How do you find renewed purpose in life when a cancer diagnosis, its symptoms or treatment has fundamentally altered the way you live?
How do you reclaim your sense of self when you can no longer enjoy the things you used to do, spend time with others, or pursue a profession in quite the same way as before?
How do you thrive when you’re dealing with chronic pain, depression or even self-consciousness about changes in your appearance?
Acceptance Commitment Therapy (ACT) provides a framework for pursuing a rich, meaningful life, despite persistent hardships, such as a cancer diagnosis. Its goal is not to eliminate your stressors, but rather, to help you navigate them by giving you the emotional resilience to work around them.
So, how does it work? Read on to learn more.
The six core processes of ACT
Acceptance Commitment Therapy is based on six core processes that promote flexibility in thinking. They are:
Acceptance: acknowledging uncomfortable emotions rather than trying to suppress them
Cognitive defusion: neutralizing negative thoughts by viewing them strictly as words
Contacting the present moment: noticing your surroundings to ground yourself in reality
Self-as-context: remembering that your thoughts and feelings don’t define you
Values: clarifying what’s really important to you
Committed action: taking concrete steps to build a meaningful life, even if it’s uncomfortable
Some of these terms may sound abstract, but most of the processes involve simple concepts, such as focusing on the here and now, rather than dwelling on the past or worrying excessively about the future.
How ACT can help
Acceptance and Commitment Therapy helps you focus on the things in life that are most meaningful to you. It also provides support for continuing to pursue those things, even while facing ongoing challenges. It helps you to move toward a more purposeful life, rather than resigning yourself to suffering.
By finding ways to continually connect with what matters most to you, you can nurture skills that promote a sense of purpose over feeling stuck in place. And that’s a worthy goal, because ongoing illness and pain often end up controlling our thoughts and behaviors. That keeps the focus on how things used to be in the past, rather than on how things are right now or could be in the future.
I work with many patients who have chronic pain. Sometimes, they say things like, “I can’t contribute to my family the way I used to.” Or, “I used to be really good at running, and now I can’t even get out of bed.” Or even, “I don’t recognize myself anymore.”
That is totally understandable. Our identities are often shaped by our roles and activities. So, dramatic changes in your physical abilities or career path can leave you feeling like you’ve lost your sense of self. You may identify so closely with your job or hobbies that you don’t know who you are anymore if you can’t describe yourself as the family breadwinner or an avid runner.
This is when ACT could be very helpful.
Acceptance Commitment Therapy (ACT) is a framework designed to help you live a rich, meaningful life, despite persistent hardship.
It is based on six core processes that promote flexibility in thinking.
ACT helps you focus on the things in life that are most meaningful to you.
What ACT looks like in practice
If you can no longer participate in foot races or endurance sports, for instance, we may work together to find other ways of moving your body that honor its current limits. Similarly, we may explore how you could channel the values of dedication and determination into other areas of your life, such as managing a challenging relationship or continuing to run your own business.
A big part of ACT is identifying the things that are really important to you — whether that’s love, knowledge, freedom, adventure or something else — and connecting those values to concrete actions that can help you redefine yourself and renew your sense of purpose. Often, that includes finding variations of previous activities that may be different from what you’re used to, yet still represent the things in life you find meaningful.
Who uses ACT?
Sometimes, cancer isn’t neatly book-ended by diagnosis on one side and treatment on the other. Symptoms may persist for months, or side effects may linger for years. So, there are many situations in which ACT can support better well-being.
What tends to contribute to many people’s suffering is the constant struggle to make pain go away, whether it’s physical or emotional. ACT can neutralize this by helping you accept that some discomfort in life may be inevitable. So, instead of feeling as if you can only move forward if the pain is totally gone, you feel supported to keep moving toward your values in spite of it.
There are times when ACT is not the best choice, though. Some people may find it too abstract, especially if cognitive impairments affect their thinking. It’s also not the best solution for very immediate problems, such as acute psychosis, complex trauma or situations that call for crisis intervention.
If you’re a UT MD Anderson patient who would like to explore ACT, ask your care team for a referral to Pain Management or Integrative Medicine.
Grace Kao, Ph.D., is a pain psychologist in Pain Medicine.
Request an appointment at UT MD Anderson online or call 1-877-632-6789.