Psychological Inflexibility: An ACT View of Suffering and Failure to Thrive
The core conception of Acceptance and Commitment Therapy (ACT) or (as it is usual called outside of a therapy context, Acceptance and Commitment Training ... also "ACT") is that psychological suffering and a failure to prosper psychologically is usually caused by the interface between the evolutionarily more recent processes of human language and cognition, and more ancient sources of control of human behavior, particular those based on learning by direct experience. Psychological inflexibility is argued to emerge from six basic processes. Stated in their most general fashion these are emotional inflexibility, cognitive inflexibility, attentional inflexibility, failures in perspective taking, lack of chosen values, and an inability to broaden and build habits of values-based action. Buttressed by an extensive basic research program on an linked theory of language and cognition, Relational Frame Theory (RFT), ACT takes the view that trying to change difficult thoughts and feelings in a subtractive or eliminative way as a means of coping can be counter productive, but new, powerful alternatives are available to deal with psychological events, including acceptance, cognitive defusion, mindful attention to the now, contacting a deeper "noticing" sense of self or "self-as-context", chosen values, and committed action. These six flexibility processes are argued to be inter-related aspects of psychological flexibility. Each of these in turn can be extended socially. For example, acceptance of emotions can extend to compassion for others; chosen values can extend to social values; a "noticing" sense of self to healthy social attachment; and so on.
The ACT Model
ACT is an orientation to behavior change and well-being that is based on functional contextualism as a philosophy of science, and behavioral and evolutionary science principles as expanded by RFT. As such, it is not a specific set of techniques or a specific protocol. ACT methods are designed to establish a workable and positive set of psychological flexibility processes in lieu of negative processes of change that are hypothesized to be involved in behavioral difficulties and psychopathology including
- cognitive fusion -- the domination of stimulus functions based on literal language even when that process is harmful,
- experiential avoidance -- the phenomenon that occurs when a person is unwilling to remain in contact with particular private experiences and takes steps to eliminate the form or diminish the frequency of these events and the contexts that occasion them, even when doing so causes psychological harm
- the domination of a conceptualized self over the "self as context" that emerges from perspective taking and deictic relational frames
- lack of values, confusion of goals with values, and other values problems that can underlie the failure to build broad and flexible repertoires linked to chosen qualities of being and doing
- inability to build larger and larger unit of behavior through commitment to behavior that moves in the direction of chosen values
and other such processes. Technologically, ACT uses both traditional behavior therapy techniques (defined broadly to include everything from cognitive therapy to behavior analysis), as well as others that are more recent "3rd wave" methods, and those that have largely emerged from outside the behavior tradition, such as cognitive defusion, acceptance, mindfulness, values, and commitment methods.
Research Support
Research seems to be showing that these methods are beneficial for a broad range of clients and positive psychological goals as well, not just in mental health areas but also in behavioral health, and social wellness areas. ACT teaches clients and therapists alike how to alter the way psychological experiences function rather than having to eliminate them from occurring at all. This empowering message has been shown to help clients cope with a wide variety of clinical problems, including depression, anxiety, stress, substance abuse, and even psychotic symptoms; to step up to the challenges of diet, sleep, exercise, or the behavioral challenges of physical disease; to help address social problems such as stigma or prejudice; or to seek positive outcomes in areas like relationships, cooperation, business, social justice, climate change, gender bias, and so on. The benefits are as important for the clinician as they are for clients. ACT has been shown empirically to alleviate therapist burnout, for example. By focusing on processes of change what began as a way of dealing with mental health issues is now a model that is used to understand and change human behavior more generally.
How Do You Learn and Apply ACT to Your Practice?
The list of resources below are a great, easy-to-access way to learn more about ACT, it's theoretical and philosophical background. We recommend checking out these pages, as they will provide an important foundation of knowledge. We've also compiled a list of ways to learn about ACT by reading ACT books, as well as getting consultation from others as you begin to apply the work to your work and practice. This additional list of resources will help you do so as well. ACBS members are strongly encouraged to join the ACT for Professionals email listserv. Once on that listserv you can ask virtually any question, or raise virtually any issue, and thousands of ACBS members will read it ... and you can almost be guaranteed of interesting and helpful responses. We've found that members of this listserv are nearly eight times more likely to remain as ACBS members over the years than those who are not on the listserv, and we think the reason is that listserv members come to appreciate the value of being part of a helpful and values-based knowledge development community. If you are not sure, join and lurk for a while. If you do not like it, it easy to step off later on -- you can do so with a single click in your membership dashboard.