Acceptance and commitment therapy

by Arran James

I first heard about ACT this summer. I had read about it in a critique of CBT and then again in as a treatment for anorexia nervosa. Around this same time I had the chance to read a manual for the application of ACT in relation to anorexia whilst sharing office space with a clinical psychologist who was only too happy to talk it through with me.

While it sounds hippy as fuck it’s actually pretty pessimistic at it’s core. It’s the only therapy, other than psychoanalysis, that I find myself spontaneously agreeing with…that is, no matter what problems I know it has, I simply find myself wanting to agree with it. Take, for instance, the reversal of traditional thinking in regards to pathogenesis in the Psych-discourses…. here ACT reads like it sits comfortably in the pessimistic tradition of Buddha, Schopenhauer, Nietzsche, Houellebecq and all that jazz. You know the team. All those sexy kids who knew all about suffering and exhaustion, making them the pivotal moments of their lives and works. So then, the ACT scpheil, coming from it’s originators:

[ACT] is based on the assumption of destructive normality: the idea that ordinary human psychological processes can themselves lead to extremely dysfunctional and destructive results and can amplify or exacerbate usual pathological processes. [1]

Also of interest is that in the founding text Haynes et al discuss suicide as the human phenomena, or more particularly as the phenomena of verbal being. Slaughterhouse of the being, indeed.

At any rate, our entire cultural inheritance has this same pessimistic truth at its core: to exist is to suffer. It is stunning to have found a cognitive-behavioural approach that places this at it’s core. Psychodynamic therapies might be gaining an evidence-base but until they return full swing, and make their training programmes a shit load cheaper, I think ACT might be an interesting development for future practice.

[1] Acceptance and Commitment Therapy: An Experiential Approach to Behavior Change By Steven C. Hayes, Kirk D. Strosahl, Kelly G. Wilson