I was first introduced to Acceptance and Commitment Therapy (or ACT for short) in a group setting. There were a dozen or so highly anxious individuals (myself included) trying to avoid eye contact with each other and the group facilitator. When the facilitator asked what we knew about ACT, we kept our eyes fixed on the ground and our mouths shut.
Being well accustomed to awkward silences, the facilitator pushed on. She said, 'I'm guessing you're all here because you've struggled with your mental health in the past'. Then she asked, 'What have you done in the past to try and cope with difficult thoughts and feelings?' Everyone's eyes slowly lifted and the room became animated; we all wanted to speak at once. We weren't strangers to struggling with our thoughts and emotions. That was precisely what had brought us here together, in this moment.
The answers to the facilitators question were varied yet comprehensive. About a third of group members referenced drugs or alcohol as their go-to coping strategy. Some would restrict their eating (or barely eat at all), while others would binge and purge. Some threw themselves into their work, leaving little time for family. Some would cut. Others would shop. We could all talk, at length, about how we had tried to rid ourselves of the emotional pain we were experiencing. Not everything mentioned was what would be considered "unhealthy". Group members spoke of repeating positive affirmations until they were blue in the face, or spending a small fortune on vitamins and supplements.
What all these coping strategies had in common is that they were an attempt to mask, distract from, push down or change our negative thoughts and emotions. They were an attempt to take back control of our emotions, at a time when we felt completely and utterly overwhelmed and out of control.
The facilitator then posed another question. 'Look back on all those things you have tried to help yourself feel better. Did they get rid of your negative thoughts and feelings?'. The group members' gazes returned to the ground. In a collective silence, we reflected on the time, energy, and, in some cases, money we had spent trying to make ourselves feel better, using strategies that simply did not work. Not in the long term at least.
The facilitator deserved a round of applause, as she had found a very effective way to introduce ACT's alternative approach to emotional suffering. Many of the group members (myself included) had already been exposed to Cognitive Behavioural Therapy, or CBT for short. The overarching principle of CBT is that our thoughts affect our feelings, which, in turn, affect our behaviour. The "cognitive" component of CBT involves challenging negative thoughts and replacing them with more balanced, neutral thoughts, whereas the 'behavioural' component involves increasing our engagement in pleasurable and meaningful activities. In other words, CBT aims to change negative thoughts, feelings and behaviour.
The approach taken by ACT is entirely different. According to ACT guru, Russ Harris, "The aim of ACT is to help you live a rich, full and meaningful life, while effectively handling the pain that inevitably comes your way". ACT recognises that painful thoughts, feelings and events are an inevitable part of life - part of which makes us humans! Unlike CBT, which teaches people to challenge negative thoughts, ACT teaches people to see thoughts for what they are – thoughts – instead of objective truths that must be believed and acted upon. ACT teaches people to engage with the present moment, and to sit with unpleasant feelings, rather than to avoid, distract or push them away.
'Why would I want to sit with uncomfortable thoughts and feelings?' you may ask. 'The whole reason I'm in therapy is to get rid of them!' ACT acknowledges that pain is a natural part of life, and that living a rich and meaningful life involves embracing the bad with the good. According to ACT:
Pain + non-acceptance = suffering
In other words, by struggling against painful thoughts and feelings, we inadvertently cause ourselves to suffer more. In contrast, when we accept the pain that inevitably comes along with the human experience and drop the struggle, we no longer suffer.
The Quicksand Metaphor illustrates the struggle we often find ourselves in by not accepting our experience. Imagine that you are stuck in quicksand: Your body is beginning to sink, and, with that, your anxiety is building. Understandably, every inch of your body is screaming at you to try to scramble your way out of there…. However, when it comes to quicksand that is the worst possible thing you can do: struggling to get out will only lead you to be swallowed up by the sand sooner! The safest and surest way to get out of quicksand is to float your way out, by gently leaning backwards until you are floating on your back and your legs are freed.
After we, as a group, had collectively answered the two questions posed by the facilitator, there was a shift in the atmosphere in the room. For myself, I realised that throughout the years I had been bending over backwards trying to escape my reality, whether it be by avoiding, distracting or dampening painful thoughts and feelings with a few glasses of wine. What's worse, I realised, is that none of these strategies had worked in the long term, with many of them only leading to an entirely new set of problems.
Running away from my reality had not helped me to escape it; it only made me tired. Struggling against my reality was exhausting, and left little time or energy for me to engage with the people and things that truly mattered to me. By struggling to close myself off from the pain in my life, I had also inadvertently closed myself off from the parts of life that I cherished the most.
After that first day of ACT, my mind had opened to a completely new way of looking at painful thoughts and feelings. I won't lie; I was feeling nervous about the prospect of being vulnerable and leaning into my emotional pain. However, I was also excited: I was beginning to see that emotional avoidance certainly wasn't the key to a better life.
To find out more about ACT, get mental health support from one of our peer workers, contact LETSS on 1800 013 755 or via webchat at www.letss.org.au
(Image from Unsplash by Kristina_Wagner)