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Acceptance and Commitment Therapy (ACT) sees suffering as a normal part of our life, that we not only suffer, but also inflict suffering. It rejects the theory that human beings are inherently happy, connected to others, altruistic and at peace with themselves, which is the underlying assumption of the psychological mainstream (e.g., biomedicalization) that assigns suffering to mental and physical disorders.
According to ACT, human suffering predominantly emerges from normal psychological processes, particularly those involving human language (i.e., symbolic activity in whatever form it occurs – whether gestures, pictures, writing forms, sounds, etc.). It acknowledges that abnormal processes do exist, but states that even with several mental illnesses, the ordinary processes embodied in self-reflective language and thought may actually make the core difficulties associated with such conditions even worse.
This is because language has evolved to include more and more terms that describe and evaluate various states of mind or emotion. With this language development, human experiences can be categorized and evaluated. Psychological pain is a normal part of life, but as we increasingly look inward (as a result of language development), life begins to seem more like a problem to be solved than a process to be fully experienced, and this causes us to suffer. In other words, we suffer because we overreact to our own inner world, to the contents of our mind. So human language gives rise to both human achievement and human misery (the idea on which the core of the ACT approach is built), and we must learn to use language without being consumed by it, to manage it rather than having it manage us.
When we strongly believe the literal contents of our mind, we become fused with our cognitions, thus suffering occurs as a result. This is called Cognitive Fusion, the first of the six core processes that ACT seeks to address. It means that our thoughts tell us how things really are and what we need to do. Our thoughts become our “knowledge” (what we believe is true and right) under the cultural influence through language.
People whose cognitions fuse are more likely to blindly follow “social rules” originated in their own mind by the cultural influence through language, e.g., what society tells them about personal health and how best to achieve it. The problem is that these rules are implicitly based on the assumption that verbal rules and deliberate problem solving are the best or even the only way to solve problems, which leads to the struggle of attaining the “right” way to feel, or to feel “right/normal” (e.g., happy, connected to others, altruistic and at peace with themselves). They try everything they can to control their world, so as to restore their internal and external environment back to “normal”. ACT states that this way of responding to suffering is not the solution, but rather the problem.
Cognitive fusion naturally leads to the next core process of psychological inflexibility: Experiential Avoidance. It means that we frequently and intensely avoid suffering experiences that have been defined by the society and us as abnormal. In this avoidance, we constantly struggle with our thoughts and feelings. As a result, we become less and less able to get into the present moment and enjoy life – Inflexible Attention to the Present Moment. With time, a kind of life numbness sets in and we go through the motions of daily life without much moment-to-moment contact with life itself – we’ve lost touch with reality, and spend most of our time on attentional autopilot.
We are too busy being what our mind says we are, which is called Attachment to the Conceptualized Self. In other words, the person I call me is my thoughts and feelings about myself; what I think and feel about myself becomes my (false) reality, my (false) identity. The damage is great: we slowly lose our sense of our life’s direction and don’t know what we want from life – Disruption of Values. Our most important life choices come to be based on how to not evoke distressing personal experiences rather than moving toward what we most deeply value. In other words, we don’t act on the things that we care about the most – Inaction, Impulsivity, or Avoidance Persistence. We become increasingly stuck in our own self-stories and avoidance of the threats to our own self-conceptions. These are the six core processes ACT sees in psychological inflexibility.
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