Acceptance and Commitment Therapy

As practiced at PCH, acceptance and commitment therapy (ACT, pronounced “act”) empowers clients to develop the psychological flexibility to simply encounter the thoughts, feelings, memories, sensations, and urges that are challenging for them. Instead of those unpleasant experiences dictating how someone acts, the goal of ACT is to give clients the tools and skills to choose how they want to respond based on their values and how they want to live their life.

Does Acceptance and Commitment Therapy Work?

Yes, acceptance and commitment therapy works exceptionally well, particularly for our clients at PCH. For treating mental health issues like obsessive-compulsive disorder (OCD), we find that ACT serves as a more beneficial psychological treatment modality than cognitive-behavioral therapy (CBT), which has been the predominant treatment option for OCD for more than 50 years. Our success rate is higher with ACT because we change the goal from eliminating certain thoughts to instead learning to accept the thoughts so they don’t interfere with life satisfaction or fulfillment.

When depression becomes so severe that a person is having thoughts of self-harm or suicidality, PCH Treatment Center is able to help. In our milieu, we can handle clients with thoughts of self-harm who are willing to agree to our programming requirements and work to get better. We have helped many clients with severe depression with or without co-occurring psychological problems, especially trauma.

Our Acceptance and Commitment Therapy Approach

At PCH, we are committed to depathologizing mental health care and removing psychiatric labels. ACT fits into our broader approach because it allows us to evaluate people based on their obstacles and challenges, not based on the idea that there is something “wrong” with them. The ultimate goal of ACT is to build a better life, not by reducing a person to an arbitrary collection of symptoms but by focusing on the life that each client wants to live and the principles they want to embody.

If you have tried therapy to treat anxiety-driven mental issues like OCD, body dysmorphia, or emotional dysregulation, ACT from PCH empowers you to lead the life you want to without trying to make the thoughts go away. Is PCH Right for You?

When practicing ACT, clients focus on developing six processes. It’s important to note that these processes do not happen sequentially but instead develop in tandem. They include:

1. Acceptance

Acceptance sounds simple enough, but it takes time to break the habit of analyzing our internal selves nonjudgmentally. We experience thoughts, feelings, memories, sensations, and urges. They are involuntary, spontaneous, and varied. Most importantly, we can’t control them. Acceptance is the acknowledgement that those are the dynamics of our internal experience. Rather than evaluating, judging, or trying to get rid of our experiences, acceptance is about learning to let them happen non-defensively, openly, and without judgment.

2. Cognitive Defusion

As humans, we naturally tend to fuse our sense of self to our thoughts, feelings, and memories. It is important to remember that these experiences are a part of us, but they do not define who we are. When we forget that, it’s easy to get stuck on our internal experiences, and we begin to relate to our inner experiences at face value.

Cognitive defusion is the process of learning to separate identity from thoughts. Doing so allows clients to look at their thoughts rather than through or from them. It starts with noticing the process of thinking and, with practice, leads to the ability to observe thoughts for what they are, separate them from identity and reality, and experience the present moment.

3. Present Moment

Present moment is about developing the skills to continually remain in the here and now. Part of the process for learning how to view internal experiences nonjudgmentally requires limiting “time travel.” If we’re always thinking about yesterday or tomorrow, we’re taking away from our options for the present moment and focusing on things we can’t control anyway.

In the present moment, we have no choice but to behave in some manner. At any given moment, we can choose and control our behavior in the present moment. We have no way of controlling our behavior from yesterday or tomorrow. An individual has more choices about how they can behave if they stay in the here and now, which is why the “present moment” is so integral to ACT. If someone is spending time focusing on yesterday or tomorrow, then they are depriving themselves of opportunities to behave in an appropriate manner right now.

4. Observing Self

Observing self, also known as self-as-context or self-as-container, involves perspective shifting that can be difficult to explain. One of the best ways to understand it is with a metaphor. Let’s say you have a chessboard in front of you, and the black and white pieces are your thoughts and feelings. The pieces are frequently at odds with each other. Some are good. Some are bad. They’re all over the place and constantly moving. But you don’t just have the chess pieces—you also have the container of those pieces: the chessboard.

With the way our minds work, we have the ability to fuse with and be the chess pieces, or we have the ability to shift our perspective to the board. By doing the latter, we begin to realize that we’re more than these warring pieces. We’re also the chessboard, or the container of those pieces, and this perspective allows us to separate or distance ourselves from our internal experiences so we can view them more objectively.

5. Values

Values are the definition of who and what in life is most important to the individual. Values are what you want your life to stand for. These Values are unique for each individual. We also refer to them as “north stars” because they remain fixed, even as your internal experiences continually change, and ultimately help guide your behavior in the present moment.

It’s important to note that these values are not attainable goals. In fact, they are stripped of outcome and can be successfully practiced independent of the result. One doesn’t strive to exhibit these values because they want to achieve a specific goal or outcome—they do it because living by these values will help them live the kind of life they want.

6. Committed Action

Most of the discussion around ACT has been focused on internal experience, but committed action is equally important to any of the internal processes taking place. Internal acceptance should lead to committed action in service of the life you want. As discussed above, you have no choice but to act. ACT empowers individuals to choose how they want to act, not based on fleeting thoughts, feelings, emotions, or impulses, but on what in life matters most to them.

We’ve found that ACT can help with a range of mental issues, including:

• Emotional dysregulation
• Psychological trauma
• OCD
• Body dysmorphia
• Hoarding issues
• Trichotillomania
• Anxiety
• Phobias
• Insomnia and sleep issues
• Suicidality
• Somatization issues

ACT Now With PCH

If you haven’t found success with other forms of therapy that involve trying to stop certain thoughts or making feelings “go away,” ACT may provide the framework you need to achieve psychological flexibility, peace of mind, and a more fulfilling life. PCH offers the unique experience of utilizing ACT to work with many psychological challenges. When you are ready, reach out to PCH, and we can help you take the next steps.