The Power of Acceptance and Commitment Therapy

Using Meditative and Mindfulness Practices to Redefine Emotion

Ryan Howes

We Americans believe profoundly not only in the pursuit of happiness, but in our unalienable right to obtain it. Despite roughly 5,000 years of written evidence to the contrary, we believe it isn’t normal to be unhappy. That’s why we have so many approaches to therapy and so many therapists. In general, we don’t want to stick around with psychological pain a second longer than necessary to get it excised from our life.

The problem is, according to Steven Hayes, professor at the University of Nevada, former Haight-Ashbury hippie turned behaviorist, and the developer of acceptance and commitment therapy (ACT), we’ve got it backwards. In fact, it’s suffering and struggle that are normal---and not the reverse. Furthermore, dealing with our inevitable psychic struggles by trying to get rid of them doesn’t work and may actually make them worse.

Instead of countering and correcting our negative thoughts, as classic cognitive therapy argues we should do, Hayes believes we should acknowledge those thoughts, accept them rather than challenge them, and then get on with living as full and worthwhile a life as we can. That’s the commitment part of ACT, and the tough-minded part as well.

In his prodigiously well-published career, Hayes has written more than 500 scientific articles and several books, including the 2005 bestseller Get Out of Your Mind and Into Your Life, and has established ACT as the most empirically supported application of mindfulness principles in the field of psychotherapy. In the following interview, he explains both the origins of ACT and what he sees as its future.

RH: How did you first develop ACT?

Hayes: ACT was first developed in the early ’80s and grew out of my own experience with panic disorder and treating other clients with anxiety problems. I’d been trained as a cognitive behavioral therapist. But when I realized that cognitive behavioral therapy (CBT) wasn’t helping me deal with my own problems with anxiety, I returned to some of the more Eastern ideas that had appealed to me earlier in my life.

If you either avoid something or fight and argue with it, you give it power. Instead, I began to see how to apply meditative and mindfulness practices to my anxious thoughts and feelings about myself. I added the idea of examining a person’s deepest values as a guide to determining the direction of change. It’s not enough to focus on what you don’t want to experience. If I don’t focus on my symptoms, what do I want to be doing with my life? That’s where the role of commitment came into ACT.

RH: Let’s make it practical here. Say you’re working with someone with panic disorder. What’s the ACT treatment plan?

Hayes: We view anxiety as a problem of psychological inflexibility. It’s an inability to come into the present moment and open up to your emotions, to see your thoughts as they are, and to focus on what’s really of importance to you. The goal of ACT is to help people develop a sense of self that’s larger than the limited story they’re used to telling about themselves and others that’s getting in their way.

When ACT works, it helps people get more in touch with their thinking and feelings as they are---not what they’re supposed to be. And instead of experiencing emotions as accidents or obstacles, people can understand their meaning and use them to move toward what gives them more energy and purpose in life. ACT isn’t a panacea or a cure, but it’s a way to organize your life around a fuller sense of purpose and meaning, one step at a time.

RH: What are the practical applications of ACT techniques?

Hayes: It turns that ACT methods apply to a stunning range of human problems and opportunities for growth. As of the end of 2014, there’ve been more than 110 randomized controlled trials of ACT and 260 total trials in almost every area of human concern. Areas with at least five published studies are what you’d expect---depression, anxiety, substance use, pain control---but others are perhaps more surprising: psychosis, stigma and prejudice, training and education, dealing with cancer.

ACT has been shown to help international-level chess players and professional hockey players. There are Olympic athletes who’ve won their gold medals using ACT. How can a therapy method achieve all that? The key seems to be improving psychological flexibility---people’s openness to experience and their ability to disentangle from distracting cognition and feelings. By increasing people’s ability to purposefully attend to the present and their ability to link their actions to their deepest values, you can put them on a path to positive growth that will likely echo for a long time, not just in their lives, but in the lives of those they love.

This blog is excerpted from “The Power of Commitment". The full version is available in the March/April 2015 issue. To subscribe, click here. >>

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Topic: Mindfulness | Anxiety/Depression

Tags: acceptance and commitment therapy | add | behavioral therapy | cbt | cognitive behavior | cognitive behavioral | cognitive behavioral therapist | cognitive behavioral therapy | cognitive behavioral therapy cbt | cognitive therapy | depression | ED | emotion | field of psychotherapy | mindful | pain control | panic disorder | practices | prejudice | psychosis | psychotherapy | TED | therapist | therapists | therapy | Psychotherapy Networker | anxious | clients

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Tuesday, May 26, 2020 7:13:25 PM | posted by Art Marr
How a true radical behaviorism gives ACT the boot and makes RFT useless In 1994, the book ‘Learning and Complex Behavior’ was published by the Skinnerian behaviorists John Donahoe and David Palmer. An entire issue of the Journal of the Experimental Analysis of Behavior, the house organ of the Skinnerian movement, was devoted to its analysis and criticism, which was mainly laudatory. (link to one of these reviews from the JEAB is below) The book attempted to reconcile cognitive psychology with a Skinnerian radical behaviorism and mapped the Skinnerian data language or syntax to micro-behavioral events, in this case neural activity. Two major hypotheses were ventured by the authors. First, that classical and operant conditioning are not distinct processes, but can be derived from higher order models of brain functioning, or neural networks. Secondly, that reinforcement was the result of dopaminergic activity, which governs attentive arousal and neural activation. Both conclusions have been verified in modern bio- behaviorism (see below link to Berridge’s article). D and P’s interpretation of a radical behaviorism is precisely the same as that which governs science, which insists on strict mapping of data languages (syntax) to real world events (semantics). Think of modern physics or medicine, which precisely map their terminology to real empiric events. The lineage of learning theories, from Thorndike and Pavlov to Bolles and Berridge in modern times, are basically radical behaviorisms, although they usually do not use a Skinnerian data language. D and P’s analysis did neglect one fact, however. The dopaminergic processes for reinforcement they discussed are affective and are core elements of emotional states. Indeed, positive affective states, as governed by opioid and dopaminergic systems, can be mapped to abstract properties of response contingencies, and can be elicited and sustained without recourse to the linguistic psychodynamics which are core to modern psychotherapies and their rationales, including ACT. In other words, sustained positive affect, or ‘happiness’ is entirely dependent upon the abstract rather than normative properties of simple response contingencies, or how rather than what we think, and can be easily replicated in day to day life, a hypothesis that can be tested with easily falsifiable procedure. The irony of this is that the metaphors of ‘acceptance’ and ‘commitment’ do apply, though RFT and ACT don’t. I offer a more detailed theoretical explanation and procedure in pp. 47-52 of my open source book on the neuroscience of resting states, ‘The Book of Rest’, linked below. This interpretation is based on the work of the distinguished neuroscientist Kent Berridge of the University of Michigan, a leading theorist on emotion and incentive motivation, who was kind to vet the work for accuracy and endorse the finished manuscript. Berridge’s Site and article on history of reward learning Shull's review of D and P and Tonneau's article on why RFT is so darn incomprehensible

Thursday, October 10, 2019 6:47:58 PM | posted by art marr
On Mindfulness and Commitment Below is a brief explanation of how a simple variation of mindfulness procedure can elicit peak, ecstatic, or ‘flow’ states. It is based on the incentive motivation theory (a radical or bio-behaviorism) of the distinguished neuroscientist Dr. Kent Berridge of the University of Michigan, who was kind to vet the argument for accuracy and endorse the work (in preface in linked MS below). The procedure presented parallels closely those endorsed in ACT, however the argument is derived from a radical behaviorism, not a behavioristic theory of language (RFT), which is the foundation of Act. Per the pragmatic principles of behaviorism my argument rises or falls on procedure, theory is a matter of justification, and is offered in the links below. Assumptions 1. Opioid systems (pleasure) are activated when the covert musculature is inactive or relaxed, and suppressed when the covert musculature is active (a state of tension). 2. Dopamine systems (attentive arousal) are activated upon the perception or anticipation of positive act-outcome discrepancy (or novelty) and are suppressed when present or anticipated outcomes are predictable or negative (boredom, depression). 3. When concurrently activated, opioid and dopamine systems can interact and co-stimulate each other, and result in self-reports of ecstatic or peak experience. Prediction Concurrent response contingencies that induce relaxation (e.g. mindfulness protocols) and attentive arousal (e.g. meaningful behavior) will result in the co-activation of both systems with self-reports of arousal and pleasure that are subjectively reported as ‘flow’ or ‘peak’ experiences. Proof Self-reports of peak experiences without exception occur during states of relaxation coupled with the continuous anticipation of high and positive act-outcome discrepancy (e.g. creative, sporting, and other meaningful behavior). (pp.82-86 of linked book below). Besides its face validity, the hypothesis also provides the procedural means for its easy falsification. (pp. 47-52). To wit, simply consistently engage in mindfulness (a relaxation protocol) while consistently pursuing meaningful behavior, and you will feel alert, aroused, and feel good to boot. That’s it. The Psychology of Rest Meditation and Rest from the International Journal of Stress Management, by this author Kent Berridge: Affective Neuroscience and Biopsychology Lab also at

Sunday, August 25, 2019 6:41:05 AM | posted by Ian Tomlinson
ACT is a great way to manage all sorts of psychological challenges. I guess where I find it helps most is by giving a reason for sitting with the uncomfortable thought or feeling that you are having. If you are doing that in service of your values, then it becomes much easier to do.

Saturday, May 27, 2017 11:49:18 AM | posted by art marr
ACT is correct, from an entirely different behavioristic perspective Linked below is the first interpretation of mindfulness from the perspective of an affective neuroscience, or in the larger perspective, a radical behaviorism. This argument is based on the research of Dr. Kent Berridge of the University of Michigan on the neurology of incentive motivation, and other published articles by this author. The argument and procedure (pp. 39-41) is short, succinct, simple and easily testable, and offers a radical reinterpretation of mindfulness, but it also emphasizes the ‘commitment’ element in ACT that differentiates ACT from other therapies. In other words, my argument conforms with ACT, but from an entirely different perspective that is nonetheless thoroughly behavioristic.

Saturday, November 5, 2016 6:38:54 AM | posted by Ashley E Britain
I suffer from extreme anxieties