I was recently browsing some of the units I completed for my counselling diploma – for revision. The human memory has not evolved to store, organise, categorise and recall all the large amounts of information we collect every day, nor is our memory always accurate. It’s important for counsellors and therapists to keep up to date with new approaches to counselling, and it doesn’t hurt to read over learned materials from college days. I thought I’d provide some learning about Acceptance and Commitment Therapy for readers.
Just to acknowledge the work of others, most of what is written below, I have retrieved and paraphrased from ACCEPTANCE AND COMMITMENT THERAPY Published by: Australian Institute of Professional Counsellors Pty Ltd.
Acceptance and commitment therapy, known as ACT (pronounced as the word ‘act’), is an approach to counselling that was originally developed in the early 1980s by Steven C. Hayes, and became popular in the early 2000’s through Hayes’ collaboration with Kelly G. Wilson, and Kirk Strosahl as well as through the work of Russ Harris. You can look them up on Youtube or Google if you’re interested in what they might have to say about ACT.
“Unlike more traditional cognitive-behaviour therapy (CBT) approaches, ACT does not seek to change the form or frequency of people’s unwanted thoughts and emotions. Rather, the principal goal of ACT is to cultivate psychological flexibility, which refers to the ability to contact the present moment, and based on what the situation affords, to change or persist with behaviour in accordance with one’s personal values. To put it another way, ACT focuses on helping people to live more rewarding lives even in the presence of undesirable thoughts, emotions, and sensations.” (Flaxman, Blackledge & Bond, 2011, p. vii)
ACT interventions tend to focus around two main processes:
Developing acceptance of unwanted private experiences that are outside of personal control.
Commitment and action toward living a valued life (Harris, 2009)
In a nutshell, ACT gets its name from its core ideas of accepting what is outside of your personal control and committing to action that improves and enriches your life.
Cognitive Defusion is the process of learning to detach ourselves from our thought processes and simply observe them for what they are – “transient private events – an ever-changing stream of words, sounds and pictures” (Harris, 2006, p. 6). I think this component of ACT is incredibly beneficial if we practice it daily. I like to say, just like the function of the heart is to pump oxygenated blood around the body, one of the brain’s functions is to have thoughts. We can observe thoughts without taking them to mean more than what they are. Some thoughts are automatic, some are subconscious, and some are unconscious or preconscious beliefs that we consider to be true and factual and “rules” about how the world operates and how we have to operate in it. If someone is defused from their thought processes, these processes do not have control on the person; instead the person is able to simply observe them without getting caught up in them or feel the need to change/control them.
Acceptance is the process of opening oneself up and “making room for unpleasant feelings, sensations, urges, and other private experiences; allowing them to come and go without struggling with them, running from them, or giving them undue attention” (Harris, 2006, p. 7). Practicing acceptance is important because it encourages the individual to develop an ability and willingness to feel uncomfortable without being overwhelmed by it (Flaxman, Blackledge & Bond, 2011). It’s important to acknowledge that to accept something doesn’t mean we like it or have a passive attitude. It is to accept something exactly as it is and then we choose what to do with it. Think of the Serenity Prayer: Grant me the serenity to accept the things I cannot change, courage to change the things I can, and wisdom to know the difference.
Contact with the present moment is the concept of being “psychologically present” and bringing full attention to the “here-and-now” experience (Harris, 2009). I’d also argue that to psychologically present, we must also be aware of our physical body and the sensations within it and outside of it. Because we have the ability to think about the past and about the future, sometimes it can be difficult to stay in the present (Batten, 2011; Harris, 2009). Having contact with the present moment is essential because that it where we find out anchor and power. We have the ability to pay attention in a flexible manner to the present moment and connect with that experience rather than ruminate on past events or future possibilities (Lloyd & Bond, 2015). Some of you might say “What if I can’t stand the present moment?”. True. If you have extreme emotional experiences or have a history of trauma, it may be functional for you to use distraction or talking to someone when the present moment is “too much to take”. What we want to work towards is using healthy coping strategies in the present moment mindfully, instead of behaviours that no longer serve us.
Values, and identifying them, (i.e., what is important to the individual) is a central element of ACT because it assists clients to move in the direction of living and creating a meaningful life. One of the central goals of ACT is to help clients to connect with the things they value most and to travel in “valued directions” (Stoddard & Afari, 2014).
Committed action is the process of taking steps towards one’s values even in the presence of unpleasant thoughts and feelings (Harris, 2009). Behavioural interventions, such as goal setting, exposure, behavioural activation, and skills training, are generally used to create committed action. The ACT model acknowledges that learning is not enough, one must also take action to create change.
Self-as-context, or what I prefer to call “the observing self” or simply just our self-awareness, creates a distinction between the ‘thinking self’ and the ‘observing self’ (Harris, 2009). The thinking self refers to the self that generates thoughts, beliefs, memories, judgments, fantasies, and plans, whereas the observing self is the self that is aware of what we think, feel, sense, or do (Harris, 2009). “From this perspective, you are not your thoughts and feelings; rather, you are the context or arena in which they unfold” (Stoddard & Afari, 2014). Being aware of the observing self allows an individual to have a greater ability to be mindful and in the present moment, as they can separate themselves from the thoughts, beliefs, and memories they have.
Identify your stressors or potential stressors. Sometimes, “stress” is frustration or fear in disguise.
Plan ahead
Decision making and problem solving
Accept what we cannot change
Changing how we see stressful situations
We may not be able to change our circumstances, but we can see them differently (Forsyth & Eifert, 2016). For example, stress can be viewed as an experience that will support our learning, growth, and personal development.
Technique: Accept – Choose – Take action
Acceptance and Commitment Therapy (ACT) has proven valuable for people learning to manage anxiety and stress; it encourages:
Letting go of the struggles that keep them stuck
Cultivating peace of mind
Accepting what is, and doing what works
Rather than struggle to reduce stress and anxiety, we:
a. accept what we are already experiencing and then
b. choose the direction we would like our life to take, and then
c. take action that reflects are values
Technique: Radical acceptance
Radical acceptance is often practiced within Dialectical Behaviour Therapy (DBT). Radical acceptance is based on the notion that suffering does not come directly from painful experiences but our attachment to them. For example, workplace stress may be more about your identity and status in the workplace rather than the stress itself.
Radical acceptance means fully accepting everything that you are experiencing in the present moment i.e., thoughts, feelings, emotions, body sensations, reactions, attitude, environment etc. We fully accept the present moment because what we resist persists. The more we deny reality the more painful (or unpleasant) we will perceive it to be. Radical acceptance is about saying “yes” to exactly what is happening for us in the moment.
Radical acceptance is about accepting life on life’s terms and not resisting what one cannot or chooses not to change.
Accepting doesn’t mean agreeing. It’s simply exhausting to fight reality, and it doesn’t work.
Resisting reality delays healing and adds suffering to one’s pain.
Technique: Challenging core beliefs
Our core beliefs can shape how we face up to the difficult times and how we react to stress (Beck, 2011) and reconstructing them in a balanced way that allows room for perceived shortcomings.
Humans subconsciously “look for” evidence to support their core beliefs about themselves and the world.
You may have to take mental control to actively on-purpose look for evidence to the contrary.
Technique: Acceptance of our thoughts and feelings
The goal of ACT is to accept what lies beyond our control and commit to life-enhancing actions instead.
There are six core processes in ACT:
1. Contact with the Present Moment
Conscious awareness of your experience in the present moment enables you to perceive accurately what is happening Gives you important information about whether to change or persist in behaviour Enables you to ‘catch’ cognitive fusion ‘in flight’ Allows you to engage fully in what you are doing.
2. Acceptance
Actively contacting psychological experiences directly, fully, and without needless defense Definition: defused, open, undefended contact with the present moment, as a fully conscious human being.
‘Opening yourself fully to experience, as it is, not as your mind says it is’.
3. Defusion
Looking at thoughts, rather than from thoughts Noticing thoughts, rather than being caught up in thoughts Seeing thoughts as what they are, not as what they seem to be Aim of Defusion is NOT to feel better, nor to get rid of unwanted thoughts Aim of Defusion IS to reduce influence of unhelpful cognitive processes upon behaviour; to facilitate being psychologically present & engaged in experience; to facilitate awareness of language processes, in order to enhance psychological flexibility.
4. Self-as-context or The Observing Self:
Observe and accept all changing experiences.
How rigid is your thinking? Allow for psychological flexibility. Think in new ways. Consider other perspectives. Ask people for their perspective.
It is a process, not a thing: an awareness of awareness itself: ‘pure awareness’.
It is that aspect of a human being that does all the noticing/observing of one’s inner and outer world. You could call this “meta-awareness” or “pure awareness” if you prefer: it’s the awareness of one’s awareness, or the noticing of one’s noticing, or the consciousness of one’s consciousness.
5. Values
Chosen life directions ‘Your heart’s deepest desires for the sort of person you want to be and the things you want to do in your time on this planet; in other words, what you want to stand for in life’ Provide motivation & inspiration Provide guidance for your actions Give life meaning Give a sense of abundance Are different to goals 6.Committed Action Overt behaviour in the service of values (may require skills training) Committed action is: values-guided, effective & mindful
Technique: Meditation for acceptance
Meditation is a powerful tool for accepting stressful situations and difficult emotions. Bring your attention, non-judgementally, to your mind, body, and environment. Here are some alternative definitions:
“Bringing one’s complete attention to the present experience on a moment-to-moment basis.” (Marlatt & Kristeller)
“Paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally” (Kabat-Zinn).
“The nonjudgmental observation of the ongoing stream of internal and external stimuli as they arise.” (Baer)
“Awareness of present experience with acceptance.” (Germer, Segal, Fulton)
“Consciously bringing awareness to your here-and-now experience, with openness, interest, and receptiveness.”
Allow everything to be just as it is. Do the following to start for 2 minutes, 5 minutes, 10 minutes, or as long as you like, whenever you like:
1. Take a seat. Find place to sit that feels calm and quiet to you.
2. Set a time limit.
3. Notice your body.
4. Feel your breath.
5. Notice when your mind has wandered.
6. Be kind to your wandering mind.
7. Close with kindness.
Technique: Grounding and centering
5-4-3-2-1 Technique
Using the 5-4-3-2-1 technique, you will purposefully take in the details of your surroundings using each of your senses. Strive to notice small details that your mind would usually tune out, such as distant sounds, or the texture of an ordinary object.
Vision
What are 5 things you can see? Look for small details such as a pattern on the ceiling, the way light reflects off a surface, or an object you never noticed.
Touch
What are 4 things you can feel? Notice the sensation of clothing on your body, the sun on your skin, or the feeling of the chair you are sitting in. Pick up an object and examine its weight, texture, and other physical qualities.
Sound
What are 3 things you can hear? Pay special attention to the sounds your mind has tuned out, such as a ticking clock, distant traffic, or trees blowing in the wind.
Smell
What are 2 things you can smell? Try to notice smells in the air around you, like an air freshener or freshly mowed grass. You may also look around for something that has a scent, such as a flower or an unlit candle.
Taste
What is 1 thing you can taste? Carry gum, candy, or small snacks for this step. Pop one in your mouth and focus your attention closely on the flavours.
Naming categories
Choose a category (e.g., colours, shapes, textures), then look around the room and name all of the things you can see in that category.
Cold water
Have a few slow sips of cold water, feeling the sensation of the cold water in your mouth and notice the sensation as you swallow.
Washing your face with cold water can also reduce your heart rate and lower stress levels.
Counting
Count backwards from 20. You can do this as many times as you need to. Say to yourself that you are becoming calming as you count down each number.
Notice your breath
Take a deep breath and as you exhale, imagine breathing out strongly through the soles of your feet. Feel the connection of your feet with the floor. Do this three times.
2. Behaviours that can protect our vulnerability to stressful situations
It is essential to consider what skills and tips we can use to manage stress and ultimately improve our wellbeing inside and outside work:
Exercise i.e., running, swimming, resistance training, aerobics etc.
Eating healthy foods
Avoiding alcohol and other drugs
Recommended sleep at the recommended times i.e., 8 hours during the night hours.
See your GP if you are experiencing physical or psychiatric illness
Spend time with family and friends
Engage in a hobby or create a hobby
Meditation, yoga, group exercise, group mindfulness classes
Listening to music
Setting a time to watch tv and having boundaries re length of time watching tv
Read a book
Self-care tips
Life, and particularly work, can be stressful. Self-care is essential to keep us functioning well and improving our overall wellbeing (Bush, 2015).
The following aspects of our health are vital to our wellbeing and crucial for managing stress better. Ask yourself the following questions when your intuition tells you that you may be in a deficit:
Without sleep, we cannot think clearly – are you getting sufficient sleep?
Exercise is one of the best cures for stress – are you prioritizing physical activity?
Our brain is maintained by the food we eat – are you eating a balanced and varied diet?
Healthy relationships are vital for our wellbeing – are you making time for the people you care about?
Self-expression enriches who we are and how we live – are you giving the focus you would like to the things you are passionate about?
Community and spirituality ground who we are and how we live – how can you make yourself more open to both?
Managing stress in the workplace
Stress is a significant factor in many workplaces, resulting in countless hours lost due to time off or non-productive hours. We may think the responsibility is on workplaces to create environments that reduce stress and help workplace stress, but it’s also very much an individual responsibility.
Putting in place each of the following will help (modified from HBR guide to beating burnout, 2021):
Increase psychological safety Trust and collaboration will reduce the perception that the workplace is a threat.
Build regular break times We cannot focus for beyond 120 minutes without appropriate rest breaks. Build them into the day and encourage people to use them.
Encourage the use of private workspaces Open offices often have many distractions that can frustrate staff when unable to concentrate. Supply private workplaces where staff can focus without interruption.
Set boundaries around time outside of work The borders between work and personal life are often blurred, especially if working remotely. Set clear expectations and stick to them.
Create flexible work policies Juggling work and family life is not easy. Flexibility can remove or reduce that stress without feelings of guilt.
Make sure people are in the right roles When staff are doing jobs they enjoy and are well supported they thrive and take challenges in their stride.
Encourage autonomy Micromanaging is stressful for everyone. Give teams the autonomy to manage their own projects and staff their individual tasks.
3. Further Stress Relief Activities
Positive emotions such as joy, awe, hope, and optimism are essential to living the good life and are known stress relief techniques. They strengthen our psychological resources for overcoming tough, stressful times (Seligman, 2011).
Boosting positive emotions
Practice gratitude. A helpful way to practice gratitude is to think of everything you have in life and imagine if something was taken away.
Spent time with people who you love.
Do something kind for someone else.
Spend time in nature.
Take a break from screens (tv, mobiles, computers).
Take a break from listening to the news.
Take a work holiday.
Laugh more – find something to laugh about and share it with someone. How often are you laughing?
Build hope
Hope is a positive, optimistic frame of mind in which we expect good events and scenarios to occur. The ability to remain hopeful can help you bounce back more effectively from life’s difficulties when they crop up (Seligman, 2011).
Improving self-awareness
Mindful reflection can leave us grounded and better aware of ourselves and our situation. The Who am I without this stress? exercise helps us focus on what is “right” with us rather than what is “wrong”.
Once centred by our breathing, ask yourself to consider:
What do I value most in life? Are my current stressors more important than what’s most important? What do I enjoy doing? What do I look forward to every day? When do I feel at my best?
Change the way you talk to yourself
When we are stressed, we sometimes say negative or self-defeating things to ourselves. Unhelpful self-talk might include things like, “I can’t cope”, “I’m too busy to deal with all this”, “This is all their fault”, or “I’ll never get this done”. Negative self-talk can make it more difficult to manage stress.
Notice your self-talk and work on using helpful, soothing, and calming self-talk, such as, “I am coping well given what I have on my plate”, “Relax, this stressful time will pass”, or “This is a stressful situation, but what is one thing I can do to help me get through this?”
Ask yourself:
Am I overestimating the likelihood of a negative outcome?
Am I overestimating how bad the consequences will be?
Occupation-linked deaths often relate to environmental exposures, physical risks, or psychological stressors.
Conclusion:
Across almost all demographics, heart disease remains the leading cause of death, followed by cancer, stroke, and—in certain populations—accidents, suicide, or infectious diseases. However, the underlying causes (social, economic, political) differ significantly based on identity, geography, and profession.
Would you like this formatted into a chart, infographic, or specific to a country or report you’re working on?
I would infer that you may be depleted in some area of your life. Generally, when I am having any of these experiences I can recognise that my basic needs, and possibly even transformative, needs are not met. My basic needs are food and water, adequate sleep, shelter and safety, social connection (belonging), and esteem needs (e.g., self-respect, self-worth, self-competence, mastery and achievement, integrity, sense of freedom and independence etc.). Perhaps only when all my deficiency needs are met, and I’m experiencing dissatisfaction with my growth needs, do I feel Restless, Irritable, and Discontent in this area of my life – however I assume some would argue that if I am feeling that way when attending to my growth needs, then I may have slipped back to Esteem Needs. You can look up Maslow’s Hierarchy of Needs for a visual representation if you like, using a search engine. Below is a GIF that I created to educate people on how we can buffer ourselves to vulnerabilities. It’s very telling to go into the body when we haven’t eat for a while, may be we’re running on caffeine, and you can feel the restlessness in the body. We have to fuel up when we’re hungry to buffer ourselves from becoming irritable and restless. If you’re feeling discontent with life, I would suggest a social activity, play time with friends, working on a project of some kind, or getting involved in your community.
