Last week I described what Acceptance Commitment Therapy (ACT) is, and how it can help you transform the struggle of a serious health issue to acceptance. I focused on two of its six principles – Contact with the Present Moment and The Observer Self. This week I explain the next two principles, Defusion and Acceptance.

I am going to recap some of last week’s post but you can also find it here if you wish to read it in full. In fact, I encourage you to because it has useful ideas and strategies you can start implementing immediately. It will also give you the full picture of ACT thereby demonstrating the benefits of this talking form of help.

The recap – Acceptance Commitment Therapy

The official definition of Acceptance Commitment Therapy, referred to as ACT (say it as the word ‘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 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 helpful to ourselves 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 we take align with that.

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

Key components of acceptance commitment therapy picture

The Key Components of Acceptance Commitment Therapy

Let’s move on to talking about the next two principles of ACT, Defusion and Acceptance.


Sometimes we can become so caught up in our thoughts, we look at our lives through them. When these thoughts are unhelpful, we feel miserable and as if nothing will change. We may often say to ourselves, ‘Here we go again!’

But sometimes we don’t even know these thoughts and our resulting actions can be unhelpful. We actually think we are doing something good for ourselves. I often see this with clients in relation to living with a serious health issue. Here’s an example

My client want to live a good life.

She tells herself that she doesn’t want to ‘give in’ to their condition. So they keep going, working hard, telling themselves they must not grumble and can’t stop for a break because what would people think.

Her chronic pain intensifies so she takes her medication early to reduce the pain.

She feels better and ends up working a longer day.

This cycle continues until she is so tired and worn out, she has to take time off.

She feels like she has ‘given in’ to the health condition and it has ‘won’.

That’s a hard place to be in. What I love about Acceptance Commitment Therapy is its approach to dealing with these situations. ACT helps you to ‘defuse’ yourself from the thoughts and strategies you use which may actually not be helping you. ACT helps you notice what you are doing by using mindfulness and putting yourself into your Observer Self, which you can learn how to do here.

This means that rather than looking through the glasses of unhelpful thoughts and strategies, you take those glasses off and see the situation for what it is – you trying to help yourself in the best way you know how. But you realise it’s not working that well so you want to find a better way to help yourself.

Here is that new way

Our thoughts are our thoughts. We are NOT our thoughts.

Unhelpful thoughts can pop up in our minds like unwanted internet pop-up windows.

The aim here is not to banish unwanted thoughts, because the good and the not-so-good are part of life. Think of unhelpful thoughts as being a bit like those pesky internet pop-up windows. They just happen. So the aim is to raise our awareness of our unhelpful thoughts, what triggers them, and find ways to move them swiftly along to reduce their negative influence.

Here’s how you can deal positively with unwanted thoughts

When you notice an unhelpful thought, say to yourself, ‘I notice I am having the thought that….’ Write it down even.

Using that language and writing down the unhelpful thought puts you in an self-observing role. Doing that puts distance between you and the unhelpful thought so you can evaluate it. To evaluate it, ask yourself:

  • Is this thought in any way useful or helpful?
  • Is this thought an old story, one I’ve heard before?
  • What does it give me to buy into this story? What does it cost me?
  • Does this thought help me take effective action? Does it get me to where I really want to be in my life?

You can also picture the thought on a cloud and watch the wind blow it away. Or

  • Picture the thought on a stick or a leaf in a stream and the flowing water carries it away.
  • Put it on a boat that sails off somewhere and you don’t know where.
  • Place the thought on a train, and you don’t get on that train.
  • Hear the thought using a silly voice.
Enhance your #wellness by putting unhelpful thoughts on a cloud and let the wind blow them away tell a friend
Get rid of unhelpful thoughts picture

How Defusion works in Acceptance Commitment Therapy


Acceptance is about accepting that the bad happens as well as the good in our lives. We can’t always prevent a serious health issue from happening like a spinal cord injury, cancer, heart attack, subarachnoid haemorrhage, stroke, Parkinson’s, etc. Just as we can’t always prevent unwanted and unhelpful thoughts.

When I say acceptance in this context, I am not saying we have to like, want or approve of the challenging health issue happening. Acceptance is not resigning to the health issue thereby giving it the power over us. Far from it.

Acceptance is about the willingness to be with the unpleasantness rather than escape, avoid or try to get rid of it.

By being with the unpleasantness, I am not asking you to unpack and live there. It is about visiting with the unpleasantness for a fixed period of time and exploring it using mindfulness.

Acceptance of a serious health issue isn't about giving up, giving in or resignation. It's the willingness to be with unpleasant feelings rather than escape, avoid or try to get rid of them tell a friend

I explain one way you can explore unpleasant feelings and emotions through an activity here. Another way is to describe what the feelings are like for you by giving them a shape, colour, weight, temperature, texture, a voice, etc.

What this process does is rather than using your energy to push the unpleasantness away, you use it to let the unpleasantness be where it is and notice it. Paradoxically, clients find this process lessens the unpleasant feelings and frees up their energy to focus on what is important to them and the action they can take to make that happen. We focus on this in next week’s post.

Acceptance is letting feelings be and noticing them picture

What’s it like for you?

What thoughts have you found particularly difficult to live with? And what has helped you to dampen their negative influence? Feel free to share your thoughts below via the comments.

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 on your journey of acceptance, 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, (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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