More about CBT

Cognitive and Behavioural Therapy (CBT) is a scientifically proven talking therapy that can help people with a wide range of difficulties. It is recommended in the NICE guidelines (National Institute for Clinical Excellence) as an effective treatment for Anxiety based problems and Depression. CBT explores how your thoughts, beliefs and attitudes impacts on what you do and feel and how a greater understanding of these cycles and processes can lead you towards solutions and change. CBT tends to be more focused on the present but might also look at your past to help you understand how your past impacts on the present. Find out more about the problems that can be effectively treated with CBT under About You.

Over recent years I have been increasingly drawn to Acceptance and Commitment Therapy (ACT). This falls under the ‘umbrella’ of CBT and is often referred to as one of the ‘third wave’ family of Cognitive Behavioural Therapies. What I love about ACT and why I’ve begun to use it more in my Practice, is that alongside its growing evidence base and great feedback from patients, I know how much more prepared I am myself to handle life’s challenges, through using these skills and ideas! It is also particularly helpful when you are experiencing a number of problems at the same time or your problems are longstanding.

What is Acceptance and Commitment Therapy?

Acceptance and Commitment Therapy gets its name from its main themes - to accept things that are out of your control and commit to changing things that can be changed to make your life better. In summary, ACT uses mindfulness and acceptance skills to develop a more flexible relationship with your thoughts, feelings, memories and sensations. Time is also taken to clarify what gives your life meaning, your values. Without being held back by tricky thoughts and feelings and with a new sense of purpose and direction, you can begin to build a more enriched and meaningful life.

Acceptance and Commitment Therapy (say Act, not A.C.T.!) is an engaging and playful approach to tackling life’s difficulties. Just like traditional Cognitive Behavioural Therapy, it is underpinned by a growing body of scientific evidence highlighting its effectiveness for many psychological problems and challenges.

ACT draws on brain science to show we are all wired to ‘suffer’ or find life difficult because we are designed to pay attention to anything we perceive as threat. This explains why we often find ourselves caught up in our in our ‘chattering’ mind, over-thinking ourselves, our problems or disturbed by our feelings. We are also programmed to find solutions, to deal with the ‘threat’, (in this case our thoughts and feelings), so we are naturally compelled to distract ourselves from this tricky stuff or avoid things that lead them to show up in the first place.

This gets us caught up in unhelpful vicious cycles, like comfort eating, relying on alcohol, retail therapy, spending too long watching shows, checking social media, sleeping or overworking… the list is long! In Act we call this, The Struggle, when in an effort not to feel or think we end up doing things or not doing things that take us away from the person we want to be or the life we want to lead. (Clearly most of these things are fine in moderation!). These ineffective coping strategies often play a key part in maintaining things like anxiety, depression and low self esteem and may cost us dearly in terms of time, energy, money, health and relationships.

How does it help?

The research underpinning Acceptance and Commitment Therapy shows that we are also pre-programmed with the capacity to develop skills to work through life’s challenges - there is hope! In sessions you will learn key skills to enable you to step back from your chattering mind and what may be at times toxic thinking and learn ways to have and handle uncomfortable or painful feelings. Through mindfulness and acceptance skills, use of metaphor, experiential exercises and the development of self compassion, we will actively construct a new way for you to respond to long-standing habits and reactions that you know are not helping. If your life has grown narrower, we will draw on tried and tested behavioural strategies such as Graded Exposure and Behavioural Activation to enable you to move TOWARDS things you may have been avoiding.

These skills help promote what ACT refers to as PSYCHOLOGICAL FLEXIBILITY, which is all about trying to build a new relationship with difficult thoughts, feelings and sensations, one that doesn’t rely on avoidance or distraction. In essence, this means we are less stressed/distressed and able to do more of what we value, giving us a greater sense of meaning, purpose and therefore, well-being

Change or connecting to what matters

If battling with our difficulties pulls us away from how we want our lives to be then getting things on track needs to take into account our ‘bigger picture’ – what is important to us in life. Taking time to identify your values will enable you to set meaningful goals, giving you a greater sense of purpose and can become a motivator when things are tricky. From my experience this work also helps people appreciate what they already have in their lives right now. ACT is also a really practical therapy of change so if moving forward involves learning new skills or solving problems we can consider this too.

Mindfulness and ACT

Here is a little more information on how mindfulness is used in Acceptance and Commitment Therapy.

It tends to be more ‘bite-sized’ based on research that shows that even brief periods of regular mindfulness practice (5- 10 mins or just mini mindful moments!) can still be beneficial and help us to ‘rewire’ our brain.

While many people think mindfulness means meditation, this is not the case. Mindfulness is a mental state of openness, awareness and focus, and meditation is just one way amongst hundreds of learning to cultivate this state.
Russ Harris

ACT breaks Mindfulness down into 4 key skills:

  1. Defusion - distancing from and letting go of unhelpful thoughts, beliefs, memories, images, rules for living etc.

  2. Willingness - making room for painful feelings, urges and sensations, and allowing them to come and go without a struggle.

  3. Contact with the present moment: engaging fully with our here and now experience, with an attitude of openness and curiosity. Getting better at being connected to the here and now and the things we value.

  4. Being the Observer of our experience so we are no longer defined by it. Not caught up in unhelpful stories of ourselves based on our past or our fears.