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Acceptance and Commitment Therapy (ACT)

What is acceptance and commitment therapy (ACT)? And how would it benefit persons with anxiety &/or OCD?

One major goal of ACT (said as the word “act”) is psychological flexibility. Anxious persons or those with OCD recognize that at times (or often) they can be very rigid in how they see things. According to Stephen Hayes within the context of ACT, psychological flexibility means “contacting the present moment fully as a conscious human being, and based on what the situation affords, changing or persisting behavior in the service of chosen values.”

Now what does that mean?

ACT teaches how language affects the interaction we have with our thoughts, feelings and ultimately our behaviors. Through challenging exercises clients learn how to have a healthier relationship with their thoughts, feelings, and memories so as to not avoid them. This in turn leads to being more psychologically flexible.

Is ACT a form of CBT?

ACT is part of the Third Wave of Cognitive Behavior Therapy. And an evidenced-based psychotherapy which simply means this treatment is scientifically supported to be effective. There is science behind this folks!

Though it is a form of behavioral and cognitive therapy, it is based more on Relational Frame Theory (RFT) which is “an approach designed to be a pragmatically useful analysis of complex human behavior, and provides the empirical and conceptual tools to conduct an experimental analysis of virtually every substantive topic in this arena,” (Hayes et al., 2001). 

ACT has moved away from the traditional CBT emphasis on changing or correcting one’s thoughts in order to alleviate suffering. Instead, ACT aims to change our reactions to private experiences (thoughts, feelings, memories, bodily reactions). With the goal of not being held hostage or “entangled” by their grip on us, changing our reactions, our patterns, to lead a more meaningful life. 

Persons diagnosed with OCD have fixed relationships with their thoughts, memories, beliefs, feelings and behaviors. Additionally, they typically work tirelessly to avoiding their feelings, avoid intrusive thoughts and avoid triggers whether internal or external. With ACT in combination with Exposure and Response Prevention we learn how to have healthier relationships with our OCD thoughts, working toward accepting and embracing anxiety, and changing our language about these feelings.

Through ACT we learn how to allow obsessions, irrational thoughts, anxiety and panic to come and go. Learning how not to have a reaction to them inevitably leads to lower anxiety, reduced intrusive thoughts and reduced avoidant or compulsive behaviors.

Sources and for further reading:

STEVEN C. HAYES, PHD

Hayes, S. C., Barnes-Holmes, D., & Roche, B. (2001). Relational frame theory: A post-Skinnerian account of human language and cognition. New York: Kluwer Academic/Plenum Publishers.

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