Many addicts in recovery discover that negative self-talk contributes to maladaptive coping behavior and bad habits. Addiction presents a vicious cycle where poor self esteem and negative self-talk creates destructive thought patterns. These, in turn, often lead to relapses and decisions that the person would not make in their normal baseline state of mind. Acceptance and Commitment Therapy (ACT) presents a targeted form of cognitive behavioral therapy geared toward affecting change through mindfulness. This offers a unique benefit to people in early recovery trying to move on from residual “addict brain” thoughts. ACT takes value judgements out of mental health issues by moving away from the stigma of pathology (i.e., teaching that feelings are normal, transient, and not something to avoid). And empirical evidence shows that ACT has a high efficacy rate for treating addiction. So how does ACT work, exactly?
What is Cognitive Behavioral Therapy (CBT)?
ACT has its roots in cognitive behavioral therapy (CBT). The CBT modality takes the approach of direct cognitive intervention and helps individuals become aware of “inaccurate or negative” thinking. Some examples include: recovering addicts romanticizing their past use, depressed individuals believing they are worthless, anxious individuals having uncontrollable feelings of worry. CBT reframes these perspectives in order to reduce the frequency and intensity of such “inaccurate or negative” thoughts.
Acceptance and Commitment Therapy recognizes the existence of these unwanted thoughts, but overall it takes a different approach to handling them. Instead of labeling thoughts as “inaccurate or negative,” ACT teaches individuals to recognize those thoughts without judgement.
Acceptance and Commitment Therapy
To explain, Acceptance and Commitment Therapy suggests that the ongoing attempt (by most Western psychotherapy) to get rid of symptoms actually creates a clinical disorder in the first place. The concept of “symptom” labels certain feelings as pathological. For example, major depressive disorder lists symptoms like “feelings of worthlessness, tearfulness, emptiness or hopelessness” in addition to “loss of interest of pleasure in normal activities.” While such feelings do describe a recognized psychiatric disorder in the clinical sense, ACT frames those symptoms as normal feelings which are transient, neutral, and observable in the therapeutic sense. By doing so, ACT aims to take the power out of unwanted thoughts.
ACT postulates that defining ANY thoughts as “inaccurate or negative” sets up a struggle with those feelings by definition. Western psychology teaches that certain thoughts and feelings are aberrant problems. But ACT rejects the concept of aberrant because they are simply part of the human experience. Why quantify whether one individual experiences more unwanted thoughts and feelings than another? While definitions of mental health disorders help physicians treat a large number of patients, those labels may be more hurtful than helpful in a therapeutic setting.
Six Core Processes of ACT
Therapists use ACT to help individuals take a step back to look at their own self-talk and how it serves them. It specifically focuses on how individuals process current events happening and the inner understanding/processing of traumatic events, problematic relationships, or other life challenges. At that point, individuals can decide if any specific problem requires immediate action/change or if it must be accepted for what it is with any helpful behavioral modifications. ACT refers to this as psychological flexibility which uses six core processes:
- Acceptance: The human experience means embracing a full range of emotions. It is not helpful to avoid, deny, or alter the unwanted ones, as that can actually make them worse.
- Cognitive Defusion: The concept refers to adding intentional space between input and reaction. It includes distancing yourself from instinctual/emotional reactions which will mitigate their harmful effects.
- Being Present: Connection to the present moment serves as a perpetual resource. The body and its environment can be utilized to diffuse unwanted emotions or encourage positive ones.
- Self as Context: Seeing yourself as unchanged by time and experience. Our emotions and experiences happened, but they do not define us.
- Values: Explore, discover, and define what truly matters. This is a conscious choice that we make for our own lives.
- Committed Action: Take real steps to pursue a balanced state of mind while holding true to one’s values.
ACT uses all of these processes to guide individuals through their experiences. It puts particular focus on how we process events and feelings within the inner mind. This stems from a core philosophy that perspective can create problems out of inherently neutral events.
Suffering Rooted in Language
ACT suggests that human language naturally creates suffering for everyone. Taking a step back to assess the utility of language helps to explain why. The ability to solve problems makes language one of our biggest evolutionary advantages. Language has helped us to create civilizations across earth and even travel into space. But the idea of “problem solving” immediately creates a value judgment toward events that would otherwise exist in neutrality.
“Problems” are things we don’t want. “Solutions” figure out how to get rid of problems or avoid them. And that distinction between problem and solution works well in the material world. Humans have devised incredibly complex concepts around it, such as science and engineering. Both offer immeasurable utility for the outside world as they create things like hospitals (science plus engineering) that save lives. But the psychological world of private thoughts and feelings do not follow the same rules as our physical world. Giving language to private experiences, paradoxically, becomes problematic in itself. But how?
Myths & Understanding around “Control”
Most people would unanimously agree that certain private feelings such as depression, boredom, anxiety, and loneliness qualify as “unwanted” and “uncomfortable.” And human language naturally suggests that, as a result, those feelings are problems. Once we peg something as a problem, the next automatic step is to seek a solution. Identifying a problem naturally transitions into problem solving without a second guess. In this way, human language builds up a myth around control.
But private feelings and thoughts do not always need to be controlled. Yes, they can be unwanted and uncomfortable. But ACT teaches that the more time and energy we spend trying to avoid or get rid of unwanted feelings, the more we set ourselves up to suffer psychologically in the long term. ACT does not suggest that we ignore our thoughts and feelings. Rather, we look them square in the eye, hold our ground, and nod. Not a nod of agreement; rather, one of acknowledgement and neutrality.
ACT for Addiction Treatment
Some degree of problem solving certainly helps in treating an established addiction. Therapy and psychiatric medication often serve as the first steps. But even though psychiatry can manage our brain’s chemicals and neurotransmitters to a degree, we will never completely control them. As therapy often teaches, a fixation on control can actually lead to maladaptive behaviors.
Addiction typically begins as an attempt to avoid or quiet uncomfortable feelings. But these attempts become both ineffective and self-sustaining in the long term. This process entrenches itself through chemical dependence. Withdrawals eventually come onto the scene as physical manifestations of our failed attempts at control. And the cycle continues. Addiction recovery disrupts this cycle; however, the disruption requires dedication and persistence to work long term. ACT serves as just one of the tools used in establishing a clean and sober lifestyle.
If you or someone you love is seeking help for a substance abuse problem, our mental health counselors are available 24/7 by phone: 855-997-4702