The hexaflex: the ACT processes

The acceptance and commitment therapy (ACT) model is distinguished by giving more relevance to the context. ACT focuses on the context in which people’s cognitive activity occurs, somewhat reducing the importance that previous generation therapies have given to content.

One of the main objectives of ACT is develop psychological flexibility and encourage contact with the present in a conscious way. At a theoretical level, the purpose of the model is for verbal and cognitive functions to be under more exact and voluntary contextual regulation, with the aim of directing behavior towards values.

According to this model, there are six processes that generate psychological flexibility: acceptance, cognitive defusion, attention to the present moment, the self as context, values ​​and committed action.

The relationship between these processes is usually represented with a hexagon known as a hexaflex. Through these six components, acceptance and commitment therapy also seeks to ensure that individuals (Ribero-Marulanda and Agudelo-Colorado, 2016):

Recognize and abandon control strategies for internal events. Observe your experiences without labeling them. Focus on behaviors aimed at obtaining valuable results, to create flexible and effective actions.

Next, we will review what each of the six components or processes of the ACT hexaflex model consists of.

The main objective of ACT is the development of psychological flexibility in the patient.

The hexaflex

As we had mentioned, the hexaflex is a hexagonal diagram that, among other functions, is used to classify and treat customer problems. Each of the six processes on which it is based corresponds to one of the basic principles of ACT. With this diagram, the therapist can also choose a starting point for her intervention.

Let us remember that ACT seeks to cultivate psychological flexibility, which is nothing more than the ability to face, accept and adapt to difficult situations. When we experience stressful situations, psychological flexibility protects us against negative feelings and can promote our mental health. Additionally, it is a buffer against stress and negative psychological outcomes.

Let’s look in depth at what each of the processes used by ACT to promote psychological flexibility consist of.

1. Acceptance

For the hexaflex model, accepting is the act of receiving what is offered to us, it is taking what life brings us: «take it completely, at the moment it is given, without defending ourselves» (Hayes, 2013). Acceptance is an attitude that motivates us not to escape of what is happening right now.

Acceptance is an invitation to say yes to life, when fighting against unpleasant experiences makes very little sense – there are circumstances that we cannot change, such as getting older, and that we have no choice but to accept. Thus, it is a willingness to open ourselves to the present, to our existence and to the vicissitudes in which it unfolds. This openness is not self-defeat, but a vital commitment to the moment as it is.

Not resisting is the essence of acceptance, it is not opposing the flow of life. When we assume the attitude of accepting what happens to us, we do not react by fighting or resisting, since all this fighting does is add unnecessary discomfort.

2. cognitive defusion

It is the strategy that allows us to detach ourselves from our thoughts, specifically, those that have become a problem in our lives. Cognitive defusion helps us understand that neither words nor thoughts are reality.

Cognitive defusion helps us in times when we have to face the challenge of managing potentially anxiety-inducing and invasive thoughts. Through this strategy we learn to observe the products and processes of thought.

It also allows us to disidentify from our ideas: “I am having the thought…”, “I am noticing this or that thought,” “I am doing something with my thoughts.” Thanks to it, we can notice the difference between mental activity and us.

Cognitive defusion does not aim to change dysfunctional thoughts for others (as cognitive restructuring would do), but rather to provide us with a perspective in which thoughts are not reality, but creations of our mind. Other objectives are the following:

Reduce the level of identification we can have with our internal experiences. Decrease the truthfulness of thoughts. Decrease the influence of thoughts on our behaviors and experiences. Facilitate cognitive flexibility.

3. Attention to the present moment

Without present moment awareness, attention is focused on our psychic life. Within the framework of ACT, therapists provide strategies to their clients so that the mental focus begins to spend more time on what is happening around us, inviting us to also be dynamic on the mental level.

The idea is that, if our environment is constantly changing and our attention is focused on it, the content of our psychic life will also flow, thus avoiding invalidating ruminations.

This training is necessary, since rigid and non-present attention is associated with psychological dysfunction. While Mindfulness is positively related to our psychological well-being (Bowlin and Baer, ​​2012). Likewise, it can reduce various psychological symptoms and emotional reactivity; In addition, it improves behavioral regulation.

Through mindfulness attention is brought to the experience of the here and now with openness, receptivity and curiosity. In it we can find an effective path for the development of acceptance, since this practice implies a commitment to the moment and to life as it manifests itself in the present.

4. The self as context

We are often fused with the stories and narratives we tell ourselves about what happens to us and, as a result, we are less able to react flexibly from moment to moment.

This psychological rigidity or inflexibility is not necessarily linked to negative thoughts. Therefore, we can become fused with beliefs such as: “I am a loving person” and, consequently, lose the willingness to recognize the ways in which these ideas hurt or harm others. The self as context does not allow us to take perspective on these stories and loosen our attachment to them.

In the hexaflex, The self as context is a space, a transcendence, from which we observe our experiences. In one sense, it sustains or contains all experience, and in another sense, there is a split between the self as consciousness and the self as the content of psychological events. We can say that these qualities of inclusion and distinction encourage more flexible patterns of behavior (Chin and Hayes, 2017).

5. The values

In the ACT hexaflex, values ​​are chosen qualities of being and doing.. When we engage in actions based on them, we establish adaptive behavioral repertoires: the reinforcing effects of an action exist in the present moment, rather than in the external results we can achieve (Chin and Hayes, 2017).

Values ​​are a central aspect in our lives, they are our compasses, and they guide us in the search for that which resonates within us. Besides, They are one of the foundations to have an authentic existence. In this sense, Van Deurzen (2002) maintains that authentic living consists of making decisions in accordance with the values ​​that we recognize are worth committing to.

In our life, values ​​are the support on which it is configured the existential meaning. By committing to their realization and living by them, we are building a valuable life worth living.

Values ​​in ACT are related to how we want to be and what we want in our life.

6. The committed action

A valuable life is shaped by concrete actions guided by our value system. Furthermore, it requires the commitment to walk, over and over again, the path of what is important to us (O’Connell, 2018).

From ACT, commitments are not promises to be made in the future. Rather, They are decisions that are made from moment to moment to build meaningful actions. Slippages in committed action are not taken as failures, but rather as opportunities to take responsibility for the failure and recommit to values-centered action.

Committed action is perhaps the central axis of the change proposed by ACT. The idea is that, Once our values ​​have been identified, let us not commit to drawing up action plans aligned with them.. In this way, we will avoid having to resolve those dissonances that cause us so much discomfort.

To conclude, the hexaflex would make the challenge of living a meaningful and valuable existence easier for us, promoting that we adopt a vital attitude of acceptance, openness and non-resistance. This attitude would be supported by an exercise of courage, that of defining our values ​​explicitly and making action plans in which these are reflected.

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