A Super Simplistic View of

Acceptance and Commitment Therapy

The holidays come around every year and every year I struggle to get through them despite depressive inclinations. The DSM V (Dismal Scrooge Manual) describes it as a tinsel-bedecked, window-flocked, overly-piped Chipmunk Christmas Album version of Seasonal Affective Disorder.* On occasion I have had to suppress the urge to strangle someone with tangled Christmas lights if they so much as Ho Ho Ho in my direction.

Based on the theory that which does not kill us makes us stronger, in the past, I have responded by leaping maniacally manically into the holiday spirit with an elaborate annual letter with photos and captions, holiday cards, and a cookie party inviting all my friends and their children to festoon my carpet with a thousand and one sprinkles.

But the stress of my life has had an accumulative toll and this year, I seriously wondered if I was going to live long enough to see my child grow up. So I got help. I’ve been seeing a therapist (because all the cool kids are doing it) and for months now I have been trying to embrace a very simple philosophy that gives me a headache when I try to employ it. Repeat after me people:

“I am not my thoughts or emotions.”

The therapy in question is called A.C.T. a lovely acronym which stands for Acceptance and Commitment Therapy. During months of weekly visits with a very nice therapist through the V.A., I’ve managed to grasp the ideas behind the program. There’s even an APP for that on the VA website.  But it’s like chess, you can learn the rules pretty easily, it’s becoming a grand master that takes practice.

Describing A.C.T., as it turns out, is harder than I thought, but here goes:

OBSERVE

First, I learned that you step outside of whatever thought you are having (good, bad, indifferent, the emotional context doesn’t matter) instead you focus on recognizing that all thoughts are separate from who you are. You accept that you have thoughts of worthlessness, failure, depression, whatever, and then you say, “Okay. I see myself thinking X, Y, Z.” The goal isn’t to get rid of the thought or even dispute them.** After you accept that you have had a thought, you are to ask yourself “Is that thought helpful?”

BE MINDFUL

Second – be present in your life. Practicing mindfulness is what I like to call the “Woo Woo” portion of ACT. This involves active observation either of a task or meditative relaxation where you might hear a soft-spoken speaker tell you to listen to your breath while imagining leaves floating on water carrying any extraneous thought away from your observer state.*** After learning mindfulness came what I consider the more concrete portion of the therapy: Commitment.

BEING COMMITTED

Third – Values versus Goals. I was given a few different lessons in determining what really matters to me—defining the way I want to live my life. Once I decided what values matter most to me—health, being a good parent, writing—I wrote goals as steps that life. Goal: I will get to sleep by 11:00 p.m. (in progress), Goal: I will not swear at my child. (Damn.) Goal: I will value my writing and make time in my day to respect my creativity. (Ta dah!)

PRACTICE

Okay, but what happens when your week sucks bilge water? I’ll give you an example of one day I reported to my therapist:

Me: “…child has been sick …. I haven’t slept…today he flooded the kitchen AND the bathroom, he emptied the liquid dish soap into a garbage can—twice— and then, he turned on the stove past the click-click starter point, filling the house with gas, and he turned off the refrigerator…blather…blather…hysterical tears…

[My therapist always gives me time to have a mini-meltdown and she makes comforting noises before redirecting me to our opening woo-woo practice. Her voice is a soft monotone and very hypnotic as she reads from the page.]

Therapist: “Okay let’s do a mindful relaxation session. Get comfortable. Focus on your breath, but you do not need to change your breath. Breathe as you normally would. You are comfortable. You sense your hands, your feet, and your head is centered on your body….”

This goes on for a bit and then I heard the following sentence:

Therapist: “…you do not need to fix yourself.”

Me: “Bwa ha ha ha ha hah!”

I laughed so hard I was crying. I laughed so hard, I almost peed myself. I laughed so hard, the therapist started laughing. She broke out of ‘robo-voice’ to say, “Well…there isn’t anything wrong with you that needs fixing.”

It took an effort, but I finally stopped snorting and threatening to burst into manic laughter every time I thought of that sentence.  Somehow we got through the exercise. Afterward, I told her it was the best session I had and it was worth it just to be able to laugh like that.

A.C.T. doesn’t pretend to be a solution to any problems you have in your life. I like that about the program. My goal isn’t to try and ‘fix’ my thoughts, or make them go away, or pretend they aren’t there. A.C.T. is teaching me that, yeah, I may be depressed, I may have negative thoughts or feelings of worthlessness, but, I’m not going to let that stop me from trying to have a better life. It’s teaching me that I can choose to act in my best interest in spite of my mental illness.

One of my favorite lines from a movie, comes from A Beautiful Mind. In this movie, Russell Crowe plays John Nash, a mathematics genius who is nominated for the Nobel Prize for his theories in economics in spite of the fact that he is a diagnosed schizophrenic. In the scene I’m remembering, Nash is meeting a member of the Nobel Committee who is there to see whether awarding Nash the prize will lead to embarrassment.

Nash say that he might embarrass the Nobel Committee, and when asked, admits that he still sees the hallucinations that mark his schizophrenia.

Nash says, “I still see things that are not here. I just choose not to acknowledge them.”

He further explains: “I’ve gotten used to ignoring them and I think, as a result, they’ve kind of given up on me. I think that’s what it’s like with all our dreams and our nightmares, Martin, we’ve got to keep feeding them for them to stay alive.”

From now on, I am going to try and feed my dreams instead of my nightmares; take the actions that will help me to live my values; and acknowledge that some days will be easier than others. I pledge to be as kind to myself as I would be to a friend who felt this bad. And I will remember “I do not need to fix myself.” In truth, I already possess a beautiful mind.

Asterisk Bedazzled Footnotes:

*Not to make light of people who actually have S.A.D. No Joke.

**Although A.C.T. has some nifty terms for handling destructive ideas–like ‘cognitive defusion’–that makes it sound like your brain is a bomb about to go off.

***For some reason, I always imagine floating elephants down a river on a leaf. I have no idea why.

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Anyone truly wanting information on the subject can check out the following links:

Social Work Today

List of Resources from Contextual Science