Acceptance and Commitment Therapy

ACT Helps Worriers

Have you ever had someone tell you to “just stop worrying” about something? It may have been something out of your control or something that was very unlikely to occur. But no matter how much you tried to reason yourself out of it, the stress and anxiety just wouldn’t go away or kept coming back. This is exactly the type of situation Acceptance and Commitment Therapy (ACT) was created to address.

This story behind ACT began over a century ago with Sigmund Freud’s psychoanalytical approach to psychotherapy. While certainly very revolutionary and influential, Freud’s approach to psychopathology was notoriously difficult to test empirically and thus ended up sorely lacking in research to back up his theories. As a result, another scientist by the name of B.F Skinner decided to focus exclusively on ideas that could be empirically tested. Skinner concentrated on behavior that could be directly observed in individuals rather than cognitive processes that could simply be speculated. This approach yielded many revolutionary concepts, such as the principle of associative learning that could be observed in animals as well as people. However, when it came to treating psychological disorders, this approach still had some serious limitations.

What happens within the human mind does not always have a clear behavioral counterpart, so focusing purely on behavioral psychology provides a limited understanding of the more complex psychological disorders. Moreover, many identical behaviors can be observed between two patients with very different conditions. For example, the observable behaviors of social withdrawal, difficulty sleeping, and general apathy with day-to-day activities are also symptoms of depression. However, they are also symptoms of Alzheimer’s disease and dementia, which differ immensely in both cause and treatment compared to that of social withdrawal and depression.

Because of this fundamental flaw in its application, people like Albert Ellis and Aaron T. Beck introduced modern cognitive therapy. This therapy focused on helping patients reframe thought processes, particularly the maladaptive ones, as a means of correcting and avoiding thought patterns that lead to anxiety (and by extension, pathological behaviors and experiences). While Freud’s models of cognition worked almost solely off anecdotal evidence, Ellis and Beck developed a model in which cognitive psychology worked with behavioral psychology, each field influencing the other to create a more holistic approach to psychotherapy. The result was the cognitive-behavioral therapy (CBT) that is now one of the most widely used therapies in the field, and for good reason, too. CBT has been found to be effective in treating a wide range of psychological disorders, from depression to post traumatic stress disorder to substance abuse (PTSD) and more.

Despite the effectiveness and usefulness of CBT, it still isn’t perfect for every situation. CBT utilizes a top-down model of cognition, meaning the therapy focuses on reframing thoughts and perceptions that lead to negative experiences. However, many types of pathological worry emerge from bottom-up processes, meaning they are driven by involuntary habits and experiences that cannot be easily avoided by simply reframing voluntary thought processes. For example, those with generalized anxiety disorder (GAD) will often find it next to impossible to simply stop worrying even if there is no logical reason to worry.

Thus, ACT was born by using the principles of Relational Frame Theory to fill in some of the gaps present in the CBT approach. Rather than working to avoid stress and anxiety, ACT focuses on fully embracing these private experiences, accepting them and changing how we respond to them when they occur. That way, rather than being taught to avoid it, ACT teaches us to accept the presence of these challenges, reassess them (it might not be as bad as you think!) and even learn to take advantage of them. That’s right—in some ways, we can harness stress and anxiety to benefit us rather than hinder us. Research has shown that some stress can actually help improve performance when a person doesn’t see a sensation as inherently negative.

If this sounds like something you think would help you with your day-to-day anxiety and stress, check out some of ACT’s free techniques available online or talk to your therapist about using the ACT approach in your life.

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