Acceptance and Commitment Therapy (ACT)

What it is

Most of us spend a lot of energy trying not to feel what we feel — distracting, avoiding, arguing with our own thoughts. Acceptance and Commitment Therapy asks what that struggle is costing you. Often the effort to control anxiety or sadness ends up shrinking your life more than the feelings themselves do.

ACT works on two fronts. The first is acceptance and defusion: learning to notice thoughts as thoughts — "I'm having the thought that I'll fail" rather than "I'll fail" — so they loosen their grip, and making room for uncomfortable feelings instead of fighting them. The second is values: getting clear on what genuinely matters to you, and taking steps in that direction even when difficult feelings come along for the ride.

What a session looks like

ACT sessions are often experiential. Rather than only talking about a painful thought, we might play with it — say it slowly, give it a name, picture it as a passenger on a bus you're driving. It can sound a little unusual, but the point is to feel the difference between being inside a thought and being able to step back from it.

We also spend time on values: what kind of partner, friend, worker or person you want to be, and what small, concrete actions would reflect that this week. Progress in ACT is less about feeling better right away and more about living more fully — though for many people, the two come together over time.

What it can be helpful for

ACT can be helpful for anxiety, obsessive thinking, low confidence, chronic self-doubt, and the aftermath of trauma. It can also suit people who feel stuck or directionless — who are "fine" on paper but disconnected from what they actually care about.