Accepting sleep problems: Overview

Acceptance and commitment therapy or ACT (typically pronounced as a word, not as separate initials) uses acceptance and mindfulness strategies mixed in different ways with commitment and behaviour-change strategies, to increase psychological flexibility. The overall goal of ACT is accepting sleep problems and to learn to live a rich and meaningful life understanding the pain that inevitably goes with it. According to ACT it is only through mindful action that we can create a meaningful life. Revealingly, when we observe our private experiences with openness and receptiveness, even the most painful thoughts, feelings, sensations and memories can seem less threatening or unbearable.

ACT differs from traditional cognitive behavioural therapy (CBT) in that rather than trying to teach people to better control their thoughts, feelings, sensations, memories and other private events, ACT teaches them to “just notice,” accept, and embrace their private events, especially previously unwanted ones. ACT helps the individual get in contact with a transcendent sense of self known as “self-as-context”—the you that is always there observing and experiencing and yet distinct from one’s thoughts, feelings, sensations, and memories. ACT aims to help the individual clarify their personal values and to take action on them, bringing more vitality and meaning to their life in the process, increasing their psychological flexibility.

ACT assumes that psychological processes of a normal human mind are often destructive by nature (as opposition to Western Psychology which is founded on assumption of healthy normality). The core conception of ACT is that psychological suffering is usually caused by fusion with our thoughts, evaluation of experience, avoidance of our experience and reason-giving for our behavior. This results in psychological entanglement and rigidity that leads to a failure to take needed steps in accordance with our core values.

ACT six core principles

  • Acceptance: Allowing thoughts to come and go without struggling with them. Feeling everything (incl. anxious thoughts) fully and without defence.
  • Cognitive defusion: Learning methods to reduce the tendency to rectify thoughts, images, emotions, and memories. Using language more as a tool to note and describe events, not simply to predict and judge them.
  • Being present: Awareness of the here and now, experienced with openness, interest, and receptiveness.
  • Self-as-context (Observer self / flexible perspective taking): Accessing a transcendent sense of self, a continuity of consciousness which is unchanging.
  • Values: Discovering what is most important to one’s true self. In ACT, acceptance, defusion, being present, and so on are not ends in themselves; rather they clear the path for a more vital, values consistent life.
  • Committed action: Setting goals according to values and carrying them out responsibly.

ACT for better sleep

Insomnia specialist Dr Meadows also uses acceptance and commitment therapy (ACT) to treat insomnia. According to him the best way to achieve your goals is to back off from striving for results and instead to start focusing carefully and seeing and accepting things as they are.

His top 4 tips how to sleep better, longer and deeper are:

1. Ignore a few nights of bad sleep. We all have bad nights once in a while. Don’t label your problem as insomnia as it will then take a centre role in your life and as a consequence only worsen the sleep.

2. Let go of all your pre-sleep problems. If you are always thinking that you ‘must read a book/have a hot bath/eat almonds/take a pill’ to sleep better, you are no longer trusting your own ability to let go and sleep.

3. If you can’t sleep, try mindfulness. Mindfulness helps to stay calm and stop racing mind. Stay in the present and bring you attention to sensations (duvet touching, breathing, smell, etc). Acknowledge thoughts and let them go. Keep on bringing your awareness back to present.

4. Live your life. Don’t cancel meetings or parties because you worry your sleep. But do lower the lights in your house and let the darker environment naturally help your body to tune into its circadian rhythms and sleep.

ACT: alternative angle

ACT highlights patience and regular practice. Our response to sleep determines our ability to sleep. This is indeed the core dilemma with poor sleepers. Ask a normal sleeper what they do to sleep and they will say ‘nothing’. Or ask a normal sleeper how many times they think about the sleep during a day and they will say ‘never!’ Ask an insomniac and they will give you a long list of all kinds of sleep aids. Furthermore, they use most of their awakening time excessively worrying and thinking about their sleep and next night.

Some experts think that the cognitive behavioural therapy (CBT) approach to sleep problems is not working, because it’s underlining the ‘control’ part which exactly is the core problem. ACT provides an alternative angle which combines a sense of increased awareness, acceptance and a non- judgemental attitude.  It’s fundamentally about accepting and then (re)-learning to let go so that your brain’s natural ability to sleep will emerge by itself.

Instead of making a massive TO DO list of all possible rules and restrictions (in order to sleep), the right answer might be much more simple, ie learning to accept and relax, value yourself and your life as it is and enjoy the little good things around us. This can be a massage, yoga and exercise classes. Instead of punishing ourselves, we should perhaps put more focus to pamper ourselves and treat ourselves more gently and friendly.

Some experts say that insomnia is a learned psycho-physiological response but certainly we do have different sensitivities as well – not everyone is equally sensitive to noise/environment/light/worries/stress/other diseases and so forth. However, working with our minds can help a lot. When we change our behaviour to deal with it we can learn to sleep again. It’s all about acceptance. When you wake up in the middle of the night accept that you are awake in the moment. Realize that that forcing to make yourself sleep will not help you sleep. Accept that fighting or avoiding your insomnia only fuels it. Finally, be prepared to consciously experience insomnia, which means accepting everything that goes with it: the worries, the anger, the panic, the beating heart, the heavy breathing and the fatigue. The commitment part means moving closer to what you value in your life (family, friends, kids, nature – anything that has a special meaning for You).

More information

Association for Contextual Behavioral Science

Association for Behavioral and Cognitive Therapies

British Association for Behavioral & Cognitive Psychotherapies

 

References & Disclaimer

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