Acceptance and commitment therapy (ACT) is a treatment that combines acceptance therapy with mindfulness. The goal of this approach is to help clients better accept unpleasant feelings without having to act out because of them. ACT differs from other approaches such as cognitive behavioural therapy in that the goal is not to teach people how to control their thoughts and emotions but instead to learn how to accept them. Emotional triggers are one of the most common reasons why individuals relapse after a period of sobriety, so ACT can be an effective path for strengthening recovery.
How ACT Works
One of the core principles of ACT is that you need to learn how to accept what is out of your control and to commit to taking actions that will improve your life. There are always going to be ups and downs as part of human existence, so it is not realistic to expect everything will go easy on you just because you have become sober. It is possible to break down the ACT approach into two main activities:
- developing psychological tools that you can then use to combat unpleasant feelings and thoughts – the primary tool here is mindfulness
- reflecting on the things that give your life purpose so that you can clarify what is important and meaningful for you (i.e. get your priorities right).
Another central idea to ACT is that most problems people end up dealing with are due to a number factors known by the acronym FEAR:
- Fusion with thoughts (stickiness between your thoughts and your behaviour)
- Evaluation of experience (for example, interpreting experiences in a negative way)
- Avoidance of certain experiences
- Reason given for certain behaviours.
Mindfulness is at the heart of ACT. Mindfulness practice is incredibly popular at the moment, but it is neither new nor a fad. Mindfulness is actually part of the human condition and in any one moment, you are either mindful or mindless. The benefit of being mindful is that it means you are not acting on autopilot, giving you the ability to look at your life in a more objective way. By learning to live in the present moment, you will be able to find everything you need to be happy and contented. One way to describe mindfulness would be to say that it involves deliberately focusing on the present moment in a non-judgemental way.
Mindfulness is closely linked with Buddhism – it is not that the Buddhists invented mindfulness, but that they have emphasised its importance and created practices for developing it. The clinical benefits of mindfulness have been researched since the seventies, and there is now no doubt that it can help in many different conditions. Therapies such as ACT are an attempt to remove mindfulness from any religious trappings and to use it as an evidence-based treatment.
ACT uses a specific description of mindfulness where it contains the following three features:
- defusion means letting go of unhelpful thoughts, beliefs, and memories
- acceptance is all about accepting the unpleasant thoughts and feelings that will just come and go as long as you don’t struggle with them
- contact with the present moment.
How ACT Can Help People in Recovery
The key to a strong sobriety is for you to feel comfortable in your own skin. This means that you find a way to be able to deal with unpleasant thoughts and emotions. ACT is a technique that can give you this ability. There are also other mindfulness approaches suitable for other types of problems in sobriety – for example, mindfulness-based cognitive therapy for anxiety and depression, and mindfulness-based relapse prevention for dealing with cravings and relapse triggers.