There’s a common idea that the goal of therapy is to manage difficult emotions: to make them smaller, or even go away completely.
But what if the goal was actually to accept these emotions as part of life?
That’s the philosophy behind Acceptance and Commitment Therapy, an off-shoot of CBT that’s all about acceptance, values, and psychological flexibility.
Read our guide to find out more about what Acceptance and Commitment Therapy is, how it works, and what makes it a helpful type of therapy for LGBTQ+ people.
What is Acceptance and Commitment Therapy (ACT)?
Acceptance and Commitment Therapy, or ACT, is a style of therapy that was developed from Cognitive Behavioural Therapy, or CBT.
CBT focuses on identifying and changing unhelpful thoughts and behaviours.
But in ACT, the emphasis is on accepting difficult feelings: instead of fighting them, you see them as part of being human, and part of your journey.
Along with accepting your emotions, ACT teaches ways to gently detach from overwhelming, distressing thoughts and feelings.
Rather than being led by feelings, ACT therapists encourage you to be led by your values. When we identify what matters most to us, we gain an internal compass that can guide us through the toughest terrain.
What does ACT stand for?
ACT stands for Acceptance and Commitment Therapy:
- Acceptance is all about embracing things that are painful or difficult, rather than trying to deny or fight them.
- Commitment refers to identifying your values – what you’re most committed to in life – and taking action that aligns with them.
What is psychological flexibility in ACT?
Psychological flexibility is a key idea in ACT – you could even see it as the goal of Acceptance and Commitment Therapy.
Psychological flexibility means being able to be open to the present moment, even if that present moment feels difficult, and to adapt to changing situations without abandoning your core values.
A person who is psychologically flexible can:
- Adapt to changing situations,
- Be open to changing their perspective, and
- Balance different competing needs, feelings, and parts of life.
Those with psychological flexibility can do all this while being authentic to themselves and what matters most to them.
Basically, this means that a healthy person isn’t someone who never feels down. It’s someone who can cope with, and adjust to, life’s ups and downs.
History of Acceptance and Commitment Therapy (ACT)
ACT was developed in the 1980s by psychologist Steven C. Hayes.
Hayes himself was diagnosed with a panic disorder as a young man. It was from his own struggle with anxiety and panic that he came up with the core principles of ACT.
In Psychology Today, Hayes wrote: "We as a culture seem to be dedicated to the idea that ‘negative’ human emotions need to be fixed, managed, or changed – not experienced as part of a whole life… Acceptance, mindfulness, and values are key psychological tools needed for that transformative shift."
Hayes developed ACT from CBT – it’s also a type of behavioural therapy, meaning that it addresses the way you behave.
But Hayes wasn’t a fan of CBT’s focus on reducing symptoms, so he also folded the ideas of acceptance and mindfulness into his approach.
While CBT focuses on restructuring unhelpful thoughts, ACT is all about meeting thoughts and feelings without judgement.
Principles of Acceptance and Commitment Therapy (ACT)
There are six core processes at the heart of ACT: cognitive defusion, acceptance, being present, self as context, values, and committed action.
Each of these important principles makes up a point on the ACT Hexaflex: a six-sided hexagon shape that represents the whole process of ACT.
At the centre of the Hexaflex is psychological flexibility. The idea is that these six components are the building blocks of a healthy, flexible mind.
Here’s a little more about each one, in no particular order.
Cognitive Defusion
“Cognitive” refers to thinking, and “defusion” means separating, or un-fusing.
So, cognitive defusion is all about learning to separate yourself from your thoughts.
Defusion allows us to make a powerful perspective shift: our thoughts don’t rule us, and they don’t shape reality. In fact, we are the ones having the thoughts, and we can choose to listen to them or not.
ACT therapists might encourage cognitive defusion using techniques like the “leaves on a stream” visualisation, in which you picture your thoughts passing by like – you guessed it – leaves on a stream. (Give it a try with Voda.)
Acceptance
The principle of acceptance is crucial to ACT – it’s right there in the name.
Acceptance doesn’t mean being overjoyed about what’s happening. But you accept it, without denial or judgement.
It’s worth being clear about what acceptance does and doesn’t mean here: ACT asks us to make peace with our difficult emotions. It does not ask us to accept unfairness, discrimination, or a world that treats you badly.
When we practice acceptance in therapy, we do so by noticing and sitting with the painful or uncomfortable emotions that are present. We don’t push them away, try to change them, or minimise them: we just let them be.
Being Present
ACT is very focused on the present moment.
By paying close attention to the here-and-now, we can avoid becoming overwhelmed by worries about the future or troubling memories from the past.
ACT therapists might use mindfulness techniques to support you to root yourself in the present.
Self as Context
ACT encourages you to build the idea of self as context – you are not your experiences, thoughts, or emotions. You are the self that connects them all.
This is also sometimes referred to as the “observing self”.
ACT therapists can support you to build a sense of yourself as a mindful observer, taking in what happens to you and what you feel, rather than being taken over by it.
Values
Values are a cornerstone of ACT: in order to live a committed, purposeful life, we have to know what matters most to us.
Values are not like tasks or goals you can cross off a list.
They’re a set of principles or beliefs that guide your decisions and actions in all parts of life.
For example, some of your core values might include: compassion, authenticity, justice, community, or knowledge.
An ACT therapist can support you to figure out what your own core values are.
Committed Action
Finally, committed action is the process of making those values a reality.
When we act with commitment, we take confident steps towards living a life that aligns with our values.
It might not always feel easy or comfortable. But committed action takes us closer to who we want to be, and how we want to show up in the world.
What Acceptance and Commitment Therapy (ACT) can help with
Acceptance and Commitment Therapy (ACT) originated from Hayes’ own experience of panic attacks, and to this day, it’s still a renowned treatment for anxiety and panic.
But it can also be helpful for people experiencing a wide range of problems, including:
- Depression, stress, and low mood.
- Addictive behaviours and disordered eating.
- Obsessive compulsive disorder (OCD).
- Psychosis.
- Chronic pain or illness.
- Processing difficult past experiences.
There are a few situations where ACT may not be recommended:
- Severe cognitive impairments or acute psychosis – this could make it difficult to engage with techniques like cognitive defusion and mindfulness.
- Immediate safety risks – the priority should be making sure that you’re safe before you work on accepting your situation and your feelings.
You might also find that ACT just isn’t quite right for you. That’s okay – therapy is personal, and one size doesn’t fit all.
Acceptance and Commitment Therapy for LGBTQ+ people
Like all LGBTQ-affirmative therapy, ACT for LGBTQ+ people should acknowledge the impact of minority stress: that’s stigma, discrimination, and other social barriers that queer and trans people face.
ACT can be a particularly good fit for LGBTQ+ people because:
- It’s all about living by your values. Not society’s values, your family’s values, or anyone else’s values – but yours alone. ACT is about living a life that matters to you, and that might be a life that ventures outside of the norm.
- Cognitive defusion can help with internalised homophobia and/or transphobia. Living in a heteronormative and cisnormative society, it’s easy to absorb some harmful beliefs. When we separate ourselves from our thoughts, we can begin to notice which ones are not our own.
- Building psychological flexibility has been shown to help LGBTQ+ people. Studies have found that queer and trans people with psychological flexibility show improved overall wellbeing and life satisfaction.
If you’re part of the community and looking for an ACT therapist to support you, it’s a good idea to check that they’re LGBTQ-affirmative, too.
Find out more about LGBTQ-affirmative therapy.
Try LGBTQ-affirmative ACT techniques with Voda
Voda is the LGBTQ-affirming mental wellbeing app that's built by us, for us.
If you’re interested in trying out queer-affirming self-care practices informed by ACT, our app has plenty to choose from.
Learn self-led techniques for defusing yourself from negative thoughts, practicing mindfulness, and identifying your values: all through a queer lens.
