“I just need to stop feeling this way.” “Why can’t I control my thoughts?” “If I could just eliminate my anxiety, everything would be better.”

If these thoughts sound familiar, you’re not alone. Most of us have been taught that difficult emotions are problems to be solved, obstacles standing between us and the life we want. But what if this approach itself is part of the problem?

This is where Acceptance and Commitment Therapy (ACT) offers a fundamentally different perspective. Instead of fighting your internal experiences, ACT teaches you to change your relationship with them. As someone who works with people facing sleep challenges and mental health concerns, I’ve seen how powerful this shift can be.

What is Acceptance and Commitment Therapy?

Acceptance and Commitment Therapy, commonly known as ACT (pronounced as the word “act,” not the letters A-C-T) is an evidence-based form of psychotherapy that combines acceptance and mindfulness strategies with commitment and behavior-change techniques.

Developed by psychologist Steven C. Hayes in the 1980s, ACT emerged from behavioral psychology and has since been validated through extensive research. Today, it’s used to address a wide range of concerns including anxiety, depression, chronic pain, trauma, and sleep difficulties.

Here’s what makes ACT different: traditional therapies often focus on reducing symptoms or changing negative thoughts. ACT, by contrast, teaches you to accept what you can’t directly control while committing to actions that enrich your life. The goal isn’t to eliminate difficult thoughts or feelings, it’s to build psychological flexibility so these experiences have less power over your choices.

The Core Principle: Psychological Flexibility

At the heart of ACT is psychological flexibility, the ability to be present with your thoughts and feelings without being controlled by them, and to take action guided by your values even when it’s uncomfortable.

Psychological flexibility allows you to respond to life’s challenges with openness, awareness, and effectiveness rather than getting stuck in patterns of avoidance or struggle. Research shows that greater psychological flexibility is associated with better mental health, improved relationships, and higher life satisfaction.

When working with people experiencing sleep difficulties, for example, I see how rigid attempts to control sleep often backfire. Someone might think, “I must fall asleep immediately” or “Any wakeful moment is a disaster.” This rigidity creates struggle. Psychological flexibility, by contrast, allows you to notice difficulty sleeping without adding layers of panic about it.

The Six Core Processes of ACT

ACT works through six interconnected processes, often visualized as the “ACT Hexaflex.” These aren’t steps to follow in order but rather skills you develop simultaneously:

1. Acceptance

Rather than fighting, suppressing, or avoiding uncomfortable thoughts and feelings, acceptance means making room for them. You acknowledge that pain is part of being human.

Acceptance doesn’t mean resignation or giving up. It means choosing not to waste energy battling experiences you can’t directly control. When you stop struggling against anxiety, for example, you free up energy for meaningful action.

2. Cognitive Defusion

Cognitive defusion helps you create distance from your thoughts. Instead of treating thoughts as literal truths that must be obeyed, you learn to see them as mental events, words and images that your mind produces.

For instance, rather than being caught in the thought “I’m a failure,” defusion helps you notice: “I’m having the thought that I’m a failure.” This small shift creates space. The thought is still there, but it has less power to dictate your behavior.

3. Being Present

This involves contacting the present moment fully and without judgment. Rather than ruminating about the past or worrying about the future, you bring flexible, voluntary attention to what’s happening right now.

Being present helps you notice opportunities, respond effectively to situations, and engage more fully with your life as it unfolds.

4. Self-as-Context

This means understanding yourself as more than your thoughts, feelings, or experiences. You’re the context in which all these mental events occur, the “observing self” that notices them.

This perspective shift helps you recognize that no single thought, emotion, or experience defines you. You contain multitudes, and you’re larger than any one part of your experience.

5. Values

Values are chosen life directions, the qualities you want to bring to your actions and relationships. Unlike goals (which can be completed), values are ongoing. You never “finish” being a loving parent or a loyal friend; you continually orient yourself in those directions.

ACT helps you clarify what truly matters to you, independent of what you think you “should” value or what others expect. This clarity provides motivation and direction, especially when things get difficult.

6. Committed Action

This involves taking effective action guided by your values, even in the presence of difficult thoughts and feelings. Committed action is where all the other processes come together into behavioral change.

You might feel anxious about reaching out to a friend, but if connection is important to you, committed action means making the call anyway. The anxiety doesn’t have to disappear first.

How Does ACT Differ from Other Sleep Therapies?

If you’re familiar with Cognitive Behavioral Therapy (CBT), you might notice some similarities and some important differences.

Traditional CBT often focuses on identifying and challenging “irrational” or “distorted” thoughts, attempting to replace them with more balanced thinking. The assumption is that changing your thoughts will change your feelings and behaviors.

ACT takes a different approach. Rather than asking “Is this thought true or false?” ACT asks “Is holding onto this thought helping you move toward what matters?” The goal isn’t to change the content of your thoughts but to change your relationship with them.

Similarly, while traditional CBT might work to reduce anxiety symptoms before taking action, ACT suggests you can take values-based action even while feeling anxious. You learn to carry difficult emotions with you as you move forward.

This distinction is particularly relevant in sleep therapy. Rather than trying to force relaxation or eliminate anxiety before bed, an ACT-informed approach helps you create conditions where sleep can happen while accepting that some nights will be harder than others.

Real-World Application: A Client Story

Consider James (not his real name), who came to me with severe sleep anxiety. Every night, he’d lie in bed monitoring his body for signs of wakefulness, each time his mind wandered, translating it as “proof” he’d never sleep.

Traditional approaches might have focused on challenging his catastrophic thoughts or teaching relaxation to reduce arousal. Instead, we used ACT principles:

• Acceptance: James learned to make room for the anxious thoughts rather than fighting them
• Defusion: He practiced saying “I’m noticing anxiety about sleep” instead of “I’ll never sleep again”
• Values: We identified that sleep mattered because he wanted energy to be present with his young daughter
• Committed action: He maintained consistent sleep habits as a values-driven choice, not a desperate attempt to force sleep

Over time, James reported that while he still sometimes felt anxious at bedtime, the anxiety no longer controlled his nights. By changing his relationship with the anxiety rather than trying to eliminate it, he created space for sleep to return.

You can read more about similar approaches in my article on the ACE Method for sleep anxiety.

Getting Started with ACT

While working with an ACT-trained therapist provides structure and guidance, you can begin exploring these principles on your own:

Notice your struggles: What internal experiences do you spend energy trying to avoid or control? What would you do differently if you weren’t trying to manage these experiences?

Practice mindfulness: Start with just 5 minutes daily, observing your breath and noticing thoughts without getting caught in them.

Clarify your values: Reflect on what truly matters to you. If you could live your life without fear or constraint, what would you choose?

Take small actions: Identify one value-aligned action you can take today, even if it feels uncomfortable.

Be patient with yourself: Learning these skills takes time. Progress isn’t linear, and that’s okay.

ACT and Sleep: A Compassionate Approach

In my practice, I combine ACT principles with Cognitive Behavioral Therapy for Insomnia (CBT-I) to address sleep challenges. This combination acknowledges that:

• You can’t force sleep to happen
• Fighting with sleeplessness makes it worse
• Accepting difficult nights doesn’t mean giving up
• Values-driven sleep habits work better than fear-based ones
• Your relationship with sleep can change even before sleep itself changes

This approach recognizes sleep anxiety and insomnia as problems that benefit from both practical behavioral strategies (CBT-I) and acceptance-based psychological work (ACT).

Moving Forward

Acceptance and Commitment Therapy offers a fundamentally different approach to suffering. Instead of viewing difficult thoughts and feelings as problems to eliminate, ACT invites you to build a different relationship with your internal experiences, one based on acceptance, defusion, and values-based action.

The goal of ACT isn’t to feel good all the time or never experience pain. The goal is to live a rich, meaningful life even in the presence of discomfort. It’s about expanding what’s possible for you rather than shrinking your life to avoid what’s difficult.

Ready to transform your relationship with sleep? Learn more about our Gently to Sleep program and take the first step toward restful nights and energized days. Contact us to schedule a free sleep consultation!

FAQs

How long does ACT therapy take to work?

Many people notice shifts in their relationship with thoughts within a few weeks of consistent practice.

Is ACT better than CBT?

Neither is universally better. We often integrate both (like CBT-I and ACT) to create the most effective, personalized approach for you.

Can I practice ACT on my own?

Yes, you can start with books and apps, but a trained ACT therapist offers personalized guidance for applying the principles to your unique challenges.

What’s the difference between acceptance and giving up?

Acceptance is acknowledging reality without adding struggle. Giving up means abandoning your values. Acceptance actually frees you up to take action.