What is Acceptance and Commitment Therapy?

Acceptance and Commitment Therapy: It is a new generation of cognitive behavioral therapy. The most representative empirical behavioral therapy method is through mindfulness, acceptance, cognitive dissociation, self-context, clear value and committed action, etc. The process and flexible and diverse treatment techniques help the visitor to increase psychological flexibility and invest in a valuable and meaningful life.

Origin of acceptance and commitment therapy

Acceptance and commitment therapy is a new psychotherapy method based on behavioral therapy established in the 1990s by Professor Steven C. Hayes and his colleagues in the United States. Another major psychotherapy theory after behavioral therapy. ACT, together with dialectical behavioral therapy and Vipassana cognitive therapy, is known as the third wave of cognitive behavioral therapy, and is the latest development of cognitive behavioral therapy.

The goal of ACT is to improve psychological flexibility: the ability to change mentally or to adhere to functional behaviors to achieve value goals. The aim is to find a broader, more flexible and effective coping style instead of refuting the specific cognitive content of narrow psychological problems; the treatment emphasizes the connection between the tested problems. ^[1]

Theoretical background of acceptance and commitment therapy

1. The philosophical background of ACT: functional contextualism

ACT originates from behavioral analysis, and modern behavioral analysis is based on "functional contextualism" [4]. Contextualism understands psychological events as the continuous interaction of the whole with specific contexts (including history and environment), seeks to maintain a connection with the entire psychological event and its context, and analyzes the psychology in a way that its integrity is not damaged Events, and try to predict and influence the continuous interaction between the whole and the specific situation, and strive to make the analysis to a certain degree of accuracy, scope and depth. Compared to the form of psychological events, contextualism pays most attention to the function of psychological events. Contextism believes that, to a certain extent, any event that deviates from history and the current situation cannot be called an "event"; likewise, behavior should be closely related to the specific situation.

Functional contextism as the philosophical background of ACT is mainly reflected in several aspects. First, ACT believes that there is no absolute universal truth in the world, stresses the importance of effectiveness, and uses values as a prerequisite for measuring effectiveness. Second, ACT's behavioral analysis takes "prediction and impact" as its overall goal, which has to include multidimensional contextual variables into the scope of analysis. In addition, functional contextualism's pragmatism orientation makes goals particularly important. ACT also emphasizes this point. Visitors are encouraged to enthusiastically engage in a life consistent with their values and achieve their goals in life, rather than pursue them. Vague theory.

2. The theoretical basis of ACT: The relational framework theory The relational framework theory is a comprehensive functional contextual model of basic research on human language and cognition. It is believed that humans have produced language in the evolution process. Understanding language and cognition is The key to understanding human behavior. The core of human language and advanced cognition is to have a learned and context-controlled ability to artificially correlate and combine events with each other and change the function of specific events according to these relationships.

There are three main characteristics of people's learning of language and cognitive relationship: first, the relationship

Sex. If a person learns that A has a specific relationship with B in a certain context, it means that B also has this relationship with A in this context. Second, this relationship has a joint push Derivative ". If a person learns that in a specific context, A and B have a specific relationship, and B and C have a specific relationship, then in this context, there must be some kind of A and B Third, this relationship can change the function of the stimulus in related stimuli, such as "Wang Mei quenches thirst", and when you hear the voice of "Mei", you will think of the real "Mei" and then it will stimulate Saliva secretion. When all three of the above characteristics determine and form a specific relationship, we call this relationship the "relationship framework."

Psychopathological model of acceptance and commitment therapy

Based on the basic assumptions of RFT, Hayes et al. (2006) summarized the psychopathological model of ACT into six major issues.

Acceptance and Promise Empirical Avoidance

Refers to people trying to control or change their specific inner experiences (including physical sensations, thoughts, emotions, memories, and automatic behaviors). Because of the paradoxical effect of depressive thinking, empirical avoidance does not play a very effective role. In addition, the simple avoidance method, even if it can delay negative emotions, often causes visitors to become numb or allergic to irritants, resulting in obstruction of living space.

Cognitive fusion of acceptance and commitment therapy

Refers to excessive or inappropriate control of behavior by language processes. The laws of language often reduce the scope of direct experience and limit the influence of incidents. In this way, people do not have good access to the experience and immediate contingencies at this time and place, but are more inclined to be governed by the laws of language and evaluation [10]. According to the theory of ACT / RFT, the content and form of cognition will not directly cause problems unless the contextual characteristics make the form of cognition affect people's behavior in an unhealthy way. For example, under the influence of language rules, people will confuse cognitive content with cognitive objects, and confuse interpretation of events with events themselves.

The past and the horrified future of acceptance and commitment therapy

Refers to cognitive fusion and empirical avoidance, continually thinking about past mistakes or terrible futures, which leads to people not being able to feel the present, losing direct and real experience at the moment, and new possibilities are excluded .

Receptive and Commitment Therapy 's Attachment to Conceptualized Self

It refers to restricting the self with conceptual language, narrowing the self, and causing inflexible behavior patterns. For example, visitors described themselves as "I'm a phobia" rather than "I'm scared."

5. Lack of clear values. It means that due to the bad social environment and past history, the visitor cannot choose a meaningful way to live, and lacks a sense of value and self-esteem.

6. Inaction, impulse or evasion: Refers to the defense of visitors by their conceptual self, manifested by the lack of vitality and action to effectively engage in various areas of life; from the short-term effects, it may reduce the negative reactions of visitors. Make the visitor feel right, but this kind of behavior will make the visitor lose contact with the lifestyle they want, which will lead to the degradation of long-term quality of life (values).

The core process of acceptance and commitment therapy

Admission and Commitment Therapy Admission

In ACT, acceptance is not just tolerance, but a positive rather than critical accommodation of the experience at the moment. That is, make room for painful feelings, impulses, and emotions. Do not resist, control, and escape them, and observe them as objects.

Cognitive dissociation of acceptance and commitment therapy

It means to separate the self from thought, image and memory, to objectively focus on ideological activity as to observe a vehicle, and to think of thought as the language and words themselves, rather than the meaning it represents, beyond their control. Mindfulness exercises can effectively help visitors focus on the process of thinking.

Acceptance and commitment therapy focus on the present

ACT encourages visitors to consciously pay attention to the environment and psychological activities they are in at this moment, and accept them without evaluation. The goal is to help visitors experience the world around them more directly, thereby increasing the flexibility of their behavior and aligning with their values.

Receiving and Commitment Observing Self

Painful thoughts and feelings threaten the visitor's ego, and this negative feeling is especially significant when the self is the conceptual object. The observing self can help visitors focus on their real experiences and promote cognitive dissociation and acceptance. ACT often uses mindfulness techniques, metaphors, and empirical processes to help visitors reach their observed self.

Acceptance and commitment therapy values

Values in ACT refer to language constructs, which are the overall, longing and chosen life direction of the visitor. Values are inseparable from people's behavior and consciously run through every purposeful action in life. Value-based actions are constructive, not to escape pain.

Acceptance and Commitment Therapy Commitment Action

ACT is not only a treatment strategy that accepts orientation, but also a treatment strategy that changes orientation. The purpose of ACT is to help visitors choose behavior changes that are consistent with their values, take responsibility for their actions, and support effective values-based life.

The six core processes of ACT can be divided into two parts. The first part is the process of mindfulness and acceptance: ACT tries to unconditionally accept, cognitively dissociate, pay attention to the present, and observe itself to reduce subjective control, reduce subjective judgment, weaken language domination, Experiential escape, living more in the present. Connected to this moment, to our values, to make behavior more flexible. The second part is the process of commitment and behavior change: ACT helps visitors mobilize and gather energy, move towards goals, and live a valuable and meaningful life by paying attention to the present, observing self, clarifying values, and committing actions. The reason why this treatment model is called "acceptance and commitment therapy" is that these two processes are integrated into an organic whole in ACT.

Acceptance and commitment therapy process

1. Challenging the old ideas: Because ACT challenges the coping strategies used by the visitor daily, the therapist usually asks the visitor to reflect on how many failed methods he has tried before the treatment begins, and asks the visitor whether he believes his thinking or whether Believe in practical experience, the purpose is to use the visitors' personal experience to challenge the idea of directly eliminating the problem before.

2. Make clear that control is the problem: Trying to suppress thoughts and emotions will cause the suppressed object to be repeated and increased. In order to make the visitor understand this principle, the therapist will guide the visitor to conduct the do nt want coffee experiment: first Briefly describe the various properties of coffee, and then ask the visitor to do the next time the only thing to do is not to think about any of the properties of coffee mentioned earlier. Through similar experiments, visitors were made aware that their attempts to control the process of automated thinking, emotion, and memory were playing a game that would never win.

3. De-fusion exercise: "Milk milk" is a typical practice of cognitive de-fusion technology: the therapist and the visitor repeat the word "milk" aloud in a short period of time. Later, the visitor will find the word "milk" It lost its original meaning and became a simple vocabulary. This exercise enables the visitor to experience the meaning of cognitive disintegration and understand words as words.

4. Learn Mindfulness Technology: In order to make the visitor better grasp the technology of mindfulness, the therapist visualizes the mindfulness technology: The visitor is asked to imagine a group of villains walking out of the left ear, bypassing the eyes, and entering the right ear. People are holding signs with pictures and words printed on them, asking visitors to stay on the sidelines and allow the queue to move freely without getting themselves into it. This process is often used as homework, allowing visitors to experience the difference between observing their own thinking and observing the world according to their thinking. Vivid imagination makes it easy for visitors to grasp the purposeful, momentary, and non-critical characteristics of mindfulness.

5. Contextualized Self: In order to transform the visitor from the perspective of the conceptualized self to the perspective of the contextualized self, the therapist will use the chessboard metaphor: Let the visitor imagine an infinitely stretched chessboard with white and blacks facing each other. Baizi is Positive experience, sunspots are negative experiences. The visitor worked hard to support Baizi's victory over the sunspot, because the superiority of the sunspot meant that the visitor's self-concept was threatened, so part of the visitor's experience became his own enemy. The therapist will remind the visitor that instead of thinking that he is Baizi, it is better to realize that he is only a chessboard.The visitor can have painful memories and bad ideas. The battle between Baizi and Kuroko will continue, but the visitor can let the fight Continue without having to live in a war zone. Through this metaphor, the visitor's understanding of the self has changed from the self conceptualized by various labels to the self as the background. Through this transformation, the visitor no longer regards negative experience as a threat, and further strengthens the connection with this place.

6. Clarify the values: Taking values as action orientation is the characteristic of ACT. The therapist will clarify the value of the visitor in several main areas of life by asking the visitor what he hopes to show in his life, and even letting the visitor imagine his funeral and what to write on the tombstone or eulogy. The therapist will emphasize that values are a continuously pursued direction rather than a specific achievable goal, and that clarification of values is a personal choice rather than being limited by evaluation or judgment.

7. Commitment to action: Finally, the visitor should commit to actions that are linked with values. This part widely uses various techniques of traditional behavior therapy. At this stage, short-term and long-term specific goals will be set, so that visitors will practice a more flexible behavior model step by step, achieve a balance between acceptance and change, and then create a valuable life.