ACT Therapy: What If the Goal Isn't to Feel Better?

This is one of the most counterintuitive things I say to clients, and it tends to land like a small shock: “What if the goal of our work together isn't to feel better?”

Not permanently, anyway. Not in the sense of getting rid of anxiety, sadness, self-doubt, or discomfort. What if those feelings are not the problem? What if the problem is what you do with them — the strategies you use to make them go away — and how much of your life those strategies have consumed?

This is the central insight of Acceptance and Commitment Therapy, or ACT (pronounced as the word “act,” not as initials). Developed by psychologist Steven Hayes, ACT is one of the most extensively researched psychological treatments in existence, with strong evidence bases across anxiety, depression, chronic pain, addiction, and trauma.

The Problem with Struggling Against Your Own Mind

Most people come to therapy with the understandable goal of feeling better — of eliminating or reducing the difficult feelings they're experiencing. And there is nothing wrong with this goal. The problem, ACT argues, is the strategy most people use to get there.

Psychological flexibility is the opposite of psychological rigidity. Rigidity looks like: I will only feel okay when I don't feel anxious. I will only take the risk when I'm sure. I will only go to the party when I feel confident. I will only apply for the job when the self-doubt quiets down.

The trouble is that trying hard not to think about something tends to make you think about it more. Trying hard not to feel anxious tends to produce meta-anxiety: anxiety about being anxious. The struggle against the feeling can consume enormous energy while actually perpetuating the very thing you're trying to eliminate. ACT calls this “experiential avoidance” — and identifies it as one of the primary drivers of psychological suffering.

What ACT Proposes Instead

ACT doesn't ask you to want your difficult feelings or pretend they're fine. Acceptance, in ACT, doesn't mean approval. It means making room — allowing the feeling to be there without fighting it, without letting it determine your actions.

The goal of ACT is to increase psychological flexibility: the ability to be present with your experience — including difficult thoughts and feelings — while still acting in accordance with what you actually value.

The framework includes six core processes:

Acceptance — Opening up to uncomfortable feelings without struggling against them. Making room rather than fighting for less room.

Defusion — Creating distance from thoughts. Noticing thoughts as thoughts rather than facts. “I am having the thought that I am worthless” is a different experience than “I am worthless.” The thought hasn't changed — your relationship to it has.

Present Moment Awareness — Contact with the here and now, rather than the mind's constant time-travelling between past regret and future worry.

Self-as-Context — The observer self that can notice thoughts and feelings without being defined by them. You are not your thoughts. You are the one who has them.

Values — Identifying what actually matters to you — not goals (outcomes you can achieve and check off) but the ongoing directions in which you want to live your life. Parent. Partner. Person who creates things. Someone who shows up with integrity.

Committed Action — Taking steps in valued directions, even when difficult feelings are present. Doing what matters despite the discomfort, not after it disappears.

ACT in Practice

ACT uses a lot of metaphors, experiential exercises, and mindfulness practices alongside more conventional conversation. It can feel quite different from traditional CBT, more experiential and less analytical. People who have found traditional CBT helpful but incomplete — who can challenge their thoughts but still feel stuck — often find ACT fills a gap that pure cognitive work couldn't.

The question at the heart of ACT is simple: in the service of managing uncomfortable feelings, what have you given up? And is that trade-off worth it?

Andrew Garnet MSW, RSW

Registered Social Worker with 18 years of experience in Scarborough, Ontario. Andrew specializes in trauma therapy, EMDR, men's mental health, and support for first responders and veterans. Full bio →