Acceptance and Commitment Therapy (ACT): principles and characteristics.

One of the third generation therapies that are generating better results.

The Acceptance and Commitment Therapy (ACT) is a type of therapy that is included within the so-called third generation therapies, which emerged between the 80s and 90s in the United States and are part of the behavioral and cognitive therapeutic models.

While the first and second generation therapies focused and (focus) on combating automatic or distress-causing thoughts and replacing them with others that are supposedly more adaptive, third generation therapies emphasize dialogue and functional context and seek acceptance and a non-judgmental attitude. and non-judgmental attitude as a way to find well-being.

What are first- and second-generation therapies.

Third generation or third wave therapies belong to the behavioral therapies. To understand what these therapies are, I will first talk about the first and second generation therapies.

First generation therapies (1960s) are therapies that were born with the aim of overcoming the limitations of psychoanalytic therapy, dominant at that time. When we speak of first generation therapies we are talking about Watson's Classical Conditioning and Skinner's Operant Conditioning. These types of therapies were useful for treating, for example, fears or phobias, and were based on the principles of conditioning and learning.

However, neither the associationist learning model and the stimulus-response paradigm characteristic of Watson, nor even Skinner's experimental advance were effective in the treatment of certain psychological problems presented by some people. Then, second generation therapies emerged (1970s), which are mainly Cognitive Behavioral Therapies (CBT) such as, for example, Albert Ellis' Rational Emotive Therapy (RE) and Aaron Beck's Cognitive Therapy, which consider thinking or cognition as the main cause of human behavior and, therefore, of psychological disorders.

However, the second wave of behavioral therapies continued (and continues) to use techniques and procedures of the first generation and thus focus on the modification, elimination, avoidance and, ultimately, alteration of private events (thoughts, beliefs, emotions, feelings and even bodily sensations themselves).

In other words, these forms of therapy revolve around the idea that if the reason for the behavior is the private event, it must be modified in order to change the behavior. This premise is widely accepted nowadays, which, at present, results in what is socially established as normal and correct behavior or as mental illness. Something that fits perfectly with a medical-psychiatric and even pharmacological model.

What characterizes third-generation therapies

Third-generation therapies emerged in the 1990s and differ from the latter.They differ from the latter because they approach disorders from a contextualist, functional perspective, and their main objective is not to reduce the symptoms presented by the patient, but to educate him/her and reorient his/her life in a more holistic way. They are based on the idea that what causes discomfort or anxiety are not the events, but how we link emotions to them and how we relate to them. It is not about avoiding what causes us suffering, because this can have a rebound effect (as many researches indicate), but the ideal situation is to accept our own mental and psychological experience, and thus reduce the intensity of the symptoms.

Sometimes it can be strange to work in this type of therapy, which invites the person to see, thanks to different techniques (experiential exercises, metaphors, paradoxes, etc), that what is socially or culturally accepted causes an attempt of control over their private events, which in itself is problematic. This control is not the solution, but it is the cause of the problem..

The importance of functional contextualism

An aspect to emphasize of the therapies of third generation is that they are based on a functional and contextual perspective of the pathologies.This is called functional contextualism. That is, the behavior of the individual is analyzed from the context in which it occurs, because if it is decontextualized, then it is not possible to discover its functionality.

On the one hand, it is of interest to know how the person relates to the context according to his history and current circumstances, always taking into account verbal behavior and the clarification of values. Verbal behavior is what the patient says to himself and to others, but it is not important for its content but for its function. A patient may say that he feels self-conscious and is very embarrassed when he has to speak in public. The important thing is not to know if he feels ashamed or is self-conscious, the objective is to know if this way of thinking is good for him or if it is detrimental to him.

In addition, third generation therapies do not distinguish between observable and private behavior, since the latter is also assessed from the point of view of functionality.

Acceptance and Commitment Therapy

Undoubtedly, one of the best known third-generation therapies is Acceptance and Commitment Therapy (ACT), which aims to create a rich and fulfilling life. aims to create a rich and meaningful life for the patient, accepting the Pain that inevitably comes with it..

ACT is presented as an alternative to traditional psychology and is a model of psychotherapy that is scientifically supported and uses different techniques: paradoxes, experiential exercises, metaphors, work with personal values and even mindfulness training. It is based on the Relational Frame Theory (RFT)and is therefore framed within the new theory of language and cognition.

Human language can transform us, but it can also create psychological suffering. That is why it is necessary to work with the meanings of language, its functions and its relationship with private events (emotions, thoughts, memories...). In addition, self-discovery and clarification of values are essential elements in this type of therapy.The patient must ask himself and question himself what kind of person he wants to be, what is truly valuable in his life and from what beliefs and values he acts.

Commitment to our values

If we look around us, it seems clear that much of our suffering is determined by our beliefs about what is right and wrong, beliefs that are culturally learned, and beliefs that are culturally learned.These beliefs are culturally learned and are based on the values promoted by Western society. While most therapies see suffering as something abnormal, ACT understands that suffering is part of life itself. That is why ACT is said to challenge social ideology and models of healthy normality, in which happiness is understood as the absence of pain, anxiety or worry.

ACT, which in English means "to act", emphasizes taking effective actions guided by our deepest values, in which we are fully present and committed.

Principles of this type of therapy

ACT employs some principles that allow patients to develop the mental flexibility necessary to improve their emotional well-being.

There are six of them:

1. Acceptance.

Acceptance means recognizing and approving our emotional experienceIt has to do with treating ourselves with affection, our thoughts or our feelings. It has to do with treating ourselves with care and compassion even though we are not perfect. We should neither fight against our private events nor run away from them.

In fact, acceptance of the present situation contributes to the fact that many of the aspects of our life that we perceive as problems cease to be problems, thus decreasing the level of anxiety and the discomfort factors associated with it.

2. Cognitive defusion

It is about observing our thoughts and cognitions as what they are, pieces of language, words, words, words, words, words, words, words, words, words, words, words.They are, pieces of language, words, images, etc. Simply observe and let go without judging them. In this way, a detached and more rational view of things is adopted.

3. Present experience

The present is the only moment we can live. Being in the here and now with an open mind and full awareness, participating fully with due attention to what is happening in us and around us is the key to our well-being.

4. The "Observing Self".

It means detaching from the conceptualized selfthat is, from the attachment to our own narratives. From the perspective of the self as observer we see things from a non-judgmental point of view.

5. Clarity of values

ACT requires a work of self-knowledge that allows us to clarify our values from the depths of our soul.What is truly valuable to us? Where do we really want to be or go? These are some of the questions to be answered. Of course, always with honesty.

6. Committed action

The direction we follow should always be determined by our own values and not by social impositions. and not by social impositions. We must engage in actions that are meaningful to us. In this way we are much more likely to commit ourselves to our projects and make them progress at the pace we want them to.

Bibliographical references:

• Hayes, S.C. (2004). Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies. Behavior therapy, 35, 639-665.
• Luciano, M.C. y Valdivia, M.S. (2006). La terapia de aceptación y compromiso (ACT).Fundamentos, características y evidencia. Papeles del Psicólogo, 27, 79-91.