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← Back to blogBeing able to say “I have lived”: Values, sequencing, and a peaceful ending in ACT
Resuming valued action comes before a reduction in suffering. Measurements across eight sessions showed this sequence.
In a randomized trial of 41 people with treatment-resistant panic disorder, the level of valued action influenced subsequent suffering; suffering was not found to determine subsequent valued action. A single study, a small sample: a strong clue, not a settled question. Still, it reminds us of the sequence: waiting to feel better before starting to live gets things backward.
🧭 ACT, or Acceptance and Commitment Therapy, answers the question of “being able to say I have lived” in terms of values, not goals. A goal is reached and completed. A value has no endpoint; it is chosen anew each morning. What changes in therapy has also been measured: a review of 67 studies involving 9,123 participants found increased contact with values and committed action, alongside reduced cognitive fusion and avoidance; these changes were associated with reductions in distress. In a meta-analysis of 39 randomized trials, ACT outperformed control conditions (Hedges' g = 0.57; g is a measure of effect size).
The findings on meaning-focused work at the end of life are not all in one direction, either. In a randomized trial of 441 terminally ill patients, dignity therapy produced no difference on measures of distress; nevertheless, patients found it more helpful. Among 253 patients with advanced cancer, meaning-centered group psychotherapy improved quality of life more than supportive group psychotherapy.
✍️ Here is something you can do today: choose a domain of values, write one sentence describing the kind of person you want to be in that domain, and translate that sentence into a single action this week. In the short term, what we do hurts; in the long term, what we leave undone takes precedence. The most enduring regret concerns the person you could have become.
If you are going through a difficult time, you are not alone: 112 · ALO 183.
This content does not constitute diagnostic or treatment advice.
References: Hayes ve ark. (2006), Behaviour Research and Therapy · Macri ve Rogge (2024), Clinical Psychology Review · A-Tjak ve ark. (2015), Psychotherapy and Psychosomatics · Gloster ve ark. (2017), Behaviour Research and Therapy · Chochinov ve ark. (2011), The Lancet Oncology · Breitbart ve ark. (2015), Journal of Clinical Oncology · Gilovich ve Medvec (1995), Psychological Review · Davidai ve Gilovich (2018), Emotion