A modern synthesis of mindfulness and cognitive behavioural therapy

The main difference between Acceptance & Commitment Therapy and classical Western approaches to psychological therapy, is that ACT does not focus on the reduction of the human experience to ‘symptoms’. Where traditionally the assumption within psychology is that humans are by nature mentally ‘healthy’ and deviations from this state are a sign of ‘disorder’ or ‘illness’, ACT suggests instead that to appeal to these concepts is at best useless and at worst harmful: our difficult thoughts and feelings are simply part of life.

Indeed, trying to get rid of symptoms is often what can land a person in the consulting room in the first place – the development of what a traditional clinical approach would term a ‘mental disorder’, Quietly aware of your thoughtssprings from attempts to suppress or ignore emotional pain.

Common so-called ‘disorders’ like anxiety, depression and addiction, are a normal aspect of human life. Even if we haven’t been ‘diagnosed’ with a specific condition, emotional and mental pain can make us suffer, and just about everyone will experience these at some time, at different levels, and perhaps over a long period of time.

This understanding comes from a view of human language as a double-edged sword: We have the capacity for complex language, and as a result, we have suffering – because it’s only as a result of language that we can articulate, conceptualize and therefore struggle with our thoughts and feelings, in a way that non-human animals simply cannot.

In therapy, ACT concentrates on teaching mindfulness—an awareness of the here and now—and a non-judgemental acceptance of the present. This can move on to a focus on developing a similar acceptance of private, internal, experiences and emotions which may be in our past or our present. The ‘commitment’ part of the therapy supports an outlook on, and reaction to, our experiences based on sound, true-to-ourselves values, to enable a more fulfilled life and work.

A therapist may share specific exercises with their client, to practise the skills of mindfulness and to track changes. As with CBT Cognitive Behavioural Therapy, you might begin with a ‘homework’ exercise to do when getting dressed in the morning, and be asked to concentrate on engaging with every sense involved. Or alternatively you might have to sit quietly and be aware of yourself, your body, your thoughts…without judgment or avoidance.

Though young, the evidence base for ACT is promising and expanding: it has shown preliminary evidence of effectiveness in randomised controlled trials for a variety of problems including anxiety, depression, chronic pain, addiction, smoking cessasion, psychosis, stress and burnout, diabetes and wright management, epilepsy control, self harm, body image and food issues, and several other areas. ACT is also beginning to be used with children and adolescents, to great results.

The House Partnership, 29th January 2012