Acceptance & Commitment Therapy for Anxiety,

People rightly come to the therapist because they have become inwardly enslaved
and they yearn to be set free.  The crucial question is: how is that freedom to be attained? 

– Rollo May, Freedom and Destiny

At a four-day “Boot Camp” for Acceptance and Commitment Therapy (ACT) in Reno this February, I aspired to actively participate in the training rather than sitting back passively. The latter is certainly the easier route, and it’s the option I sometimes take in life, but it leaves me feeling a bit lifeless. On the other hand, while raising my hand and speaking in front of 150 other attendees invigorates me, the thought of doing so also brings in its wake a swell of fear and trembling that seems to pin me down into a state of passivity. I experience unpleasant bodily sensations, unwanted thoughts, a strong urge to flee, and tired stories about why I am the way I am. This spectrum of unwanted experiences and the behavioral tendencies that follow from them – my anxiety – is something I struggled with during the training, and it’s a struggle familiar to me throughout my adult life. It’s the same struggle many clients come into therapy with.

As the quote from Rollo May indicates, people come into therapy because they don’t feel free in some important area of their lives. They feel “inwardly enslaved” and locked into an internal struggle with a part of themselves. Therapy may be a last ditch effort to attain freedom from their psychological snares, and our clients enlist our aid in this struggle for freedom. To paraphrase May, the crucial question for us as therapists is, how do we best serve clients in attaining that freedom?


The traditional strategy targets symptoms,
reasoning that freedom to pursue what one aspires to
first requires freedom from one’s unwanted experience


 

The traditional strategy is to help clients eliminate, control, or avoid the psychological barriers to freedom. In other words, target the symptoms attached to the distress. What drew me to ACT and the Boot Camp is what I had already experienced in my own life, namely, that this strategy simply doesn’t work very well. An agenda of controlling the symptoms reasons essentially as follows: freedom to pursue what one aspires to pursue first requires freedom from one’s unwanted experience (anxiety, depression, urges). Living by such reasoning results all too often in a constricted life oriented toward keeping clear of the things that bring unease but could enrich one’s life. It’s the reasoning that would keep me quietly in my seat sitting on my hands and arguing with myself rather than participating in the training in the way I wanted. At the Boot Camp I learned more about ACT’s alternative agenda, one that takes explicit and consistent aim at “meaningful living” rather than at “symptom reduction.”


“Freedom to” has no prerequisites.
Control is the problem.


 

Sidestepping the mind’s control agenda, ACT’s basic approach promotes the individual’s ability to respond to her situation with the freedom to take the behavioral steps required to create a flourishing, meaningful life rather than focusing on gaining freedom from unwanted experiences. “Freedom to” has no prerequisites. In ACT, the “freedom from” or avoidance-and-control agenda creates the individual’s inwardly enslaving chains. Control is the problem; in its place ACT promotes an agenda of willingly experiencing whatever life dishes up while moving behaviorally toward what the individual values. To the mind’s control-agenda reasoning – “freedom to” first requires “freedom from” – ACT poses a pragmatic question: does this reasoning work in creating the kind of life you want? Does living by it move you toward your aspirations, or does it keep you stuck at a distance from them or even move you away from them? If the reasoning doesn’t work in the context of living a flourishing life, then from ACT’s pragmatic perspective it is faulty.

As a therapist, I get excited about this focus on helping clients create meaningful lives rather than struggling to be free from themselves. The shift from a control agenda to an acceptance and commitment agenda is in itself liberating. Since returning from the training, a colleague and I have initiated a twice-monthly ACT peer consultation group aimed at providing a supportive environment for clinicians to both learn about and practice the clinical use of ACT. I invite all who are interested to join us in the shared endeavor of becoming more skilled practitioners of this life-affirming and active therapy.


The “freedom from” agenda is a trap.
We can’t be totally free from many of our unwanted experiences.
The good news is that we don’t have to be.


 

Rollo May asks how the freedom we all seek is best attained. ACT answers that the “freedom from” agenda is a trap. We can’t be totally free from many of our unwanted experiences. But the good news is that we don’t have to be. As I learned in Reno, we are even now free to pursue our aspirations, maybe in fear and trembling, and with no guarantee that the outcome will be anything like what we want it to be or hope for. But we are free nonetheless, and we serve our clients best when we help them experience the difference between the dead end of “freedom from” and the vitality of “freedom to.”

Written by Brian Bowles, PhD, LPC