Acceptance and Commitment Therapy (ACT) for OCD and Anxiety
Moving toward what matters when your mind says it is impossible
If you have spent years trying to eliminate anxiety, control your thoughts, or make intrusive images disappear—and found that the harder you try, the more stuck you become—ACT offers a fundamentally different approach.
Rather than treating uncomfortable thoughts and feelings as problems to solve, ACT asks a more useful question: Are your efforts to control these experiences actually helping you live the life you want?
For many, the answer is no. Strategies like avoidance, reassurance-seeking, and mental rituals consume enormous energy while pulling you further from your values. ACT addresses this cycle directly.
What Is ACT?
Acceptance and Commitment Therapy is an evidence-based approach that targets psychological inflexibility. This is the rigid pattern of avoiding uncomfortable internal experiences even when that avoidance costs you what matters most.
ACT does not focus on reducing symptoms. Instead, it builds psychological flexibility: the ability to stay present with whatever thoughts arise while taking action guided by your values rather than by fear.
The Six Core Processes
ACT is built on six pillars that work together to create flexibility:
Acceptance: Making room for thoughts and feelings without struggling against them.
Cognitive Defusion: Learning to see thoughts as just words and images, not commands or absolute facts.
Contact with the Present Moment: Being fully present rather than lost in rumination or worry.
Self-as-Context: Recognizing that you are the "observer" of your thoughts, not the thoughts themselves.
Values: Clarifying what genuinely matters to you and what you want your life to stand for.
Committed Action: Taking concrete steps toward your values, even when difficult feelings show up.
How ACT Actually Works
ACT starts from a counterintuitive premise: The problem is not the anxiety or the intrusive thought; the problem is the struggle to eliminate them.
When you are "fused" with a thought—such as "I might fail"—it feels like a fact. You may then organize your entire life around avoiding that possibility. ACT calls this experiential avoidance. This is the attempt to alter the frequency or intensity of your thoughts and feelings, even when doing so causes harm to your quality of life.
The alternative is willingness. This is the active choice to make room for discomfort so you can pursue a meaningful life.
What ACT Looks Like in Practice
Identifying the Costs of Control
We begin by examining what your attempts to control anxiety have cost you. We look at the relationships or opportunities you may have passed up to avoid triggers. This helps us recognize that "control" is often the problem, not the solution.
Practicing Defusion
You will learn to notice when you are fused with a thought. Defusion techniques help you shift from "I am unlovable" to "I am having the thought that I am unlovable." This loosens the grip thoughts have on your behavior so you can choose your actions based on your values.
Building Willingness
Willingness is the opposite of avoidance. For someone with contamination OCD, willingness might mean experiencing the anxiety of using a public restroom because they value the freedom to travel. The anxiety is still there, but you are carrying it toward something that matters.
ACT for OCD and Anxiety
For OCD specifically, ACT complements exposure work (ERP). Rather than focusing narrowly on "stopping the compulsion," ACT asks what becomes possible when you are willing to sit with an obsession without neutralizing it. This reframes treatment as an act of courage rather than just symptom reduction.
For anxiety disorders—including Panic, Social Anxiety, and Generalized Anxiety—ACT targets the core maintaining factor: the avoidance of uncomfortable sensations. You learn that you do not need to eliminate anxiety to live well; you need the flexibility to have anxiety and still do what matters.
Who Benefits Most from ACT?
ACT is particularly effective for:
Individuals who have tried to "fix" their thoughts without lasting success.
People whose lives have become narrowed by avoidance strategies.
Clients who feel stuck between knowing something is "just OCD" but still acting as if the threat is real.
Those ready to practice taking action even while feeling "unready" or anxious.
About the Author: Kevin Jaworski is a licensed therapist (LPCC) specializing in OCD and anxiety disorders. He provides telehealth therapy throughout Ohio. Kevin utilizes ERP, I-CBT, and ACT to help clients break free from obsessive patterns and build a life of meaning and flexibility.