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The acceptance and commitment therapy (ACT) model is characterized by giving relevance to the context of a situation. In fact, ACT focuses on the environment in which people’s cognitive activity occurs, somewhat reducing the importance that previous-generation therapies placed on content.
One of the main goals of ACT is to develop psychological flexibility and encourage contact with the present in a conscious way. At a theoretical level, the purpose of the model is that verbal and cognitive functions are under a more exact and voluntary contextual regulation, in order to direct behavior towards values.
According to this model, there are six processes that generate psychological flexibility: acceptance, cognitive defusion, contact with the present moment, the self as context, values, and committed action.
The relationship between these processes is usually represented by a hexagon which is known as a hexaflex. Through these six components, acceptance and commitment therapy seeks that individuals (Ribero-Marulanda and Agudelo-Colorado, 2016):
- Acknowledge and abandon internal event control strategies.
- Observe their experiences without labeling them.
- Focus on behaviors aimed at obtaining valuable results, to create flexible and effective actions.
Next, we’ll each of the six components or processes of the ACT hexaflex model.
The hexaflex
As we mentioned earlier, the hexaflex is a hexagonal diagram that’s used to classify and treat client issues. Each of the six processes on which it’s based corresponds to one of ACT’s core principles. With this diagram, the therapist can also choose a starting point for the specific intervention.
ACT seeks to cultivate psychological flexibility, which is nothing more than the ability to face, accept, and adapt to difficult situations. When we experience stressful situations, psychological flexibility protects us against negative feelings and can promote our mental health. In addition, it acts as a buffer against stress and negative psychological results.
Let’s take a closer look at each of the processes used by ACT to promote psychological flexibility.
1. Acceptance
In the hexaflex model, accepting is the act of receiving what’s offered to us and taking what life brings us, “taking it completely, at the moment it is given, without defending ourselves” (Hayes, 2013). Acceptance is an attitude that motivates us not to evade what’s happening right now.
Acceptance is an invitation to say yes to life when fighting against unpleasant experiences makes little sense. For instance, there are certain circumstances that we can’t change, like getting older, and we have no choice but to accept them. Thus, acceptance implies a willingness to open ourselves to the present, to our existence, and to the ups and downs in which it unfolds. It’s not self-defeatist, but a vital commitment to the moment as it is.
“Acceptance is really a different way of being in life, of living kindly and with an open heart with our inner landscape, with what happens to us and fully embracing it.”
-O´Connell, 2018-
The essence of acceptance lies in not resisting. It means not opposing the flow of life. When we assume the attitude of accepting what happens to us, we don’t react by fighting or resisting, because that only adds unnecessary discomfort.
2. Cognitive defusion
This is the strategy that allows us to detach ourselves from our thoughts, more specifically from those that have become a problem for us. Cognitive defusion helps us understand that neither words nor thoughts are reality.
Cognitive defusion helps us in the moments when we have to face the challenge of managing potentially anxious and intrusive thoughts. By employing this strategy, we learn to observe the products and processes of our thoughts.
It also allows us to disidentify from our ideas: “I’m having the thought…”, “I’m noticing this or that thought”, “I’m doing something with my thoughts”. Thanks to cognitive defusion, we can tell the difference between our mental activity and ourselves.
Cognitive defusion isn’t intended to replace dysfunctional thoughts with others (as cognitive restructuring would do), but to provide us with a perspective in which our thoughts aren’t real, but creations of our mind. Other objectives are to:
- Reduce the level of identification that we have with our internal experiences.
- Decrease the character of the truth of our thoughts.
- Decrease the influence of our thoughts on our behaviors and experiences.
- Facilitate cognitive flexibility.
3. Contact with the present moment
Without awareness of the present moment, we tend to focus attention on our psychic life. Within the framework of ACT, therapists provide strategies so we can focus more on what’s happening around us. It also invites us to be dynamic on the mental plane.
The idea is that if our environment is constantly changing and we’re aware of it, the content of our psychic life will also flow, thus avoiding invalidating ruminations.
This kind of training is necessary, as rigid and absent attention is associated with psychological dysfunction. On the other hand, mindfulness is positively related to psychological well-being (Bowlin and Baer, 2012). It can also reduce various psychological symptoms and emotional reactivity. Furthermore, it improves behavior regulation.
Through mindfulness, our attention is brought to the experience of the here and now with openness, receptivity, and curiosity. It helps us find an effective path for the development of acceptance. Indeed, mindfulness implies a commitment to the moment and to life as it manifests itself in the present.
4. The self as context
We’re often infused with the stories and narratives we tell ourselves about what happens to us. As a result, we’re less able to react flexibly from one moment to the next.
This psychological rigidity or inflexibility isn’t necessarily linked to negative thoughts. Therefore, we might merge it with beliefs such as: “I’m a caring person” and lose the willingness to recognize the ways in which those ideas hurt or harm others. The self as a context doesn’t allow us to adopt a perspective on these stories. Thus, we loosen our attachment to them.
In the hexaflex model, the self as a context is a space, a transcendence, from which we observe our experiences. On the one hand, it supports or contains all of our experiences. On the other, there’s a split between the self as consciousness and the self as the content of psychological events. We can say that these qualities of inclusion and distinction encourage more flexible behavior patterns (Chin and Hayes, 2017).
5. Values
In the ACT hexaflex, our values are our chosen qualities of being and doing. When we engage in actions based on them, we establish adaptive behavioral repertoires and the reinforcing effects of action exist in the present moment, rather than in the external results we can achieve (Chin & Hayes, 2017).
Values are a central aspect of our lives. In effect, they’re our compasses and they guide us in the search for what resonates within us. Furthermore, they’re one of the foundations of having an authentic existence. In this sense, Van Deurzen (2002) argues that authentic life consists of making decisions in accordance with the values that we recognize as being worth committing to.
In our lives, values are the support on which existential meaning is configured. By committing ourselves to their realization and living according to them, we build valuable lives that are worth living.
“My life will only make sense if I develop my own value system.”
-Adams, 2012-
6. Committed action
A valuable life is configured from concrete actions guided by our value system. In addition, it requires the commitment to repeatedly walk the path of what’s important to us (O’Connell, 2018).
For the ACT, commitments aren’t promises to be made in the future. Rather, they’re decisions that are made from one moment to the next to build meaningful actions. Slip-ups in committed action aren’t seen as failures, but as opportunities to take responsibility for the mistake and recommit to values-focused action.
Committed action is perhaps the central axis of change as proposed by ACT. The idea is that, once we’ve identified our values, we commit to drawing up action plans aligned with them. This means we’ll avoid having to resolve the dissonances that cause us so much discomfort.
To conclude, the hexaflex makes the challenge of living a meaningful and valuable existence easier for us. It also encourages us to adopt a vital attitude of acceptance, openness, and non-resistance. This attitude is supported by an exercise in courage, explicitly defining our values, and carrying out action plans in which these are reflected.
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