Acceptance and Commitment Therapy (ACT): Living in Line With What Matters

Recently in clinic, I have been working with a number of clients who are facing difficult decisions in their lives relating to work, relationships, and family. These situations often bring with them painful thoughts, emotions, and bodily sensations. Many people find themselves struggling to tolerate these internal experiences and instead trying to push them away or avoid them.

All of us develop ways of distancing ourselves from emotional discomfort. This might involve self-criticism, substance use, deflection, over-working, or keeping ourselves constantly busy so we do not have to sit with what feels painful or uncertain.

It is entirely natural to want these experiences to go away. Much of what we are taught, both culturally and internally, suggests that feeling better means getting rid of uncomfortable thoughts and emotions as quickly as possible. Acceptance and Commitment Therapy, often referred to as ACT, takes a different approach.

Rather than focusing on eliminating difficult inner experiences, ACT helps people learn new ways of relating to them. By developing the capacity to sit with thoughts and feelings without being overwhelmed or driven by avoidance, individuals are better able to live in ways that are meaningful, engaged, and guided by their values, even when life feels challenging.

One of the reasons I value using ACT with clients is that it provides a flexible framework for moving forward. It can be helpful for immediate short-term concerns as well as longer-term, ongoing issues. ACT is both compassionate and forward-facing. It supports clients to reflect on how they want to relate to their difficulties, clarify what matters most to them, and identify values-based actions they would like to begin taking.

What is Acceptance and Commitment Therapy?

Acceptance and Commitment Therapy is a modern, evidence-based form of psychotherapy that integrates behavioural principles with mindfulness and values-based action. ACT is grounded in the understanding that psychological pain is not a sign that something is wrong with you. Rather, it is a natural part of being human and having a mind that can remember the past, anticipate the future, judge, and imagine.

From an ACT perspective, suffering often increases not simply because we have difficult thoughts or feelings, but because of the struggle to control, suppress, or avoid them. You might reflect on a time when, instead of fighting a difficult emotion, you allowed it to be present. Even small moments of acceptance can sometimes create a sense of space or relief.

ACT aims to support psychological flexibility, which refers to the ability to stay present, open, and engaged with life, even when uncomfortable internal experiences arise.

Psychological Flexibility: The Core of ACT

Psychological flexibility involves six interconnected processes that ACT works with in therapy.

These include acceptance, which involves making room for difficult or painful thoughts and feelings rather than fighting them, and cognitive defusion, which refers to learning to step back from thoughts and noticing them as mental events rather than facts or commands.

ACT also emphasises present-moment awareness, which involves bringing attention to what is happening in the here and now, and self-as-context, which is the ability to recognise that you are more than your thoughts, emotions, or diagnoses. For example, noticing feelings of anxiety rather than defining yourself as an anxious person.

Values are another central process in ACT and involve clarifying what truly matters to you and what qualities you want your actions to reflect. Committed action refers to taking steps aligned with those values, even when doing so feels uncomfortable or challenging.

Together, these processes help people move from a life organised around avoiding pain to a life organised around what matters.

Acceptance Does Not Mean Liking or Giving Up

One of the most common misconceptions about ACT is that acceptance means resignation or approval of suffering. In ACT, acceptance refers to allowing thoughts and emotions to come and go without unnecessary struggle, letting go of the constant fight with your inner world, and choosing how you respond rather than reacting automatically.

ACT often uses metaphors such as sushi train metaphor to help illustrate this idea. These metaphors invite people to notice thoughts as they arise and pass, without needing to engage with them or push them away.

This approach often creates more space for change rather than less. When people stop expending energy trying to control what cannot be controlled, they often experience greater clarity, vitality, and freedom to act in meaningful ways.

What Happens in ACT Sessions?

ACT is an experiential therapy. Rather than focusing solely on talking about problems, ACT sessions involve collaboration between therapist and client. Sessions may include mindfulness and awareness exercises, metaphors and imagery to explore how the mind works, gentle behavioural experiments, and values clarification, alongside practical ways of responding differently to difficult thoughts and feelings.

ACT is flexible and tailored. It does not rely on a single rigid technique, but adapts to the individual, their goals, and their life context.

Who Can ACT Be Helpful For?

ACT has been widely researched and applied across a broad range of concerns, including anxiety and panic, depression and low mood, chronic stress and burnout, trauma and post-traumatic responses, chronic pain and health-related distress, relationship difficulties, performance pressure, and life transitions such as loss and identity change.

ACT can be used in both short-term and longer-term therapy and is suitable for individuals across the lifespan, with the approach adapted to the person’s level of understanding and needs

ACT at Peninsula MindCare

At Peninsula MindCare, ACT-informed counselling and psychotherapy may be used as part of an integrative approach to support clients navigating emotional distress, life challenges, and personal growth. ACT is one of many therapeutic models that may be drawn upon, and sessions are shaped around your individual needs and where you are at.

If ACT resonates with you, it can be explored and adapted alongside other therapeutic approaches where appropriate. You do not need to feel ready or have everything figured out. ACT begins exactly where you are.

If you are interested in exploring Acceptance and Commitment Therapy or would like to know whether it may be a good fit for you, you are welcome to get in touch.