Acceptance and Commitment Therapy (ACT) For Cancer Patients

ACT is based on the principle that avoiding or struggling with difficult thoughts and feelings causes more long-term suffering. Instead, patients learn to make room for and accept these internal experiences without judging them or trying to change them. This acceptance paradoxically leads to more peace and freedom, rather than avoidance and struggle. As patients become more psychologically flexible, they can step back and choose how to respond in each situation, rather than reacting automatically.

Some of the core components of ACT include:

Mindfulness skills

For those going through cancer treatment, the mind can be flooded with thoughts of fear, anxiety, sadness and worry about the future. ACT teaches mindfulness skills to create some distance from this turbulent inner experience. Through mindfulness, patients cultivate the ability to observe their thoughts and feelings with acceptance and compassion, rather than getting overwhelmed by them.

Cancer patients learn to pay attention to the present moment, noticing thoughts and emotions as they arise, without judging or trying to change them. This creates a separation between their true self and the constantly changing stream of mental chatter.

Thoughts begin to be seen as just thoughts – subjective stories the mind tells, not necessarily facts or truth. Feelings are experienced as temporary waves that will eventually pass. This separation from the inner experience allows patients to respond with greater wisdom and choice, rather than reacting automatically.

Common mindfulness practices that can be particularly powerful for cancer patients include:

Breath awareness – Focusing attention on the breath flowing in and out anchors the mind in the immediacy of the present. It pulls patients out of consumed thinking about the past or future.

Body scan meditation – Systematically bringing awareness to each part of the body can have a grounding, calming effect during the treatment of side effects like pain or nausea. It connects patients to the physicality of the present moment.

Mindful movement – Simple movements like stretching or walking done with full present awareness can replace the automatic pilot with appreciation and vitality. Cancer treatments make this connection to the body especially important.

Everyday mindfulness – Being fully present and engaged while doing routine activities like eating, showering or household chores. This prevents patients from getting trapped in their minds and stories about cancer.

Through mindfulness, cancer patients can access inner stillness and peace amidst the outer turmoil. They realise their thoughts and feelings are not the totality of their experience – there is a deeper observing self. This awareness cultivates acceptance, wisdom and the freedom to act with greater choice.

Defusion

A cancer diagnosis can trigger a whirlwind of frightening thoughts and stories in the mind. “I’m going to die. My family will suffer. The treatment won’t work.” These thoughts can take on an oppressive reality of their own, leading to anxiety, depression and a struggle against what is.

ACT defusion techniques help cancer patients distance themselves from these thoughts and see them for what they are – just words, pictures and stories created by the mind, not necessarily truth or reality. Through defusion, thoughts are disarmed of their distressing power.

Some helpful defusion exercises for those going through cancer include:

Leaves on a stream – Picture your thoughts as leaves floating down a gentle stream. There’s no need to try and stop, control or avoid them. Simply allow them to show up, be noticed, and float on by.

Thank your mind – When you notice yourself becoming hooked by a troubling thought like “This is never going to get better,” you can thank your mind for that thought and remind yourself it’s just a thought, not reality.

Label your thoughts – Give your worries and inner narratives about cancer labels like “Here’s the story again” or “Isn’t that an interesting thought?” This helps create separation.

Physicalizing thoughts – Imagine thoughts as images, words or shapes outside of yourself that you don’t have to believe or follow. Let them come and go without attachment.

The repetitive practice of defusion helps cancer patients see their thoughts are transitory events in the mind, rather than reality itself. Worries and stories about death, suffering or hopelessness no longer have to be treated so literally or depended upon.

Instead of struggling to get rid of or control these distressing thoughts, defusion promotes acceptance and letting go. With this newfound mental flexibility, patients can then refocus on what matters most – their values, sources of meaning, and taking values-guided action in the midst of difficulty.

Values clarification

A cancer diagnosis can feel like being plunged into darkness, questioning everything you once took for granted. In this upheaval, it’s easy to lose touch with what gives your life deeper meaning and motivation. ACT helps cancer patients reconnect with their core values to serve as a guiding light.

Values clarification explores what matters most – the kind of person you want to be and what you want to stand for in this life. Common domains include relationships with family and friends, personal growth, career/purpose, spirituality, and living according to principles like courage, compassion or integrity.

For a cancer patient, values might include being a loving and present parent, maintaining involvement in cherished work, practising equanimity in the face of adversity, or never giving up one’s zest for learning and adventure despite health challenges.

By getting clear about their core values, patients can then use these as a compass for how to meet the demands of their situation with intention and integrity. Values provide motivating reasons to keep opening up to life rather than shutting down.

A patient valuing closeness with family may commit to having more candid conversations to grow that intimacy. Someone who values making a contribution could explore new volunteer work that fits their circumstances. Living spiritually may mean starting a daily meditation practice.

No matter the difficulty of cancer, choosing to act in alignment with one’s values creates a life that is vital, meaningful and filled with a sense of purpose. This inspirational force helps patients feel more empowered rather than overwhelmed by the challenges they face.

Connecting with core values reminds cancer patients of the preciousness of each day and why it’s profoundly worthwhile to keep showing up and participating as fully as possible. Values provide the “Why” that makes all the hardship worth it.

Committed action

Once cancer patients have clarified their core values and what matters most, the next vital step is translating those values into committed action. This means taking concrete steps to have a rich, meaningful, and engaged life, even in the midst of difficult circumstances.

Rather than putting everything on hold while struggling against the internal turmoil of a cancer diagnosis, ACT encourages making room for difficult thoughts and feelings while still moving forward. The focus shifts to proactive, values-guided behaviour.

For example, a patient who values being an involved, loving parent may commit to cherishing each moment with their children – reading bedtime stories, going to their activities, and having open conversations. They allow distressing thoughts like “I might not beat this” to be present, while still being wholeheartedly engaged in parenting.

Someone who values their career passion as an artist could commit to continuing creative projects that are possible within the constraints of treatment. 

A spiritual person may commit to starting each day with meditation, prayer or journaling to stay centred. A thrill-seeker may research new adventures suited to their energetic limitations.

The specifics of committed action will look different for each person based on their values and situation. But the core is about flexibly persisting in what you most care about in life, making a choice to still fully participate despite unavoidable pain and struggle. Difficult feelings are made room for but are no longer seen as a barrier to moving forward.

With clarity about core values and commitment to guided action, cancer need not relegate someone to being a passive, disengaged patient. ACT helps people open up to their lives fully while navigating the challenges with courage and dignity.

While the cancer experience can shake someone’s foundations, ACT provides tools to restore peace and engagement with living. Patients learn to make room for the full range of thoughts and emotions, while staying connected to their core values and what gives their life meaning and vitality.

If you or a loved one is dealing with cancer, consider exploring ACT therapy as a powerful tool for coping, healing and living life more fully during this immense challenge.

In Edinburgh Therapy Service, we specialise in ACT therapy and we can help you. Contact us today to book your appointment or for more information!