In my practice, I use Acceptance and Commitment Therapy, or ACT. However, I rarely use the word “acceptance” with my clients. This is because it often leads to miscommunication. When the word acceptance is said, many people interpret that to mean “tolerance” or worse yet “resignation.” While this is slightly closer to the definition of acceptance than avoidance, it is only just so.
Acceptance could more accurately be interpreted as “welcoming” or “making room for.” Tolerance maintains a negative appraisal of an experience and allows it to happen while trying to “look the other way.” When we try to simply ignore an experience, it will begin to take over more and more – unnoticed until it makes itself known in a catastrophic way. When we resign ourselves to an experience, we give our power of action over to that experience. Martin Seligman – now famous for the Positive Psychology movement – was originally famous for a study done on dogs in which he had some in open cages and others in closed cages. They were both administered electric shocks and the dogs in open cages left the cage. The dogs in closed cages whined at first and eventually just laid down and gave up, even later when the door was open they whimpered with the shocks but did not leave because they had resigned themselves to the experience.
When we welcome an experience and make room for it, we take the time to notice the experience for what it is. If it is anxiety, we notice that it is a feeling of fear that comes with an apparent automatic response of increased heartrate, shorter-shallower breathing, and an impulse to fight, fly, or freeze. We acknowledge that this is a feeling, that thoughts associated with that feeling (e.g. “I’m not safe” or “I’m going to die.”) are just thoughts. By welcoming them into the space with us and not pushing them away, we allow ourselves to focus on other things in life – things that are more important to how we want to live our lives.
This is easier said than done because the brain is a wonderful machine for learning through conditioning and relationship building. We experience anxiety and take an action to try to avoid it. This removes or reduces the anxiety and when we remove something in our experience we see as negative, our brains learn to associate that relief with the distraction and provide us with a reward for the relief. We all know this experience – one of “ahh that’s finally over” and the wave of pleasure that comes with it. This is something that behaviorists call “negative reinforcement.” It’s negative because it is taking something away and it is reinforcement because it causes a behavior to occur more frequently. In this case that behavior is whatever we are doing aimed at reducing the anxiety experience. It’s particularly problematic when, the avoidance behavior has evidenced its own strong effects on dopamine in the brain’s reward center – but that’s a post for another time.
Still, it is not until we are able to accept our experience that we are truly able to effectively reduce avoidance behaviors that lead to people missing out on elements of life. Remember, the experience of anxiety in and of itself does not inherently limit our participation in life – our responses to that anxiety does, but those responses are often well established in our brains by the time we seek help. In order to affect change in those systems, a lot of practice must take place. Therapy is a place to learn those practices, but like any other exercise – it’s daily action that makes a difference.
Acceptance is just one of six major parts of ACT. I’ll post about each of the rest in the future.
Marvin Bellows LPC, CRC
A note to therapists getting started using ACT: I’ve been blessed to see a lot of discussions about ACT. One thing that isn’t uncommon is a misunderstanding that it is against the principles of ACT to try and eliminate the causes of discomfort. This could not be further from the truth. Much like Behavior Analysis from which ACT was developed we have a commitment to looking at the function of the behaviors in the environment and if it is workable to change the environment, we do so. An example that may seem a bit silly that I like to use follows.
A client comes in complaining of depression. We get a behavioral definition of that behavior, what it looks like. The client says “I’ve just given up walking out of my room, it’s hopeless, there’s no point, it’ll just end in more pain.” Then we ask about what is going on when those feelings come up and find out that there are tacks in his floor and he lives alone and can’t see well enough to pick up the tacks without even more injury. It is perfectly consistent with ACT to help the person change their environment by picking up the tacks.