Acceptance and Commitment Therapy when grief, change or overwhelm are part of the picture
Sometimes waiting makes sense. We may need more information before deciding, more support before tackling something difficult, or simply more time to recover. Other times, we wait for something inside us to change. We might tell ourselves that we will start going out again when the grief is less intense, make a decision when we feel more certain, or deal with something we have been avoiding when we finally feel motivated.
The difficulty is that our internal world does not always change on the timetable we prefer. Grief may still be present when an opportunity to reconnect with life appears. Anxiety can accompany us into something we have decided is important. Motivation may arrive after we start rather than before it. We can also feel uncertain about a decision that nevertheless needs to be made.
This is one of the reasons I draw on Acceptance and Commitment Therapy, usually known as ACT, in my work with grief, life transitions and overwhelm. ACT does not depend on getting rid of difficult thoughts and feelings before we can do something differently. Instead, it considers whether we can change our relationship with some of those experiences while paying attention to what matters to us and what is actually possible in our circumstances.
Acceptance is not the same as resignation
I think acceptance deserves some care. For someone who is grieving, being encouraged to accept what has happened can sound remarkably close to being told to move on. For someone living or working in genuinely difficult circumstances, it can sound as though the task is to become better at tolerating them. Neither is what I mean here.
Some things in life can and should be changed. We may need to set a boundary, ask for support, alter an environment, challenge an expectation or leave a situation that is harmful. Some realities we cannot undo, no matter how much we wish we could. A person has died. A relationship has ended. A career is over. Our health or circumstances have changed. An imagined future may no longer be available to us.
Some experiences cannot be fixed or made acceptable simply by thinking about them differently. I explore this further in When Life Can’t Be Fixed: Learning to Live Alongside What Hurts.
ACT is interested in what happens when much of our energy becomes tied up in struggling with an internal experience that is already present. If grief is here today, for example, does everything else have to wait until it is gone? If I am anxious about taking a particular step, must I first succeed in making myself feel confident?
Acceptance in this sense is not approval of what has happened. It is an acknowledgement of what we are carrying while we consider what is workable from here.
When our thoughts become very convincing
Our minds are good at producing explanations, predictions and judgements, particularly when we are under pressure. After a loss or significant change, thoughts such as I should be coping better by now, I don’t know who I am anymore or I can’t do this can begin to feel less like thoughts and more like facts.
In ACT, cognitive defusion means creating a little more distance from our thoughts. This does not require replacing a difficult thought with a positive one. If I am thinking I can’t manage this, I don’t have to persuade myself that I can manage everything perfectly. It may be enough to recognise that this is what my mind is telling me at the moment and become curious about how much influence I want that thought to have over what I do.
I find this aspect of ACT useful because it does not require us to win an argument with ourselves. A thought can remain present without automatically becoming an instruction.
When life changes, identity can change too
Significant change often unsettles more than our circumstances. It can also affect identity, belonging, relationships and our sense of where life is heading.
Retirement is one example. Leaving a profession after decades may mean losing routine, colleagues, status, competence, and a familiar answer to the question, “What do you do?” Redundancy can bring some of the same losses without the opportunity to choose when they occur. Separation changes not only a relationship but often friendships, family routines, finances, home and expectations about the future.
Other transitions can be harder to name. Children become adults and need us differently. Caring roles begin or end. Health changes what is possible. We relocate. We reach an age we imagined would feel quite different from how it actually feels.
There can be pressure to turn these experiences into a new beginning quickly. Find a purpose. Reinvent yourself. Embrace the next chapter. Sometimes people do feel excited by change, but there can also be relief, sadness, uncertainty, resentment and curiosity, sometimes at the same time.
There is often a period in which the old way of understanding ourselves no longer quite fits, while whatever comes next is not yet clear. I don’t think that space needs to be filled too quickly.
Major life changes can also leave us in an uncomfortable space between what has ended and what has not yet taken shape. I explore this in Life Transitions and Grief: Honour the Space Between No Longer and Not Yet.
What still matters?
This is where another part of ACT can be useful. Values are less about identifying a perfect life purpose and more about considering what we want to matter in the way we live.
Connection, curiosity, care, independence, contribution, learning or creativity may remain important even when the circumstances in which we once expressed them have changed. Someone who valued contribution through their career may find other ways to contribute after retirement. A person whose relationship has ended may still value connection, even though relationships now look different. After a loss, something that mattered within the relationship may continue to influence how we live.
This can give us somewhere to begin when we cannot yet answer the larger question of what comes next. We may not know what the next five years look like, but we may have some sense of what we would like to remain connected to while we find out.
When getting started isn’t simple
When someone has been overwhelmed for a long time, “just start somewhere” is rarely as simple as it sounds.
There may be too many decisions, difficulty working out where to begin, competing demands on attention, fatigue, shame about what hasn’t been done, or an environment that makes the task harder. If executive-function difficulties or neurodivergence are part of the picture, telling someone to think differently or become more motivated misses much of what may be going on.
Difficulty initiating or organising a task is not simply an unhelpful thought that someone needs to distance themselves from. The task may need fewer steps. Expectations may need to change. Another person may be helpful alongside them. The environment may need to be adapted, or the person may simply not have the capacity for that task today.
At the same time, thoughts and feelings can become part of what keeps an already difficult situation stuck. I’ll never get on top of this. I’ve let it get too bad. I should have dealt with this years ago. Shame can make it harder to ask for help, and overwhelm can make the whole problem feel as though it needs to be solved at once.
This is where I think the ACT idea of workability is particularly useful. Rather than asking whether a thought, feeling, or response is good or bad, we can focus on whether what we are doing is working for us in this situation. Is it helping? Is it making things harder? Does something about the task or environment need to change?
Sometimes you can make room for discomfort and do something small that matters. Other times, the useful change is to the task, the expectations, the support, or the environment. ACT should not become another way of telling someone to try harder.
Grief does not have to be left behind
Grief perhaps makes the distinction between acceptance and resignation clearest.
A common idea is that we grieve and then, eventually, return to life. I don’t think it is always that tidy. People can miss someone deeply and become interested in life again. An anniversary can be painful in a year that also held joy. Someone can value a new relationship or experience without it diminishing the significance of the person who died.
This movement between attending to grief and engaging with life is sometimes described as oscillation in the Dual Process Model of coping with bereavement. I explore this further in Why Grief Is Not a Straight Line: The Dual Process Model of Coping With Bereavement.
There may also be periods, particularly when a loss is recent or life has been turned upside down, when very little needs to happen. Getting through the day may be enough. You don’t need to turn grief into action, find meaning in what happened, or start rebuilding your life before you’re ready.
Over time, however, grief and life do not have to be mutually exclusive. The relationship with the person who died can continue through memory, meaning, connection and the ways they remain part of our lives. Becoming interested in life again does not require leaving them behind.
This is one reason ACT sits comfortably for me alongside a continuing-bonds understanding of grief. The question is not necessarily how to finish grieving so that life can resume. It may be how grief can have a place in a life that keeps changing around it.
Living in the space between
There are periods when we know that something has ended or changed but have very little idea what will replace it. That can be an uncomfortable place to occupy, particularly when there is pressure to recover, decide, organise or find a new direction.
ACT does not provide an answer to what the next part of someone’s life should look like. What it can offer is a way to work with the thoughts and feelings that accompany uncertainty, while staying interested in what matters and what is possible now.
For me, that is where ACT fits particularly well with the idea behind Changes in Between. The space between what was and what comes next is not necessarily something to hurry through. Sometimes we need time there. At the same time, grief, uncertainty or overwhelm do not necessarily have to disappear before something else can begin.
ACT in my work
I draw on ACT alongside relational Gestalt psychotherapy and other approaches rather than using one approach for every person or every situation.
What I particularly value about ACT is that it leaves room for the reality that some things cannot be fixed or undone, while also asking what remains possible. That makes it relevant to much of my work with grief and loss, life transitions, and chronic disorganisation and overwhelm.
Sometimes the work is about making room for something painful. Sometimes it is about understanding what is getting in the way. Sometimes circumstances need to change. At other times, we may be finding a way to live alongside something we would never have chosen.
Therapy does not need to begin with knowing where all of this will lead. It can begin with where you are.
Considering counselling or psychotherapy?
If you are experiencing grief, adjusting to a significant life change, or feeling overwhelmed and stuck, you can learn more about Counselling & Psychotherapy or book an initial appointment.
