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"How Can ACT and Mindfulness Work Together for Mental Health?"

ACT is a type of therapy that combines different approaches like mindfulness and cognitive behavioral therapy. While it shares some similarities with other therapies, it also has its own unique features. One big difference is how it incorporates mindfulness compared to other mindfulness-based therapies.

Where Does “Mindfulness” Come From?

Mindfulness isn't a new idea—it's been around for thousands of years and can be found in many ancient spiritual and religious traditions like Buddhism, Taoism, Hinduism, Judaism, Islam, and Christianity. Even practices like tai chi and martial arts incorporate mindfulness. While many people associate mindfulness mainly with Buddhism, it actually predates Buddhism by about 1,400 years and has roots in other traditions like Yogic, Taoist, and Judaic practices. Interestingly, even Buddhist scriptures mention that Buddha learned mindfulness from a Yogi. However, in the Western world, most mindfulness-based approaches draw heavily from Buddhism, but ACT stands out as an exception to this trend.

So What IS Mindfulness?

If you dive into a few books about mindfulness, you'll notice that there's no single definition that everyone agrees on. However, if you combine all the different definitions, they basically say this: Mindfulness is a bunch of mental abilities that help you live better by being open, curious, kind, and flexible when paying attention.

This idea gives us five key points.

  • First, mindfulness involves a variety of skills. These range from accepting tough emotions to enjoying good moments, from calmly watching your thoughts to finding stability when emotions are intense.

  • Second, mindfulness is about where you put your attention, not about what you think about. It's about focusing on your present experience rather than getting lost in your thoughts.

  • Third. mindfulness comes with a specific attitude: one of openness and curiosity. Even if what you're experiencing is tough or uncomfortable, you can approach it with openness and curiosity instead of avoiding or battling it.

  • Fourth, mindfulness also means being flexible with your attention. You can consciously widen, narrow, sustain, or shift your focus to pay attention to different parts of your current experience as you choose.

  • Lastly, mindful attention is marked by kindness. It's not distant and clinical like a scientist studying a specimen; instead, it's warm and caring, like how a loving parent pays attention to their child.

Mindfulness offers us a powerful tool to wake up, connect with ourselves, and fully embrace each moment of our lives. It helps us deepen our self-understanding, allowing us to better recognize our emotions, thoughts, and reactions. By practicing mindfulness, we can forge strong and meaningful connections with the people we care about, including ourselves. Moreover, mindfulness empowers us to consciously shape our behavior and expand our ways of responding to the world around us. It's like mastering the art of living consciously, which greatly boosts psychological resilience and enhances overall life satisfaction.

However, ACT encompasses more than just mindfulness. It also emphasizes living in line with our core values, guiding us to take consistent action that reflects what truly matters to us. In fact, in ACT, we teach mindfulness skills primarily to support people in living authentically according to their values.


The Core of Mindfulness Exercise: Noticing X

At the heart of every mindfulness exercise, whether it's a quick ACT technique or a lengthy meditation retreat, lies one basic instruction: "notice X." This means directing your attention to something specific in the present moment. You might hear variations like "observe," "pay attention to," "focus on," "be aware of," or "bring awareness to." The "X" represents anything present in the moment: a thought, a feeling, a sensation, an urge, a memory, your body posture, your actions, or anything you can perceive with your senses.

Depending on the situation, you might broaden your focus to take in everything around you, like when walking in the countryside. Or, you might narrow your attention, such as when driving in heavy rain, focusing solely on the road. Sometimes, you might focus inward on your thoughts and feelings, while other times, you might focus outward on the world around you. Often, you'll shift between both inward and outward focus as needed—this ability to flexibly shift attention is called flexible attention.

The "notice X" technique is incredibly versatile, making it a central aspect of ACT. Most ACT exercises, if not all of them, circle back to "noticing X".

Mindfulness ≠ Meditation

There are places where mindfulness gets a bad rap; one of them stemming from the assumption that mindfulness is the same thing as meditation.

Let's clarify the distinction between "mindfulness" and "formal meditation." Mindfulness isn't always about sitting down for a formal meditation session, like focusing on your breath or body sensations. It encompasses a wide range of skills and practices that may not resemble traditional meditation at all.

Moreover, there are various types of meditation, some quite different from mindfulness meditation. For instance, in certain meditation styles, the goal is to clear the mind of all thoughts—a stark contrast to mindfulness, where you acknowledge and observe thoughts without trying to eliminate them.

In some ACT protocols, like Eifert and Forsyth's Acceptance and Commitment Therapy for Anxiety Disorders, formal mindfulness meditation plays a significant role. However, this isn't the norm across all ACT protocols. Most emphasize informal, quick mindfulness techniques that can be seamlessly integrated into daily life, regardless of location or activity.

Why this down-to-earth approach? Well, if our goal is to encourage more people to practice mindfulness, demanding lengthy meditation sessions might lead to resistance and dropout. Instead, we opt for simpler, more accessible practices, akin to suggesting small lifestyle changes to promote physical activity. This way, mindfulness becomes easier to incorporate into everyday life, increasing the likelihood that people will engage with it regularly.

Mindfulness: A Dodgy Word

The word "mindfulness" has become loaded with various meanings, making it sometimes more confusing than helpful to use. Some associate it exclusively with Buddhism or meditation, while others mistake it for positive thinking, relaxation, or a way to avoid unwanted thoughts and feelings. However, as we've discussed, in the context of ACT, mindfulness doesn't necessarily mean any of these interpretations.

If mindfulness isn't the best term for you to use when trying to engage in mindfulness activities, another word to use could be "unhooking" or develop "unhooking skills". If you want to make room for feelings, then maybe thinking about "expanding around" or "opening up and making room" for these feelings, then refer to "expansion" or "opening up" skills. If focus is a problem, then concentrate on "training attention" or "being present". As a term, "mindfulness" is often misunderstood or too abstract to be apart of our issues.

One thing to remember is that it's crucial to distinguish between "practicing mindfulness" and "practicing mindfulness meditation" because they're not the same. While mindfulness meditation is one way to practice mindfulness, there are countless other ways to incorporate mindfulness into daily life without ever meditating. Many clients may not be interested in or comfortable with meditation, and pushing it on them in a therapy context could be met with resistance. Instead, focusing on practical, everyday mindfulness practices that suit their preferences and lifestyles can be more effective in therapy settings.

Essentially, when tackling our thoughts and feelings with ACT, we need to use our mindfulness skills in relevant issues, and to set goals for improvement and therapy. Understanding why the skills are useful helps feel the benefits of applying mindfulness into our lives.

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