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Acceptance and Commitment Therapy (ACT) and Anxiety in Sport

by Stephen Renwick


Anxiety can cause many behavioral issues for athletes and this can result in poor performances or even avoidance of competition and training. An athlete with moderate to severe anxiety will typical seek to avoid any situation which cause unpleasant thoughts, feelings and sensations. As human beings we seek solutions that work to help eliminate anything uncomfortable (Problem-Solution). The challenge here is that this temporary elimination of anxiety is a short-term solution and the patterns end up repeating or the athlete gradually pulls away from their sport. In ACT, the focus is on willingness to experience anxiety and unpleasant thoughts, feelings and sensations while choosing a behavior which moves you towards what’s most important to you in your sport. 

Psychological Flexibility

ACT helps the athlete to create ‘psychological flexibility’ to free them up psychologically and allow anxiety to come and go rather than running away, fighting it or avoiding it. This is highly beneficial because it results in the athlete living a more fulfilled life, instead of avoiding everything, which may result in life shrinking away. An example of this is as follows. An athlete experiences thought about ‘dying’, feelings of ‘dread’ and sensations of ‘tightness’. The way they deal with these ‘not wants’ are to seek ‘fix it’ behaviors e.g. staying in, avoiding certain competitions or not training. These choices result in moving the athlete away from what’s most important to them in life (their values) and living an unfulfilled life. Therefore, in ACT the solution is to give up their original solution and to make choices which move them towards their values, while being willing to experience some uncomfortable thoughts, feelings and sensation. ACT uses several key tools which form the foundation for therapy.

These are the Hexa-Flex, which focuses on ‘psychological flexibility’ by utilizing acceptance, defusion, self-as-context, present moment, values and committed action. These all help the athlete to accept anxiety, choose a behavior and take action in life (without anxiety running their lives). The Hexa-Flex six components are conceptualized as a psychological skill that athletes can improve e.g. cognitive defusion.


Another tool ACT use are metaphors, which also help to create cognitive short-cuts and create­­ psychological understanding alongside distance from thoughts and feelings. For example, if an athlete is ‘cognitively fused’, we may ask them to ‘observe their thoughts’ or ‘imagine a sushi bar’ where the thoughts are the plates and you have a choice which ones you pick. Athletes are taught to understand that a thought is only a thought and some thoughts are actually true with a capital T. Athletes might be asked to say ‘I can’t lift my right arm’ while lifting their right arm up. One further metaphor is to imagine you’re sinking in quicksand and to imagine what happens if you fight against it. People tend to sink, right? If athletes learn to accept things can be difficult and learn not to fight against them, they can firstly save energy and secondly spend their time doing more positive things. Finally, the Chinese ‘finger trap’ is a fantastic metaphor to highlight what happens when you struggle with anxiety and try to fight it. The result is your fingers get stuck, and things get worse. The solution is to do the opposite, relax and gentle release your fingers. This has helped many of my athletes in private practice to stop fighting against anxiety and to relax, ultimately improving their performance. 

The Matrix

After an athlete has been through the ‘Hexa-Flex’, they tend to become more flexible in their mindset and don’t react with behaviors that move them away from their values. This works is typically planned out using ‘The Matrix’, which is a fantastic visual map of the athlete’s life, showing their values, and how behaviors move then towards or away from these (A-T). The matrix maps out the athlete’s life, sporting behaviours and really helps them to understand why they are doing what they are doing. 

The Sports Lifeline

An additional tool is the ‘Sports Lifeline’, which allows athletes to see why they must move towards certain behaviors because by doing so, they are doing what’s most important for them and be willing to put up with some short-term or long-term discomfort. The metaphor to help understand the Sport Lifeline would be making a choice between to paths. Path one is familiar, comfortable and causes no issues, however at the end of the road there is nothing you value in life. The second path has brambles, nettles and branches sticking out, causing some level of discomfort, however at the end of this road is everything that is most important to you in life. Which road would you pick? ACT would encourage you to make the ‘towards value move’, rather than the ‘away from value move. 

This means that an athlete may experience more anxiety because they are experiencing more of it, however they are not impacted in the same way and they allow the anxiety to move freely in their daily life, rather than ‘hooking onto it’ and allowing it to take over. This can result in the intensity of anxiety being reduced and an athlete with better mental health and psychological well-being.


ACT Key Message

The key message from ACT is to embrace anxiety, accept it, live with it and choose behaviors that result in a valued direction and a more fulfilled life. The idea is that we can’t get rid of anxiety, and by avoiding it, we only live a life at half our potential, this is known as ‘experiential avoidance’, whereas in ACT we encourage individuals to experience anxiety and learn to be comfortable with it, embrace it and see its exitance as anxiety and not who you are.