Acceptance and Commitment Therapy

Thursday, 27 Feb 2020

I read about Viktor Frankl many years ago and whilst some of you may know about him, I’d thought this is worth sharing. I found his story (in various iterations) as I was researching for this week’s Newsletter.

In September 1942, Viktor Frankl, a prominent Jewish psychiatrist and neurologist in Vienna, was arrested and transported to a Nazi concentration camp with his wife and parents. Three years later, when his camp was liberated, most of his family, including his pregnant wife, had perished - but he, prisoner number 119104, had lived. In his bestselling 1946 book, Man’s Search for Meaning, which he wrote in nine days about his experiences in the camps, Frankl concluded that the difference between those who had lived and those who had died came down to .....: Meaning and purpose, an insight he came to early in life.

In 1991, the Library of Congress listed Man's Search for Meaning as one of the 10 most influential books in the United States. Now, over twenty years later, the book's ethos - its emphasis on meaning, the value of suffering, and responsibility to something greater than the self - seems to be at odds with our culture, which is more interested in the pursuit of individual happiness than in the search for meaning. "To the European," Frankl wrote, "it is a characteristic of American culture that, again and again, one is commanded and ordered to 'be happy.' But happiness cannot be pursued; it must ensue. One must have a reason to 'be happy.'"

Research has shown that having vision, purpose and meaning in life increases overallwell-being and life satisfaction, improves mental and physical health, enhances resiliency, enhances self-esteem, and decreases the chances of depression. On top of that, the single-minded pursuit of happiness is ironically leaving people less happy, according to research. "It is the very pursuit of happiness," Frankl
said, "that thwarts happiness."

When people suffer from various mental health conditions, many try to pursue happiness which becomes a futile hedonistic pursuit.  In a recent article from John J Donahue (assistant professor in the Division of Applied Behavioural Sciences and programme director in the Certificate Program in Professional Counselling Studies, both at the University of Baltimore) in AEON (It’s better to focus on where you are going than how you are feeling) and related to the above, he suggests that there a mistaken assumption that we have a baseline of happiness and notes that one in two adults will meet the criteria for a mental health condition at some point in their life. “Given that psychological pain is so ubiquitous, we should focus less on what might make us happy, and more on achieving a sense of meaning, regardless of how we’re feeling. Psychotherapy should help people manage effective functioning while they are distressed, above and beyond aiming to reduce symptoms such as difficult thoughts, emotions and sensations,” says Donahue.

Donahue writes about Acceptance and Commitment Therapy (ACT) which uses other techniques to ameliorate problematic thoughts and emotions. It seems to be more about nurturing meaningful behaviours aimed at ‘valued living’. “Think of valued living as going about your daily life in the service of values that you find important, whereby engaging in these actions creates a sense of meaning and purpose”. 

Japan’s great author Haruki Murakami says “pain is inevitable but suffering is optional” and I suppose what’s being driven home here is the notion that we might not have any control over the pain we experience – in fact, our emotional pain is profoundly human – but one area where we can exert some control is what we do in response to that suffering. Many people choose destructive paths to ameliorate their pain or alleviate their distress but this is short term and ultimately damages our relationships, jobs and personal wellbeing. “By letting go of an agenda guided by minimising pain, and recalibrating toward a more value-driven agenda, our choices can be based on who we want to be, rather than how we want to feel”.

Donahue says that enacting behaviours that align with personal values has been linked to positive outcomes. It is a challenge to go into too much detail here but Donahue recommends the following to those who are keen to know more: 

Get Out of Your Mind and Into Your Life (2005) co-authored by the founder of ACT, Steven Hayes, and also Things Might Go Terribly, Horribly Wrong (2010) co-authored by another ACT pioneer, Kelly Wilson. And here is the international directory of ACT therapists, maintained by the Association for Contextual Behavioral Science.
Meaning and the good life Mental health

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