Acceptance

Commitment
Therapy
Steven Hayes’ view

(in addition with some ideas by Russ Harris)

Ana Cecy Ahedo

Intro to Hayes’ ideas… an e-mail by
the author
In his classic book Man’s Search for Meaning, Viktor Frankl tells the story of a
client of his who was terrorized by a constant fear of sweating. Whenever he expected
to perspire, he would become anxious, leading him to sweat profusely, which would
thus confirm his greatest fear. This cycle got worse and worse, until eventually, he
decided to seek out professional help. He did not like what came next.
Frankl gave him an almost impossible task: The next time he perspired, he should
show it to others. No more hiding. Instead, he should display his sweaty armpits for the
world to see. And as if this wasn’t enough, he should try sweating as much as possible.
This was his worst nightmare coming true. And yet he followed through with the
advice. And after years of suffering, in just a week he was freed from his phobia.
 Many years later we’ve learned a lot about how "exposure" works and
can best be done. It can indeed have a very rapid impact in many clients, and
it is one of the best supported intervention methods in all of behavioral
science. But what is the deeper lesson of emotion and exposure?
Your emotions help you make sense of the world. At the core of an
emotion is a subjective experience of the valence of it -- what emotion
scientists call "affect." Regardless of your situation, your emotions are quick
to weigh in and generally speaking, affect is what we are most focused on. Do
you have chocolate cake in front of you? That’s good! Do you see a spider on
the table? That’s bad! Do you see the spider crawling towards your chocolate
cake? That’s extremely bad!
Your affective reactions tell you which experiences are desirable, and
which aren’t, but the total emotional experience includes what your body
does, what thoughts you have, the context you are in and sensitive to, your
urges, and your motivation. Emotions aren’t a simple guide but you can learn
a lot by observing and describing them. You can learn a lot by appreciating
their secret life.
 The problem is this: The affective features of emotions tend to dominate
… NOW. Our subjective valence of emotion is almost all we can see. This is
great when you want to decide which topping goes best for your ice cream.
But it can be harmful for your more meaningful goals and interests.
When emotions are only about what is pleasant or unpleasant in
subjective experience right now - the more important features of emotion
disappear. We should be noticing those features. What does this situation
remind me of? Exactly what am I feeling in my body, and where? Is there a
name for this? Have I felt it before? What does this feeling suggest I need or
should attend to?
You can learn a lot by just noticing and describing how you feel, and
what it suggests about how best to reach your goals. These are the very issues
that most impact you in the long term. When your life revolves entirely around
the subjective valence of what you feel NOW, those all recede into the
background.
You are actively programming emotional ignorance. You are in for
trouble.
 Instead of exploring healthy eating, you might disappear mindlessly into
another bowl of ice cream with rainbow sprinkles. Instead of saving and
investing for the values-based ways you can use your money, you might spend
way too much on frivolous online shopping. Instead of reconciling a conflict
with your partner, you let out an uncensored rant. And instead of letting
emotional vulnerability orient you toward what you care about, you may let
your irrational fears and insecurities control and dictate your life.
If you can slow down and expand; if you stop running or clinging and
adopt a sense of curiosity, emotions become more nuanced and differentiated.
Remember how scary it used to be when you first drove a car and how that
impact made it hard to sequence your skills? Chances are you experience a
softer and broader set of emotions now while driving and their unwelcome
behavioral interference is much less. Instead, now you can appreciate the drive.
When you broaden your actions and shift more to curiosity and noticing
-- even though affect tells you to run -- you can learn more and emotions
become a helpful guide. This is why I advocate for making room for your
emotions, but without clinging.
 When fear comes up, don’t just walk away so that fear dissipates. Instead,
stay. Allow yourself to feel the nervousness, the churning of your stomach, the
weak knees, the sweating, and everything else that comes along with it. It’s one of
the hardest things to do in life, but it’s also one of the most rewarding, because it
allows you to do what matters to you: Whether this is about driving a car, reaching
out for support, or carelessly sweating in public.
When joy comes up, savor and appreciate but do not cling. Remember that
"this too shall pass" and that is a good thing. For emotions to carry useful
information it needs to be so.
If you run, you are telling basic parts of your brain "I guess this threat really
was real. I better crank up the emotional lever, so I’m protected next time". You are
training yourself to fear, regardless of that situation. If you cling, you are saying
"Change from this emotion is a threat" and since that is itself not a happy place to
be, happiness slips through your hands like sand.
Fortunately, it also works in the opposite direction: The more you allow
yourself to feel your emotions, as they are -- not as your immediate valenced
reactions say they are -- the more the rise and fall of emotions can ground you in
the moment in a helpful way.
 Note that you cannot fool yourself. If you open up to an emotion in
order to get rid of it, you will be disappointed. Allow the full emotion –
without ifs or buts.
If you want healthy control of your life, you need to actively train
your emotions to be your ally. They have a role to play that is richer and
far more interesting than their subjective valence in the present. You will
never enter into their secret life until you stop running or clinging.
Observe. Describe. Appreciate.
Do that and you may find you have allies for healthy living that
were there all along.
Hayes’ intro OUR STORIES, DESCRIPTIONS,
AND EVALUATIONS ARE NOT
in A TAKE AN ODD JUST USED FOR SOCIAL
COMMUNICATION. THEY ALSO
QUESTION
contextual SERIOUSLY, JUST
HAVE AN IMPACT ON OUR
BEHAVIOR. PEOPLE WHO

behavioral FOR A MOMENT:

BELIEVE THEY ARE
WORTHLESS MAY ACT
WHO ARE YOU? DIFFERENTLY FROM PEOPLE
guide to the WHO BELIEVE THEY ARE THE
GREATEST. EITHER SELF-
self CONCEPT CAN BE A PROBLEM
—BUT THAT IS NOT THE POINT.
THE POINT IS THAT OUR SELF-
CONCEPT CAN MAKE A
DIFFERENCE.
 When the multiple meanings of the term
“self” are more fully understood, and when
their underlying principles are revealed, it is
Hayes’ intro easier to think through how issues of self
might be dealt with in practice.
in A
contextual
behavioral These rules can be applied with extreme
inaccuracy; they may be unfair expressions of
guide to the stigma and bias.

self
 There is a temptation—one that many clinicians fall prey to
—for practitioners to directly challenge and change their
clients’ self-concepts. Often, however, that is the more
difficult course.
Hayes’ intro
in A Clinically, it may be far more difficult to lay out new sets of
contextual rules or new evaluations of roles than to help a client
radically redefine what a self-concept is, and to change the
behavioral place of the self-concept in the client’s system of thinking
and behaving.
guide to the
self Healthy selfing is a skill that can be learned, but it is not
one that society does a good job of teaching. Part of the
problem is that lay theories of self get in the way, but
another part is that unhealthy selfing can often pay off for
others.
 That is one reason why it is important for
practitioners to have thought deeply and
scientifically about issues of self. The culture,
unaided by scientific theory and data, simply cannot

Hayes’ intro be trusted to provide good guidance.

in A
contextual
behavioral The science road is not an easy one, precisely
guide to the because a prescientific understanding of self is
so pervasive. But the science road is important
self because the understanding one can glean from it
has powerful, creative implications that can open
new and useful domains for exploration by
clinical work.
 What is ACT?
• Acceptance and Commitment Therapy (ACT) is at its core a behavioral therapy (Harris, 2019).
The purpose of ACT is to increase the ability of an individual for mindful and values-guided
action; this is also called, psychological flexibility (Harris, 2019).
• Professor Steven C. Hayes created ACT in the 1980s and his colleagues - Kelly Wilson and
Kirk Strosahl - expanded it further. ACT is based on contextual behavioral principles (Hayes,
2012). It is based on Relational Frame Theory (RFT) and Functional Contextualism (FC)
(Hayes, 2012). RFT is a behavioral theory of cognition (Harris, 2019). From the perspective of
FC an act derives meaning from its context instead of more general assumptions (Hayes,
Pistorello, & Levin, 2012).
Does ACT only help us to accept inner
experiences? Or does it also help us to
accept external events and situations -
and if so, how?

• On the ACT hexaflex, the word ‘acceptance’ is

short for 'experiential acceptance' - which means
the acceptance of your inner experiences
(thoughts, feelings, urges, memories etc.) This is
just one of the core ACT processes involved in
acceptance of external events and situations.
 a) Defusion. We aim to defuse from
cognitions that pull us into a struggle
with it - e.g. harsh judgments, or beliefs
like ‘This shouldn’t happen!’

To accept
anything - b) Contact with the Present Moment.
We aim to be fully present with this
whether it’s aspect of reality, attending to it with
openness and curiosity.
inside us or
outside us - we
benefit from
This applies to both our cognitions,
emotions, urges and memories
(experiential acceptance) and to the
external world (overt acceptance).
 a) practice defusion: from judgments and
narratives that pull us into an unhelpful struggle
with the external events,

b) practice contact with the present moment:

noticing these external events with openness and
curiosity
So to accept
external events c) practice experiential acceptance and self-
and compassion: opening up and making room for the
difficult thoughts and feelings that arise within us
circumstances, when external events are not what we want - while
treating ourselves kindly.
we need to
And of course, ACT does not advocate 'passive
acceptance'. If there are values-congruent actions
that can improve the situation in a way likely to
enhance your life, ACT advocates doing so. (In
some circumstances, this may involve leaving the
situation.)
Practical module

• Divide the group in teams

• Research interventions for each process of the Helaflex model
• Each team will be assigned with an ACT treatment protocol
• The teams will review the treatment protocol and practice on a fake
scenario – that fits your protocol – using the ACT ADVISOR