Acceptance and Commitment Therapy in Addiction Rehab

Acceptance and Commitment Therapy (or ACT) is a psychotherapy technique used in numerous applications and contexts. It is particularly effective in drug addiction recovery rehabilitation. ACT belongs within the larger mindfulness-based therapy framework. For those unfamiliar with mindfulness therapy, it’s an approach that includes counseling and meditation that teaches the addict to think and live in an independent and self-help manner, outside of settings involving clinical or hospital care. It has recently gained prominence in the world of structured mental health and drug addiction treatment programs.

There’s wisdom in regards to accepting what you cannot change and changing what you can so that you can get more out of your life and your full human potential. A person yearns for fortune, fame, success, and self-actualization because as humans we all want to strive to better ourselves and make our mark in the world. Accepting that we are only flawed humans is the first step to empowering ourselves and unlocking not only sobriety but also the freedom from the blockade of imperfection.

History of Acceptance and Commitment Therapy

Steven Hayes, Ph.D. (Hayes, Strosahl & Wilson, 2011) is the specialist who developed Acceptance and Commitment Therapy. It’s another form of Cognitive Behavioral Therapy that also focuses on acceptance and self-awareness in order to alter your behavior for the better. It’s also quite similar to Dialectical Behavioral Therapy or DBT. Both ACT and DBT teach clients about Eastern meditative practices and the value of mindfulness meditation. ACT in particular is all about cognitive defusion. During times of distress, people often become fused with their feelings and thoughts. Therefore, we tend to overblow the importance of our emotions.

Instead of objectively and logically dissecting that we might be overreacting to what we’re feeling through ego, pride, selfishness, and at times shallowness, we start believing these feelings and thoughts. We can mistake our feelings for facts about ourselves and the world. We should instead be more objective than realistic rather than overly emotional and overreactive. ACT teaches people to notice and acknowledge these thoughts and feelings as of no particular importance other than the importance you can subjectively put on them. This is particularly helpful when getting over feelings of distress and inadequacy that can push you to drinking alcohol or taking drugs to “feel better”.

The Different Cores of ACT

ACT focuses on six main facets as claimed by the National Registry of Evidence-based Programs and Practices or NREPP. They include the following:

1. Acceptance: This is the first main or core area of ACT, which is also theorized in Dialectical Behavior Therapy. You can end up continuously enmeshed in the same physically or emotionally grinding problems because you aren’t accepting of your reality. Because you’re in denial, you tend to repeat self-destructive patterns to cope with issues like low self-esteem, death, job loss, bullying, loneliness, domestic abuse, trauma, post-traumatic stress disorder, and so forth.
2. You should accept that you feel stressed out by the situation instead of pretending everything is fine while the stimuli you’re denying instead of accepting is eating you up inside. Accept the circumstances in order to find ways to change them or change yourself in order to better cope with things you cannot change. Never underestimate a person’s ability to adapt to any situation.
3. Defusion: Defusion follows acceptance as the second main area of ACT. It trains recipients of ACT in how to detach from their ego, behaviors, and identity from their thoughts in order to view things as objectively as humanly possible. For example, if you’re thinking, “Gee, I want to get high with cocaine right about now”, you don’t need to act on that thought or impulse. This thought alone won’t make you a drug user or abuser either.
4. In the process of defusion and though examination, the thinker attempts to gain greater control and power over his impulses that have manifested themselves into conscious thought and desires that you have the choice to act or not act upon. Through defusion, you’re less likely to engage in unhealthy acts or destructive behaviors. You can also say no to a though instead of letting it bully you, but you need to be aware that you’re thinking of it first to act on it or say no to it.
5. Presence: The third main area of ACT is presence. Similar to mindfulness teachings found in mindfulness meditation and the like, you should learn how to be present in the moment rather than thinking too much of the past or thinking too much ahead in the future. This is necessary in order to restore your mental balance and harmony. Drug addiction rehabilitation should be approached in a moment-to-moment basis as well as in a case-to-case basis.
6. You should be present in the moment by meditation or focus in order to keep you from relapsing to living by impulse, letting your cravings dictate your needs and actions, and maintaining the power of refusal of yourself and your addiction neediness as your body acclimates to a state of sobriety. Don’t let your addiction and cravings for drugs and alcohol live in your head rent-free.
7. Self-Awareness: Self-awareness and presence is the fourth core area of ACT. It’s a quality that’s part of the mindfulness benefit package. If you’re more self-aware you’re less likely to go on autopilot and do impulsive yet inherently self-destructive or shameful things. A self-aware person has more control over himself and his actions. Drug addicts are usually not self-aware or willfully ignorant of the self-destructive spiral they’re in.
8. A self-aware person will cringe at certain behaviors, which serves to stop them from doing such acts even when addiction symptoms and cravings creep into their subconscious and worsened by their drug-altered brain chemistry. Self-awareness also helps the addict realize there’s more to life than alcohol, drugs, partying, fulfilling fleeting desires over long-term goals, and the hedonistic way of life. He’s empowered enough to gain personal change.
9. Value Identification: ACT’s fifth core area is value identification. There are times when an individual’s life is controlled, invaded, or dictated upon by someone else’s values or even society’s values, leading to him living a life that’s not authentic or within his control. Instead of being empowered he feels like he’s being depowered or left under the whims of others. Value identification is a way around this circumstance of being pushed around and manipulated like a puppet by society or by others. This core builds your new foundation for living.
10. ACT’s value identification allows you to identify your personal truths or values before beginning to pursue them. What do you personally want to do with your life? Worry about that instead of depending on what others think about you for your self-esteem. This will then shift you away from destructive behaviors like drug addiction or alcoholism, which undermines your recovery and is usually a manifestation of you feeling like you have no control over your life. A recovering person can use value identification to support and promote what really matters to you.
11. Commitment to Action: The last core or main area of ACT is to literally act or being committed to action. Commitment to action is the practical exam and application of everything you’ve learned while undergoing your ACT sessions. ACT is supposed to restructure your belief system to lead to positive changes, but without action and a change in your behavior, all these lessons from ACT would be for naught. This is the point where you’re supposed to end your drug and alcohol abuse in order to build a sober life.
12. Your new existence in sobriety requires affirmative commitment from the values you’ve learned and established, the self-awareness that will keep you from succumbing to your impulsiveness, your presence of mind so that you can live in the present rather than existing in autopilot, your defusion that allows you to let go of your ego and pride to take on circumstances more objectively, and your acceptance of being a flawed individual who has succumbed to addiction. ACT clients who have willingness to change are the ones who can get the most out of the program in making healthy life alterations towards sobriety.

Working on the Individual’s Psychological State

ACT mainly works with the individual’s psychological state in order to change the person’s behavior in a positive and constructive manner. This is the main similarity it has with Cognitive Behavioral Therapy or CBT. However, the ACT methodology is a bit different due to its use of six core values and its approach towards the fact that many people aren’t receptive to change at first. ACT knows this possibility and it accordingly gives the recipients the ability to grow and accept the process, which in turn helps them mobilize towards changing for the better.

• Protecting Their Twisted Reality: The ability of humans to adapt is both a blessing and a curse. Just as addicts can adapt towards sobriety after using drugs for a long time, so too can they fall victim to drug abuse in the first place. One painful reality when it comes to attempting recovery from addiction is that the addict will grow so accustomed to abusing drugs and alcohol that they unwittingly begin to protect their way of life, even defending their vices during therapy or avoiding these treatment sessions altogether. They’re like victims of abuse and torture who’ve started building sympathy for their captors a la Stockholm Syndrome.
• The Dynamic ACT Therapy Process: The process of ACT therapy is quite dynamic though, which can lead addicts to building a new, healthier way of life and thinking that should undo their seeming Stockholm Syndrome for their addiction to illicit and prescription substances. It’s from that pain-free or pain-reduced platform that the addict can take the right steps to effect real-life changes when it comes to their addiction tendencies. Once they discover how to be more constructive, they’ll stop drug use, cease harmful behaviors, start a new career or educational path, or let go of harmful relationships/circumstances that led them to drink or do drugs.
• The Importance of Acceptance in ACT: Acceptance is integral to the ACT process and bears further elaboration on how it’s applied in this form of psychiatric therapy in particular. Many of the internal feelings and emotions that keep you from changing for the better can be removed by accepting them instead of denying their existence. Denial is about indulging in ignorance and pretending everything is fine, so your body goes on autopilot and uses drugs or alcohol to cope with your negative emotions of insecurity, grief, sadness, depression, loss, boredom, and other feelings of inadequacy. Acceptance involves not only addressing your innate problems but doing something about them.
• Worrying about Uncontrollable Situations: You might get stuck worrying about why things are and feeling betrayed by the unfairness of life by trying to worry or control uncontrollable situations like the loss of a loved one, the lack of romance or failed past relationships, mistakes in your past that come back to haunt you later on, and the fact that you’re only human and you might end up making further mistakes down the line. A lot of popular self-help literature and the mental health field itself have advised people to let go and accept that there are things beyond your control or ability to change.
• Acceptance Isn’t a Call of Inaction Though: Just because ACT is all about accepting that there are some things you can’t change, it doesn’t mean that you should let everything go or live a life of irresponsibility, as though everything in life is out of your control or hands. Rather, acceptance teaches you to focus on things that you can change so that you can cope with the things you can’t better and do things that are more productive, constructive, and proactive in your life. Living a lifestyle that’s mentally sedentary is just as bad as being physically sedentary.
• Moving from Acceptance to Commitment to Action: You still need to accomplish much needed life changes after accepting the things you can’t change about society, your circumstances, and others, especially if you’ve been using drugs to cope with life. After you’ve accepted your current reality with the help of ACT treatment and a registered psychotherapist, you should then undergo a personal change. Paradoxically, acceptance doesn’t lead to complacency and a failure to change but instead self-empowerment and the ability to make significant life changes because you’ve stopped putting your life in addiction autopilot.

Introduction of Acceptance Strategies

How does one even get to the point of acceptance? It’s easier said than done. Regardless, the psychotherapist using ACT will go about it by introducing different strategies for acceptance that include the following:

• The ACT patient should be guided to let their emotions, thoughts, and beliefs flow through himself instead of feeling the need to impulsively act on or react to them every time.
• The addict should be coached to observe his weaknesses and shortcomings without over-expressing them while at the same time taking note of his strengths as well.
• The patient should be dynamically taught compassion for the personal reality and circumstance he faces, particularly the fact that he isn’t perfect and he doesn’t have to excel or succeed at every single thing that he does.
• The ACT patient should find support from the ACT psychotherapist in acknowledging his present challenges without feeling like he needs to engage in escapism or avoid his responsibilities in an unhealthy manner.
• Point out to the addict that acceptance doesn’t mean inaction or leaving things as is, particularly when it comes to his addiction. Although there are things he can’t change or he has no control over, he does and should have power over his own self and his fate.
• Instill to the patient that through ACT, he can gain control or power over how he feels, thinks, acts, and reacts so that he can stop trying to control things beyond his control and focus on the things within himself and around him he does have power over.

Although it’s not always obvious that acceptance strategies can lead to empowerment, feedback and research from patients and clinicians alike support this objective yet constructive view of the world is what empowers the ACT patient in order to “act” on his own dire circumstances, whether he’s face with depression, PTSD, or addiction to certain mind-altering substances. ACT was not the first to discover the power of acceptance, of course. It’s present in many other psychotherapeutic methods and treatments.

ACT and Mindfulness in a Nutshell

Mindfulness therapy and meditation posits that every individual has the ability to pull himself by his bootstraps and fight against his own alcoholic compulsions and drug cravings by stepping back from what he’d normally consider as negative or traumatizing thoughts and change his point of view of them, witnessing them in a nonjudgmental manner. This way, he can avoid automatic reactions that are negative or destructive to things, places, and people that have traumatized him in the past. It’s about him changing himself instead of expecting the stimuli to change for him.

By practicing greater mindfulness, those who adhere to such beliefs can organically achieve personal transformation and strength of mind when dealing with the everyday stressors or stimuli of life. This also makes them less susceptible to using drugs or alcohol as a crutch to cope with stressful situations like losing your job, the death of loved ones, failed relationships, isolation and loneliness, a feeling of being trapped by your circumstances, and so forth.

After you’ve accepted yourself and your limitations, then you can test your limits and amaze yourself at what you can do because you’re not bound by mental constrictions. You can realistically go for your goals, stop letting your mind go on autopilot and allowing your impulses to illogically control your behavior, deny yourself momentary pleasure in order to achieve long-term worthwhile goals, and learn from your mistakes rather than be damned by them.

The Acceptance and Commitment Therapy of Lanna Rehab

It makes sense that the Lanna Rehabilitation Center in Thailand also offers Acceptance and Commitment Therapy or ACT when it comes to treating drug addiction and alcoholism because the center believes in the effectiveness of the holistic treatment paradigm. ACT is all about being mindful and nonjudgmental of your situation in order to objectively treat your addiction issues without bias or emotionality.

Contact the Lanna Rehab staff and crew in order to avail of or get free consultation for its all-inclusive addiction treatment that includes ACT. Their toll-free numbers are available 24/7 and give you the opportunity to organically achieve personal transformation to better your chances for sobriety. Call Lanna today.