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Does ACT Work With Post Traumatic Stress Disorder?

Caregivers Who Develop PTSD



Topics Covered in This Post 

  • How traumatic events can change us. 
  • Can acceptance and commitment therapy (ACT) help people with PTSD? 
  • ACT as living in the ‘and’. 
  • The importance of values when building a life following PTSD.
  • •ACT and defusion.
  • How we can get better at dealing with emotional pain. 
  • ACT provides a set of tools (the 6 core principles) that we can use in response to different situations. 

What Happens When We Can’t Deal with a Traumatic Event?

Sometimes things happen to us that are so horrible that we just can’t deal with them. This could be a single traumatic experience or repetitive incidents over many years (e.g. growing up in a violent home). The impact of trauma can be so great that it changes who we are, and it can leave us with ongoing mental and physical symptoms known as post-traumatic stress disorder (PTSD). 

The symptoms of PTSD can include flashbacks, nightmares, panic attacks, anger outbursts, depression, psychological reactivity (e.g. increased heart rate in response to a reminder of the past trauma), emotional numbness, and an inability to enjoy life. There can also be guilt and shame about not being able to get over the past. In fact, this idea that we should just pull ourselves together is part of the problem. It is based on the misconception that we choose how our body reacts to traumatic events and we are therefore responsible for our symptoms. This is simply not the case. 

“Trauma interferes with some of our basic assumptions about the world.”
Sheela Raja - Overcoming Trauma and PTSD: A Workbook Integrating Skills from ACT, DBT, and CBT

Can Acceptance and Commitment Therapy (ACT) Help People with PTSD? 

ACT is now being used to treat a variety of conditions including PTSD. This approach helps clients to face what happened to them and deal with the thinking patterns that drives symptoms. The overall goal is to be able to break free of the past in order to build a better future. Now we will look in more detail at the different ways in which ACT can be of value to those of us with PTSD. 

PTST and Living In The ‘And’

Living in the ‘and’ means accepting what has happened to us (and how things can be difficult for us) while still taking action to live a life based on our values. For example, it is not about ignoring or removing fear from our life, but about learning to take action despite this fear (this topic is explored in depth in the following YouTube video ). 

The importance of acceptance can be found in almost all spiritual as well as philosophical traditions (e.g. stoicism). It is an important element of ACT too. There is no point resisting things that we can’t change, and the past is one of those things that is beyond our ability to alter. Acceptance can sound like an overly passive way of relating to life, but we are only asked to accept the inevitable. ACT also focuses on committed action that will move our life in a positive direction. This is where the ‘and’ comes in.

The Past is Done But We Can Create a Future Based On What Is Important To Us 

One of the things that makes ACT attractive to people dealing with PTSD is it the focus is on the future and not just the past. The goal is to create a better life based on our values while learning to accept the things that have happened to us (see living in the ‘and’ above). 

Values are one of the core principles in ACT. The idea is that if we can build a life based on what is most important to us then this will be a life worth living. The approaches uses questionnaires and worksheets to identify these values – it is vital that they are things that are genuinely the most meaningful to us rather than things we think ‘should’ be. This work provides a foundation for everything else we do in ACT. These values can help us make sense of our lives, give us a sense of purpose, and provide the motivation needed to take committed action that will lead to a better life. 

An article in Social Work Today ( ), by Claudia J. Dewane, mentions how soldiers who have a sense of a larger purpose are less likely to develop PTSD in the first place. Using our values as a foundation for our life provides this larger purpose, so this means we will have more psychological resilience moving forward. This can make it easier for us to deal with the past as well as any issues that might arise in the future. 

PTSD Involves Fusion With Thoughts – ACT Teaches Defusion 

“…trauma survivors, through processes of holding the content of their mind to be literally true (fusing with verbally constructed futures, imagined ideals, reasons as causes of behavior, and evaluation), get entangled with their minds and become overidentified with the content of their mental lives in ways that keep them stuck in psychological turmoil and traumatic pasts.”
Robyn Walser and Darrah Westrup – Acceptance and Commitment Therapy for Post-Traumatic Stress Disorder and Trauma Related Problems

Repetitive thinking loops and stories about what happened to us can be a major driving force behind PTSD symptoms. It is like we fuse with these thoughts about the past so that we are unable to view them objectively. If we are standing too close to something, we won’t be able to make sense of it, and the same is true of our thinking. Defusion is another of the core principles of ACT and it allows us to become unstuck from our thoughts so we can see things more clearly. 

ACT Provides The Strength to Face Emotional Pain 

Another driving force behind PTSD is a tendency to avoid emotional pain. This is not something that we necessarily do consciously, but just a path taken by a mind that feels overwhelmed. Unfortunately, any attempt we make to avoid emotional pain doesn’t work in the long-term. Indeed, it turns out that most of the suffering we experience is due to this psychological tendency to avoid pain. 

The ability to face emotional pain is a skill that we need to develop. In spiritual circles, it is sometimes referred to as ‘self-compassion’. We can think of this skill as a form of resilience. It is not about learning to feel less but being able to feel more without it causing us to resist. A crude analogy would be to say that this skill is similar to lifting weights; we get better by doing it. Just like weights, we don’t start out by lifting the heaviest thing we can find, but by slowly building up as we build our resilience muscle. 

ACT introduces us to a tool called the ‘observing self’. This is a way to be with emotions and thoughts without taking what is happening too personally. We also learn to make contact with the present moment when things become too much for us. 

ACT and the Importance of Psychological Flexibility 

There is an old saying, ‘when the only tool you have is a hammer, everything starts to look like a nail’. One of the things that can make life more difficult is when we have a limited number of inner resources for dealing with things. For example, growing up, we can discover how anger can be a useful tool when standing up for ourself – the problem begins when we start using anger as a response to every challenge. 

ACT provides us with a set of tools including: defusion, acceptance, contact with he present moment, values, committed action, and the observing self. This means that we have a number of potential responses to what is happening in any given moment, and we can choose the tool that is most appropriate. This gives us psychological flexibility which is a key component of mental well-being. 

Finding Help for PTSD 

Here at 180 Sanctuary we provide a dedicated program for people suffering from PTSD ( ). As well as ACT, we also utilized other approaches including EMDR, DBT, exposure therapy, and trauma therapy to give you the best chance of achieving well-being and mental wellness. We are happy to answer any questions you might have, so contact us right away.  

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