Montserrat Martínez: «The approach to ACT is highly experiential»

Acceptance and Commitment Therapy (ACT) is one of the most used psychological intervention modalities from among contextual therapies. One of its keys is to help people not avoid everything that causes them discomfort, thus minimizing its impact on emotional well-being.

Bearing this in mind, it is not surprising that it is effective for many anxiety problems, since this kind of Alterations have a lot to do with the self-fulfilling prophecy: the fear of anxiety itself favors the appearance of is. We talked about it with the psychologist Montserrat Martínez, from Emotional Astronaut.

• Related article: "The 4 types of Contextual Therapy: what are they and what are they based on"

Interview with Montserrat Martínez: the treatment of anxiety from Acceptance and Commitment Therapy

Montserrat Martínez is a psychologist specialized in cognitive-behavioral therapy, ACT and Behavioral Medicine, as well as a member of Astronauta Emotional. In this interview she tells us about the treatment of anxiety problems from Acceptance and Commitment Therapy.

What are the characteristics of Acceptance and Commitment Therapy that you consider most interesting?

I think that something very valuable about ACT (Acceptance and Commitment Therapy) is the perspective it has on discomfort. It invites us to reflect on what would happen if only half the effort we put into avoiding emotions such as sadness, pain or frustration, we would reverse it to get closer to what really matters to us in the lifetime.

Usually there is a thought about "you must be well, you must be happy and if you are not, something is wrong with you", then ACT comes to tell you that discomfort is part of life, and that this is not incompatible with the fact that you can be the person you like to be and can live a life valuable. It is super important to clarify that accepting discomfort as part of life is not the same as resigning ourselves.

For example, imagine that you are experiencing a lot of pain in your knee. Resigning yourself to living with that pain and "pretending it doesn't hurt" could hurt you even more. Accepting the presence of pain allows you to recognize that there is something in your body that needs your attention. That, in turn, will give you the opportunity to give yourself the care you require and allow you to rest when you need it.

ACT promotes acting based on what is truly valuable to each person, practicing our curiosity as we approach day-to-day experiences.

Is it easy for patients to understand how these kinds of psychological intervention programs work?

Sure! Above all, because the approach to Acceptance and Commitment Therapy is highly experiential. In ACT, a lot of work is done with metaphors and various experiential exercises that facilitate patients' contact with the main components of therapy.

How does it work to help us overcome our fears?

Precisely a characteristic of ACT is that it does not seek to overcome / leave behind / remove discomfort, in this case fear. Anyone might think that it is absurd to receive a treatment that does not seek to alleviate, but rather seeks make room for discomfort and move towards what is important to each person (flexibility psychological).

However, this is related to the popular idea that our uncomfortable emotions are problems that we must fix.

Here the proposal is not to change emotions, but to change our relationship with them. What would you do if fear didn't weigh so heavily on your decisions? In ACT, the patient is made aware that emotions are part of various life experiences. You cannot choose if you will ever feel fear again, but by changing your relationship with that emotion, you can choose that fear does not take you away from what is important to you.

Does the principle of acceptance also help to manage cases of excessive perfectionism and fear of not doing things right?

Of course. Imagine that when you are doing activity X, thoughts like: “I don't like the way it looks, why can't I get it right? I can't leave it like that, because if it stays like that then… (insert catastrophic phrase of your choice here) ”.

You can try a lot of things to avoid this discomfort, such as repeating the activity several times, dedicating a lot of time and effort so that it is as close to what you consider perfect... The point is, if you invest all your resources in activity X, you will end up leaving aside other things that may also be valuable to you.

ACT strategies allow us to accept or make room for the various uncomfortable thoughts or emotions that we are experiencing at that moment. They promote being an observer of those experiences, getting down to that literal touch that they have when we get hooked.

In that way, our attention is no longer wrapped in thoughts, but we have the opportunity to direct it back to what is valuable to us.

In which cases of care for people with anxiety problems is Acceptance and Commitment Therapy most useful?

It has been shown to be effective in treating conditions known as generalized anxiety, panic attacks, Obsessive-Compulsive Disorder, etc. Again, the goal of ACT is not to remove symptoms, but if this occurs it is considered an indirect gain of the real objective: to generate psychological flexibility to get in touch with what is important, making room for discomfort.

What are the main phases of Acceptance and Commitment Therapy?

The basic processes of ACT are the following: contact with the present moment, I as context, acceptance, cognitive defusion, values, and committed actions.

They are not necessarily implemented in that order, since as with any intervention, it is not a cooking recipe. It is very important to carry out an adequate analysis of the case, from which it will be decided with which process to start and with which specific strategies that process will be trained.