Acceptance and Commitment Therapy: Develop a New Relationship with your Thoughts

by Dr Gordon Wong, Specialist in Psychiatry

MBBS (HK), MRCPsych, FHKCPsych, FHKAM (Psychiatry), MSocSc (Couns)(South Australia), DCPsyc RCP&S (Irel), DFM (HKCFP), Dip Med (CUHK), PGDipClinDerm (QMUL)

Acceptance and Commitment Therapy is one of the so called “third wave” psychotherapy, meaning it is newer and uses a fresh perspective to achieve therapeutic goals. It is defined by its founders as “a therapeutic approach that uses acceptance and mindfulness processes, and commitment and behavior change processes, to produce greater psychological flexibility”.

Acceptance and Commitment Therapy, abbreviated to ACT (and it is pronounced as 'act'), is a collection of skills that I find very useful. As the title suggests, its main goal is to accept what is beyond our control, and commit to taking action that enriches our life. There are six core processes in Acceptance and Commitment Therapy. They are cognitive defusion, acceptance, mindfulness, the observing self, values clarification and committing to action. I would like to go through these skills briefly in this article.

Cognitive defusion means that we see what thoughts as they really are. People often think that all thoughts must be true, and cognitive defusion is to learn to have another relationship with thoughts. We try to look at thoughts, rather than from thoughts. We notice thoughts, rather than getting caught up in thoughts. It means that the contents of the thoughts are still there, but we don't struggle with them.

Acceptance is an active embrace of the present moment with openness. It is not toleration or giving up. Acceptance allows us to stand back and choose the best course of action to take.

Mindfulness is the ongoing, intentional and non judgmental contact with the here and now. This is a great skill to learn, as it allows us to focus on the now, instead of dwelling on the past or worrying about the future.

The observing self of the part of you that you are aware of being aware. It is the part of you that sees everything changing, and yet this part of you never changes. It is a safe place for people to let go of their attached thoughts and self concepts.

Values clarification is to find out what qualities in life truly matters to you, and live your life according to these values. These values will act as a beacon of light from a lighthouse, guiding you to be on the right path for the rest of your life.

Last but not least, committed action is an important catalyst to change. Select a value that is important to you, and then set a specific measurable goal that will get you closer to this value. Create a plan and commit to taking action towards your goal. Then pick another goal when your goal is achieved.

I find Acceptance and Commitment Therapy very useful. It relieves anxiety, depression, stress, suffering and psychological pain. It is a positive psychotherapy in the sense that it does not tell you that you are thinking wrong. Instead, it helps people to create a new relationship with their painful experiences. Pain is inevitable in life, but suffering isn't. It is also a set of skills that can be applied pervasively in many aspects of life. Indeed, it can be used on healthy individuals as well, for optimising the mind and enhancing mental performance.