Introduction to ACT

The New Model of ACT (Acceptance and Commitment Therapy)

Introduction to ACT ACT (pronounced like the word "act") is a behavioral therapy modality first summarized in the seminal work “Acceptance and Commitment Therapy, The Process and Practice of Mindful Change” developed by Steven C. Hayes, Kirk D. Strosahl, and Kelly G. Wilson. It is grounded in a complex behavioral theory known as Relational Frame Theory, which is beyond the scope of this discussion. This post will cover the core principles of ACT, some perceived shortcomings of the traditional model, and how these concepts have been evolved through a decade of focused work in the ACT model and recent developments as a psychedelic psychotherapist. ACT Principles The fundamental principles of ACT are encapsulated in what is known as the ACT Hexaflex. The Hexaflex represents core ACT principles as equal and related parts, working together to help individuals achieve "Psychological Flexibility." This flexibility enables a person to adapt their behavior to achieve their goals, even in the face of difficult or unwanted thoughts and feelings. Shortcomings of the Traditional Hexaflex Through my work with ACT, I found some traditional tools less effective. For example, diffusion techniques like imagining thoughts as words on a computer screen and playing with their appearance seemed somewhat trivial to me and didn’t translate to meaningful change for my clients. Dr. John Forsyth suggested that diffusion could be simplified to asking, "What is your mind telling you?" While this made sense, it still didn’t significantly impact my clients. Similarly, I struggled with the Acceptance principle. While I fully embraced the idea of accepting emotions and focusing on behavior, getting clients to a place of willingness was challenging. Dr. Jamie Forsyth noted that the original ACT model lacked an emphasis on self-compassion, which I found to be a critical oversight. The concept of "Self-As-Context" also posed challenges. The metaphor of separating oneself from their experiences using objects in a bag didn’t resonate well with clients. They often struggled to apply this concept practically in their lives. Despite these challenges, I spent ten years working with the ACT model, focusing on Values and setting treatment goals around Values work, using mindfulness practices as tools to achieve psychological flexibility. Integrating Psychedelics into ACT In 2022, I joined Innerwell, a startup focused on Ketamine-Assisted Psychotherapy, which revolutionized my approach to therapy. Ketamine allowed me to see beyond behavior change and led to a reevaluation of the ACT Hexaflex. I modified the model, influence by IFS and my work with psychedelics: The New ACT Model

1. Contacting the Present Moment: This is foundational. Being present is essential before accessing other principles. It allows us to focus on current behavior and align with our values.
2. Values: Values guide our actions and create a life of purpose and meaning. Knowing our values allows us to set and pursue value-congruent goals.
3. Committed Action: This involves taking deliberate actions to live according to our values. For example, prioritizing family time over other activities to be a consistent presence for our children.
4. Observing Self (Self-As-Context): Also referred to as the Active Observer, this principle aligns with the concept of Self in Internal Family Systems (IFS). It involves recognizing the parts of ourselves that present thoughts and emotions, and approaching them with self-compassion.

Example: Applying the New ACT Model During a snowboarding experience, I encountered anxiety despite knowing my skills. By accessing my Observing Self, I identified internal parts presenting anxiety and addressed them with compassion. This allowed me to accept my anxiety, diffuse it, and more meaninfully engage in value-based behavior, leading to a more fulfilling experience. Conclusion This new ACT model integrates self-compassion and a deeper understanding of the Observing Self, allowing for more effective therapy. While perfection is never the goal, striving for incremental improvement and value-congruent living can lead to a meaningful, fulfilling life. I aim to share more tools and stories to help others understand and apply this process, and I welcome feedback and collaboration to continue evolving this model.