ACT — Acceptance and Commitment Therapy

ACT (Acceptance and Commitment Therapy) is a therapeutic method developed by Steven Hayes and collaborators since the early 1980s. It is part of the so-called third-wave therapies—along with DBT (Linehan) and MBCT (Segal-Williams-Teasdale). It is empirically validated for depression, anxiety, trauma, chronic pain, addictions, and eating disorders.

Central premise: human suffering does not stem so much from painful internal experiences (thoughts, emotions, sensations) but from the struggle against them—trying to eliminate, control, or avoid them. This struggle consumes life and energy. The way out is to accept the presence of internal experiences and direct actions towards one's values, regardless of how we feel.

Six core processes (ACT hexaflex): acceptance · cognitive defusion (not fusing with thoughts) · contact with the present moment · self as context · values · committed action. Psychic health emerges from flexibility among these six processes.

Important distinction from CBT: classic CBT tries to change dysfunctional thoughts. ACT does not try to change them—it tries to change the relationship with them. Accepting that a painful thought is present without fighting against it, and still acting according to one's values, is the central skill of ACT.

Application to trauma: especially useful for clients with chronic trauma who compulsively try 'not to feel' or 'not to remember'. ACT teaches them that the way out is not to eliminate the emotions of trauma—which exist and will exist—but to stop fighting with them and build a meaningful life in their presence.