Conceptualizing the process of experiential acceptance during an episode of anxiety: A qualitative study of individuals with prior experience in mindfulness- and acceptance-based interventions

Introduction: Experiential acceptance refers to the capacity to be open to internal experiences without attempting to change or avoid them. Although acceptance is a core emotion regulation strategy within mindfulness- and acceptance-based interventions (MABIs) and a protective factor for mental health, its conceptualization and implementation remain unclear and ambiguous. The aim of this study was to clarify and develop a model of accepting anxiety as experienced by individuals with prior experience in MABIs.

Method: Twenty-six participants from a non-clinical sample with varying levels of prior experience in MABIs took part in semi-structured interviews exploring their experience of accepting anxiety. Data collection and analysis followed the principles of Grounded Theory to generate a data-driven model of the acceptance process.

Results: We identified a five-stage dynamic model involving distinct processes: observing through the body with attentional focus on interoceptive experience; identifying and acknowledging anxiety; validating and normalizing the experience through validation and self-compassion; observing from an observer stance characterized by decentering; and maintaining flexible contact with the experience via interoceptive exposure and nonreactivity. We also identified facilitating factors that support engagement in the acceptance process.

Conclusion: These findings refine the understanding of acceptance as a multidimensional emotion regulation process by highlighting an active dynamic involving multiple mechanisms underlying the acceptance of anxiety. As experienced by individuals with prior MABI experience, this model provides a framework for developing more targeted clinical interventions and for investigating individual and contextual variability in these subprocesses.