The Use Of Acceptance-Commitment Therapy

By John Troncale, M.D.

Various therapies have been employed throughout the years to help treat people with addiction and mental health issues. One treatment that numerous studies have shown to be efficacious is called Acceptance-Commitment Therapy, or ACT (pronounced “act”).

ACT is considered the third wave of Cognitive Behavioral Therapy. Its fundamental premise is that an individual can work to move in one of two directions: either toward suffering, or toward their own values. Suffering stems from self-invalidation and a perception of low self- worth. This, of course, leads to a perceived need to escape the suffering. People hit the “escape button” in a number of different ways. For some it can be as simple as a distraction, such as watching television or listening to music, while others choose self- soothing skills such as talking with others or eating.

And yet, escaping can take a pathologic turn and become compulsive or self-destructive. Escaping one’s feelings with the use of alcohol or drugs, with compulsive eating or with impulsive sexual behavior can quickly develop into a pattern. These patterns, in turn, become addictions.

So what are some of the alternatives to “hitting the escape button”? To put it simply, we have to educate individuals, to help people develop skills and learn to accept their feelings rather than flee from them.

Sounds like a fairly simple task, right? Well, nothing is further from the truth. In fact, when it comes to our psychology, most of us have learned from a very early age how to be successful “escapees”. ACT states that to develop what’s called “psychological flexibility” (the opposite of escaping), the individual should do three essential things:

1) Be present (learn to stay in the moment).
2) Be open (learn not to get “stuck” on feelings or ideas).
3) Do what matters (figure out one’s values and organize life around activities and occupations consistent with those values).

If you are interested in learning more about ACT, there are plenty of places online to find information. Additionally, there is a great (and inexpensive) book that discusses these principles called The Happiness Trap by Russ Harris.

Joseph Troncale, MD is Retreat’s Medical Director. Over the past 35 years Dr. Troncale has established himself as one of the premier physicians working in the field of addiction. He is both a fellow and a member of the American Society of Addiction Medicine (ASAM) and was named Outstanding Clinician by Addiction Magazine in 2010.