Two Days of ACTing (Acceptance and Commitment Therapy)

     I spent two days in an ACT workshop. For anyone who does not know what ACT (called act) is, it is Acceptance and Commitment Therapy. It operates by stitching together behavior therapy into softer mindful interventions. It has several merits and appears helpful. The people in the audience seemed impressed. I was bored. 
     Because the trainer was a behaviorist at heart, when he talked about the operant conditioning and aversive reinforcement, he glowed. When he talked about the mindful processes, he became esoteric and vague. The combination worked because he was, in a small way, willing to deal with the whole person, not just the behavior. Throughout the workshop, he appeared defensive and cautious waiting for an attack from a generally supportive group. 
     On an early slide, he offered a definition from the founder Stephen Hayes that states “…ACT brings direct contingencies and indirect verbal processes to bear on the experiential establishment of greater psychological flexibility primarily through acceptance, defusion, establishment of a transcendent sense of self, contact with the present moment, values, and building larger and larger patterns of committed action linked to those values.” To make it simpler, ACT is about making people more psychologically flexible, meaning they can handle a broader range of events that happen in their lives successfully. The interest I had in the process was the idea that even with all the psychobabble, the bottom line is flexible “patterns of committed action”. 
To my thinking, the speaker, though entertaining, never made the connection of why these two divergent topics had to be together. He never took the final step in the journey and recognized that he was talking about patterns the whole time. Behaviorist deal in patterns of reinforcement and extrapolate their mouse data to humans in sophisticated patterns of explanation. If in the end, the client buys off on their behavioral interpretation, change happens. As in most therapies, the therapist and the client are the most important ingredients of therapy, not the technique. The problematic issue is that to perform behavioral reinforcement on people the therapist needs client permission and participation. Thus, the mindful process is a way to achieve permission to apply behavior therapies to people. The depth of change depends, not only on the behavioral technique, but on the strength of the therapeutic relationship. 
     Dr. Haye’s appears to be a different animal. He describes therapy from a healthy model and proposes using the DSM as a guide rather than a bible. His approach is close to patterns, offering a person the ability to become healthy through a positive psychotherapy. I like it. But it could be simpler. What if, the person became aware of their individual pattern (the way they lived daily that was unhealthy) and with the therapist, they developed options that offered a choice about the change they want. They problem solve the outcome into what they choose in their life, and with the support of the therapist, they practice the change until it becomes the life they desire. Wouldn’t that increase psychological flexibility? The product is the same, a healthier life. The process is much simpler than ACT.