How to deal with insomnia? It s one of the most searched sleep-related questions on Google right now (searches are up over 5,000% in the last 30 days), so it seems we’re living in something of a sleepless world. How to overcome it? According to Dr. Guy Meadows, founder of The Sleep School, the key is acceptance and commitment therapy (or ACT), a type of psychotherapy.
What is acceptance and commitment therapy?
“ACT is a third-wave psychological therapy that focuses on transforming an individual’s relationship with the pain and discomfort that’s arising in their life. It teaches them how to be open to accepting it while moving towards what’s important to them,” says Dr. Meadows.
A newer form of cognitive behavioral therapy (or CBT)—which focuses on symptom reduction—ACT works on the premise that our daily struggles to get rid of pain and discomfort actually make it worse.
“For example, if you’re feeling anxious, a CBT method might be to breathe deeply in order to get rid of the anxious feeling, however, that doesn’t always work in the middle of the night as the brain and body can respond differently,” says Dr. Meadows. “ACT, on the other hand, is about changing the way you relate to the painful content in your life, with all the thoughts, feelings, sensations and worries that accompany it, rather than changing the content itself.”
How to know if you suffer from chronic insomnia
Chronic insomnia is “the worry about not sleeping,” says Dr. Meadows. “The less you sleep, the more you worry, and the more you worry, the less you sleep. It becomes a conditioned response.” As an example, some of his clients will feel sleepy while watching the TV, but as soon as they move towards the bedroom and lay their head on that pillow, they enter a state of fight or flight. “The first thing we do is teach people how to give themselves permission to be awake, and to feel the feelings and thoughts they’re experiencing,” says Dr. Meadows.
How ACT works
There are three core elements to Dr. Meadows’s practice, all of which are harnessed via the Sleep School app.
The first part of the process is to work on grounding yourself in the moment throughout the day (“insomnia is a 24-hour disorder if you’re not sleeping”), and during the night. “If it’s the nighttime, it could be as simple as noticing the sense of contact between your body and the bed,” explains Dr Meadows. “Do a body scan and notice where your skin makes contact with the bed. This helps to cultivate present moment awareness, which means you are better able to view what you’re experiencing through an objective lens.” It also helps you to move away from the narrative of “I need to get to sleep.”
“We need to be open and willing to experience what’s showing up at the moment—this is the real game changer with acceptance and commitment therapy,” he says. “Thoughts and feelings are just bits of noise passing through.” Instead of trying to change, reduce, or avoid them, we witness them. You might say something like, “I’m noticing my mind telling me that if I don’t sleep, I won’t be able to cope tomorrow”, explains Dr. Meadows. That helps you understand that it’s just your mind, which is hardwired to worry, and it’s okay.
“The metaphor we often use is holding a beach ball underwater,” says Dr Meadows. “Most people can probably do that for a minute, but if you try doing it all night, it becomes really difficult and the beach ball just wants to bounce up to the surface. My clients have 10 beach balls that they’re trying to push down and hold under the water, which consumes vast amounts of their time, energy, and emotion. The struggle to keep them under control is literally what’s keeping them awake. What if they learn to allow the ball to sit on the surface? That takes courage and skill, but it’s what we teach them.”
This step is about connecting to your values, because “what is commonly expressed when the amygdala (the bit of the brain that is responsible for emotion and memory) takes hold are impatience, frustration or being harsh to oneself,” says Dr. Meadows. “When we connect to our values, we ask ourselves how we would most want to respond to these thoughts. You might say some compassionate and kind words to yourself, acknowledging that your sleep situation is really painful right now, and that’s okay. You’re resting your body, and that’s good enough right now.”
This helps remove the “battle” element of going to sleep. When you lean into the discomfort and express kindness and curiosity to yourself, you send a message to your amygdala that it’s safe to sleep, which encourages natural slumber.