Acceptance and Commitment Therapy

[Guest_2350]

 Dear All,

I have started ACT and I am right at the beginning. Has anyone experience with this kind of therapy? For me the concepts are new and very difficult to grasp. I have been diagnosed with depression and PTSD, tried CBT, but it made me feel worse.

To start with I want to work on acceptance. My psych wants me to stop fighting. At least that is the way I understand it. So I questioned if I stop fighting and accept how shit I feel what do I do then? Just give in? My psych answered, that I should accept and then choose my reaction based on my values. I feel it is a long road ahead, but somehow it feels I am heading the right direction. Very confusing and confronting at times.

But I am starting to understand that my picture of recovery and the picture of myself will change and also reading a post from Tony WK brought it closer to me that I cannot get the past back, no matter how hard I fight. Perhaps it is time to stop walking against the storm and see where it takes me.

Take care, Yggy

[White_Rose]

Dear Yggy

Thanks for this post. I am constantly in awe of your writing and the subjects you deal with. Writing about your struggles with different aspects of your life gives me hope that I will manage my life more successfully.

The psych I have been seeing recently has also suggested ACT to me. Some of the concept s I found familiar and feel they come from what I have learned in CBT. Or at least the version I was taught. Acceptance is hard and for me is a daily exercise. Some days I win, other days are not so good.

I have been working on self-soothing, something I also have problems with. Soothing by using the five senses; vision, hearing, smell, taste, touch. And doing these things mindfully. Sounds easy and delightful, but of course the trick is to remember them at the right time and not after the storm has passed, although it's still good then.

It's part of the Distress Tolerance process. Accept both yourself and your current environment in a non-judgmental way. Learn to observe your environment without putting demands on it to be different. Learn to observe your thoughts and behaviour patterns without necessarily attempting to to stop them or control them. Learn skills required for tolerating and surviving cries without making things worse, and for accepting life as it is at the moment.

So there are four sets of Distress Tolerance skills: Distracting. Self-soothing, Improve the moment, Thinking the pro and cons.

I find looking at the whole process enormously challenging, so I need to look at small bits otherwise I will feel overwhelmed and stop doing anything.

Yes, the door to the past is closed. All we get is the window to look through. I try not to do that.

Your psych sounds great. I imagine it's very easy to tell someone how to feel etc. but putting the onus on you makes you think more about what you want to happen.

Oh dear, it's too early in the morning for too many Deep and Meaningful (D&M) chats. I need to get ready to go out. Thanks for sharing.

Mary

[OhmeOhmy]

Hi Yggy

My understanding of ACT is that is based on the principle that there will always be things that happen in life that we can't control and that in life we can't avoid painful feelings or thoughts but we can learn to accept this truth and still experience happiness or positive thoughts and feelings at the same time.  For example you may be enjoying a beautiful day at the beach, the breeze is blowing gently on your skin, the water is refreshing and you feel good when suddenly a memory of a past love one who is no longer with you enters you mind and you are instantly sad and in pain. ACT teaches you to accept that pain but by using 'mindfulness techniques' bring you attention back to the present moment and the positive feelings you were experiencing before you had the painful memory.  It's about acceptance of the pain rather than trying so hard to push it away or  ignore (which is exhausting) and once you have acknowledged the pain you can then choose to do or think about something that is in line with your values or goals which can be as simple as feeling happy. positive or something more specifically goal orientated like painting, studying or getting fit. I personally have found that acknowledging and accepting my pain has been life changing as it is deserving of acknowledgement and after I did this it created the space for me to move my attention to things that make me feel better. I hope it works for you too.  I think its great that you are open to trying it. I wish you all the very best.

[Guest_2350]

Dear Mary,

Dear OhmeOhmy,

thank you for your posts. It gives me hope that there is a way forward. May it be a long or very long process, I know that it will take time to challenge old thought processes.

And this is already where it starts. Challenging? I thought it is about accepting. And to stop fighting. 

I am at the beach at the moment watching the tide coming in. And I am watching the waves thinking about my own thoughts and watching how they my move little or larger items, wash away footsteps, fish jumping... I am trying to imagine that is my mind and my thoughts. The turmoil, the changing tides, the spring tide, the ever changing beach. I was wondering if I should start learning how to surf, to really understand what it means to go with the waves. 

There is so much I don't understand. But I am willing to give it a go. I have meditated for months now and sometimes I think I got it and then I realise that all I thought I understood was done with my analytical thinking.  So I keep repeating the same lessons over and over again. I'm hoping that one day I will be ready to move on, I will feel like something has changed. 

Take care, Yggy

[White_Rose]

Dear Yggy

I think ACT is about acceptance rather than challenge.  I am struggling with something that happened a couple of weeks ago and which triggered all the dreadful stuff that happened frequently for two years. Now two years later I thought I was letting it go, but one reminder has me back there. Well that's what I thought and I was surprised to find while I still had a lot of emotion about it, it was far less painful than previously.  And this gives me hope that the process will continue until I can be reminded without fear and anxiety.

Meditation is not done with your analytical mind.  So I can understand why you get frustrated. Not sure how you meditate, but it is a process of letting go all your thoughts and focusing on a single object or word. When other thoughts pop into your mind you simply acknowledge the thought and return to your meditation. I know that sounds easy and in reality it's not. But it is part of the letting go of all those thoughts that buzz around your mind and do nothing except worry and upset you. It will take a while but it does get easier. Unfortunately, like depression, you will have times when meditation seems a million miles away and you are tempted to throw up your hands in despair and run away. It's especially important to continue then because you learn so much.

One thing I have learned with meditation is that I have not noticed the difference. It happens so gradually that it often escapes you. One day someone will comment that you have changed from this to that and you will realise how far you have come. In the meantime, don't try and measure your achievements. Focus on what you are doing.

I do hope you had a great day at the beach. Water is such a calming place to be. I love listening to the sea and watching the unending waves roll onto the shore. The sea was here before us and will be here when we leave. It puts all our problems into perspective I feel.

Mary

[OhmeOhmy]

Hi  Iggy

Your day at the beach sounds similar to my days at the beach, I get quite contemplative in that space.  I'm not good at meditating as I get too caught up in trying not to think so I just focus on being mindful as often as possible throughout my day.  Being mindful is a kind of meditation in a way as it allows you to separate yourself from your thoughts. The aim is to become 'the observer' of your thoughts which means that your notice them with interest but you don't grab hold of them and become focused on them.  Instead you acknowledge them and then bring your attention back to what you are perceiving through your senses, what you hear, taste, smell and feel physically,  When you bring your attention back to the now you can then direct it to what you want to focus your attention on. It's a continual process that you have to work on but it does help and get easier.  Sometimes I do it well and sometimes I don't even remember to do it.

 I hope this makes sense. I do have trouble explaining this kind of thing. 

Stay in contact and let us know how your doing. I care.

[P12]

I have trouble understanding acceptance and commitment theory.

I understand one principle of ACT is that the human mind was made for cognition but not meta-cognition. It was made to formulate thoughts but not to think about those thoughts. The theory appears to argue that the mind becomes incredibly confused when involved in meta-cognition. This can be overcome and distress reduced by mindfulness (reducing cognition), accepting negative thoughts and feelings (reducing meta-cognition), and focusing on values (increasing pleasure). An example of meta-cognition is written and verbal language (structuring thoughts so they can be communicated to others). 

The first trouble I have is that understanding the theory seems to conflict with the principle of the theory. It takes meta-cognitive effort to make sense of the theory and how to apply it. To identify meta-cognition and suppress it apparently requires tertiary-cognition, which would seem to cause even more distress than meta-cognition. The second trouble I have is that it appears to be suppressing a natural characteristic of the human mind. While this may work for short periods of time, my experience suggests it is unsustainable. It may help reduce isolated distress, trauma, or incorrect thought, but I have doubts about its effectiveness for individuals with lifelong psychosocial conditions.

I found cognitive behaviour theory a little more effective. It is similar to the principles of science and faith. These are arguably two of society's best creations. However, I still found difficulties and limitations of this theory.

Would anyone like to share their views on this subject?

[P12]

Is the acceptance and commitment theory synonymous with Eastern philosophies? If so, what is the significance of its alignment for achieving its purpose of assisting individuals with mental illnesses?

It seems to me the theory has at least been inspired by, if not theoretically aligned with, such practices. Many of its principles appear to oppose those of more traditional mental illness treatment methods, which appear to share principles with Western philosophies. 

Although a community may benefit from the opposition of theories, as this is a way of testing the theories to determine their correctness, how may individuals benefit? The theories appear to work in generalisations, which help proportions of the community, but not individuals who do not fit exactly in a model.

[P12]

I also had the thought that ACT says to observe thoughts and feelings when they occur rather than acting on them. This makes me conflicted because a large part of my upbringing encourages and delights at feelings and thoughts when they occur. Without embracing them I think life would be pointless.