From Avoidance to Acceptance: Exploring Pain in ACT

Michelle-Woidneck2

Utah State University
Boys Town Center for Behavioral Health

Key Points

  1. In ACT, clients learn to move from avoiding feelings to fully accepting them as they are.
  2. ACT differentiates natural life pain (clean) from pain caused by avoidance (dirty), focusing on acceptance of the former.
  3. Stacy’s treatment involves understanding and accepting ‘clean pain’ while reducing ‘dirty pain’ created by avoidance.
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Understanding the Six ACT Processes in Stacy’s Case

The Acceptance Process

Acceptance is one of the six core processes in acceptance and commitment therapy (ACT), and it’s seen as a continuum. On one end is experiential avoidance, where individuals attempt to avoid unwanted feelings or sensations, often leading to more problems. On the other end is complete acceptance, characterized by the willingness to experience feelings or sensations as they occur without trying to control or change them.

At the beginning of treatment, Stacy exhibits high levels of experiential avoidance, particularly regarding feelings of doubt, uncertainty, and, to some extent, anxiety. The treatment aims to move her towards the acceptance end of the continuum.

Clean Pain vs. Dirty Pain

ACT differentiates between ‘clean pain’ and ‘dirty pain.’ Clean pain is the unavoidable discomfort that comes with being human. It’s the natural pain one experiences due to life’s inherent challenges, like disappointment from failure or grief from loss.

Dirty pain, on the other hand, arises when we are unwilling to experience this clean pain and take actions to avoid it. These actions often lead to secondary pain, like guilt or compounded sadness, which is the dirty pain. The treatment will focus on helping Stacy navigate these types of pain, particularly in learning to accept the clean pain as part of her human experience.

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From Avoidance to Acceptance: Exploring Pain in ACT