If you try to avoid painful or distressing feelings or experiences, you’re not alone — many people do.
Your brain and body work together to help you avoid pain, like when you reflexively yank your hand back from a hot stove without even thinking about it.
Of course, you might also make this choice intentionally. For instance, if you know your parents will criticize your decision to take a more interesting but lower-paying job, you might dodge their calls because you don’t want to have an argument. Or maybe, when your partner seems a little distant, you focus on keeping things light and fun to avoid a serious conversation.
But how might your reaction change if you approached unpleasant situations from a different perspective? Instead of categorizing emotions like sadness, anger, and fear as “bad,” what if you accepted them as simply part of your complex life experience?
This core principle underlies acceptance and commitment therapy (ACT). ACT views “negative” emotions and experiences as part of life. Trying to avoid them can lead to unhelpful or unproductive behaviors.
ACT (pronounced “act”) helps you accept the reality of these experiences and commit to pursuing your values.
Read on to learn the basics of ACT, including who can benefit, what to expect from therapy, and how to try it.
Values vs. goals
Values can serve as guides that help shape your life path overall. Your goals, on the other hand, refer to more specific, short-term target actions that often reflect your values.
Your values, for instance, might include knowledge, creativity, and personal development. A goal that embodies these values might be attending a prestigious art college.
In some cases, avoidance can be a useful problem-solving strategy, but it can backfire if you use it too often.
For example, if you put off a difficult conversation with your best friend, it might give you time to explore your feelings and find a way to approach the subject delicately. On the other hand, if you’re giving a presentation at work and are nervous about public speaking, you might distract yourself from your worries by watching TV instead of preparing.
Procrastination may relieve performance anxiety in the short term, but it may leave you unprepared on the big day.
The likely result in the example above? Your less-than-stellar presentation convinces you that public speaking is difficult and frightening. The next time you need to give a speech, you may feel even more stressed and tempted to procrastinate.
You didn’t avoid preparing due to laziness, but because your anxiety loomed too large and distracting to ignore. That’s where ACT comes in. This approach can teach you new skills to help you accept those intense feelings without relying on distractions or avoidance techniques.
ACT doesn’t aim to help you manage or control unwanted feelings, thoughts, or physical sensations. It also doesn’t suggest you should “grow a thicker skin” and repress those feelings.
Rather, it helps you redefine your relationship with them so you can do the things you want to do while allowing distress or other emotions to simply be present as part of your experience.
In short, ACT can help you identify key values and explore ways they might guide your actions toward a meaningful life. You can then learn to make choices that match your objectives (such as giving a good presentation) and values (like success or professionalism) instead of your internal emotions (fear of failure, for example).
Steven Hayes and Robert Zettle published the first study on ACT in 1986.
Since then, hundreds of randomized controlled trials have demonstrated this therapy’s effectiveness for a range of mental health conditions, according to 2020 research.
ACT is a transdiagnostic therapy, meaning its principles can be applied to almost any mental health concern.
Mental health professionals often use ACT to help treat:
- anxiety and chronic stress
- substance use disorder (SUD)
- treatment nonadherence, or difficulty following your treatment plan as prescribed
1. Anxiety and stress
ACT won’t get rid of stress triggers or diminish anxiety completely. In fact, ACT theory considers these experiences part of your experience as a human being.
What ACT can do is teach you techniques to change the way you respond to anxiety and stress.
Maybe you have social anxiety but still want to build meaningful connections with others. You might, then, work on skills to start conversations or interact more easily, despite fears of rejection or judgment.
ACT doesn’t focus on decreasing your anxiety as a goal of therapy, though that might happen as a natural consequence of exposing yourself to more social situations. The goal lies in building the life you want — which, in this instance, might be a life that involves more social connection and emotional intimacy.
Or maybe your demanding job places a lot of stress on you for a lower salary than you’d like. ACT can help you learn to accept those feelings because you know the situation is only temporary until you gain the experience to find a better job. At the same time, you might set goals that better match your values of financial security and a satisfying career, like asking for a raise or finding and applying to three new jobs each month.
According to ACT theory, you can add meaning and importance to your life by taking actions that align with your values, even if they don’t necessarily produce feelings of happiness. To put it another way, you don’t have to put off doing the things you want to do until your feelings of depression improve.
By helping you find ways to live out your values rather than your current emotions, ACT can help you get some distance from thoughts of hopelessness, shame, and regret. It may also have particular benefit for treating anhedonia, the inability to feel pleasure, according to 2020 research involving people with terminal cancer.
One 2018 study compared the benefits of CBT and ACT for 82 people with major depression. According to the results, 75% of people who tried ACT reported remission of their depression symptoms and improvement in their quality of life. These benefits held up through the 6-month follow-up point.
3. Substance use disorder
You may not necessarily use substances to feel intoxicated. Some
Some addiction interventions, like cognitive behavioral therapy (CBT), focus on teaching skills to avoid triggers for cravings. But ACT helps you:
- focus on how you may have used substances to avoid or numb unwanted or distressing internal experiences
- explore the impact of substance use on your ability to create a meaningful or purpose-driven life
- learn to accept and tolerate emotional pain without numbing or avoiding it
4. Treatment nonadherence
Coping with a new health concern can present any number of challenges, and you may not always find it easy to adjust to treatment. ACT can help you work through obstacles that may be preventing you from fully participating in your treatment plan.
For example, you may skip physical therapy after a serious injury in favor of bed rest because you worry about embarrassing or hurting yourself further. You could also stop taking your medication because you don’t like the side effects.
But maybe rest and self-care alone don’t improve your symptoms, and you start to feel worse. In this situation, ACT can help you recognize how avoiding physical therapy due to worries about pain and embarrassment doesn’t line up with your values of personal wellness and living a full life.
Typically, ACT is organized into distinct modules that teach you six core skills, according to a
ACT skills include:
1. Practicing mindfulness
Mindfulness helps you focus on the present moment, or your current thoughts, feelings, actions, and physical sensations.
Why does mindfulness matter? Well, you might find it easier to control your reaction to a situation when you can recognize how it affects you as you experience it.
Maybe bad news makes your head swim and your thoughts race, and you can’t catch your breath. Naming those sensations in your brain and body can help you find ways to work through them, like sitting down and taking several slow, deep breaths.
2. Keeping a balanced perspective
ACT helps you recognize and remember that you are not your feelings. You are a consciousness experiencing those feelings, which means you can choose how to respond to them.
Your thoughts might urge you toward a specific action — like texting your ex when you feel lonely — but that doesn’t mean you have to actually follow through on that action.
3. Identifying values and goals
In this stage, you identify your strongest values, like serving your community, keeping your promises, or showing kindness to everyone. These values can help clue you in on the goals and dreams you’d find most meaningful to pursue.
Living a life of purpose, as a general rule, often becomes easier when you have a clear destination in mind and a good understanding of what matters most to you.
4. Committing to values and goals
Dreams tend to stay stuck in your head until you put in the effort to make them a reality.
To put it another way, fantasizing about Mr., Ms., or Mx. Right won’t make your happily ever after come any quicker. If you want to make romance happen, you’ll need to take steps to meet new people, whether that involves attending community events, finding a group of people interested in the same hobby, or trying out a dating app.
5. Accepting unwanted feelings
Sometimes you’ll need to overcome some challenges in order to reach your goals.
If you want to save up money to attend college in a bigger city, for instance, you might have to spend some time working at a job you don’t enjoy. This might cause some day-to-day frustration or resentment toward friends who don’t need to earn money for college.
Instead of trying to squash those emotions or feeling guilty about them, ACT aims to help you learn to carry those feelings with you and accept them as part of the process.
In other words, you can learn to fight for your dreams, not against yourself.
6. Cognitive defusion
When your thoughts or feelings interfere with your goals, a technique called cognitive defusion can help you take a mental step back and consider those thoughts from a more detached, objective point of view.
Cognitive defusion can also help you avoid considering the world from the perspective of your current thoughts and emotions. Remember, emotions reflect your internal state, not the objective reality of the world around you.
Here’s an example
You may feel worthless during an episode of depression, but that emotion isn’t a reliable way to measure your value as a person. Instead, challenge yourself to create some distance from that thought.
You might, for instance, think “I’m having the thought that I’m worthless.”
You could also try visualizing that thought as an annoying pop-up ad. Rather than giving it space in your brain, just click the X in the corner to close the window.
ACT can help you accept even severe emotional distress and recognize it as part of the human experience, rather than a sign of something “wrong” with you.
This approach can help you learn to engage in life even when challenged by things you can’t control, like illness, pain, loss, and severe mental health symptoms.
What’s more, ACT works well in a variety of therapy formats: face-to-face sessions, guided online courses, or even interactive apps.
A typical session might last from 30 to 60 minutes, with treatment taking place over the course of 6 to 12 weeks. If you have a packed schedule, you have other options, such as:
micro-learning programs, where you practice therapy techniques in daily 10-minute sessions. 1 -day group workshops, where you learn the six core skills in a single session of 4 to 6 hours.
The following resources can help you find an ACT therapist in your area:
- Healthline FindCare
- Association for Contextual Behavioral Science directory
- Association for Behavioral and Cognitive Therapies directory
- American Psychological Association psychologist locator
You can also:
- Use any online therapist directory to find local mental health professionals who offer ACT.
- Ask a doctor or other healthcare professional for a referral.
- Check your insurance plan for covered therapists or out-of-network therapy benefits.
According to ACT’s primary philosophy, healing stems from accepting your emotions — not getting rid of them. ACT can help you address anxiety, depression, and general emotional distress by helping you learn to accept and allow distressing or unwanted feelings as part of your lived experience.
This versatile therapy approach has a wealth of evidence to support its effectiveness. It also works well in tandem with physical treatment, according to a 2020 controlled trial. It may help physical pain and discomfort associated with chronic pain, diabetes, or cancer feel more tolerable, too.
At the end of the day, learning how to live with difficult emotions may provide more control over how you react to them. This frees up valuable energy and attention so you can pursue your values and live life the way you want to.
Emily Swaim is a freelance health writer and editor who specializes in psychology. She has a BA in English from Kenyon College and an MFA in writing from California College of the Arts. In 2021, she received her Board of Editors in Life Sciences (BELS) certification. You can find more of her work on GoodTherapy, Verywell, Investopedia, Vox, and Insider. Find her on Twitter and LinkedIn.