives according to one’s values, they will create a full and meaningful life. It isn’t possible to be happy all the time. As I wrote in part one, thoughts and emotions come and go and change. It is, however, possible to live a life full of meaning. That is contingent on action.

Values: Values are different for each individual. In The Happiness Trap, there is a vigorous questionnaire to help the reader identify his/her values. It covers all aspects of life, including family, friends, work, health, spirituality and recreation. The idea is to determine what one wants to bring to each of those areas of one’s life.

Values are broad so it’s acceptable to make a sweeping statement such as, “I want to be a loving, supportive, interested, fun and thoughtful partner.” Values are like a compass by which we set our lives and are on-going.

Goals: Once one determines what their values are, it’s time to set goals. Goals are achievable steps that enable one to live by values. Goals are the action one takes in order to live a meaningful life. For example, I identified one of my values as being a loving, supportive, interested, fun and thoughtful partner. That’s pretty broad. My goals are the action I take to live by that value. I may incorporate small acts into my life such as calling my partner at lunchtime to see how his day is going, make sure I give him hello and goodbye kisses and hugs every day and give him my full attention when we’re interacting.

The Happiness Trap suggests setting long and short-term goals and doing something each day to facilitate them. I’m still at a point where my goal for the day may simply be getting out of bed and caring for my family. That’s okay by me because that’s one of my values and I’m taking action – no matter how I feel – to do so. I would, however, like to stress that, if someone is suffering from depression, even doing that may be difficult. The Happiness Trap is not meant in any way to be a treatment plan for depression, although ACT can be one form of therapy. Furthermore, if someone’s depression has made them too ill to do so, medical help should be sought.

The book also talks about urges and willingness. Urges are something we all experience and they can be strong. Another one of my values is to take care of my body. I really enjoy chocolate and that’s not a problem. Sometimes, however, if I’m upset, I’ll binge on sugar. Ultimately, I feel much worse after doing so and I know it’s not in line with my value of taking care of my body. The Happiness Trap suggests dealing with those urges by using de-fusion, expansion and action. The action that I would take in that situation might be to do something that is in line with my value instead of sugar binging. I could go for a walk instead. Even better for me, I could crank up the sound on my ipod and dance that urge away.

I’d like to stress that urges and addiction are two different things and I’m referring to the former. ACT may work for someone as an adjunct to a twelve-step program but an addiction requires greater help.

Willingness is an essential component. One must be willing to embark on a course of action to meet goals and live by one’s values. Furthermore, one must be willing to do so, even if – and maybe especially if – there is a chance of failure. Maybe the goal may not ultimately be met. By trying, however, one is living one’s values and also giving oneself the satisfaction of trying.

To put ACT in a nutshell, one defuses from one’s thoughts, expands to allow emotions to be there instead of fighting them and commits to a course of action based on one’s values. Once taking action, it is best done mindfully, fully connecting with it. Furthermore, it is an on-going process.

I suppose that incorporating ACT into my everyday life, rather than just using it when I’m anxious is now one of my goals. The value? To live as calmly and peacefully as I’m able.

Acceptance Commitment Therapy Part One

I finished reading The Happiness Trap and am glad I did so. It helped me to understand Acceptance Commitment Therapy better. I’d now like to share my interpretation, based on my readings.

Although the word, therapy, is in its name, I think it’s more of a lifestyle choice than a therapy. Therapy can imply a course of action on which one embarks to make oneself better. ACT can be incorporated into a well person’s life, as easily as an unwell one’s. I think it’s a tool for improving the quality of one’s life, regardless of one’s mental or physical state.

ACT can initially be broken down into three components: thoughts, emotions and actions.

Thoughts: thoughts can be looked at as the stories the mind creates to interpret and make sense of our lives, situations etc. They may not, in fact, be true. For example, if I pass a friend at the shopping centre and she seems to look right through me, it’s possible that she hasn’t seen me. My mind, however, may tell me the story that she doesn’t like me anymore. That’s not a fact; yet, my mind has told it to me and I’m likely to agree with it. I have “fused” with that thought and am now feeling pretty upset about the fact that my friend doesn’t like me anymore.

The first step in ACT is to “defuse” with our thoughts. There are several ways to do so but they all work on the idea that thoughts are not facts. My favourite way to defuse is to slightly distance myself from the thought by saying to myself, “I’m having the thought that Hermione hates me” instead of “Hermione hates me.” Another way to do so is to say to oneself, “Oh it’s the old Hermione hates me story.” The idea is to acknowledge the thought without fusing with it. It’s just a thought.

Emotions: Let’s say that it turns out that Hermione actually does hate me. I’m going to be very upset when I find out. This is where, in ACT, “expansion” comes in. Instead of feeling bad that I feel like bad and guilting myself for a perfectly normal emotional reaction to the situation or trying to make myself feel better with positive platitudes, I’m going to make room for the feelings. I’m going to sit quietly and, rather than thinking about Hermione or something distracting, I’m going to focus on how my emotions are manifesting themselves physically. I’m going to notice that there’s a knot in my stomach, a lump in my throat and tears just behind my eyes. The idea of expansion is to make room for the feelings and allow them to be there. Once I notice them, I address each one separately, and simply let it be there. Whilst it doesn’t make one feel better – that’s not the point of it – it can circumvent both an escalation of the feelings and the barrage of unhelpful thoughts.

As a society, we tend to think of emotions as being “good” or “bad”, and that we have a choice as to how we’re going to feel. Emotions are just the way we feel; they’re neither good nor bad. Some groups even believe that happiness is our natural state. I disagree. I believe emotions are a response to what is happening in our lives or in our heads. I wasn’t at all happy when my mum passed away; I experienced the normal reaction of grief. We expend a lot of energy trying to fight and or deny the ones which make us feel bad. In ACT, we just have to make room for them.

The other day, I felt really happy for an unknown reason. My immediate reaction was to try to work out why and then tell myself that whenever I felt happy like that, something bad would happen so it wasn’t good to feel happy. First of all, I used “defusion” to distance myself from the unhelpful thought. Then, however, I thought that, if my thoughts were true, wouldn’t the best thing to do be to enjoy the feeling while it was there, rather than make it go away with such thoughts. Consequently, I used “expansion” with a “good” feeling. I focused on the way my mouth was shaped into a smile, my stomach had delicious butterflies and a laugh was a bubble in my throat waiting to be released. Eventually, like all feelings, it passed. This time, however, I fully experienced the feeling and simply allowed it to be there. It was very enjoyable, too. Maybe something bad is going to happen. Who knows? If it does, I have a lovely feeling of happiness to remember that may just help.

Action: Another important part to ACT is living by one’s values. I’m going to deal with that in my next blog post. The idea of action is the third component to the first part of ACT. Having defused from one’s unhelpful thoughts and expanded to allow room for whatever one’s emotions are, one commits to a course of action doing something one values or working towards a goal that allows one to live by one’s values, and giving it one’s full attention.

The most frequent situation in which I use ACT is when I’m out and about and feeling nervous. I simply commit to continue what I’m doing. I value being able to get out, after having experienced agoraphobia. Even though my mind is telling me that I’m going to have a panic attack and die and my heart is trying to beat its way out of my chest, I choose to commit to being wherever it is that I am and doing whatever it is that I’m doing. Furthermore, I try to notice all that is going on in that situation. I do so by sense. I focus on what I can see, hear, smell, taste and feel, depending on what I’m doing. Of course, thoughts and emotions always come and go. I try my best to let them do so without engaging.

We can’t help what we think or feel; all we can do is defuse from our thoughts and expand for our emotions. We can, however, control what we do and how we do it. There will always be “unhelpful” thoughts and “negative” emotions, over which we have no control. To be able to walk out the front door, say no to another drink, walk away from a futile argument with a loved one, say no to that chocolate cake because your doctor has told you that you’re morbidly obese and you want to be around to see your kids reach adulthood are actions which can be chosen to live one’s values.

None of it is easy. That’s why it’s important to identify what matters to one in one’s life. That’s coming in the next post.

ACT, values and goals

I’m currently reading a book titled, The Happiness Trap, by Dr Russ Harris. It’s essentially an in-depth look at Acceptance Commitment Therapy (ACT). My psychologist taught me ACT but reading the book is leading me to a deeper understanding.

ACT involves accepting thoughts, beliefs and feelings rather than challenging them. That’s what I like about it. I’ve learnt to disengage myself – to a certain extent – from my thoughts and feelings by simply acknowledging them. “Yes, I’m feeling very anxious about such and such.”

Following that, I commit myself to a particular course of action. Usually, it’s to continue what I’m doing. I’ve just come back from being on holiday and I always seem to move more out of my comfort zone when I’m away. Consequently, I use ACT a lot. I don’t want to miss out on the things that I’ve come a long way to do so I have to accept my anxiety and commit to doing those things, regardless of my feelings.

Another aspect to ACT is values. The idea is to commit to action which is in accordance with one’s values and goals. This is my stumbling block. I very much use ACT to get through whatever situation I’m in, thinking only of the short-term goal of what I’m doing at that moment.

To be honest, I don’t think about values and/or goals anymore. It’s all I can do to keep my head above water and get through each day. At this stage, any goals I have are purely short-term and informed by my PAD. A few months ago, just as an exercise, I wrote a “life plan” but, again, it was written within the boundaries of my disorder.

When I finished my allocated round of sessions with my psychologist and was doing better, I said to her that I felt like a cage door had been opened but that I didn’t know how to walk out. I don’t think she quite got what I meant. I saw her again recently for other reasons and it came up again. I still didn’t feel as if I were pointed in the right direction.

For a control freak and list maker, it’s uncomfortable to careen from day to day without any tools for planning how I want my life to be. I can plan my week, based around chores, errands and appointments and I can daydream about living in Paris and writing in smoky cafes but I find it impossible to look at what my values are and use them to determine the kind of life I want to be living. Of course, I can use ACT to deal with those feelings of discomfort!

Therein lays the difference between the book I’m reading and my therapy. Although I have no one to bounce ideas off of, the book has a part – which I haven’t read yet – about using ACT and values to make plans and goals. If ACT can add that extra layer to the acceptance and commitment I’m already using, it will be a great therapy, indeed.

(Just to clarify, I think my psychologist is wonderful!)