Psychological Counseling ACT Therapy

The core logic of ACT therapy in psychological counseling, full name Acceptance and Commitment Therapy, is not to eliminate your negative emotions and painful thoughts, but to help you learn to live with these symptoms, return your attention to the things you really care about, and act in the direction of your own values.

I have been doing ACT-oriented cases for almost 7 years. When I first came into contact with this therapy, I thought it was outrageous: the client was in so much pain that he couldn’t sleep all night and couldn’t go to work. You didn’t let me help him solve his pain, but instead let him accept it? I am not the only one who has this question. Controversies about ACT among colleagues have never stopped. Many teachers who do classic CBT feel that ACT is too "soft" in intervening on symptoms, which is equivalent to putting all the responsibility for healing on the client. Psychoanalytically oriented counselors feel that ACT is too "rushed" and does not deal with the root conflict, but only treats the symptoms rather than the root cause. These statements are all reasonable. I have seen many cases where the rigid application of ACT technology only aggravated patients' self-denial, and I have also seen cases where ACT was used to quickly restore social functions. The essence still depends on adaptability.

Let’s talk about a case that was just concluded last week. A 32-year-old Internet operator was so anxious that he couldn’t eat. He was always worried that the project would fail and be optimized. I used to follow online tutorials to record CBT emotions. Every time I finished recording, I would scold myself, “Why can’t I control myself from thinking about the worst outcome?” This made my anxiety level even higher. During the first consultation, I didn’t mention anything about “acceptance” to him. I gave him a small exercise first: write down the thoughts that run through my mind every day, such as “I will be optimized” and “I am very poor” on a note, fold it into a small square and put it in my jeans pocket, and tell him “This These small notes are now your belongings. You don’t have to take them out to read them, and you don’t have to try to throw them away. When it’s time to change the plan, when it’s time to pick up the child, when you remember that you have this thing in your pocket, just touch it.” He did it dubiously, and when he came in the third week, he said that at the project review meeting last week, he was so nervous that the notes in his pocket were soaked with sweat, but he still finished the plan in full. When he stepped down, he realized: "I didn't have time to think about whether I would be fired? ”

You see, ACT never asks you to "endure the pain and do nothing." Instead, the core part is "action." We often joke in our circle that CBT teaches you how to turn off the noise in your head, psychoanalysis helps you understand where the noise comes from, and ACT teaches you how to cook, go shopping, and play with your children without the noise. Everyone should have heard of that analogy: you are a bus driver, and there will inevitably be some strange and abusive passengers on the bus. You don’t have to kick them off before you can drive to your destination, and you don’t have to stop and argue with them. You can just let them sit in the back seat, hold your steering wheel, and drive where you want to go. Those negative emotions and bad thoughts are the passengers in the back seat. The more you fight with them, the more unstable the car will be, and it may even drive into a ditch.

What’s funny is that I stayed up until three o’clock last week working on Party A’s plan, and all I could think about was “What kind of rubbish did I write?” “I’m going to be scolded to death tomorrow.” I also did a dissociation exercise, imagining these thoughts as barrages on a video website, floating over and over. I continued typing my words, and the final plan actually came through in one go. To put it bluntly, consultants themselves use these methods every day, and they are not some theory floating in the sky. The techniques of dissociation, acceptance, and value clarification that we usually use in practice may sound mysterious, but they are very concrete and small things in life: when you don’t want to go to work, you don’t have to force yourself to say “I can’t be negative.” Sit down first and list the three most urgent things today, and tick each one after you do it. As you do it, you will find that the feeling of not wanting to live has faded away.

Of course, I won’t boast that ACT is a magic medicine that can cure all diseases. I once took over a senior high school student whose hands were shaking so much that he couldn't write. He was always worried about failing to pass the 985 exam. When I first told him that "you don't have to force yourself to eliminate anxiety," he immediately exploded: "If I wasn't anxious, I wouldn't study. You are hurting me!" ”Later, we didn’t hesitate about whether to accept it or not. We first asked him to list “If anxiety is always with you, what are the three small things you want to do most today”. What he wrote was “make a set of math choices, eat the hand cakes downstairs, and talk about the football game with my deskmate for 5 minutes.” After he finished these three things that day, he came back and said to me, “It turns out that when I was doing the questions just now, I forgot that I was anxious.” But if the client has just experienced an acute trauma, or is in a severe depressive episode and can't even get out of bed, I generally won't use ACT techniques first. Forcing the client to "accept the pain" will make them feel that "I can't even resist my emotions, and I'm useless." In this case, the first priority is to stabilize the mood and even take medication as prescribed by the doctor. After social functions have recovered, ACT can be used to build long-term value.

I still won’t tell clients that ACT is the best therapy. Last month, a girl who had done ACT three times said she still wanted to dig up her childhood trauma. I directly referred her to my colleague who is doing psychoanalysis. Last week, she told me that the girl is now in much better condition. In the final analysis, therapy is just a tool. It is never right or wrong. It can help you live your life the way you want, whichever is best for you.