Her anxiety of being “out there” is replaced with the more intense loneliness and depression of avoiding people. Although this allows her to avoid the anxiety of being in social situations, Juanita is stuck because she lacks the social relationships that she needs. To avoid the resultant pain, she begins staying home and watching television by herself. Juanita is depressed and feels ignored in all social situations. Only a dead person experiences no unpleasant emotions, so a different approach is needed.Īn example might illustrate further.
This “control” agenda is in reality hopeless. The more effort that is spent on trying to avoid pain, the more pain it causes.
This paradoxically results in more suffering and a tightening of the pattern’s grip - much like trying to escape from a Chinese finger trap. They thus spend their days trying to avoid discomfort that is inevitable in life. ACT authors somewhat mischievously refer to counseling that tries to help clients never to feel any anxiety or sadness as pursuing “dead person’s goals.” These clients become intent on avoiding all suffering and discomfort, and in so doing become “stuck” in their thinking, feeling and behavior. ACT enters this debate by suggesting a core concept that produces suffering across many diagnoses: psychological inflexibility.ĪCT argues that some pain, including emotional pain, is natural and inevitable in life. The search is now on for the core processes that account for emotional suffering rather than just naming more and more diagnostic categories. That is a challenge given that comorbidity is more the rule than the exception in diagnosis. Earlier efforts to find empirical support for counseling models focused on identifying specific therapies for each diagnosis. In the counseling world, the idea of diagnosis is being increasingly questioned, particularly because of the overlap of symptoms and the lack of discrete categories. That is, it works across diagnoses and does not make much of traditional diagnostic categories. One of the attractions of ACT is that it is transdiagnostic. One encouraging note is that studies show that counselors starting out in ACT generally feel less confident than they do with CBT but see better results. Counselors can utilize ACT with confidence that it can help. More than 120 randomized trials have shown it to be as effective, if not more effective, than traditional therapies. In keeping with its heritage, ACT is built on empirical research and boasts a bevy of studies showing its effectiveness across a wide spectrum of problems. Rather, the goal is to form a different relationship with one’s thoughts. Although thoughts and language play a role in ACT, ACT does not share CBT’s focus on disputing the thoughts rationally. Part of RFT shows how metaphors are very beneficial in helping us understand and change how we see things.) One can be a competent ACT therapist without being an expert in RFT.ĪCT also draws from cognitive behavior therapy (CBT) but pursues goals that are quite distinct. RFT is a bit difficult to understand, but ACT is like operating a car: You can drive it without understanding all that is going on “under the hood.” (By the way, my use of metaphors is deliberate. This fascinating approach concerns how our “languaging” about things can cause and perpetuate emotional distress. It draws largely on insights from a branch of behavioral research into language called relational frame theory (RFT). Maybe, like me, you’ll find this worth a closer look.ĪCT actually evolved from behaviorism, although it is far from the old stereotypes of behavioral therapy. So, if you’ll share with me a few minutes of your time, I’d love to introduce this intriguing model for clinical work. It is a model that stands on the shoulders of long-endorsed approaches to counseling, yet it takes these ideas into new and, I believe, more fruitful directions. Yet another model of counseling? I would have asked the same question before my introduction some years ago to acceptance and commitment therapy (ACT, and pronounced as the word, act).
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