Acceptance and Commitment Therapy
How many of us have struggled with anxiety or depression?
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.1 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.2
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 point”2; 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:
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)
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
Videos
How The
mediterranean Diet Improves Your Mood - What The Science Shows - YouTube
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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