Acceptance and Commitment Therapy (ACT) is relatively new psychological treatment that has shown promise in the treatment of anxiety disorders including OCD. Acceptance and commitment therapy’s central philosophy is that anxiety is part of life and that it is our reaction to the experience of anxiety (and not the anxiety itself) that can be the real problem. For instance, to keep from experiencing anxiety many people avoid certain people, places or activities at the expense of leading a rich and fulfilling life. According to acceptance and commitment therapy, trying to live a life free from anxiety is impossible and only leads to isolation, frustration and disappointment.
ACT works to build flexibility in thinking rather than trying to eliminate distressing thoughts like obsessions using a variety of mindfulness techniques, metaphors and life enhancement exercises. Like cognitive-behavior therapy (CBT), ACT makes use of exposure techniques, but within a totally different framework. ACT uses exposure to facilitate people moving towards the values and goals that are important to them, rather than reducing symptoms.
For example, in ACT, you would be encouraged to drive to a friend’s house to watch a movie despite experiencing a distressing obsession about hitting someone with your car while driving. According to ACT, it is not helpful (or realistic) to wait until you are free from anxiety (or, as in this case, an obsession) to do the things you want to do; anxiety is a part of life and will always be there to some extent. If you wait forever, life will pass you by. Thus, ACT encourages you to face your fears -- not in the service of reducing your anxiety, but to allow you to live the life you want to live.
In general, the available research suggests that ACT is an effective treatment for anxiety disorders including OCD as well as the distress associated with chronic physical conditions such as multiple sclerosis or epilepsy. ACT usually takes place over 10 to 15 one-hour sessions, although your therapist may recommend extending treatment.
If you are interested in learning more about ACT, be sure to look at the following on-line resources:
- Contextual Psychology - This is the official site for the Association for Contextual Behavioral Science and has lots of ACT resources for the public, including information, discussion groups, a search tool to find ACT therapists, recommended books and audio tapes for meditation, and centering exercises.
- ACT for Anxiety Disorders - This is the homepage for the book Acceptance and Commitment Therapy for Anxiety Disorders, which is co-authored by Dr. Forsyth. The site contains excerpts from the book that will give you a nice overview of ACT for anxiety disorders and has a great list of websites and other online resources.