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.