Acceptance and Commitment Therapy (ACT): principles and characteristics
The Acceptance and Commitment Therapy (ACT) is a type of therapy that is encompassed within the so-called third generation therapies, which emerged between the 80s and 90s in the United States and are part of behavioral and cognitive therapeutic models.
While the therapies of first and second generation focused and (center) on combating the automatic thoughts or causing discomfort and replacing them with others supposedly more adaptive, Third-generation therapies emphasize dialogue and functional context and seek acceptance and the nonjudgmental attitude as a way to find welfare.
- Related article: "Types of psychological therapies"
What are first and second generation therapies
The therapies of the third generation or the third wave belong to behavioral therapies. To understand what these therapies are, first I will 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 psychoanalytic therapy, dominant at that time. When speaking of first generation therapies we are talking about the Watson Classic Conditioning and the Skinner Operational Conditioning. This type of therapies were useful to treat, for example, fears or phobias, and were based on the principles of conditioning and learning.
However, neither the associationist learning model and the stimulus-response paradigm characteristic of Watson, nor even the experimental advance of Skinner were effective in the treatment of certain psychological problems that some people presented. Then, second-generation therapies (70s) emerged, which are mainly Cognitive-Behavioral Therapies (CBT), such as, for example, Rational Emotive Therapy (TREC) by Albert Ellis and Cognitive Therapy by Aaron Beck, which they consider thought or cognition as the main cause of human behavior and, therefore, of psychological disorders.
However, the second wave of behavioral therapies continued (and continues) using techniques and procedures of the first generation and, therefore, focus on the modification, elimination, avoidance and, ultimately, the alteration of private events (thoughts , beliefs, emotions, feelings and even one's own bodily sensations).
In other words, these forms of therapy revolve around the idea that if the reason 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 a mental illness. Something that fits perfectly with a medical-psychiatric model, and even pharmacological.
What characterizes third-generation therapies
Third generation therapies emerged in the 90s , and they differ from the latter because they focus on the disorders from a contextualist, functional perspective, and their main objective is not to reduce the symptoms presented by the patient, but to educate and reorient their life in a more holistic way. They are based on the idea that what causes discomfort or anxiety are not the events, but how we link the 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 investigations indicate), but the ideal situation is to accept our own mental and psychological experience, and thus reduce the intensity of the symptoms.
Sometimes it can be strange to work in this type of therapies, which invite the person to see, thanks to different techniques (experiential exercises, metaphors, paradoxes, etc.), that what is socially or culturally accepted causes an attempt to control its private events that in itself is problematic. This control is not the solution, but is the cause of the problem .
- Related article: "Self-acceptance: 5 psychological tips to achieve it"
The importance of functional contextualism
One aspect to highlight of third generation therapies is that are based on a functional and contextual perspective of pathologies , what 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 their history and current circumstances, always taking into account the verbal behavior and the clarification of values. Verbal behavior is what the patient says to himself and others, but it is not important because of the content but because of its function.A patient may say that he feels self-conscious and that he is very embarrassed when he has to speak in public. The important thing is not knowing if you feel embarrassed or self-conscious, the objective is to know if this way of thinking is doing you good or if it hurts you.
In addition, third-generation therapies do not distinguish observable and private behavior, since the latter is also valued from functionality.
Acceptance and commitment therapy
Undoubtedly, 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 .
The ACT is presented as an alternative to traditional psychology and is a model of psychotherapy that is scientifically supported and that uses different techniques: paradoxes, experimental exercises, metaphors, work with personal values and even mindfulness training. It has its bases in the Relational Framework Theory (RFT) , so it is framed in new theory of language and cognition.
Human language can transform us, but 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 ...). Further, self-discovery and clarification of values are essential elements in this type of therapy , in which the patient must ask himself and question 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, 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 see suffering as something abnormal, ACT understands that suffering is part of life itself. That is why it is said that the ACT questions the social ideology and healthy normality models, in which happiness is understood as the absence of pain, anxiety or worries.
ACT, which in English means "acting", emphasizes taking effective actions guided by our deepest values, in which we are totally present and committed.
Principles of this type of therapy
The ACT uses some principles that allow patients to develop the mental flexibility necessary to improve their emotional well-being.
These are six:
1. Acceptance
Acceptance means recognizing and approving our emotional experience , our thoughts or our feelings. It has to do with treating us with affection and compassion despite not being perfect. We must not fight against our private events or flee from them.
In reality, acceptance of the present situation contributes to many of the aspects of our life that we perceive as problems cease to be, thus decreasing the level of anxiety and the factors of discomfort associated with it.
2. Cognitive defusion
It is about observing our thoughts and cognitions as what they are , pieces of language, words, images, etc. Simply, observe and let go without judging them. In this way a distanced and more rational view of things is adopted.
3. Present experience
The present is the only time we can live . Being in the here and now with an open mind and full consciousness, participating fully with due attention to what is happening in us and around us is the key to our well-being.
4. The "I observer"
It means to get rid of the conceptualized I , that is, the attachment to our own narrations. From the perspective of the self as an observer we see things from a non-judgmental point of view.
5. Clarity of values
The 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 want to be or actually go? These are some of the questions that must be answered. Of course, always honestly.
6. Committed action
The direction we follow should always be determined by our own values and not by social impositions. We have to get involved in meaningful actions for ourselves. In this way we are much more likely to commit to our projects and make them progress at the pace 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). The acceptance and commitment therapy (ACT) .Fundamentals, characteristics and evidence. Papers of the Psychologist, 27, 79-91.
