Learn / Treating Addiction With Acceptance and Commitment Therapy (ACT)
Addiction can hijack your behavior. This condition makes it easy to lose sight of your goals, values, and even immediate needs. Instead, many people prioritize drug use over the things that matter most to them.
In rehab, you’ll have space to take a step back and look at your life as a whole. That perspective can inspire lasting change. Acceptance and commitment therapy (or ACT, pronounced like the word “act”) shows people how to make those changes. This treatment empowers you to behave in ways that align with your own highest ideals.
In a rehab with acceptance and commitment therapy, you won’t work toward standardized goals, or fight against your own needs. Instead, you’ll start building a life that works for you.
ACT is a type of behavioral therapy founded by psychologist Steven Hayes in the 1980s. In some ways, it resembles dialectical behavior therapy (DBT) and cognitive behavioral therapy (CBT). All of these behavioral treatments include talk therapy, but focus on teaching you practical skills. Between sessions, you’ll put those skills into action. Then you can tell your therapist about your progress, and strategize ways to do even better.
Dr. Russell Harris, world-renowned ACT therapist, explains that acceptance and commitment therapy is based on mindfulness.1 He writes, “the goal of ACT is to create a rich and meaningful life, while accepting the pain that inevitably goes with it.” Therapists use metaphors and exercises to guide you toward your own values. The goal is to reach a state of balance, in which you can navigate life’s obstacles with grace.
This treatment gives you the tools you need to define your own personal values. Those values might be different from those of the people around you—including your therapist. And that’s okay.
In ACT, you’ll learn to do what’s right for you. Patients achieve this by focusing on a few core ideals.
ACT has 6 central principles2 that inform all the exercises you’ll do with your therapist. These concepts aren’t prescriptive—meaning, they’re not there to tell you what to do. Instead, they describe a general approach to living well. To quote Dr. Harris, the principles are as follows:
3. contact with the present moment
4. the observing self
6. committed action
You’ll learn how to put these into practice during rehab. Then, once you complete initial treatment, you can use them to build a meaningful life back at home.
Think of defusion as de-fusing with overwhelming emotions. This principle asks you to take a step back. You learn to see thoughts, feelings, and events as what they are. You can assign meaning to anything—that’s a natural human impulse. But it doesn’t mean that you should. It can be helpful to recognize that some things don’t have greater implications.
This idea can be life-changing for people with addiction and co-occurring disorders. It’s all too easy to get lost in self-doubt, judging yourself harshly for your own experience. Defusion illustrates that you are not your thoughts or your feelings. These are experiences you have. They don’t need to define your identity or your behavior. You can just accept what’s happened, and move forward.
In ACT, acceptance is just what it sounds like3 —accepting present reality just as it is. This includes external events, and your own thoughts and feelings. The act of resisting a feeling is usually exhausting, and rarely effective. These strategies teach you to save that energy, and focus instead on ways you can affect change.
Acceptance isn’t passive. On the contrary, ACT teaches you practical skills to accept what’s happening in your life. For example, people with OCD and addiction can both benefit from urge surfing. In this ACT technique, Dr. Harris says patients learn to “ride urges like a wave.4 Let the wave crest and fall. Don’t resist it.” You can engage with your cravings as an observer, without acting on them. This mindfulness technique helps people stay present in their own lives.
When we act mindfully, we stay in contact with the present moment. With this core principle of ACT, you’ll cultivate resilience.5 As Steven Hayes writes, the goal is for people to “experience the world more directly so that their behavior is more flexible and thus their actions more consistent with the values that they hold.”
To stay in touch with the present, you can implement a variety of mindfulness techniques. You might learn these from your ACT therapist, or from another treatment provider. For example, many rehab centers offer yoga and meditation. These strategies help you stay open and centered, even when you’re facing great challenges.
This principle of ACT builds on the ideas established by defusion.2 Dr. Harris writes that these strategies let you access “a transcendent sense of self; a continuity of consciousness that is unchanging.”
This greater self is always observing your life. You can go to rehab, relapse, move to a new city, get promoted, or take up swing dancing. It doesn’t matter how much you change. Your observing self will always be there, with you and for you. Once you recognize this, you can learn to trust yourself again. This can be powerful for anyone, especially people in addiction recovery.
Early in ACT, your therapist will take you through the process of defining your values.6 There are a few different ways to achieve this. They might have you go through a deck of cards with different values, and rank them in order of importance. Or, you might do a writing exercise. Whatever method you use, you’ll end up with a list of core values that are unique to you.
Your values serve as a guiding light, informing every decision you make. These ideals may change over time. But in any given moment, you can know what your highest values are, and act in a way that honors them.
When you take committed action, you act in accordance with your personal values. This principle is the culmination of ACT’s other ideals—but it doesn’t have to come last. Healing isn’t a linear process. For example, you can act on your values while you’re still learning to stay in contact with the present moment.
Committed actions are creative ways to work toward the life you want. You can examine your impulses, and reframe them in light of your ideals. For example: do you really value drug use? Or do you actually value feeling emotionally stable? If it’s the latter, you can achieve that by going to therapy, meditating, or engaging in a healthy hobby. And by doing those things instead, you can honor your values in a more sustainable way.
In acceptance and commitment therapy, you’ll learn to experience your feelings safely. You can act in accordance with your values even when you’re triggered.
It may seem counterintuitive, but when you stop trying to change how you feel, you take back control of your life.
According to Steven Hayes, ACT is uniquely helpful for people in addiction recovery.7 As he explained in one interview, the very word “addiction” explains how it can leave patients feeling out of control. “That dict part of ‘addiction’ is ‘being spoken to,’ like a dictator. Having the rule laid down. And who’s laying down that rule? It’s your own mind. And part of what our perspective is, is trying to back up and catch how it is that your own mind could become your own dictator. Your own body can become your own dictator. And you can find yourself involved in patterns that lead you farther and farther away from what you really care about.”
ACT interrupts the spiral Hayes describes. This treatment teaches you how to move toward the things you care about. But it emphasizes that those things are philosophical and emotional. They might even be spiritual. And because of that, there is no finish line.
Dr. Harris talks about a common behavioral pattern he calls “the happiness trap.”8 In this pattern, people run themselves ragged trying to achieve happiness. They think of this emotion as an end goal. But feelings aren’t permanent. And when you act like they can be, you set yourself up for failure.
If you value security, for example, you can look for a stable job and living situation. That’s all well and good. But it’s not the end of the story. If you get promoted, you might have to move to a new city. You’ll have more job security, but you’ll need to find a new home. Only you can decide which option aligns with your values. By using the mindful techniques you learn in ACT, you can make the best possible decisions for you.
ACT skills aren’t only a way of processing your feelings. It’s more accurate to call them a way of life. And during addiction recovery, you can use these tactics to build a life that meets your needs, in a fulfilling and meaningful way.
To find a rehab program that offers acceptance and commitment therapy, browse our directory of treatment centers to learn about what therapies they offer, compare your options, and reach out directly.
Reviewed by Rajnandini Rathod
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