Montserrat Martínez: "The approach to ACT is highly experiential".

We talked about Acceptance and Commitment Therapy with psychologist Montserrat Martínez.

Acceptance and Commitment Therapy (ACT) is one of the most used psychological intervention modalities among the contextual therapies. among contextual therapies. One of its keys is to help people not to avoid at all costs what causes them discomfort, thus minimizing its impact on emotional well-being.

Taking this into account, it is not surprising that it is effective against many anxiety problems, since this kind of alterations have a lot to do with the self-fulfilling prophecy: the fear of anxiety itself favors the appearance of anxiety. We talked about it with the psychologist Montserrat Martínezof Astronauta Emocional.

Interview with Montserrat Martínez: the treatment of anxiety from Acceptance and Commitment Therapy.

Montserrat Martínez is a psychologist specialized in cognitive-behavioral therapy, ACT and Behavioral Medicine, as well as a member of Astronauta Emocional. In this interview she talks about the treatment of anxiety problems from Acceptance and Commitment Therapy.

What are the characteristics of Acceptance and Commitment Therapy that you consider most interesting?

I think that something very valuable of ACT (Acceptance and Commitment Therapy), is the perspective that it has on the discomfort. It invites us to reflect on what would happen if only half of the effort we put into avoiding emotions such as sadness, Pain or frustration were invested in getting closer to what really matters to us in life.

Usually there is a thought about "you must be well, you must be happy and if you are not, something is wrong with you", then ACT comes to tell you that discomfort is part of life, and that it is not incompatible with being the person you like to be and living a valuable life. It is very important to point out that accepting discomfort as part of life is not the same as resigning ourselves to it.

For example, imagine that you are experiencing a lot of pain in your knee. Resigning yourself to living with that pain and "pretending it doesn't hurt" could hurt you even more. Accepting the presence of pain allows you to recognize that there is something in your body that needs your attention. That, in turn, will give you the opportunity to give yourself the care you need and allow you to rest when you need it.

ACT promotes acting on the basis of what is truly valuable for each person, practicing our curiosity in approaching day-to-day experiences.

Is it easy for patients to understand how this kind of psychological intervention program works?

Of course, especially because the approach to Acceptance and Commitment Therapy is highly experiential. In ACT we work a lot with metaphors and with various experiential exercises that facilitate the contact of patients with the main components of the therapy.

How does it work in helping us overcome our fears?

Precisely one characteristic of ACT is that it does not seek to overcome / leave behind / remove the discomfort, in this case fear. Anyone would think that it is absurd to receive a treatment that does not seek to alleviate, but rather seeks to make space for discomfort and move toward what is important to each person (psychological flexibility).

However, this is related to the popular idea that our uncomfortable emotions are problems that we must fix.

Here the proposal is not to change emotions, but to change our relationship with them. What would you do if fear did not weigh so heavily in your decisions? In ACT the patient is made aware that emotions are part of the various experiences of life. You cannot choose whether you will ever feel fear again, but by changing the relationship you have with that emotion, you can choose not to let fear keep you from what is important to you.

Does the principle of acceptance also help manage cases of excessive perfectionism and fear of not doing things right?

Of course it does. Imagine that when you are doing activity X, thoughts come to you like: "I don't like the way it looks, why can't I do it right? I can't leave it like this, because if it stays like this then... (insert catastrophic phrase of your choice here)".

You can try a lot of things to avoid that discomfort, like repeating the activity several times, spending a lot of time and effort to get it as close to what you consider perfect.... The point is that, if you invest all your resources in activity X, you will end up leaving aside other things that may also be valuable to you.

ACT strategies allow us to accept or make room for the various uncomfortable thoughts or emotions that we are experiencing at that moment. They promote being an observer of those experiences, bringing down that literal touch they have when we get hooked.

In that way, our attention is no longer wrapped up in thoughts, but we have the opportunity to direct it back to what is valuable to us.

In what cases of attention to people with anxiety problems is Acceptance and Commitment Therapy most useful?

It has been shown to be effective in treating conditions of what is known as generalized anxiety, panic attacks, Obsessive-Compulsive Disorder, etc. Again, the objective of ACT is not to remove the symptoms, but if this occurs it is considered as an indirect gain of the real objective: to generate psychological flexibility to get in touch with what is important, making space for the discomfort.

What are the main phases of Acceptance and Commitment Therapy?

The basic processes of ACT are the following: contact with the present moment, self as context, acceptance, cognitive defusion, values, and committed actions.

They are not necessarily implemented in that order, since, as with any intervention, it is not a recipe. It is very important to carry out an adequate analysis of the case, from which it will be decided which process to start with and which specific strategies will be used to train this process.