Psychological Flexibility: The Key to Better Mental Health and Resilience

Consider a time when something truly went wrong: a relationship ended, a job was lost, a health scare came down out of nowhere. How varied are the ways individuals deal with them? Everyone has a tendency to avoid any emotional state that is painful. It seems the logical thing to do. However, research has repeatedly found emotional avoidance, the tendency to avoid uncomfortable emotions, to be one of the most consistent predictors of long-term anxiety, depression and mental health outcomes  (Hayes et al., 2006). Psychological flexibility is the skill that’s the polar opposite of avoidance, and it’s one of the most overlooked mental health skills that many people don’t know about. This article covers what it is, what research has found and how to begin creating it.

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What is Psychological Flexibility 

Psychological flexibility means being present in the moment with all thoughts, feelings and sensations, including unpleasant, uncomfortable, and painful ones, then choosing to act in a way that is consistent with one’s values. ACT (pronounced “act”) is a well-researched psychological therapy developed in the 1980s and 1990s by Steven Hayes and colleagues (Hayes et al., 1999).To truly understand psychological flexibility, it’s important to begin by understanding what it isn’t.

It’s not about telling oneself that things are okay, turning around one’s own negative feelings and thoughts for positive ones, or ignoring feelings that are not okay.  These tactics, known as experiential avoidance, are strategies that will collectively make difficult emotions stronger over time. The more we attempt to suppress or ignore thoughts and feelings, the more mental energy they will consume (Hayes et al., 2006). 

Finally, psychological flexibility is not synonymous with surrendering to all feelings and moods. Being bed-bound when a person is feeling sad does not mean that they are staying home because they are feeling sad; being rude towards someone when they are feeling angry does not mean that they are avoiding a hard conversation when they are feeling anxious. Flexibility is not passivity, but the ability to feel the feeling without being driven by it, and to continue to go toward the life one desires even when that life is difficult. Psychological flexibility is a collection of six skills that Hayes refers to as the ACT Hexaflex.

The following are the 6 key components: being in the moment; willing to accept thoughts and feelings without judgment; observing oneself with a sense of perspective (defusing, stepping back from thoughts and seeing them as possible thoughts and feelings, instead of as facts); connecting to a stable sense of self; identifying one’s values; taking committed action towards their values despite difficult thoughts and feelings (Hayes et al., 1999). These six skills are a means of relating to the inner world that is open, grounded and purposeful. 

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Impact on Mental Health 

The evidence for psychological flexibility is now quite large. The results of this extensive meta-analysis, which combined and re-analysed the results of more than 300 studies involving tens of thousands of participants from diverse populations and cultures,  indicated a significant link between psychological inflexibility (measured as an avoidance of difficult emotions and thoughts) and anxiety, depression, stress, and quality of life (A-Tjak et al., 2015).

Importantly, the effects of enhancing psychological flexibility, via ACT-based interventions, on these outcomes were a consistent reduction.  Another crucial part of resilience is psychological flexibility, the capacity to bounce back and adapt following tough times. Resilience is not a state of being immune to adversity,  but rather being able to endure or tolerate something without losing one’s ability to persevere.

Kashdan and Rottenberg (2010) found that one of the most important mechanisms of resilience is psychological flexibility, which is the ability of an individual to think and act flexibly in response to fluctuating circumstances without becoming overwhelmed or trapped. Another domain in which psychological flexibility makes a demonstrable impact is that of emotional regulation: how we feel and how our feelings play out in our behaviour. 

Typical ways of regulating emotions tend to be about suppressing or diminishing feelings that are not appropriate. In the ACT approach, however, the emphasis is on changing the relationship with the emotions, rather than the emotions themselves. A  psychologically flexible person tries not to suppress their feelings of anxiety, but rather attunes and names them, welcomes them, and remains faithful to their values despite their presence. 

Other studies have shown that psychological flexibility is protective in very different types of stress: in the workplace, stress-related burnout, chronic pain, grief, illness, and relationship difficulties. A recent study involving individuals with chronic pain found that psychological flexibility is linked to less pain-related disability and overall functioning, despite similar pain levels (McCracken & Vowles, 2014). There was no change in the pain. It was not that something had changed about the person, but rather something had changed in the person’s relationship with it.

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Strategies to improve in Daily Life 

Fortunately, psychological flexibility is a skill and not a personality trait. It may be learnt and developed through practice. Here are four scientific strategies for beginning to create it. 

1. Label the Feeling Without Judgement

The ability to name the emotions more precisely has been studied, and it has been found that people who can name their emotions more precisely are less reactive to emotions and recover faster from stressors (Kashdan et al., 2015). Labelling an emotion engages the prefrontal lobes (the brain’s reasoning/regulating centre), and dampens the activity of the amygdala (the brain’s alarm system).  

2. Learn to Defuse Unhelpful Thoughts

The ACT word for stepping back from thoughts and not believing them to be facts is defusion. This will decrease the power of the thought because it puts it in the category of what the mind is doing rather than in the category of what is true (Hayes et al., 1999). 

3. Knowing What is Important

There is no such thing as being psychologically flexible without direction. It has purpose because of values. A value is not a goal; it is a quality of how one wants to live and act. For instance, a goal could be ‘getting a promotion ‘. If one is aware of their values, they can make decisions that are congruent with their values even when one is feeling anxious, sad or uncertain (Wilson & Murrell, 2004). 

4. Doing what one thinks is difficult

Each and every time one takes a values-based action rather than an avoidance-based action, they increase their psychological flexibility. This is not doing everything they are afraid of, at once. It involves lots of little steps, little moves, toward what is important and not what is difficult. With time, these actions create evidence for oneself of being able to experience difficult emotions and function, the lived experience of psychological flexibility  (A-Tjak et al., 2015). 

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Conclusion 

Psychological flexibility is no guarantee of a pain-free, anxiety-free, uncertainty-free life. There are no skills that can do that. What it enables is something far more valuable, namely, to continue living without being impeded by the more difficult emotions, and to persist in a way of living that feels meaningful even when life seems challenging. This is a radical reframe in a world that never ends, selling the message that the mental health mission is “feel good all the time”. 

The research is clear and consistent: individuals with openness and flexibility to their inner experiences are more resilient, have stronger emotion-regulation skills, are less prone to anxiety and depression, and are better able to create lives that align with what is important to them. It’s not a hard concept to grasp. But it is contrary to human nature; that’s why it takes practice. 

References + 

• A-Tjak, J. G. L., Davis, M. L., Morina, N., Powers, M. B., Smits, J. A. J., & Emmelkamp,  P. M. G. (2015). A meta-analysis of the efficacy of Acceptance and Commitment  Therapy for clinically relevant mental and physical health problems. 
• Psychotherapy and Psychosomatics, 84(1), 30–36.  https://doi.org/10.1159/000365764 
• Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the  Difficulties in Emotion Regulation Scale. Journal of Psychopathology and Behavioural Assessment, 26(1), 41–54.  https://doi.org/10.1023/B:JOBA.0000007455.08539.94 
• Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and  Commitment Therapy: Model, processes, and outcomes. Behaviour Research and  Therapy, 44(1), 1–25. https://doi.org/10.1016/j.brat.2005.06.006 
• Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and Commitment  Therapy: An experiential approach to behaviour change. Guilford Press. 
• Kashdan, T. B., Barrett, L. F., & McKnight, P. E. (2015). Unpacking emotion differentiation:  Transforming unpleasant experience by perceiving distinctions in negativity.  Current Directions in Psychological Science, 24(1), 10–16.  https://doi.org/10.1177/0963721414550708 
• Kashdan, T. B., & Rottenberg, J. (2010). Psychological flexibility as a fundamental aspect of health. Clinical Psychology Review, 30(7), 865–878.  https://doi.org/10.1016/j.cpr.2010.03.001 
• McCracken, L. M., & Vowles, K. E. (2014). Acceptance and Commitment Therapy and mindfulness for chronic pain: Model, process, and progress. American  Psychologist, 69(2), 178–187. https://doi.org/10.1037/a0035623 
• Orsillo, S. M., & Roemer, L. (2011). The mindful way through anxiety: Break free from chronic worry and reclaim your life. Guilford Press. 
• Twohig, M. P., & Levin, M. E. (2017). Acceptance and Commitment Therapy as a treatment for anxiety and depression: A review. Psychiatric Clinics of North  America, 40(4), 751–770. https://doi.org/10.1016/j.psc.2017.08.009 
• Wilson, K. G., & Murrell, A. R. (2004). Values work in Acceptance and Commitment  Therapy. In S. C. Hayes, V. M. Follette, & M. M. Linehan (Eds.), Mindfulness and acceptance: Expanding the cognitive-behavioural tradition (pp. 120–151). Guilford  Press.