Most therapeutic approaches, and most of our cultural messaging about mental health, operate on a control model: identify the negative thought, challenge it, replace it with a more accurate or positive one. This approach has genuine value. But for many people — particularly those dealing with trauma, chronic pain, or deeply entrenched patterns — it creates a secondary problem: the exhausting, futile effort to control what cannot be controlled.
Acceptance and Commitment Therapy (ACT), developed by psychologist Steven Hayes in the 1980s and now one of the most empirically supported therapeutic approaches in the world, offers a different framework. ACT does not ask you to change your thoughts. It asks you to change your relationship to your thoughts.
The Core Insight
The foundational insight of ACT is that psychological suffering is not caused primarily by difficult thoughts and feelings — it is caused by our struggle against them. The technical term is experiential avoidance: the attempt to suppress, escape, or control unwanted internal experiences. The research is clear that experiential avoidance, while providing short-term relief, increases long-term suffering and narrows the range of a person's life.
ACT proposes that the goal of therapy is not the elimination of difficult internal experiences but the development of psychological flexibility — the ability to be present with difficult thoughts and feelings without being controlled by them, while moving toward what matters.
The Six Core Processes
ACT works through six interconnected processes: acceptance (making room for difficult experiences rather than fighting them), defusion (learning to observe thoughts rather than be fused with them), present-moment awareness, self-as-context (a stable sense of self that is not defined by thoughts or feelings), values clarification, and committed action.
Of these, values clarification is often the most powerful in a coaching context. Many high-functioning individuals have never done the work of articulating what actually matters to them — as distinct from what they have been told should matter, or what their performance record suggests matters. ACT's values work creates the foundation for committed action that is genuinely self-directed.
ACT and the Veteran Population
ACT has a particularly strong evidence base for trauma and PTSD, and Dr. Dent has found it especially valuable in work with veterans and first responders. The military culture of suppression — "drive on," "push through," "don't show weakness" — is a form of experiential avoidance that ACT directly addresses. Learning to acknowledge difficulty without being defined by it is not weakness. It is the kind of psychological strength that actually holds up under sustained pressure.