Living with Health Conditions: Acceptance and Commitment for Chronic Illness

Do you live with a chronic illness? Chronic illnesses are long-term health conditions that may not have a cure. Disease-specific symptoms can be managed, but it may never fully go away.

Understandably, chronic conditions can be extremely difficult to live with, especially when disease-specific symptoms, like pain or fatigue, are not externally visible. And it’s been found that people with chronic pain conditions, like migraine or Crohn’s disease, are more likely to experience co-occurring mental health conditions like depression. It’s no wonder; anybody would feel exhausted and depressed after going through pain day after day.

Although there may be no cure for chronic illnesses, there are ways to address the psychological distress that often comes along with them. 

Acceptance and commitment therapy, or ACT, is an evidence-based therapy method that could help you focus on what you have control of in your life and, by doing so, help you heal from the emotional effects of chronic illness.

What is Acceptance and Commitment Therapy?

ACT helps people to be mindful of and accept the circumstances of their life -- even the most painful ones. Many interventions for chronic illness and other conditions (like mental health issues) focus on reducing pain and suffering. Although ACT therapists -- of course -- wish for less pain for you, that isn’t the primary aim of treatment.

The goal of ACT is to help you be with both physical and emotional pain without internal struggle. So often, we take one of two routes when we’re in pain: we either fight against or become too attached to our suffering. And as a society, we have a strong belief that painful emotions need to be “fixed” or banished.

The founder of ACT, Steven Hayes, wrote: "We as a culture seem to be dedicated to the idea that ‘negative’ human emotions need to be fixed, managed, or changed—not experienced as part of a whole life. We are treating our own lives as problems to be solved as if we can sort through our experiences for the ones we like and throw out the rest.” 

ACT helps you to become present with all of your experiences, including the painful ones.

At its heart, ACT is a behavioral therapy. An ACT therapist will work with you to change your behavioral reactions to events in your life instead of trying to change your thoughts about them.

Is ACT effective for chronic illness?

Mental health is deeply interconnected with physical health. If you live with a chronic illness or chronic pain, then you probably feel its effects on your thoughts and feelings, too. Many people with chronic illnesses feel like they have lost a part of themselves with their diagnosis. 

You might think a lot about how unfair life is that you live with this illness while your peers are healthy. You may ruminate on your symptoms and how much your wish things were different.

This is why ACT can be so effective for helping people cope with chronic illness. Instead of focusing on reducing pain and distress -- because these things may not go away -- ACT helps you accept these things as a part of your life. That doesn’t mean that these things aren’t difficult to live with, or that it’s “fair.” It also doesn’t mean that you should give up or stop receiving treatment so you can get some relief.

Acceptance just means acknowledging that the fact that you have this illness is unchangeable and out of your control. And the more we battle with unchangeable truths, the worse we feel.

ACT isn’t about reducing pain; it’s about helping you to live a fulfilling life no matter what.

Studies have shown that ACT is a promising treatment method for people with chronic illness and chronic pain. One study found that ACT lessened disease-related disability, even when it didn’t reduce pain. In another, ACT decreased physical disability, psychological disability, and symptoms of depression for older adults with chronic pain.

What does ACT for chronic illness look like?

In a therapy session, an ACT therapist may help you:

·       Accept your chronic illness. Acceptance doesn’t mean that you’ve lost hope of ever feeling better. It just means you can differentiate what’s in your control from what’s outside your control. For example, you might practice acceptance that you have arthritis but continue to take medication so you can have less pain.

·       Be aware of thoughts without becoming attached to them. In a session, an ACT therapist might teach you how to step back and observe a thought without judgment rather than reacting right away. You might have the thought, “I can’t do anything because of my illness.” Instead of having an emotional reaction to the thought, ACT teaches you to observe it neutrally.

·       Practice non-judgmental awareness of each present moment, including the full range of emotions and experiences that are present. For example, you might learn to notice and observe when you’re having a symptom flare-up without getting lost in thoughts of the past or future that those symptoms may bring up.

·       Remember who you truly are, outside of your chronic illness. They might help to remind you that your illness does not define you. Your sense of self does not need to be tied to your illness.

·       Remember and connect with your most meaningful values. The process of ACT helps you identify what’s most important to you and fine ways to include those things in your life, even with a chronic illness.

·       Set objective goals around how you will behave differently in your life with chronic illness. For example, you could set the goal of connecting with a friend every week, even if you don’t feel quite up to it.

ACT for chronic illness in D.C.

At North Star D.C., several of our therapists are experts in Acceptance and Commitment Therapy. 

Our post-doctoral fellow, Alaina Carr, specializes in using ACT to help people with chronic illness live full and satisfying lives. 

“I help my clients shift their perceptions of their identity from being overly tied to their condition. I help them realize they are more than their pain, suffering, or chronic illness. Together, we can identify what is most meaningful in your life so you can act in accordance with these things and find a sense of purpose.” -Alaina L. Carr, PhD

If you’re interested in receiving ACT in the Washington D.C. area, get in touch with us for a free consultation today.