1 Steven Hayes and the paradox of emotional struggle
Founded in the late 1990s by American psychologist Steven C. Hayes, Acceptance and Commitment Therapy begins with a revolutionary clinical observation: psychological suffering is often multiplied by our desperate attempts to avoid, suppress or control painful thoughts and emotions. The more we struggle against anxiety or sadness, the more we strengthen their hold over everyday life.
2 The Hexaflex: six foundations of psychological flexibility
ACT rests on six interconnected, dynamic processes: acceptance of unpleasant inner experiences; cognitive defusion, learning to step back and see thoughts as passing words rather than absolute truths; contact with the present moment through mindfulness; self-as-context, disidentifying from mental labels; clarification of deeply held life values; and, finally, committed action in everyday life.
3 Clinical indications and existential transformation
Numerous validated scientific studies have examined ACT in the treatment of intractable chronic pain, generalised anxiety, recurrent depression, obsessive-compulsive disorder and painful life transitions. Its aim is not to make all discomfort magically disappear, but to live a rich, full and meaningful life in its presence.
4 The place of this approach within care
Within care, this approach offers a powerful existential perspective: it invites patients to stop postponing their lives while waiting to feel unafraid. Metaphorical and behavioural exercises help them immediately realign everyday actions with their most cherished values.
5 Ongoing practice of presence and a compass of values
ACT is conceived as a practical philosophy of life rather than merely a collection of techniques. Metaphors and cognitive defusion exercises become part of everyday life: patients use their deepest values as a genuine compass, guiding professional, family and personal choices with courage.