In psychology, several theoretical approaches or orientations guide psychologists in the way they practice psychotherapy. The Ordre des psychologues du Québec describes four main approaches: the psychodynamic-analytical approach, the humanistic-existential approach, the systemic-interactional approach and the cognitive-behavioral approach (commonly known as CBT).
In these four main approaches research has led to the development of slightly different ways of doing things. I will briefly introduce you to the Acceptance and Commitment Therapy* (ACT), a rather recent branch of the cognitive-behavioral approach, which is based, among other things, on acceptance.
First, a little history!
ACT is part of what is known as the third wave of cognitive-behavioral therapies. It was developed in the 1980s by Steven Hayes and described in the 2000s by Russ Harris.
The approaches in the third wave of CBTs focus on how we perceive and relate to our thoughts and emotions. In more traditional cognitive-behavioral therapies, the goal was to change our thoughts and emotions, but here we try to recognize and accept them. The different types of third wave therapy, including ACT, all share the common feature of integrating mindfulness (also called “attentive presence”).
The ACT in two words
The principles of ACT can be applied and useful in everyone’s daily life. The purpose of ACT is to enhance psychological flexibility, that is, our ability to engage in actions that are important to us, our context and our environment. In other words, it is what allows us to accept what we cannot change within ourselves and in the environment, and to mobilize ourselves in actions that allow us to get closer to the person we want to be, in accordance with our values.
As its name suggests, ACT focuses on:
1- Acceptance (I will come back to this in more detail);
2- Commitment, i.e. the adoption of behaviors that connect us to the person we want to be and therefore to our values.
What is acceptance?
In ACT, “acceptance” refers to the acceptance of our emotions, thoughts, sensations and memories, even the least pleasant ones. We are concerned about our ability to welcome these human realities and to fully experience them. The opposite of acceptance is experiential avoidance, that is, all our attempts to avoid a thought, feeling, emotion or memory. Acceptance, unlike resignation or tolerance, is an active process that aims to make room for our inner experience.
Acceptance, why?
Why should we accept all these unpleasant sensations, thoughts or emotions?
First, because emotions are useful!
Our emotions are not only at the heart of the balance in our social relationships, they are also necessary for our survival. For example, fear pushes us to save ourselves in the presence of danger, while sadness allows us to receive comfort from others when we need it. All emotions are valuable! In this sense, there are no “negative” emotions.
Secondly, because fighting is exhausting!
Struggling to not feel certain emotions demands a lot of energy and attention. In ACT, the fight against emotions or thoughts is compared to a “tug-of-war” game where the opponent is a monster: we exhaust ourselves by resisting the monster to prevent it from dragging us into what we perceive to be a dangerous ravine.
Third, because the struggle is in vain!
In the short term, the fight can work and allow us to avoid unpleasant sensations. However, in the long term, this attitude causes even more grief and exhaustion. The more we avoid, the more the experience we try to evade takes up space in our lives, and the less attention we can pay to the things that are important to us. When you must pull the rope all the time, it is very difficult to pay attention to what is around you, because all your energy is focused on pulling the rope so that you don’t fall into this notorious ravine!
*image of the struggle against emotions*
How do we get there?
The ” formula” for acceptance? Drop the rope!
To succeed in letting go, we must first recognize what is happening inside us, observe our emotions, feelings or thoughts, without judging them or ourselves. The goal is simply to become fully aware of what is inside us, as if we were observing these sensations from the outside by scrutinizing them carefully, without attributing any positive or negative connotations to them. In short, we’re looking at the monster from every angle!
We must then allow these feelings, emotions or thoughts to exist, to be there, to inhabit us without judgment. We welcome them into our lives rather than trying to distance ourselves from them or control them. This is the most difficult part of the process, as it requires us to be indulgent towards ourselves, to accept our shortcomings and to practice self-compassion. Here, we accept that the monster is there, we make room for him and we no longer pull the rope.
Practice exercise
I suggest a first exercise to begin your practice of acceptance. The goal here is for you to take the time to stop, reflect, and to observe your own inner struggle. Very often, we do not notice the actions we take to fight against emotions we do not want to feel or to stop certain thoughts that disturb us. I, therefore, invite you to take a break to become aware of this struggle. To do this, first, try to answer the following questions.
What do you tend to avoid?
A discussion with a friend? A family evening? A one-to-one meeting with your spouse? Anger or sadness? Stress symptoms? A place? A person?
The situations I tend to avoid are:
The emotions I tend to avoid are:
The thoughts I tend to avoid are:
The sensations I tend to avoid are:
What actions do you take to avoid these things?
Think about the obvious ways to avoid, such as not calling someone back, avoiding being in a place where there might be a crowd, forcing you not to think about something, postponing, drinking alcohol or taking drugs, etc. Also think about the subtler actions that can interfere with the way you manage your suffering. For example, getting angry to avoid feeling ashamed or sad, pretending that the situation does not affect you, getting dizzy by filling out your schedule as much as possible so that you have no time to think about the painful situation, etc.
The actions I do to avoid are:
After you have answered the questions, I invite you to be mindful of when these situations, thoughts or emotions will arise again in your daily life.
1- Notice them.
2- Observe your reflex in front of them (your struggle).
3- Observe them carefully and rather than trying to repel them, try to welcome them into yourself.
Good practice !
* It is important to note that this article is an overview of the therapy and is not a substitute for it. If you feel a need or are in a distress situation, consult a professional.
Resources and references:
Bailey, A., Ciarrochi, J. and Hayes, L. (2012). Get Out of Your Mind & Into Your Life for Teens: A Guide to Living an Extraordinary Life. Oakland : New Harbinger Publications.
Harris, R. (2014). Le piège du bonheur. Montréal : Les Éditions de l’Homme.
Harris, R. (2017). Passez à l’ACT : pratique de la thérapie d’acceptation et d’engagement. Bruxelles : De Boeck.
Hayes, S. C. (2005). Get Out of Your Mind & Into Your Life: The New Acceptance and Commitment Therapy. Oakland : New Harbinger Publications.
Ordre des psychologues du Québec. (n. d.). Les orientations théoriques. Repéré à : https://www.ordrepsy.qc.ca/les-orientations-theoriques.
Schoendorff, B., Grand, J. and Bolduc, M. (2011). La thérapie d’acceptation et d’engagement : guide clinique. Bruxelles : De Boeck.
By Valérie Courchesne, PhD in Psychology, Associate Psychologist, MOVEO Psychology Clinic
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