Acceptance and Commitment Therapy


How many of us have struggled with anxiety or depression?

It can look like wanting to sleep all day, wanting to numb out in various ways, feeling irritated or overwhelmed to the point of non-functioning, and every other way one can imagine as it differs from person to person.  One thing for sure is that it is generally unwanted and can prevent the person experiencing it on a regular basis from enjoying their life.  

Some studies even link repressing or resisting emotions, sometimes known as experiential avoidance, to developing physical health issues, anxiety and depression being among the mental side effects.4

Depression and anxiety occur most frequently among women in the general population and can have huge effects on the quality of their lives.1

Seeing as women are often the primary caregivers of children and have an undoubtably large influence on their children and communities, it is important that women focus on improving their own mental health and make it a greater priority.



Acceptance & Commitment Therapy Explained


Acceptance and Commitment Therapy (ACT) has proven from multiple studies to help people struggling with anxiety and depression.1

What is ACT? It is based on the idea that no memories, thoughts, or feelings cause issues for a person, but are entirely based upon the perspective in which the person experiencing them views them from. A leading expert in the field of ACT, Russ Harris, describes the therapy as a way to decrease the effect of difficult thoughts and emotions (acceptance) and at the same time, creating a life based on the person’s values to create a more meaningful experience in life (commitment).2

Essentially, life is going to throw difficult circumstances at each one of us that cause pain emotionally or physically, but ACT can allow us to handle the pain more effectively to reach our goals and feel more at peace with our lives. 



There are six main skills that make up ACT to create mental/emotional resilience, or psychological flexibility, which can help people avoid values and opportunities less in their life.3

Psychological flexibility is defined by researchers as the “ability to act on the long-term chosen values in life and accept undesired thoughts, feelings and short-term impulses stemming from distressing life events”4, essentially allowing a person to cope better and be in control of creating the life they truly want.

 These skills include acceptance, being present in the moment, cognitive defusion, self as context, values, and commitment1 In total, these skills help a person to use mindfulness and values to create more desired behaviors and reduce compounding difficult emotions with resistance to them.1  So what do all of these skills mean? Let’s break it down.

Acceptance: the willingness to allow unwanted thoughts, emotions, memories, and urges. 2 Where people typically want to  shove painful, triggering, or embarrassing experiences down or distract themselves away from feeling or thinking them, acceptance urges people to welcome them to be felt.

Being present in the moment: This can be described as connection with yourself and your environment in the moment.2

Cognitive defusion: Often people don’t realize their thoughts are separate from themselves and think of them as unchangeable truth or facts.  Defusion means to separate ourselves from the thoughts, beliefs, or feelings that arise and view them neutrally.2

Self as context: This is the part of each of us that notices thoughts, judgements, feelings, or experiences.2

Values: are what you want your life to be, how you want to act to yourself, others, and your environment.2

Commitment: This is action that is steered by a person’s specific values.2




An important note about ACT is that it does not intentionally aim to eliminate or even reduce symptoms of an unpleasant experience, though a decrease in negative thoughts and emotions usually happens.3 ACT instead tries to help people to detach from the resistance to the negative thoughts and emotions and create a more workable result for their specific values and goals.3 Though Acceptance and Commitment Therapy may not be a cure all for anxiety and depression, there is no doubt in the research that it has a positive impact on people who are able to implement it into their lives.1 ACT has been found most helpful in people with mild to moderate symptoms, rather than severe, which may need additional help other resources like medication.  The wonderful part of ACT is that it can be used in everyday situations that affect everyone. 

Many women who experience depression and anxiety are also mothers.  A specific group of women that have been found to have increased symptoms of depression, anxiety, and overall stress are mothers of children with disabilities.3 One study found that women of children with mental or physical disabilities had substantial improvements in their overall mental health from applying Acceptance and Commitment Therapy.3  Some of this came from them neutralizing their own judgments of themselves as parents or accepting the painful thoughts and emotions of their circumstances rather than resisting them as they had before.3

If the stress load in a person’s life is too much for the internal and external resources they have available to handle it, then it can overflow, causing anxiety and depression. Studies have shown that as psychological flexibility increases through methods like ACT, parents also tend to use more workable ways to parent their children and enjoy their parent-child connections more.3 Interestingly, even the children with disabilities in the study experienced a decrease in emotional and behavioral problems as the parent’s psychological flexibility increased3, proving the overall benefits on the family of increasing the mother’s health and well-being.

Choice Point

You are at that moment when everything around you is breaking down; the kids are screaming, it's raining outside so you are stuck inside, and the house is a mess.  You feel the anxiety bubbling up, about to spill over onto the little people nearest you.  This is an example of a “choice point2; a point in time when you have the choice to make a “towards” or “away” move from the person you actually want to be.  These can be things you do or things you do not do; physical or mental.  Examples of away moves for someone with a core value of patience could be reacting at the children through yelling, blaming, or mental thoughts like you are a terrible mother, which will only keep you in a negative cycle.  Examples of towards moves for the same person could be taking a moment to ground yourself by washing your hands, doing some breathing, getting some fresh air, or becoming in tune with where the anxiety and overwhelm is in your body and what it feels like.  The video below describes "choice point" in more detail:




A way to ground yourself in the present moment to avoid getting sabotaged by negative thoughts and feelings is to do a mindfulness exercise.  They can vary in length, but even a short few minutes can change the direction of the day.  A few examples are below called "dropping anchor", by Dr. Russ Harris.  



More on Values

Values are defined as “our heart’s deepest desires for how we want to behave, how we want to treat ourselves, other people, and the world around us.  They describe what we want to stand for in life, how we want to act, what sort of person we want to be, what sort of strengths and qualities we want to develop”.2 Three parts make up values, including how you want to act mentally and physically continuing throughout your life, qualities of ongoing action like being supportive or friendly, and ways you desire to be, but aren’t yet.2

ACT isn’t about taking just any steps or actions, it is about basing the next steps moving forward on the person’s core values2, which may need to be discovered.

So how does one figure out what their values are since part of ACT hinges on discovering and defining core values.2

Values are defined as “our heart’s deepest desires for how we want to behave, how we want to treat ourselves, other people, and the world around us.  They describe what we want to stand for in life, how we want to act, what sort of person we want to be, what sort of strengths and qualities we want to develop”.2 Three parts make up values, including how you want to act mentally and physically continuing throughout your life, qualities of ongoing action like being supportive or friendly, and ways you desire to be, but aren’t yet.2

 

Values can change and evolve, and should be re-addressed every so often to make sure you are aware of what is important to you and evaluate if your life is based on your values.  Living a life based on your personal values will bring greater fulfillment and direction as you make choices.2

Values will be as varying from person to person as ice cream flavors and there is never a wrong answer.2

There are helpful links below that can be printed and filled out to explore and narrow down core values.  I personally like to narrow it down to my top five values that I want to live by daily because it is a small enough amount that I can remember them and check in with myself daily if I am making choices to live by those values.  I encourage you to print off at least one worksheet and fill it out to discover your own values.  This is a great first step in creating a more fulfilling life!





Worksheets to print


Value Discovery:

Common Values in 4 Domains - A Checklist.pdf - Google Drive (highly recommend this one)

The Life Compass.pdf

Dare to Lead | List of Values - Brené Brown (brenebrown.com)

40 values checklist - 2021.pdf - Google Drive

_Bull's Eye Worksheet- 2019 version.pdf - Google Drive


In Discovering "towards" and "away" moves:

Problems and Values Worksheet.pdf - Google Drive (highly recommend this one)

Dissecting The Problem - 2019.pdf - Google Drive

The Getting Hooked Worksheet.pdf - Google Drive

HARD Barriers Worksheet - Russ harris.pdf - Google Drive


References

1. Beygi, Z., Tighband Jangali, R., Derakhshan, N., Alidadi, M., Javanbakhsh, F., & Mahboobizadeh, M. (2023). An overview of reviews on the effects of acceptance and commitment therapy (ACT) on depression and anxiety. Iranian Journal of Psychiatry, 18(2), 248–257. https://doi.org/10.18502/ijps.v18i2.12373

2. Harris, R. (2019). Act made simple: An easy-to-read primer on acceptance and commitment therapy. New Harbinger Publications, Inc.

3. Holmberg Bergman, T., Renhorn, E., Berg, B., Lappalainen, P., Ghaderi, A., & Hirvikoski, T. (2022). Acceptance and Commitment Therapy Group intervention for parents of children with disabilities (navigator act): An open feasibility trial. Journal of Autism and Developmental Disorders, 53(5), 1834–1849. https://doi.org/10.1007/s10803-022-05490-6

4. Zhang, Z., Leong Bin Abdullah, M. F., Shari, N. I., & Lu, P. (2022). Acceptance and commitment therapy versus mindfulness-based stress reduction for newly diagnosed head and neck cancer patients: A randomized controlled trial assessing efficacy for positive psychology, depression, anxiety, and quality of life. PLOS ONE, 17(5). https://doi.org/10.1371/journal.pone.0267887

 

Pictures

221,926 Women With Anxiety Images, Stock Photos & Vectors | Shutterstock

act diagram - Bing images

 

Videos

Free Videos | ACT Mindfully

How The mediterranean Diet Improves Your Mood - What The Science Shows - YouTube


Comments

  1. Wow! This is an incredible, centralized collection of helpful information related to anxiety, depression, PTSD, especially for mothers. The explanation of ACT, how you break it down in digestible and relatable ways and the enclosed resources are invaluable. I look forward to applying some of the principles I've learned!

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