A brief introduction to Acceptance and Commitment Therapy
I started my career steeped in behaviourism. The idea is that if we can alter our own and others’ behaviour, transformation, personal growth, quality of life, and happiness are inevitably possible. It is that simple, shape behaviours, and we can solve a problem.
Behaviourisms and Watson
This is reinforced by the famous quote by John B. Watson, the founder of Behaviourism.
This is reinforced by the famous quote by John B. Watson, the founder of Behaviourism.
“Give me a dozen healthy infants, well-formed, and my own specific world to bring them up in and I’ll guarantee to take any one at random and train him to become any type of specialist I might select, doctor, lawyer, artist, merchant-chief and, yes even begger-man and thief, regardless of his talents, penchants, tendencies, abilities, vocations and race of his ancestors”
When I started working with autistic children early in my career, behaviour modification was the default treatment plan. It is embedded in theories of behaviourism, many of you may be familiar with classical conditioning (Pavlov’s dogs), operant conditioning (Skinner’s pigeons) and social learning theory (Bandura’s Bobo Doll). Each of these theories affects the world around us, the decisions we make, and the ones we do not make.
Let me use classical conditioning and Pavlov’s salivating dogs to illustrate how this works and how it might apply to your life. Theories of classical conditioning pair an unconditioned stimulus (the smell of food) with a conditioned stimulus (the sound of a bell). The food elicits an unconditioned response (salivation), but once the bell (or, in my dog’s case, the sound of kibble being poured into the bowl) is paired with it, a conditioned response is produced. Just ringing the bell or shaking the food in the bowl causes the dog to salivate or come running (in my dog’s case).
Let me now share a poignant but frustrating example of grocery shopping with my daughter when she was in elementary school. Walking down the cereal aisle was the worst. My daughter would point to a box of cereal with Disney characters on it. “Mummy, can we get that? I love that kind.” My daughter had paired her love of Disney characters with her desire for the cereal she had never tasted, but in her mind, based on the stimulus she valued, Disney, the two were not mutually exclusive. This type of marketing is used to shape our purchasing behaviour.
Cognitive Behavioural Therapy CBT
Cognitive behavioural theory (CBT) grew out of behaviourist theories. Similar to the example above, CBT assumes that repeating and reframing thoughts can influence behaviour. For instance, the ABC (Activating event, Belief, and Consequences) worksheet is a core aspect of many CBT treatment plans. How we think undoubtedly shapes how we behave and needs to be part of the therapeutic process. However, in my experience ,CBT misses the mark in several key areas.
First, it misses the importance of the relationship. The relationship you create with your child, dog (for dog training), partner, or therapist is the catalyst for change. Although the gold star may reinforce the behaviour, it does not sustain the behaviour. The relationship that underpins these actions is the leverage point for long-term change. What troubles me about the widespread use of CBT is its limited focus on the underlying emotions that drive behaviour such as anxiety, depression, and addiction.
Acceptance and Commitment Therapy (ACT)
This is why I obtained a certificate from the Acceptance and Commitment Therapy (ACT) immersion online training. Although ACT acknowledges the importance of behavioural theories, it extends beyond traditional approaches to develop what ACT calls “psychological flexibility”. ACT, developed by Steven Hayes, provides a well-researched framework, grounded in Relational Frame Theory (RFT), to help you address emotional distress.
Functional Contextualism is the philosophical underpinning of both RFT and ACT. I often use the image of an onion to illustrate how personal growth helps us peel away layers.
Functional contextualism helps you focus on an area of distress and what you are trying to accomplish. It invites other ways of knowing into the equation to achieve the desired outcome. It avoids big “T” truths but instead explores how to expand our psychological flexibility. Functional contextualism helps us understand our emotions, feelings, and behaviours in the context of our environment, personal history, and current situation.
What I love the most about this approach is how it articulates core human yearnings and links them to the process of growth and change.
Distress in these areas occurs when our human yearnings are mishandled. ACT helps us accept what is. ACT does not try to eliminate unwanted thoughts or feelings. It uses techniques such as cognitive defusion and acceptance to gain a deeper understanding of the context in which thoughts and feelings arise.
The goal is to understand what works in practice within the context of Rational Emotive Behaviour Therapy (REBT) and Acceptance and Commitment Therapy (ACT).
I am going to walk you through an exercise to help you gain a deeper understanding of how this might work. It is my hope that you begin to understand the importance of psychological flexibility.
I want you to start by thinking about something that you find distressing.
Question 1:
What is the core yearning that you are trying to fulfill?
Let us use the example of belonging
Belonging is a core human need and is linked to levels of happiness and other good mental health outcomes, but at times, our desire for belonging is misplaced.
The result is aloneness and alienation.
We avoid authenticity and hide behind various masks, believing they will increase our sense of belonging.
You say yes when we really mean no to avoid alienation.
We believe we will only belong when we earn a place in the group.
This leads to small results in the short term, but decreases the long-term potential for belonging.
Many people try to get along with everyone, believing this will lead to greater happiness. As we adapt and mould ourselves to others, it is often at the expense of our own authenticity.
This is the source of pain. The pain is the absence of belonging.
What we need to do is pivot from this place. To become an observer of the self to increase our sense of awareness.
Here we enter a process of “Defusion,” the ability to separate our thoughts from the present moment.
“How do you feel when you try to get along with everyone?”
I am not suggesting that you are not pleasant and respectful toward those in your community. I am inviting you to examine this idea of trying to get along with everyone.
Acceptance and Commitment Therapy helps us learn to accept what is; it helps us shift from avoiding positive or negative emotions to emotional flexibility.
Psychological Flexibility is created by drawing on the different components of ACT’s Hexaflex model.
Each of these helps us reflect on our Human Yearning. By reflecting on ACT’s six areas of the Hexaflex, we increase our psychological flexibility and work towards greater alignment with our values and authentic self. This is where happiness and joy are experienced.
Thank you for your time. Please let me know if you have any questions. It is a complicated approach with many different concepts. If you want to expand your learning in this area, there are many great resources online. You can also take a course, as I did with Steven Hayes.
If you would like to learn more about my practice and approach as a psychotherapist, please click here.
