We are not our thoughts, just the thinkers of them, argues CBT therapist and author Michael O'Sullivan.

The founder of Acceptance and Commitment Therapy (ACT), Steven Hayes was right when he told us that “life is tragic”. He was also not saying anything new. When Freud spoke about how therapy turned “hysterical misery into common human unhappiness” he was acknowledging the same fact. Getting “better” requires us, at some level to “accept” all of the difficulties that life can throw at us. How we “accept” is summed up by the words in the Serenity Prayer.

God grant me the serenity
to accept the things I cannot change;
courage to change the things I can;
and wisdom to know the difference.

Being able to accept that which cannot be changed means being able to tolerate feeling uncomfortable. It is important because when we try to suppress anything which feels uncomfortable we invariably create problems.

When Basil becomes agitated in the episode of Fawlty Towers when German tourists visit the hotel, he tries to suppress his thoughts and feelings. However, the more he tries to do this by instructing himself “not to mention the war”, the stronger his discomfort becomes until he creates the very problem he fears.

Basil was unable “to sit” with his thoughts and feelings. We may be able to sit with feelings but in doing so we may find that we still feel depressed. If this happens, it is less about acceptance and more about grim resignation to the reality that life is tragic. How do we tell the difference between these two experiences?

Scramble in quicksand and you will sink

Grim resignation is when those negative feelings that we’ve accepted take over our life, like a drop of ink in a glass of water. Acceptance is about acknowledging both that “bad things happen” whilst recognising that we can change our lives. In thinking about acceptance as a technique, the skills can appear counterintuitive, involving seemingly “not doing anything."

In making sense of this, ACT uses the metaphor of quicksand. If we are in quicksand, struggling will just make things worse. If we "do nothing" we float to the surface and we survive.

Acceptance recognises that sometimes fighting the problem makes things worse. We can be helped in this by remembering that we do not have to like our suffering.

We are not our thoughts, just the thinkers of them

Buddhism tells us that pain is inevitable but our suffering is optional. Mindfulness, with its roots in Buddhist practice, talks about developing a different attitude to suffering. We can acknowledge our thoughts but we don’t have to buy into them, seeing them as facts. Put simply, we are not "our thoughts" but the "thinkers" of our thoughts.

In the film A Beautiful Mind John Nash, played by Russell Crowe, is constantly undermined by Charles, played by Paul Bettany. Charles is part of John’s delusions. He finally finds peace by changing his perspective towards Charles. He accepts his presence but does not interact with him.

Acceptance can be easier if we understand exactly what it is we are accepting. Often this will be the reality of our lives. It is no coincidence that Acceptance is the final stage of the grief cycle of Elisabeth Kubler Ross. The reality of life is often the acceptance of a loss. Loss is at the heart of many depressions. Once this reality is accepted we are in a better position to move forward with our lives.

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'A Practical Guide to Working with Depression - A cognitive behavioural approach for mental health workers', by Michael O'Sullivan, is available to order through PavPub.com.