What is ACT & Briefly on Medication

Welcome to Brisbane ACT Centre’s first ever blog post. I thought I’d talk in a less formal way about “What is ACT” and how we integrate with medication use in psychological problems. Firstly, off the bat, I personally reckon that “Acceptance and Commitment Therapy” – the underlying model for our work here at Brisbane ACT Centre – is a pretty awful name for a fabulous approach. But it is a name which just happens to make for a great acronym – ACT!

Okay, better break down what I mean by that: Acceptance can easily sound like tolerance, like simply putting up with feeling anxious, depressed or in pain, which is not at all what we mean. The acceptance part of ACT is about learning specific, easy to practice, evidence based and self-compassionate mindfulness skills to better handle difficult experiences so they’re less likely to be an obstacle to living your life. We’re not asking you to want, or like feeling lousy but we might ask – how long have you struggled to get rid of those feelings? And how successful has that been, long term? And what has it cost you? Skilled ACT therapists can teach you simple ways to be more present in the moment, to simply notice to your worrisome thoughts “as thoughts – not as truths or untruths“, to experience difficult feelings as manageable sensations, and do what matters in your life, in this moment and the next.

Commitment might come across as “having to do things, or forcing yourself”, again, not at all what we mean. See what I mean, great name hey? The commitment part of ACT is more about learning to be a little more aware of what you care about in life. From tiny things like chilling out, eating a bit more healthily, to bigger ones like relationships and work, and becoming a little more able to make small moves, day by day, toward these things. Our values are like a direction on a compass, and small goals are like towns along the way, letting us know when we’re heading where we wish to go. Having a skilled navigator to help us choose our directions and having a great support team to encourage and check up on our progress, can help us along the way. That’s the therapist or coaching role in ACT.

ACT may seem new to many, but really has a 70 year pedigree. ACT simply integrates the best evidence-based practices of decades of behavioral and cognitive research and treatment in an ongoing, ever developing and improving therapy. This includes a scientifically grounded, pragmatic approach to the use of medications.

We recognise that all medications may have benefits and harms, and we’re very careful with informed consent and wise use. It surprises many people to hear that psychiatric medications don’t “fix chemical imbalances” but may take the edge off difficult feelings by causing imbalances – yet this is well known and long proven, and is not unusual with drugs – paracetamol doesn’t help my headache or fever by fixing a paracetamol imbalance, but it can certainly be helpful in certain situations, and less in others. Same for psych drugs. See this recent article also here and this related blog post for more on disproven medication beliefs and their unintended consequences. For more on how ACT therapists relate to medication use, stay tuned!

Acceptance and Commitment Therapy is at heart about workability. Being where you are, and doing what matters in your life. We use any and all ways to help you with this, and we research these scrupulously, test our assumptions, try to find out where we are wrong, and continuously improve. In only the 9 short years I’ve been learning and practising ACT, our approach has deepened, with even more self-compassion focus, briefer and broader applications, more neuroscientific support, and an exponentially growing clinical and research community. Welcome again to Brisbane ACT Centre, and to our blog.

With heart.

Dr Rob Purssey
Psychiatrist and ACT Therapist

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