Musings – 08.17.21

Acceptance and Commitment Therapy (ACT)

“I am not what happened to me, I am what I choose to become.” 
Carl Jung.

I’ve been working within the specialty of Posttraumatic Stress Disorder (PTSD) since I began my career back in the late 1990s. I started my career as a social worker within the County of San Diego Health and Human Services Agency, in the Child Welfare Department as Protective Services Worker working with foster children. As nearly anyone can imagine, foster children are almost always exposed to trauma, and act out in various ways.

I worked in a specialized unit that worked with children diagnosed with Severe Emotional Disturbance (SED) who lived in treatment level foster placements. These placements were licensed group homes, of various treatment level, to treatment level foster homes. These children started me on my journey of working with PTSD, as nearly all of the children were diagnosed with it.

When I became a therapist, I started my training toward certification with Eye Movement Desensitization Processing (EMDR) and was passionate about what EMDR could do.

However, with the start of the pandemic (indeed about 11 months before it began) I started working exclusively in online therapy, specifically with BetterHelp. In the meantime, I also was working with clients in my private practice, also online.

Now, I find that online therapy is not conducive to EMDR, as one of the challenges with PTSD is something called dissociation, where a client’s mind will process information differently, i.e., disconnecting from one’s thoughts, feelings, memories, even surroundings. This can be a dangerous state, and generally requires a therapist and client be in the same room, to facilitate the therapist’s quick reaction to any dissociation the client may experience.

I, however, did want to offer my clients some kind of treatment for their trauma, so I found Acceptance and Commitment Therapy (ACT). I was INSPIRED, as much of ACT is how I actually live my personal life, indeed, incorporating a lot of the concepts of ACT into all manners of my treatment of all manners of clients.

So, here we are. ACT is basically built on the concept of Psychological Flexibility.

In short, psychological flexibility means that connect with the present moment fully, and, based on the aspects of the present moment, change one’s behavior or perceptions based on one’s values. In otherwards, hold thoughts and emotions lightly, and use longer term values and goals, rather than shorter term thoughts and emotions, and, indeed impulses. 

6 Core Psychological Flexibility Processes

Stage 1 – Acceptance, to allow unwanted states/events/experiences to come and go without fighting them.

Most simply, acceptance is a different way of thinking about negative states/events/experiences. We spend much of time traying to avoid thinking about these experiences, and, I think, for many of us, that avoidance doesn’t work. ACT encourages making an active choice to ALLOW the negative states/events/experiences to exist, without trying to deny or change them.

Stay tuned for the next Mental Health Musings, which will explore Stage 2 – Defusion.

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