Acceptance and commitment therapy (ACT) was developed in the 1980’s by psychologist Steven C. Hayes in response to his own struggles in dealing with panic attacks. Instead of arguing, ignoring, avoiding or negotiating with our emotions we should accept them as reasonable responses to situations we fear, but refuse to let them define the outcome. It’s a way to understand where the feelings come from so we can then change not only how we see those thoughts but the behaviors they encourage as well.
One source shares, “We as a culture seem to be dedicated to the idea that ‘negative’ human emotions need to be fixed, managed, or changed—not experienced as part of a whole life. We are treating our own lives as problems to be solved as if we can sort through our experiences for the ones we like and throw out the rest. Acceptance, mindfulness, and values are key psychological tools needed for that transformative shift.”
In order to accept who we are we must first embrace all aspects of our thoughts and emotions. ACT doesn’t aim to manage or control unwanted thoughts or sensations by encouraging a “thicker skin” or repressing the emotions. Instead it helps to redefine how we see those emotions so they no longer control our reactions. Rather than responding reflexively, it gives us the opportunity to take a breath, think about the emotions and thoughts swirling in our head and then decide the best way forward.
In one study, combining acceptance and commitment therapy with active changes through physical therapy achieved an even better outcome. For example,
“I can’t walk without pain.”
Changes to,
“I can push myself a little every day.”
And improves with,
“Adding physical therapy really helped me to honor my fears and work through them safely with the appropriate guidance.”
ACT promotes six ways to do this, allowing us to be more flexible and adaptive.
Acceptance
Running from those thoughts that hurt or denying them isn’t the answer. Rather than avoiding or rejecting them, let them through. Acknowledge they exist along with any and all other feelings. It’s ok to be angry, sad, overwhelmed, or frustrated. Sometimes we just have to live with those feelings until we can move on, understanding and accepting improvements take time and perseverance. We all adapt eventually.
“I will never get better.” Changes slowly as more mobility and activity is possible.
“I’ll be weak and limited for life.” Morphs to the strength and fortitude you’ll see as you broaden your abilities with time and effort.
Cognitive Defusion
ACT theorizes that pain itself is only one source of suffering. Others include the psychosocial struggles that come from living with chronic pain. Accepting some pain will always be a part of our lives, we learn to pursue goals that can be realistically achieved.
“Traveling is too painful.”
“I can’t walk as far as I’d like.”
“I can’t lift my child.”
All may be true on some level but that doesn’t have to stop us from enjoying life and learning new ways to cope that will bring joy and expanded horizons. Separate yourself and put distance between you and those thoughts. This lessens the impact and harm they can cause. Take each thought, label it for how you see it impacting your life, then change the dimensions- size, depth and volume. Slowly see them shrink each time they rear their ugly head.
Or write one down and carry it with you. Envision how you can live with this thought, not fight it. “Yes, my life is different with chronic pain but that doesn’t mean it can’t be fulfilling and enjoyed.”
“Not lifting cramps my style but I can have my child crawl into my lap.”
“My pain doesn’t have to limit me, I’ll use a cane, walker or even a wheelchair when needed to go the extra distance.”
“Traveling won’t be easy but I’ll find ways that work with my pain.”
You control the narrative.
Being Present
There are several techniques that can help us stay in the here and now instead of spiraling off into the abyss of woulda, coulda, shoulda. Accept yourself, limitations and all. Focus on where you are, what the air smells like, the chair against your back, others in the room…take a calming breath and then decide how you want to respond. Let the chemical reactions the anxiety is generating flow through your body and get released.
Use the 5,4,3,2,1 method. Focus on a piece of food. Practice mindfulness. Breathe.
We Are More
We are more than just our thoughts and experiences. We have a choice in how we respond to emotions and feelings. They don’t have to direct or define us. Our higher consciousness does. They may push us in a direction that’s not helpful- like skipping an exercise session or lashing out when we’re in pain- but that doesn’t mean we have to listen.
“I’ll never be able to function again without agony.”
“I’m weak and dependent.”
None are true. And in calmer times we know these feelings just lead us down a rabbit hole of despair and anguish. Letting them occur, then acknowledging they don’t have to determine our responses or actions is empowering.
Values
Define what matters and don’t be driven by how we feel or how others see us. That never bodes well. We need to decide what’s in our own best interest then strive to make that a reality by not living a dream of what could be but putting in the time and effort to make it happen in the here and now. When we live by others’ rules or perceptions it’s easy to lay blame when they don’t succeed.
“I will use my strengths, determination, persistence and discipline to move through fears and obstacles.”
“I am not alone. I have loving people in my life who care and are there for me.”
Action
It’s easy to wish, hope or dream to be pain free. In that space everything is perfect, but it’s not real. Taking whatever steps are necessary to push safely through the pain to more mobility and endurance takes commitment. We know it won’t happen overnight. Expecting otherwise sets us up to fail. But in time, every bit of improvement will make a huge difference.
“I’m too tired and in pain to exercise after work,” can change to, “I’m tired and hurting but I know I’ll feel better if I move, stretch and surge needed nutrients to my aching muscles.” “Once the endorphins release it’ll be worth the effort.” “If I don’t move it, I’ll lose it.”
The underlying philosophy is learning to accept our emotions and not be ruled by them. Healing begins when we address those concerns and realize they are a part of the experiences that make us who we are today.
-https://www.healthline.com/health/mental-health/acceptance-and-commitment-therapy#how-to-try-it
-https://www.psychologytoday.com/us/therapy-types/acceptance-and-commitment-therapy
-https://www.sciencedirect.com/science/article/pii/S2212144720301940
-https://www.sciencedirect.com/science/article/pii/S1526590019300653