Motivation and emotion/Book/2013/Acceptance and Commitment Therapy and emotion
How does ACT suggest we approach emotional experiences?
Overview[edit | edit source]
This chapter is committed in educating you on the intricacies of how acceptance and commitment therapy (ACT) works, what the philosophical basis of ACT is and how you can approach emotional experience using some of these strategies. The chapter will also attempt to provide information surrounding emotions so as to educate you on what is occurring in your body when you’re feeling. The chapter includes specific strategies to combat certain psychopathology such as anxiety and depression in everyday life. Acceptance and commitment therapy (ACT) was not constructed for a specific treatment plan thus is can be used in everyday life to resolve dysfunctional behaviour. That said, one should keep in mind that the present research should be taken as a tool for learning rather than a means of treatment.
Defining ACT[edit | edit source]
Theories[edit | edit source]
Functional contextualism[edit | edit source]
- Through research I’ve come to understand that clinical definitions of Acceptance and Commitment therapy are extremely complex and have many facets. ACT has philosophical underpinnings which are based on functional contextualism and theoretical roots in Rational Frame Theory (Hayes, 2004; Hayes, Levin, Plumb-Vilardaga, Villatte & Pistorello, 2013; Rector, 2012; Twohig, 2012 ;). I know you’re thinking, what does this mean? I will attempt to provide an understandable description: Functional contextualism perceives psychological events as a set of interactions between whole entities which are ongoing throughout all aspects of life, emphasising both historically and situationally defined contexts (Hayes, 2004). This perspective highlights the goal of predicting and influencing events based on empirical concepts and rules (Ruiz, 2010). Furthermore, according to functional contextualism, thoughts and feeling do not directly cause action it is the context in which these events occur that activate certain behaviour (Ruiz, 2010). Functional contextualism is reflected in ACT, as ACT emphasises effective action as a truth criterion, the truth criterion is based on finding out what works for that individual through setting analytic goals (Hayes, 2004). These analytic goals are based on the premise that thoughts are neither correct nor incorrect rather useful tools in acquiring a more valued life (Ruiz, 2010).
Relational Frame theory (RFT)[edit | edit source]
- We will not go into too much details in reference to RFT as it will help you better understand ACT but it will not assist in a therapeutic manor. RFT is concerned with how humans learn a language and suggest that cognitions and language are abilities under contextual control and a consequence of randomly related events both reciprocally and in combination (Hayes et al 2006). Languages and cognitions have the ability to change functionality of events, specifically based on their relation to other events (Hayes et al 2006). An example proposed by Hayes et al (2006): a child will have the understanding that a 50cent coin is bigger than a 1dollar coin in physical size, but that child does not understand that the smaller coin is of larger value until society advices him as such. From an ACT perspective a key cause of psychopathology is formed via a problematic interaction between language and cognition, which results in failure to continue or modify behaviour connected to self-valued goals (Hayes et al., 2006). According to ACT such inflexible behaviour arises from fragile and obstructive contextual control over processes of language (Hayes et al., 2006).
Description of ACT processes and strategies[edit | edit source]
- Acceptance and commitment therapy (ACT) perceives thoughts, feelings and bodily situations as inner experiences that are not inherently problematic or positive;
- it is rather how these events function for the individual that determine outcome (Twohig, 2012).
- Acceptance and commitment therapy (ACT) perceives thoughts, feelings and bodily situations as inner experiences that are not inherently problematic or positive;
How does ACT suggest we improve cognitive inflexibility?[edit | edit source]
knowingly avoiding feelings of sadness or anxiety and continually looking at everything that’s gone wrong, just falling deeper and deeper into your own thoughts and constructions until you felt like you may explode?… Sound familiar? Well you’re not alone in your actions; we have all felt like that at some point but the question is how do we get out of this pit of despair? ACT suggests ways you can help yourself.
Research suggest six core treatment process of ACT,which include:
- Contact with the present moment
- Self as context
- Commitment action
(Powers, Zum Vörde Sive Vörding, & Emmelkamp, 2009).
These processes are applied through specific exercises, which are described bellow (Powers et al., 2009).
Emotional experiences[edit | edit source]
How can we define an emotion? Emotions work in mysterious ways, strong emotions can make you do things you normally wouldn’t such as, avoiding situations that are generally enjoyable, we understand how to stop such pervasive reactions through ACT but it would help to understand the cause (Gross & Munoz, 1995). Gross and Muñoz (1995) define emotions as: “biological based reactions that coordinate adaptive responding to important opportunities and challenges; each emotion appears to address a somewhat different adaptive problem” (p.152). As our emotions physically and mentally respond to situations in our lives, contextual reasoning for feelings can have a major impact on how we react (Gross & Munoz, 1995). This explanation is likened to that of B.F Skinner (1938) who posed that “all of behaviour reflects reaction to rewards and punishments (reinforcers) provided by the environment” (as cited in Rolls, 1999. p. 605). Viewing emotions and behaviour from this perspective gives the impression that environments with continual negative reinforcements will have obstructive outcomes on emotions for example: if an individual consistently thinks their life is not worth living and everything just doesn’t go their way, their emotions and behaviour will reflect this attitude, which is the core issue that ACT strategies intend on resolving.
- The next section of the chapter will focus on applying ACT strategies in everyday emotional experiences such as depression, anxiety and stress.
Applying ACT to everyday emotional experiences[edit | edit source]
Depression[edit | edit source]
Difficulties regulating your emotions have been suggested to be a foremost cause in depression and anxiety (Aldao, Nolen-Hoeksema, & Schweizer, 2010; Joormann, & Gotlib, 2010; Ehring, Tuschen-Caffier, Schnülle, Fischer & Gross, 2010).Emotional regulation can be defined as: an individual’s ability to consciously and unconsciously control their emotions in response to environmental stressors (Aldao et al., 2010; Bargh, &Williams, 2007). Individuals adopt regulatory strategies in order to adjust their emotional experiences to fit the emotion provoking event (Aldao et al., 2010). Research suggests that Acceptance and mindfulness strategies such as those previously mentioned in the chapter can minimize an individual’s distress (Aldao et al., 2010).
Take depression for example, it is not how an individual initially responds to a negative event, rather the ability to which an individual can revive their mood after feeling a negative emotion such as sadness (Joormann, 2010). Therefore, frequent negative thoughts, selective attention to negative stimuli and easily assessable negative memories are all interrelated and consequences of negative moods (Joormann, 2010). The issue is in the in congruency between research and practicality, as it is theorised that an individual should be able to quickly change cognition to regulate mood states (Joormann, 2010). However, people with depression have an inability to do so and rather fall into a self-defeating cycle of negativity (Joormann, 2010).
The ACT perspective sheds some light on the current problem, and views this self-defeating cycle as made up of psychological inflexibility and suggests strategies such as acceptance of the negativity, keeping in contact with the present (which reduce the reliance of past memories of negativity) self as context (removing yourself from these negative evaluations), values (to increase ones capability of behavioural change in accordance with own values) and committed action (Hayes et al., 2013). If you’d like a further explanation of the ACT processes refer to section () of the book chapter. This exercise can be initiated and sustained through activities such as: carrying a self-monitoring index card to refer to when you encounter a difficult situation (Powers et al., 2009). The index card is suggested to have two sides; one side: The fear algorithm which is a reminder for patients to review whether they’re avoiding inner-experiences, fusing thoughts, evaluating experiences and giving reason for behaviour (Powers et al., 2009). On the other side is the ACT algorithm: a positive reminder of acceptance of inner-experiences, living in the present moment with self as context, choosing a valued direction and taking action (Powers et al., 2013). We can conceptualise the sides as depicting the ease to which we move from the barriers that stop us from achieving our goals, to the realistic removal of those barriers and visualising a value directed life (Powers et al., 2013).
For more information regarding emotional regulation refer to 
Stress[edit | edit source]
Anxiety[edit | edit source]
Everyone has been guilty of avoiding a situation because of fear or embarrassment, and at times it feels unbearable. You may not want to leave your house in fear of coming into the contact with the problematic situation so you don’t, or maybe you've “chucked a sickie” at school or work due to fearing embarrassment. An example of how we can make it easier to face our fears is through engaging in ACT processes.
ACT vs.Cognitive Behavioral Therapy(CBT)[edit | edit source]
Does acceptance and commitment therapy actually work?[edit | edit source]
The evidence surrounding the effectiveness of ACT is large; all articles reviewed suggested that ACT does work (Hayes et al., 2013; Zettle, 2012; Twohig, 2012). Many of studies conducted found positive results for the six ACT processes (Twohig, 2012). A major area of success is found in anxiety disordered patients (Twohig, 2012). A meta-analytic review was conducted by Powers et al., (2009) which concluded that ACT had better follow up results then other treatments, it should be noted that the present study found little difference between ACT results and other established treatments. Thus suggesting that although evidence is in favour of ACT it works better than other therapies in limited areas (Powers et al., 2009;Forman, Herbert, Moitra, Yeomans, & Geller, 2007). Another consideration is the difficulty in measuring the effectiveness of ACT on specific disorders, as ACT is not made for one disorder but rather a range of board problems (Powers et al., 2009; Hayes et al., 2013). As ACT is a relatively new therapy and still in the growth stages further research needs to be conducted (Powers et al., 2009).
Conclusion[edit | edit source]
- I hope you've come to understand the six process of ACT and how you can implement ACT in problematic situations. As in every therapy there are limitations and ACT will not work for everyone however, I would encourage you to have a look at the external links for further information and strategies regarding ACT.
Quiz[edit | edit source]
References[edit | edit source]
Arch, J. J., & Craske, M. G. (2008). Acceptance and commitment therapy and cognitive behavioral therapy for anxiety disorders: Different treatments, similar mechanisms?. Clinical Psychology: Science and Practice, 15, 263-279. Doi: 10.1111/j.1468-2850.2008.00137.x
Arch, J. J., Eifert, G. H., Davies, C., Vilardaga, J. C. P., Rose, R. D., & Craske, M. G. (2012). Randomized clinical trial of cognitive behavioural therapy (CBT) versus acceptance and commitment therapy (ACT) for mixed anxiety disorders. Journal of Consulting and Clinical Psychology, 80, 750-765. Doi: 10.1037/a0028310
Bargh, J. A., &Williams, L. E. (2007). On the nonconscious of emotion regulation. In J. Gross (Ed.), Handbook of emotion regulation (pp. 429−445). New York: Guilford Press.
Bond, F. W., & Bunce, D. (2000). Mediators of change in emotion-focused and problem-focused worksite stress management interventions. Journal of Occupational Health Psychology, 5, 156.
Dalrymple, K. L., & Herbert, J. D. (2007). Acceptance and commitment therapy for generalized social anxiety disorder a pilot study. Behaviour Modification,31, 543-568. Doi: 10.1177/0145445507302037
Ehring, T., Tuschen-Caffier, B., Schnülle, J., Fischer, S., & Gross, J. J. (2010). Emotion regulation and vulnerability to depression: spontaneous versus instructed use of emotion suppression and reappraisal. Emotion, 10, 563-572. Doi: 10.1037/a0019010
Flaxman, P. E., & Bond, F. W. (2010). A randomised worksite comparison of acceptance and commitment therapy and stress inoculation training. Behaviour research and therapy, 48, 816-820. Doi: 10.1016/j.brat.2010.05.004
Forman, E. M., Herbert, J. D., Moitra, E., Yeomans, P. D., & Geller, P. A. (2007). A randomized controlled effectiveness trial of acceptance and commitment therapy and cognitive therapy for anxiety and depression. Behavior Modification, 31, 772-799. Doi: 10.1177/0145445507302202
Gross, J. J., & Muñoz, R. F. (1995). Emotion regulation and mental health. Clinical psychology: Science and practice, 2, 151-164. Doi: 10.1111/j.1468-2850.1995.tb00036.x
Hayes, S. C. (2004). Acceptance and commitment therapy, relational frame theory, and the third wave of behavioural and cognitive therapies. Behavior therapy, 35, 639-665. Doi: 10.1016/S0005-7894(04)80013-3
Hayes, S. C., Levin, M. E., Plumb-Vilardaga, J., Villatte, J. L., & Pistorello, J. (2013). Acceptance and commitment therapy and contextual behavioural science: Examining the progress of a distinctive model of behavioural and cognitive therapy. Behaviour Therapy, 44, 180-198. Doi: 10.1016/j.beth.2009.08.002
Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and commitment therapy: Model, processes and outcomes. Behaviour research and therapy, 44, 1-25. Doi: 10.1016/j.brat.2005.06.006
Joormann, J., & Gotlib, I. H. (2010). Emotion regulation in depression: relation to cognitive inhibition. Cognition and Emotion, 24, 281-298. Doi: 10.1080/02699930903407948
Joormann, J. (2010). Cognitive inhibition and emotion regulation in depression. Current Directions in Psychological Science, 19, 161-166. Doi: 10.1177/0963721410370293
Powers, M. B., Zum Vörde Sive Vörding, M. B., & Emmelkamp, P. M. (2009). Acceptance and commitment therapy: A meta-analytic review. Psychotherapy and psychosomatics, 78, 73-80. Doi: 10.1159/000190790
Rector, N. A. (2013). Acceptance and Commitment Therapy: Empirical Considerations. Behaviour Therapy, 44, 213-217. Doi: 10.1016/j.beth.2010.07.007
Rolls, E. T. (1999). The brain and emotion from nature. Nature Medicine, 5, 605. Doi: 10.1038/9446
Ruiz, F. J. (2010). A review of Acceptance and Commitment Therapy (ACT) empirical evidence: Correlational, experimental psychopathology, component and outcome studies. International Journal of Psychology and Psychological Therapy, 10, 125-162. Retrieved from: http://zh9bf5sp6t.scholar.serialssolutions.com/?sid=google&auinit=FJ&aulast=Ruiz&atitle=A+review+of+Acceptance+and+Commitment+Therapy+(ACT)+empirical+evidence:+Correlational,+experimental+psychopathology,+component+and+outcome+studies&title=Revista+internacional+de+psicolog%C3%ADa+y+terapia+psicol%C3%B3gica&volume=10&issue=1&date=2010&spage=125&issn=1577-7057
Twohig, M. P. (2012). Introduction: the basis of acceptance and commitment therapy. Cognitive and Behavioural Practice, 19, 499-507. Doi: 10.1016/j.cbpra.2012.04.003
Zettle, R. D. (2012). Acceptance and commitment therapy (ACT) vs. systematic desensitization in treatment of mathematics anxiety. The Psychological Record, 53, 197-216. Retrieved from: http://opensiuc.lib.siu.edu/cgi/viewcontent.cgi?article=1477&context=tpr&sei-redir=1&referer=http%3A%2F%2Fscholar.google.com.au%2Fscholar%3Fq%3Dacceptance%2Band%2Bcommitment%2Btherapy%2B%2528ACT%2529%2BVS%2Bsystematic%2Bdesensitisation%2B%26btnG%3D%26hl%3Den%26as_sdt%3D0%252C5#search=%22acceptance%20commitment%20therapy%20%28ACT%29%20VS%20systematic%20desensitisation%22