Acceptance and Commitment Therapy: What is it?

The Acceptance and Commitment Therapy (ACT) It is a type of therapy that is included within the so-called third generation therapies, which arose between the 80s and 90s in the United States and are part of the behavioral and cognitive therapeutic models.

While first and second generation therapies focused and (focused) on combating automatic or discomfort-causing thoughts and replacing them with supposedly more adaptive ones, third generation therapies emphasize dialogue and functional context and seek acceptance and the non-judgmental attitude as a way of finding well-being.

• Related article: "Types of psychological therapies”

What are first and second generation therapies

Third generation or third wave therapies belong to behavioral therapies. To understand what these therapies are, I will first talk about first and second generation therapies.

The first generation therapies (60s) are the therapies that were born with the aim of overcoming the limitations of the psychoanalytic therapy, dominant at that time. When we talk about first generation therapies we are talking about

Classical Watson Conditioning and the Skinner Operant Conditioning. This type of therapy had its utility to treat, for example, fears or phobias, and were based on the principles of conditioning and learning.

However, neither the associationist learning model and Watson's characteristic stimulus-response paradigm, nor even the Skinner's experimental breakthrough were effective in treating certain psychological problems presented by some people. Then, second generation therapies emerged (70s), which are, mainly, the Cognitive-Behavioral Therapies (CBT) as, for example, the Rational Emotive Therapy (RET) by Albert Ellis and the Aaron Beck Cognitive Therapy, who consider thinking or cognition as the main cause of human behavior and, therefore, of human behavior. psychological disorders.

However, the second wave of behavioral therapies continued (and continues) to use first generation techniques and procedures and therefore focuses on modification, elimination, avoidance and, ultimately, the alteration of private events (thoughts, beliefs, emotions, feelings and even the sensations themselves bodily).

In other words, these forms of therapy revolve around the idea that if the motive for the behavior is the private event, it must be modified in order to change the behavior. This premise is widely accepted today, which, at present, brings as a consequence what is socially established as normal and correct behavior or as Mental illness. Something that fits perfectly with a medical-psychiatric and even pharmacological model.

What characterizes third generation therapies

Third-generation therapies emerged in the 90s, and they differ from the latter because they approach disorders from a contextual, functional perspective, and their The main objective is not to reduce the symptoms that the patient presents, but to educate him and reorient his life in a more holistic. They are based on the idea that what causes discomfort or anxiety are not the events, but how we link emotions to them and how we relate to them. It is not about avoiding what causes us suffering, because this can have a rebound effect (as many research indicates), Rather, the ideal situation is to accept our own mental and psychological experience, and thus reduce the intensity of the symptom.

Sometimes it can be strange to work in this type of therapy, which invites the person to see, thanks to different techniques (experiential exercises, metaphors, paradoxes, etc.), that what is socially or culturally accepted causes him to attempt to control his private events, which in itself is problematic. This control is not the solution, but it is the cause of the problem.

• Related article: "Self-acceptance: 5 psychological tips to achieve it"

The importance of functional contextualism

A noteworthy aspect of third-generation therapies is that are based on a functional and contextual perspective of pathologies, which is called functional contextualism. That is, the behavior of the individual is analyzed from the context in which it occurs, because if it is decontextualized, then it is not possible to discover its functionality.

On the one hand, it is interesting to know how the person relates to the context according to her story and current circumstances, always taking into account verbal behavior and clarification of values. Verbal behavior is what the patient says to himself and others, but it is not important for its content but for its function. A patient may say that he feels self-conscious and very embarrassed when he has to speak in public. The important thing is not to know if you are ashamed or self-conscious, the objective is to know if this way of thinking is doing you good or if it hurts you.

Furthermore, in third-generation therapies, observable and private behavior are not distinguished, since the latter is also valued from functionality.

Acceptance and commitment therapy

Without a doubt, one of the best known third generation therapies is Acceptance and Commitment Therapy (ACT), which aims to create a rich and meaningful life for the patient, accepting the pain that inevitably comes with it.

ACT is presented as an alternative to traditional psychology and is a scientifically supported psychotherapy model that uses different techniques: paradoxes, experimental exercises, metaphors, work with personal values ​​and even training mindfulness. It is based on the Relational Frame Theory (RFT), so it fits into a new theory of language and cognition.

Human language can transform us, but it can also create psychological suffering. That is why it is necessary to work with the meanings of language, its functions and its relationship with private events (emotions, thoughts, memories ...). What's more, self-discovery and clarification of values ​​are essential elements in this type of therapy, in which the patient must ask himself and question himself what kind of person he wants to be, what is truly valuable in his life and from what beliefs and values ​​he acts.

Commitment to our values

If we look around us it seems clear that much of our suffering is determined by our beliefs of what is right or wrong, beliefs that are culturally learned and that are based on the values ​​promoted by Western society. While most therapies view suffering as abnormal, ACT understands that suffering is part of life itself. That is why it is said that ACT questions social ideology and healthy normality models, in which happiness is understood as the absence of pain, anxiety or worries.

ACT, which in English means “to act”, emphasizes taking effective actions guided by our deepest values, in which we are fully present and committed.

Principles of this type of therapy

ACT employs some principles that allow patients to develop the mental flexibility necessary to improve their emotional well-being.

They are these six:

1. Acceptance

Acceptance means acknowledging and approving of our emotional experience, our thoughts or our feelings. It has to do with treating us with love and compassion despite not being perfect. We must not fight our private events or run from them.

In reality, the acceptance of the present situation contributes to many of the aspects of our life that We perceive as problems no longer be, thus reducing the level of anxiety and the discomfort factors associated with this.

2. Cognitive defusion

It is about observing our thoughts and cognitions for what they are, bits of language, words, pictures, etc. Simply observe and let go without judgment. In this way a distanced and more rational vision of things is adopted.

3. Present experience

The present is the only moment we can live. Being in the here and now with an open mind and mindfulness, fully participating with the due attention to what is happening in us and around us is the key to our well-being.

4. The "observer self"

It means letting go of the conceptualized self, that is, of attachment to our own narratives. From the perspective of the self as an observer we see things from a non-judgmental point of view.

5. Clarity of values

ACT requires a work of self-knowledge that allows us to clarify our values ​​from the depths of the soul. What is truly valuable to us? Where do we really want to be or go? These are some of the questions that need to be answered. Of course, always honestly.

6. Committed action

The direction we follow must always be determined by our own values and not because of social impositions. We must get involved in actions that are meaningful to ourselves. In this way we are much more likely to commit to our projects and make them progress at the rate we want.

Bibliographic references:

• Hayes, S.C. (2004). Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies. Behavior therapy, 35, 639-665.
• Luciano, M.C. and Valdivia, M.S. (2006). Acceptance and commitment therapy (ACT). Foundations, characteristics and evidence. Papers of the Psychologist, 27, 79-91.