Acceptance and Commitment Therapy (ACT)

I’ve decided to expand this blog beyond just recipes and fashion… Don’t get me wrong, I love to cook, I love to bake, I love makeup, and I love clothes… But in my personal life, I have been going through myriad challenges, and I thought that perhaps it would be mutually beneficial if I showed my followers a more vulnerable side of myself. I want to be able to connect with you all, so I am going to open up about my personal struggles in hopes that any of you out there, in the far-reaching corners of the internet, who deal with similar struggles, may not feel so alone.

I have struggled with overwhelming anxiety for as long as I can remember. I have let it hold me back from doing so many things that I wanted to do. Worry and stress have been a constant in my life. But up until recently, I had only occasionally experienced what I now know is diagnosed as a panic attack. Since moving cross country, though, I have been suffering from full blown panic disorder with agoraphobia.

Some of you may have experienced this, whether you knew what it was or not. (The NIMH estimates that over 6 million Americans suffer from panic disorder.) For me, I develop tunnel vision. My heart starts pounding out of my chest. I start to feel faint, I break out in a cold sweat, my stomach churns, my breath becomes short, and all my thoughts become focused on how I can escape whatever situation I am in, in that moment. Perhaps the worst one I experienced was my first day on a new job soon after I moved here. It hit me hard; it felt like I was dying. I told my supervisor I had to leave, that I just wasn’t ready to take this step. At the time, it was humiliating. In retrospect, I’m almost glad I didn’t make it through the day. It felt like rock bottom, and that was the motivation I needed to get help.

For months, I was scared to leave my house, save to go to the grocery store from time to time. Before we embarked on a weekend trip to Las Vegas, I started gagging. It took every ounce of will power within myself to not turn back around and go home.

I realized that I was wasting my life away. Someone close to me recommended Acceptance and Commitment Therapy, or ACT (pronounced like the verb – this is important). I researched psychologists in my area who specialized in this form of therapy, and made an appointment with one who seemed good. My first session with her, I knew she was the perfect fit for me. We shared a similar background (and a similar love of Harry Potter), and she was incredibly warm and compassionate. This was, admittedly, a relief. I have had some sour experiences with therapists. I saw a psychiatrist in Baton Rouge, who, after I gave him my family history, he laughed dryly and said, “Well, you’re fucked.” I saw another woman who judged me harshly within the first 10 minutes. As such, it was a welcome experience to find such a friendly and impartial ear. She diagnosed me with panic disorder with agoraphobia, and she wondered if I had something she called “neophobia” – a fear of new things. I thought this was pretty spot on.

We began by reading Russ Harris’ “The Happiness Trap,” over a period of several months, a book which I vehemently recommend to anyone and everyone. This book, along with the skills I have learned in ACT, have dramatically changed my life.

Harris starts by arguing that our general definition of happiness is fleeting and unattainable. When we define happiness as just positive, joyous feelings, we are doomed to remain in a constant game of cat and mouse. However, what if we were to redefine happiness? What if happiness is the more sustainable sense of fulfillment that comes by acting on what we value? This is a process that is not always pleasant or comfortable…for instance, if you value being healthy, working out at 5 a.m. will not always be a pleasurable experience. But the rewards that come as a result of living in accordance with this value are far more indelible.

We, as a society, are constantly searching for a quick fix to what we perceive as our problems. We do everything in our power to avoid uncomfortable thoughts, feelings, emotions, and urges. We take a pill for everything, we distract ourselves with reality television, we eat our feelings, we abuse substances, we we are workaholics, we sleep our days away – all this to avoid feeling bad. But these avoidance measures merely beget more painful and uncomfortable feelings. ACT teaches that instead of running from these feelings, we should embrace them – anxiety and depression are completely NORMAL emotions in the vast spectrum of human experiences. In this day and age, it is more abnormal NOT to ever struggle with such things. To experience these uncomfortable feelings is to be fully human.

There are several important tenants to ACT that Russ Harris describes in his book. The first of these is defusion: you must understand the fact that your thoughts, feelings, and urges are just that – thoughts, feelings, and urges. They do not have to define reality. If you think in your head, “I cannot stand up right now. I can’t do it. I can’t stand up,” does this thought actually prevent you from standing? Your thoughts do not have to feel threatening or scary. The metaphor he uses is a radio: your thoughts are background static and noise on the radio. We need only tune in when the thoughts are helpful.

Another important exercise Harris describes is expansion. When you feel an uncomfortable sensation or urge in your body, focus on where you feel it physically. What color is it? What shape is it? Spend a few minutes just observing it as it is, without judgment. Then breathe into it. Welcome it into your body. Let it exist.

Defusion and expansion operate on the idea that the more we actively struggle against uncomfortable feelings, the worse they will become. The more we try to control them, the more they control us. When we devote so much time and energy into trying not to feel bad, we take away precious moments that could be spent doing what we value. This is why ACT is pronounced like the verb, act, and not A-C-T. At every turn we have a choice. We can stop and realize we are fusing with our thoughts. We can commit to taking an action in a valued direction, instead of in a direction that is intended to avoid “negative” feelings. And then, we ACT. We move forward.

Mindfulness is incredibly important in ACT. You are encouraged to connect with your “observing self” as often as possible, as opposed to your “thinking self.” Merely observe where you are, what you are doing, and how you are feeling – without any judgment. My therapist always reminds me that whenever I get caught up in some thoughts, to ask myself: “Where are my feet?” Right here. Below me. Feet flat on the ground. This is mindfulness.

Before you can act in any way that is meaningful, of course, you must define your values. These are different for everyone, and there are no wrong values. You can value family, work, leisure time, romance, education, exercise, and so on and so forth. Determine the values that make up your ideal life. Remember that values are different from goals: values always exist, goals have a definite end (they end when you accomplish them). If you value education, one of your goals might be to get a bachelor’s degree. But your value doesn’t stop once you have graduated. Throughout your life, you can act in accordance with that value.

One exercise that helps you to decide what kind of life you truly want to live is to write your own eulogy. You can write a eulogy of what people would say about you if you died today, and then write a eulogy of how you would want to remember people you. What kind of legacy do you want to leave behind?

The point of this post isn’t to judge anyone. It is completely natural to have uncomfortable thoughts and feelings, and it is just as natural to try to avoid these feelings. I certainly had (and sometimes still do have) many methods of avoiding feelings of discomfort. I took lots of naps, took various medications, procrastinated, spent countless hours watching Law and Order: SVU. But I am learning to face uncomfortable feelings head on. I am learning to take the thoughts that fly in and out of my mind with a grain of salt. I am learning to welcome unpleasant sensations into my body, instead of fighting against them. I am learning what my values are. Pain is inevitable; suffering is optional. So, I am ACTing. I am embracing life. I am moving forward.

 

What struggles and experiences have you had with anxiety, panic, depression, etc.? Please, feel free to comment or send me a private email. I am happy to answer any questions, give advice, or simply provide a listening ear.

 

3 thoughts on “Acceptance and Commitment Therapy (ACT)

  1. JoannStrickler

    Betty, So glad to hear you are getting some help. I’ts wonderful to have a good therapist! I’ve had one for years(before moving to Glen Meadows). I also have depression , but mostly anxiety that I take medicine to help control. I’ve suffered panic attacks as well. I knew you had medical issues but not to this extent. My thoughts are with you as you learn to control these issues. I know you can do it. I have. One day, one issue at a time. love you , JoAnn

    Reply
    1. Neurotic Noodles Post author

      Joann, thank you very much for your support. I look forward to seeing you at Mika’s wedding.

      Reply
  2. Michael Cunard

    I known you for a while Betty, but after reading this I didn’t realize you suffered from major anxiety issues like I do. You know I had major issues with depression and anxiety in the past, but over the years it just seem to stop and I was happy for once in my life, but in the long run I just don’t feel anything anymore, I just feel numb now and while I do care for people that I love and my education. I just don’t feel anything anymore, nothing bothers me and that kinda worries me. Any advice you can give to tell what is happening to me?
    Your friend, Michael

    Reply

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