ACT lesson 3: making room for feelings

Most of us try to get rid of painful feelings fast. We push them down, stay busy, avoid people or places, or reach for a drink. This can bring quick relief, but over time the struggle can shrink your life.

Acceptance and commitment therapy (ACT) asks you to stop fighting hard feelings and make room for them, so you can keep doing what matters.³ This lesson teaches a short practice for that.

Why this step matters

ACT teaches that trying to control inner experiences, like fear, sadness or pain, often fails in the long run. Letting them be tends to help more.¹ Acceptance skills, together with the other ACT skills, build what therapists call psychological flexibility: being able to feel what you feel and still choose your actions.²

A well-known study shows why fighting can backfire. People told not to think about a white bear kept thinking about it. Later, they thought about it even more than people who never tried to push it away.⁴ Feelings often work the same way. The harder you try not to feel anxious, the more you watch for anxiety, and the more you find.

What acceptance is and is not

Acceptance is for feelings, thoughts, memories and body sensations, not for problems you can fix. If you are in danger, get safe. If you have new pain, see your doctor. Acceptance helps with the feelings that remain after you have done what you can.

ACT also uses the word willingness: saying "yes" to a feeling because you are moving toward something you care about. You may not want to feel nervous at a family gathering, but you may be willing to, because you value time with your grandchildren. See lesson 1: finding your values.

Pain, and the struggle with pain

A painful feeling often comes with a second layer: the struggle with it, such as worry, self-blame and avoidance. You cannot always remove the first layer. Loss hurts. Chronic pain hurts. But you can often ease the second. ACT for chronic pain shifts the aim from getting rid of pain to living as fully as you can with it.¹

ACT therapists often compare this to a tug of war with a monster. Acceptance is like dropping the rope. The monster is still there, but your hands are free to do other things.

Steps: make room for a feeling

This practice takes about 5 to 10 minutes. Start with a mild feeling, like a little worry or irritation, not your hardest one.

1. Sit comfortably with your feet on the floor. You can close your eyes or look at one spot on the floor.
2. Notice the feeling. Take a moment to let yourself feel it, without trying to change it.
3. Name it. Say to yourself, "Here is sadness," or "I'm noticing worry." Naming it gives you a little space.
4. Find it in your body. Scan from head to toe. Where do you feel it most? Maybe a tight throat, a heavy chest or a knot in your stomach.
5. Look at it with curiosity, as if for the first time. Where does it start and stop? Is it hot or cool, still or moving?
6. Breathe into it. Take slow breaths. Imagine your breath flowing into and around the feeling.
7. Make room for it. Imagine the space around the feeling opening up. You are not pushing it out or pulling it in. Say to yourself, "I don't like this, but I can make room for it." Or simply, "Allow."
8. Be kind to it. If you like, rest a hand gently where you feel it most, the way you would comfort a hurt friend.
9. Widen your view. Notice the feeling, and also your body in the chair and the sounds in the room. The feeling is one part of a larger moment.
10. Ask: "What matters to me right now?" Then do one small thing that fits your values, and bring the feeling along with you.

The feeling may shrink, stay the same or briefly grow. All of these are fine. Success means you made room for it, not that it went away.

For more practice noticing your body, try the body scan. DBT teaches a related idea called radical acceptance; see DBT distress tolerance skills.

Later life, health and caregiving

Later life can bring feelings that cannot simply be fixed, like grief, health worries or sadness as a loved one changes with dementia. Acceptance can help you carry these feelings and still live by your values. See grief and grieving someone still here. With chronic pain, acceptance works alongside your medical care, not instead of it. See chronic pain and mood.

Family caregivers often feel guilt, anger or resentment, then feel ashamed of those feelings. Making room for them without judging yourself can ease that extra struggle. See caregiver stress and burnout.

Does acceptance-based therapy work?

A review that combined 39 studies with 1,821 patients found that ACT worked better than a wait list or usual care. It worked about as well as cognitive behavioral therapy (CBT) for anxiety, depression, addiction and some physical health problems.⁵ Moderate evidence

A division of the American Psychological Association once rated the evidence for ACT as strong for chronic pain and modest for depression and anxiety. These ratings now await a new review.^1,2,3 See the ACT overview.

Mindfulness-style practices like this one are generally thought to carry few risks, though few studies have looked closely. In one review of 83 studies, about 8 in 100 people (8%) reported an unwanted effect from meditation, most often more anxiety or low mood. That rate was similar to other talk therapies.⁶

Common problems

The feeling got stronger when I paid attention to it.

That is common at first, because you are no longer looking away. Open your eyes, feel your feet on the floor, and notice the room. Try again later with a milder feeling. Lesson 4 teaches dropping anchor, a skill for strong feelings.

I'm accepting the feeling so it will go away. Is that okay?

This is a common trap. Making room only to get rid of a feeling is still a fight in disguise. Try to make room with no deal attached. The feeling often eases over time, but that is a side effect, not the goal.

Painful memories come up, and it feels like too much.

Stop the practice and ground yourself in the room. Try grounding. If memories of trauma keep returning, it is best to work with a trained therapist. See PTSD and therapy for PTSD.

Can I use this instead of a therapist or my medicine?

Self-help is a good start. ACT is usually done with a trained therapist, often over about 8 to 12 sessions.^1,2 See how to find a therapist. If you take medicine for mood or anxiety, keep taking it. Talk with your doctor or pharmacist before changing anything.

When to get help

Next: Lesson 4: being present. Or go back to lesson 2: unhooking from thoughts or the ACT overview.

Education only. This page is general information written from the sources listed. It is not medical, legal or financial advice and does not replace a doctor, therapist or lawyer who knows your situation. How we write and check pages.