I hear the word acceptance a lot in relation to living with a challenging health issue, whether that be an illness, injury and/or disability. My clients often say,

I can’t accept this.

If I could get to a place where I can accept this.

I think my issue is accepting what has happened.

Or a variant thereof. There is a lot of meaning wrapped up in the word ‘acceptance’ for my clients. And struggle, emotions and hope. For them, it’s often about finding a way back to a place of peace and calmness in relation to living with the impact of their illness, injury and/or disability. And experiencing a quality of life and sense of wellness.

So I’m attuned to forms of support which may help them in addition to what I already offer

Some years ago I came across Acceptance Commitment Therapy and wondered if this was a therapy that helped people get to that place of acceptance. I read more about it. And earlier this year I completed an 8-day course on it. I learned that it can help you transform the struggle of living with a serious health issue into energy you can apply to what you value in your life.

In this post and the next two, I will explain how Acceptance Commitment Therapy can help you do that. It has so many useful nuggets and ways of thinking that can help you to create the life you want whilst living with a serious health issue. I will also share strategies you can start implementing immediately to get yourself and your life going in a direction you value.

Also, when you decide to get help so you can find a way to live well with a challenging health issue, you may have a number of questions. What are the benefits? How does the process work? What is expected of me? Will it work? Experiencing some concerns, anxiety and just wanting to make sure your money is well spent is normal. This post and the next two will also help answer those questions too.

First, I have a disclaimer

You see Acceptance Commitment Therapy (ACT) and wonder if I am a therapist. I am not a trained therapist and so I do not practice therapy. I am a trained coach and you can see my qualifications here. You can also learn more about coaching and my approach here.

Even though ACT originated in the therapy world, there are aspects which can be used by professionals in other helping professions. In fact, on my training there were other coaches and Human Resources and Learning & Development professionals in addition to therapists. Supervision is important to ensure this is done within the professional’s skillset and competence. And that I have.

Disclaimer done.

So, what is Acceptance Commitment Therapy?

The official definition of Acceptance Commitment Therapy, referred to as ACT, is:

The goal of ACT is to increase psychological flexibility: the ability to contact the present moment and the psychological reaction it produces, as a fully conscious human being, and based on the situation, to persist with or change behaviour for valued ends. (Harris, 2007; Mindfulness Training Ltd., 2017)

Or to put it simply – To create a rich, full and meaningful life whilst accepting the pain and suffering which inevitably goes along with it.

The key aspects of ACT are referred to in the above definitions

  1. The ability to contact the present moment is being able to bring our attention openly, non-judgementally and with curiosity to what is happening in the here and now to ourselves, to others around us, to the situation. This is also known as mindfulness.
  2. Another side to contacting the present moment is being able to step outside of and observe ourselves. This is the first step in learning how ‘to stand in another person’s shoes’ and experiencing empathy with and for another. This can be learned.
  3. Become aware of our psychological reactions to the present moment and identify whether these are helping us or not.
  4. Pain and suffering is a normal part of life, including unpleasant reactions we have to our here and now experiences, and it is important that we accept that. And accept the good things too.
  5. If our reactions are not helpful, then we may wish to change our behaviour.
  6. We change our behaviour to obtain what it is we value and want, i.e. our valued ends. But we need to know what it is we value to ensure our behaviour and actions align with that.

The following diagram, referred to as the hexaflex, refers to these themes.

key components of acceptance commitment therapy

The Key Components of Acceptance Commitment Therapy

How will Acceptance Commitment Therapy help me?

The best way to share the benefits of ACT is to give you a taster of it following the hexaflex above. Today’s post will focus on points 1 and 2 above – Contact with the Present Moment and The Observer Self.

Contact with the present moment (mindfulness)

This is something you can easily practice throughout your day. When you are drinking a cup of tea, walking/rolling somewhere, eating lunch, brushing your teeth, changing your clothes, etc. Whatever it is you are doing, deliberately notice the experience.

Feel your hand cupping the warm mug, or your hands as they push the wheels of your wheelchair or power its control. Feel the sensation of the cool air on your cheeks, the feel of toothpaste in your mouth. Notice everything in exquisite detail. Notice it as you do the activity.

If you start thinking of something else, that is ok. There’s no need to get upset with yourself. Just bring your attention back to the activity and notice what it feels like as you do the activity. I have to bring my attention back a lot!

mindfulness acceptance commitment therapy

Mindfulness is the process of refocusing your mind’s attention

Keep practicing

Notice when you feel upset, angry with someone, rejected by someone, other unpleasant emotions and feelings and what you are telling yourself, what you are thinking.

Also, pay attention to where the unpleasant sensations are in your body. Describe them or even draw a picture of them. Sometimes people feel a heavy weight on their shoulders, or a fluttering in their chest, or a ball of knots in their stomach.

Take note when you are being kind to yourself and when good things happen – what you tell yourself, how you feel, where you feel those pleasant feelings and sensations in your body and what they are like. That is equally important.

The Observer Self

This is about stepping outside of yourself (figuratively) so you can notice what you are doing, saying, thinking and feeling. You start to do it by getting in touch with the present moment (mindfulness).

A great analogy is being the fly on the wall of your own life so you see everything that you do, the impact on others, their impact on you, etc. When you are the fly on the wall, you have stepped into your Observer Self.

fly on the wall acceptance commitment therapy

You are you and the fly on the wall.

Another analogy is chess. The black and white pieces are playing a game, or fighting a battle with the aim of winning. The chessboard hosts the game but is not invested in the outcome. It doesn’t care about who will win; it just hosts the game of chess.

In this analogy, you are the chessboard, not the pieces. You host the game. You notice what is going on in the game. But like the chessboard, you are not invested in who wins or loses. You are not invested in the struggle.

When you step into your Observer Self, you step into a place of being and you notice what you are doing, saying, thinking and feeling, and there isn’t the concern of winning or losing, of giving in or resignation.

Observer Self Acceptance Commitment Therapy

The advantages of being the chessboard in your life

Imagine what that would be like. To notice, to let go of the concern of winning, giving in or resignation, to just be and feel that sense of calmness that comes with it. To live in the present moment.

What’s it like for you?

What helps you to turn your attention from the past or future and live in the present moment? What are your thoughts of the analogies of being a fly on the wall or the chessboard? Feel free to share your thoughts and experiences in the comments below.

If you are living with a chronic illness or the after effects of a serious illness or injury, or are caring for someone who is and would like support to help you objectively look at your life and live a valued life, have a look at how we can work together and get in touch for a free no obligation consultation.

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© Copyright Barbara Babcock 2017


Harris, R. (2007). Acceptance and Commitment Therapy (ACT) Introductory Workshop Handout. Available

https://thehappinesstrap.com/upimages/2007%20Introductory%20ACT%20Workshop%20Handout%20-%20%20Russ%20Harris.pdf, (2017, November 20).

Whitfield H. (2011), Acceptance & Commitment Therapy Handbook, ACT Four Day Skills Intensive Part 1 & 2. London: Mindfulness Training Ltd.

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