A Basic Guide to ACT for Chronic Illness
Acceptance
-Accepting and grieving your illness
-Accepting what you can and cannot do both physically and mentally
-Accepting the uncertainty of your diagnosis and future
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Commitment
-Commitment to living the best life you can despite your illness
-Commitment to doing what you can to improve your health or condition despite limitations
-Commitment to life with chronic illness
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Therapy
-Individualized advice
-Working through problems logically
-Recognizing and acknowledging complex feelings about illness
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Why do I recommend ACT?
-lacks toxic positivity present in many other types of therapy
-does not rely on the "it gets better" mentality making it compatible with the chronic and degenerative illness
-focuses on mental health independent of physical health
-allows for processing grief related to chronic illness
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"Give me the strength to change the things I can, accept the things I cannot and the wisdom to know the difference."
When people with MEcfs, fibro or chronic illness or severe disability, in general, come to me with depression, ACT or acceptance and commitment therapy is always my first suggestion.
Unlike CBT and many other types of therapy aimed at #mentalillness, ACT starts by validating things like chronic pain and chronic fatigue. There is no toxic positivity telling you to just think more positively about objectively terrible circumstances.
Instead, ACT is like the opening quote. Focusing on accepting the parts of your life you would rather deny. On grieving your former life so you can find acceptance in your chronically ill one. Separating out the bits of your life you can control and make small improvements that can lead to big quality of life changes.
For people with myalgic encephalomyelitis severe ME and other diseases like diabetes or cystic fibrosis that require strict control over one's life to prevent decline and relapses ACT is a way of speeding up the process of accepting your illness and therefore being able to take the steps necessary to protect your health. This is why it can be such an important treatment for doctors and medical students to know about.
Finally, because of the huge focus on acceptance, ACT therapy is far less likely to be the culprit of medical gaslighting as it does not assume that your beliefs are irrational or that you are perpetuating your illness in any way. In fact, the assumption is far more often than you are overly rational and far too focused on getting your life back to learn to accept the life you are actually stuck with (something that feels far closer to the beliefs of myself and other newly diagnosed spoonies)
In short, ACT isn't a magic bullet, doesn't market itself as one, and is a great way to get trained help processing the #grief and #depression that comes along with a chronic or terminal diagnosis. While it's not right for everyone*, it tends to be the best fit for anyone experiencing a sudden loss of quality of life due to factors outside their control.
*In particular if you experience primary depression or anxiety and have since before your chronic illness symptoms started you may suffer from a lot of irrational thoughts like catastrophic thinking and black and white thinking that would be better addressed by other therapy modalities. See my next post on primary vs secondary depression to know if ACT is right for you.
