Discover how ACT can help you make room for difficult emotions, manage your thoughts with compassion, and live a more meaningful, values-driven life.

If you tend to steer clear of painful or distressing feelings, you’re in good company.

Your mind and body are wired to protect you from pain, like when you automatically pull your hand away from a hot stove before you even realize it.

Sometimes, though, this avoidance is intentional. Maybe you ignore your parents’ calls because you don’t want to argue about your decision to take a lower-paying but more fulfilling job. Or perhaps you keep conversations with your partner light and casual to sidestep a tough discussion.

But what if you responded to difficult emotions differently? Instead of labeling sadness, anger, or fear as “bad,” what if you simply recognized them as natural parts of being human?

That idea lies at the heart of Acceptance and Commitment Therapy (ACT). ACT teaches that uncomfortable emotions and experiences are an inevitable part of life, and avoiding them often leads to more distress.

Rather than fighting these feelings, ACT (pronounced “act”) encourages you to acknowledge them and commit to living in line with your values.

Read on to learn the basics of ACT, including who can benefit, what to expect from therapy, and how to try it.

Values vs. goals

Values can serve as guides that help shape your life path overall. Your goals, on the other hand, refer to more specific, short-term target actions that often reflect your values.

Your values, for instance, might include knowledge, creativity, and personal development. A goal that embodies these values might be attending a prestigious art college.

In some cases, avoidance can be a useful problem-solving strategy, but it can also become unhelpful if you rely on it too often.

For example, if you put off a difficult conversation with your best friend, it might give you time to explore your feelings and find a way to approach the subject delicately.

On the other hand, if you’re giving a presentation at work and are nervous about public speaking, you might distract yourself from your worries by watching TV instead of preparing.

Procrastination may relieve performance anxiety in the short term, but it may leave you unprepared on the big day.

The likely result in the example above? Your less-than-stellar presentation convinces you that public speaking is difficult and frightening. The next time you need to give a speech, you may feel even more stressed and tempted to procrastinate.

You didn’t avoid preparing due to laziness, but because your anxiety loomed too large and distracting to ignore. That’s where ACT comes in. This approach can teach you new skills to help you accept those intense feelings without relying on distractions or avoidance techniques.

ACT doesn’t aim to help you eliminate or control unwanted feelings, thoughts, or physical sensations. It also doesn’t suggest you should “grow a thicker skin” and repress those feelings.

Instead, it helps you accept that uncomfortable emotions are an inevitable part of life and teaches you how to stop struggling against them when they arise.

Over time, you learn that just because a feeling is unpleasant doesn’t mean it’s unbearable. This shift can build greater self-trust and emotional flexibility.

In essence, ACT guides you to redefine your relationship with difficult experiences so you can continue doing what matters most, even when distress is present.

It helps you identify your core values and use them to steer your choices, so your actions align with what’s meaningful to you, rather than being driven by fear, discomfort, or self-doubt.

FYI

Steven Hayes and Robert Zettle published the first study on ACT in 1986.

Since then, hundreds of randomized controlled trials have demonstrated this therapy’s effectiveness for a range of mental health conditions, according to 2020 research.

ACT is a transdiagnostic therapy, meaning its principles can be applied to almost any mental health concern. Research from 2020 suggests it can prove particularly helpful if you’re experiencing multiple conditions at the same time.

Mental health professionals often use ACT to help treat:

1. Anxiety and stress

ACT won’t get rid of stress triggers or diminish anxiety completely. In fact, ACT theory considers these experiences part of your experience as a human being.

What ACT can do is teach you techniques to change the way you respond to anxiety and stress.

Maybe you have social anxiety, but still want to build meaningful connections with others. You might, then, work on skills to start conversations or interact more easily, despite fears of rejection or judgment.

ACT doesn’t focus on decreasing anxiety as a goal of therapy, though that might happen as a natural consequence of exposing yourself to more social situations.

The goal lies in building the life you want, which, in this instance, might involve more social connection and emotional intimacy.

Or maybe your demanding job places a lot of stress on you for a lower salary than you’d like. ACT can help you learn to accept those feelings because you know the situation is only temporary until you gain the experience to find a better job. At the same time, you might set goals that better match your values of financial security and a satisfying career, like asking for a raise or finding and applying to three new jobs each month.

2. Depression

According to the ACT theory, actions that align with your values can add meaning and importance to your life, even if they don’t necessarily produce feelings of happiness.

To put it another way, you don’t have to put off doing the things you want to do until your feelings of depression, for instance, improve.

By helping you find ways to live out your values rather than your current emotions, ACT can help you get some distance from thoughts of hopelessness, shame, and regret. It may also have particular benefit for treating anhedonia, the inability to feel pleasure, according to 2020 research involving people with terminal cancer.

One 2018 study compared the benefits of CBT and ACT for 82 people with major depression. According to the results, 75% of people who tried ACT reported remission of their depression symptoms and improvement in their quality of life.

These benefits held up through the 6-month follow-up point.

3. Substance use disorder

You may not necessarily use substances to feel intoxicated. Some evidence from 2019 suggests, for instance, that people living with opioid use disorder may use opioids primarily to avoid cravings and symptoms of withdrawal.

Some addiction interventions, like cognitive behavioral therapy (CBT), focus on teaching skills to avoid triggers for cravings. But ACT helps you:

  • Focus on how you may have used substances to avoid or numb unwanted or distressing internal experiences.
  • Explore the impact of substance use on your ability to create a meaningful or purpose-driven life.
  • Learn to accept and tolerate emotional pain without numbing or avoiding it.

4. Treatment nonadherence

Coping with a new health concern can present any number of challenges, and you may not always find it easy to adjust to treatment. ACT can help you work through obstacles that may be preventing you from fully participating in your treatment plan.

For example, you may skip physical therapy after a serious injury in favor of bed rest because you worry about embarrassing or hurting yourself further. You could also stop taking your medication because you don’t like the side effects.

But maybe rest and self-care alone don’t improve your symptoms, and you start to feel worse.

In this situation, ACT can help you recognize how avoiding physical therapy due to worries about pain and embarrassment doesn’t line up with your values of personal wellness and living a full life.

Typically, ACT is organized into distinct modules that teach you six core skills, according to a 2022 meta-analysis. Your therapist will also give you exercises to help you practice the techniques as you learn them, a 2020 study notes.

ACT skills include:

1. Practicing mindfulness

Mindfulness helps you focus on the present moment, or your current thoughts, feelings, actions, and physical sensations.

Why does mindfulness matter? Well, you might find it easier to control your reaction to a situation when you can recognize how it affects you as you experience it.

Maybe bad news makes your head swim and your thoughts race, and you can’t catch your breath. Naming those sensations in your brain and body can help you find ways to work through them, like sitting down and taking several slow, deep breaths.

2. Keeping a balanced perspective

ACT helps you recognize and remember that you are not your feelings or thoughts; you are the consciousness, or sense of self, that experiences them.

This perspective, known as self-as-context, enables you to view your emotions and thoughts as fleeting experiences rather than fixed definitions of who you are.

In this way, you don’t have to live according to a rigid or narrow identity. Instead, you can respond flexibly to situations based on the context and your chosen values.

Your thoughts might still urge you toward specific actions, such as texting your ex when you feel lonely, but recognizing that you are the observer of those thoughts gives you the space to choose how to respond.

You can act in ways that align with your values, rather than being driven automatically by fleeting emotions or stories about who you “should” be.

3. Identifying values and goals

In this stage, you identify your strongest values, like serving your community, keeping your promises, or showing kindness to everyone. These values can help you identify the goals and dreams you’d find most meaningful to pursue.

Living a life of purpose often becomes easier when you have a clear sense of direction in mind and a good understanding of what matters most to you.

4. Committing to values-based actions and goals

Dreams tend to stay stuck in your head until you put in the effort to make them a reality.

To put it another way, fantasizing about Mr., Ms., or Mx. Right won’t make your happily ever after come any quicker.

If you want to make romance happen, you’ll need to take steps to meet new people, whether that involves attending community events, finding a group of people interested in the same hobby, or trying out a dating app.

5. Accepting unwanted feelings

Sometimes you’ll need to overcome some challenges in order to reach your goals.

If you want to save up money to attend college in a bigger city, for instance, you might have to spend some time working at a job you don’t enjoy.

This might cause some day-to-day frustration or resentment toward friends who don’t need to earn money for college.

Instead of trying to squash those emotions or feeling guilty about them, ACT aims to help you learn to carry those feelings with you and accept them as part of the process.

In other words, you can learn to fight for your dreams, not against yourself.

6. Cognitive defusion

When your thoughts or feelings interfere with your goals, a technique called cognitive defusion can help you take a mental step back and consider those thoughts from a more detached, objective point of view.

Cognitive defusion can also help you avoid considering the world from the perspective of your current thoughts and emotions. Remember, emotions reflect your internal state, not the objective reality of the world around you.

Here’s an example

You may feel worthless during an episode of depression, but that emotion isn’t a reliable way to measure your value as a person. Instead, challenge yourself to create some distance from that thought.

You might, for instance, think, “I’m having the thought that I’m worthless.”

You could also try visualizing that thought as an annoying pop-up ad. Rather than giving it space in your brain, just click the X in the corner to close the window.

ACT can help you accept even severe emotional distress and recognize it as part of the human experience, rather than a sign of something “wrong” with you.

This approach can help you learn to engage in life even when challenged by things you can’t control, like illness, pain, loss, and severe mental health symptoms.

What’s more, ACT works well in a variety of therapy formats: face-to-face sessions, guided online courses, or even interactive apps.

A typical course of ACT may involve sessions lasting 30 to 60 minutes over a period of 6 to 12 weeks. Research studies often use these time frames, and many people experience meaningful progress within that period.

However, the length and structure of therapy can vary widely depending on your individual goals, needs, and circumstances.

If you have a packed schedule, there are also flexible options available, such as:

The following resources can help you find an ACT therapist in your area:

You can also:

  • Use any online therapist directory to find local mental health professionals who offer ACT.
  • Ask a doctor or other healthcare professional for a referral.
  • Check your insurance plan for covered therapists or out-of-network therapy benefits.

According to ACT’s primary philosophy, healing stems from accepting your emotions, not getting rid of them. ACT can help you address anxiety, depression, and general emotional distress by helping you learn to accept and allow distressing or unwanted feelings as part of your lived experience.

This versatile therapy approach has a wealth of evidence to support its effectiveness. It also works well in tandem with physical treatment, according to a 2020 controlled trial.

It may help make physical pain and discomfort associated with chronic pain, diabetes, or cancer feel more tolerable, too.

Ultimately, learning to manage difficult emotions may give you greater control over your reactions to them. This frees up valuable energy and attention, allowing you to pursue your values and live life the way you want to.

Emily Swaim is a freelance health writer and editor who specializes in psychology. She has a BA in English from Kenyon College and an MFA in writing from California College of the Arts. In 2021, she received her Board of Editors in Life Sciences (BELS) certification. You can find more of her work on GoodTherapy, Verywell, Investopedia, Vox, and Insider. Find her on Twitter and LinkedIn.