Acceptance and Commitment Therapy For Dummies®
Published by: John Wiley & Sons, Ltd., The Atrium, Southern Gate, Chichester, www.wiley.com
This edition first published 2016
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Library of Congress Control Number: 2015960021
ISBN 978-1-119-10628-9 (pbk); ISBN 978-1-119- 10629-6 (ebk); ISBN 978-1-119- 10630-2 (ebk)
Successful businesses across the world apply this simple principle: focus more on the few things that do a lot, rather than the many things that do a little.
This is such a book.
If you look at the table of contents for this book you will see that after a handful or two of short chapters it bangs through a pretty incredible list of important topics: love, anxiety, depression, anger, pain, addiction, work and even psychosis. And every one of those later chapters shows how psychological flexibility applies.
Is that even possible?
It turns out that it is. ACT is about the few core things in psychology that make an important difference in lots and lots of different areas. Last time I counted there were over 125 controlled studies (and hundreds more of lesser kinds) showing that the small set of skills that ACT targets makes a difference virtually everywhere that human minds go.
This is an ACT For Dummies book, but you could also call it an ACT for When You Are Too Smart for You Own Good book. Minds do not know when to stop! They are figuring it all out even when what they need to do is just be quiet and let people learn new ways of being and doing. There is a conflict between how your analytical mind works and how learning by direct experience works. Our analytical minds are great for doing taxes – but they are awful at getting over past hurts. Your minds are great in the role of a tool and lousy when put in the role of being the boss or dictator. What ACT does is to teach you how to put your mind on a leash – so you can use it when you want rather than it using you when it wants.
This book will help. There is nothing dumb about that!
Steven C Hayes, PhD
Foundation Professor of Psychology, University of Nevada
Co-developer of ACT
Acceptance and Commitment Therapy (said as one word, ‘ACT’) is an evidence-based psychological intervention that uses acceptance and mindfulness techniques alongside behaviour change strategies to help you live life according to what really matters to you. Based on recent breakthroughs in understanding how language works, ACT offers a genuinely original perspective on the human condition and the challenge everyone faces in living a life with meaning and purpose.
ACT is all about doing the things that really matter to you and not letting your mind get in the way. Often, without you realising it, your mind — what goes on in your head — can push you around and interfere with your daily life. You’re so connected with your thoughts that you don’t always notice what they do and, importantly, what they stop you doing. But your mind is really just a tool and, like all tools, is good at solving certain problems and pretty hopeless at addressing others. ACT shows you how to use your mind for what it’s good at and then to set it aside when your thoughts are less helpful.
To help you get on with the life you want to be living, ACT uses a range of exercises to enable you to become more open, aware and active:
This is an exciting time for ACT. Every month, new research articles and books explore how it can be applied in different settings and to a host of human problems. In fact, so many new applications are being developed that there’s insufficient space in this book to cover them all. Rather, we provide a general introduction to ACT with the aim of helping you understand the central principles, ideas and practices that underpin the model. Contrary to popular belief, doing the things that really matter to you can be quite difficult. And the reason for that, according to ACT, is human language. While language enables you to do amazing things, it also allows you to ruminate on the past and worry about the future. And when you become overly entangled in your thoughts you stop living the life you want to be living — and instead your life is dictated by your anger, fears, worries and doubts. This insight isn’t particularly new, but where ACT differs to other approaches is in how it responds to these events. Rather than tackling this negativity head on, ACT shows you new ways to relate to your thoughts, feelings and emotions so that they have less impact on your day-to-day life.
If you want to know more about ACT and how to apply it to your own life, then this book’s for you. In broad terms, we:
Developing new ways to relate to your own thoughts, feelings and memories (collectively, your ‘mind’) takes practice and can’t be achieved through the understanding that results from reading alone. Understanding how to relate to your thoughts differently isn’t enough; you actually need to practise the necessary skills directly to be able to do it. It’s rather like learning to swim — no amount of reading or knowledge about swimming will ever be a substitute for getting into the water and learning how to swim directly. The exercises in this book aim to help you ‘learn to swim in your mental world’. While these experiential exercises aren’t always easy to do, they’re central to ACT and we recommend that you try as many as possible.
While reading the whole book will give you the fullest picture of what ACT involves, it’s not necessary for it to be useful to you. It’s better to think of this book as a general reference guide about ACT rather than a manual that needs to be read sequentially. That said, we do recommend that you read the chapters in Part I sequentially because we wrote it that way to take you through the key features of the ACT model. Reading those chapters in the order in which they’re written, while not absolutely necessary, enables you to find out about ACT in a systematic way, without any gaps. The chapters in the rest of the book can be read in whatever order you fancy.
Of course, the downside of ensuring that each chapter has enough information in it to make sense on its own is that some repetition of ideas exists. We’ve endeavoured to keep this to a minimum but you will note some recurrence of key points. On the upside, it means you’ll have multiple opportunities to make sense of the core principles, ideas and exercises.
Throughout the book you’ll find sidebars that provide additional detail that’s interesting but not necessary to understanding the main text. You can read them if you choose.
We’ve assumed some things about you and why you’re reading this book:
Finally, a comment on the technical language we use from time to time. While we try to avoid being overly technical, sometimes ‘therapy speak’ is necessary because an understanding of the subject matter isn’t fully possible without it. When you come across technical terms and explanations, we advise you to stick with them but not worry about understanding them all in one go. It’s often better to skim read the text a couple of times to get the general picture and thus not get bogged down and frustrated. Because the chapters often repeat or build on ACT concepts, you gradually come to understand the technical details.
For Dummies books use icons to alert you to important details in the text. We use the following:
In addition to the material in the print or e-book you’re reading right now, this product also comes with some access-anywhere goodies on the web. Check out the free Cheat Sheet at www.dummies.com/cheatsheet/acceptanceandcommitmenttherapy
for helpful tips and pointers to help you understand ACT and how to apply it to your life. You can also find extra articles at www.dummies.com/extras/acceptanceandcommitmenttherapy
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A good place to start is Chapter 1! It sets out some of the basic ideas that we expand on in more detail in subsequent chapters. After that, you can read the rest of the chapters in Part I as we recommend, or check out the contents and jump into whichever chapter you feel is relevant to you at the time.
Part I
In this part …
Discover the basic ACT model and how it applies to your life.
Learn more about the nature and origins of human suffering from an ACT perspective.
Explore how to use ACT techniques to engage in a fuller and more meaningful life.
Use mindfulness to enhance your wellbeing.
Chapter 1
In This Chapter
Recognising what matters to you
Working on your psychological flexibility
Taking an active approach to your own life
Acceptance and Commitment Therapy (ACT) is a genuinely new way of understanding the human condition. Informed by the scientific understanding of language, it offers a radically different perspective on human cognition and emotion and why human beings can struggle to be happy.
ACT is an evidence-based Cognitive Behavioural Therapy (CBT) that uses acceptance and mindfulness techniques alongside behaviour change strategies to help you live in line with what really matters to you. While the ‘T’ in ACT stands for therapy, ACT goes beyond that: it provides a framework for a deeper understanding of what it is to be human and, more specifically, how to live your life with purpose, openness, vitality and fun!
ACT has never been needed more. In spite of being materially wealthy, many people in Western societies struggle to find a sense of meaning, happiness and fulfilment in their everyday lives. Psychological distress and mental health problems result. ACT was developed (and is continuing to be developed) in response to these challenges.
This chapter explains how your linguistic ability to evaluate parts of your own experience as negative, and therefore something to be avoided, can get in the way of doing the things that matter to you. ACT shows you how to respond more flexibly to your experiences so that, rather than battling against yourself, you can live in line with what truly matters to you.
Put simply, ACT aims to help people identify their values and then to live consistently and openly with them. This is important because when you live in line with your values you’re more likely to feel that your life has meaning and direction. And conversely, when you don’t do what matters, you can feel frustrated, unfulfilled and dissatisfied, even anxious and depressed.
You may think that doing the things you feel are important would be pretty easy — unfortunately, that’s not the case. Human beings are well-practised at delaying, avoiding, stopping or simply not starting things that really matter to them. For example, even though the following things may be important to you, you may:
Take a moment to think about your own life. When did you last avoid, delay or stop doing something that really mattered to you? You can probably think of numerous examples. It’s a curious fact that doing what matters to you isn’t always easy or straightforward. But why is this? According to ACT, experiential avoidance is the answer.
Figure 1-1 shows how human beings, like all animals, generally approach things that lead to positive experiences and avoid those that lead to negative ones. Behaving in this way makes complete sense in evolutionary terms, because it means you’re more likely to avoid dangerous situations and embrace people and experiences that are good for you.
For human beings, however, the situation is more complex. Because language enables people to evaluate their thoughts and feelings as good or bad, it’s easy for people to move towards or away from their own experiences — even when doing so isn’t in their best interests. If you evaluate part of your experience as ‘bad’, you’ll be inclined to stop doing the things that led to it even if doing so also stops you doing what you really want. Consider walking up a mountain. Before you start out you may have doubts about whether you can do it and, during the hike, you’ll inevitably experience some physical discomfort as you go higher. If you’re not prepared to experience these negative thoughts and feelings, you won’t experience what it’s like to walk in the mountains.
Figure 1-2 shows this situation pictorially — unwillingness to experience negative thoughts and feelings causes you to turn around and move away from the things that matter to you. While doing so may solve the immediate problem — you reduce the impact of negative thoughts and feelings — unfortunately, it also creates another problem: you’re now no longer moving in a valued life direction. Experiential avoidance is occurring!
As well as interfering with everyday life, experiential avoidance can be a major contributor to mental health problems. Avoiding daily doubts, reservations or sources of emotional discomfort is one thing, but some people who experience highly disturbing thoughts and memories go to even greater extremes in order to evade them, such as disassociation or drug and alcohol misuse. When this happens, their solution becomes their problem.
You can counteract your inclination to avoid parts of your own experience by becoming more psychologically flexible.
ACT focuses on six core processes associated with psychological flexibility. Although they’re set out as distinct processes, lots of overlap exists between them. And, while they can be applied individually, ACT is really about all six processes functioning together as one.
Self as context: Getting in touch with your deep sense of self — the ‘you’ who sits just behind your eyes, who observes and experiences, and yet is distinct from your own thoughts, feelings and memories
We return to these six core processes in Chapter 3 so that you can really understand how they work and link together. Here, it’s important to understand that ACT aims to enhance your psychological flexibility so that you can get on with doing what matters.
Many traditional therapeutic approaches focus on changing or altering unwanted or troublesome thoughts and feelings. ACT is different in that it works to change how you relate to these events rather than to change them directly. The aim is to become more open to, and accepting of, your thoughts and feelings instead of battling against them.
ACT takes this approach because research carried out over the last 20 years or so indicates that people have much less control over their thoughts and feelings than they often think they do. For example, while you can choose to think about different things, such as a red car or a polar bear, you can’t sustain these thoughts for anything other than short periods before your attention moves on to something else. And if you try your best not to think about something, then the opposite happens and you end thinking about it all the more. These findings (and what does your own experience tell you?) mean that your efforts to control, minimise or avoid your thoughts can only ever have marginal success. Chapters 7 and 11 explain in more detail how your thoughts work.
A similar situation exists with your emotions. What you feel depends on what’s happened to you, and this means that you can’t change how you feel at any one point in time without first changing your past. Of course, that’s impossible, and so attempts to manage or change your feelings in the present won’t be successful.
The aim of ACT is to help people live open and fulfilling lives, which is difficult to do if they’re spending lots of their time trying to change, control or avoid things that can’t be easily changed, controlled or avoided. For this reason, acceptance is so important. When faced with things you can’t change, your best option is usually to accept them. This challenge is nicely summed up by Reinhold Niebuhr’s Serenity Prayer:
Grant me the serenity to accept the things
I cannot change,
The courage to change the things I can,
And the wisdom to know the difference.
Acceptance provides an alternative to experiential avoidance as a way to engage with life. In practising acceptance you create the space to do the things that really matter to you rather than waste your time and energy on trying to control the uncontrollable. This doesn’t mean that everything you do will be successful. Some things you do will work out and others won’t, but at least you’re now doing the things that are important to you rather than trying to control or avoid the things you don’t like. At the end of each day you can then rest your head on the pillow and fall asleep knowing you’ve lived according to your values.
And something else happens when you practise acceptance: life becomes less scary and less focused on the negatives. It transpires that your unpleasant thoughts and feelings aren’t as bad as you think they are. Sure, they’re not very nice, but they aren’t something you need to unduly worry about much of the time. And they certainly aren’t things to which you need to devote significant energy trying to avoid or control.
Human language can occur in the public domain (speech and writing) and the private domain (thoughts and cognitions). While human language is an essential part of modern life and helps you with all kinds of challenges and problems, when you become too attached to its literal content it can also lead to difficulties.
When you believe that your thoughts reflect the world accurately (as it ‘really’ is), they can have a greater influence over how you behave. Allowing your thoughts (and language in general) to direct your actions is problematic for a number of reasons. For a start, your thoughts are usually negative and often wrong. And even when they’re accurate, your thoughts aren’t always useful to you in terms of living in line with your values. Consider a young woman who wants to quit smoking. She might have the thought, ‘A cigarette right now would relax me’. And such a thought may be accurate; having a cigarette may indeed allow her to relax. However, being ‘fused’ with (believing it literally) and acting on that thought would move the young woman no closer to her value of healthy living.
When you see your thoughts as just bits of private language in your head, you reduce their influence on your behaviour and this enables you to act in line with your values.
The good news is that, while the exercises take some effort, they’re often also fun.
Chapter 2
In This Chapter
Discovering the link between language and human suffering
Seeing how trying to avoid or control negative thoughts and feelings is counterproductive
Understanding how little control you have over your thoughts and feelings
Viewing healthy normality in a new light
Every day people struggle to live meaningful and positive lives. Rather than feeling energised and upbeat, people often report feeling anxious, stressed or depressed. What’s going on? Why do people find it so hard to be happy or to do the things that matter to them? According to recent breakthroughs in psychological science, the root cause of our suffering is human language and how we respond to it.
Your language is what enables you to remember sad events from the past or worry about things that may happen in the future. These events in themselves, though unpleasant, aren’t necessarily problematic. But it’s when you try to control or avoid them that you can get into trouble and embark on a road that takes you away from doing the things that really matter to you and leads to yet more psychological suffering.
This chapter looks at how your language enables you to evaluate your own experiences as well as events in the external world. We introduce the assumption of healthy normality and how it encourages you to try to avoid or control those parts of your experience that you evaluate negatively. This chapter also begins to describe how ACT offers an alternative way forward, in which you connect with your values and what really matters to you in life rather than try to avoid or control your negative thoughts and feelings.
Language is at the heart of humanity’s greatest achievements, from science, engineering and architecture to literature, music and art. In many ways, language is the defining feature of human beings and it sets us apart from the other animals on this planet.
Language enables you to:
But language also has a darker side, which makes it possible for you to:
Some of these more negative mental processes can be useful, of course. Worrying about things can help you to understand what’s happening and then to do something about it. But sometimes your thoughts and feelings can come to dominate your experience to such an extent that they interfere with your ability to get on with your life.
Even when life is good, you can still worry and feel anxious or sad. Other animals aren’t like humans in this regard. Give a dog a good meal, some exercise and a warm place to sleep and it will be quite content — every day! Of course, animals can be anxious or distressed, but only when they’re in negative or adverse circumstances. In contrast, human beings can experience negative thoughts and feel lost, scared and alone at any time. And it’s language that enables this to happen. If the events you think about are negative, you’ll experience negative feelings no matter what your immediate circumstances.
Non-human animals don’t have this problem because they don’t have the same language ability. How human language functions is at the heart of ACT. ACT is based on a new theory of language called Relational Frame Theory (RFT). This theory provides a contextual account of language that has wide-ranging implications for psychological wellbeing and, indeed, almost all walks of human life.
Private language refers to your mental processes, or what you experience ‘inside your head’, and includes:
Language enables you to link all sorts of things together, which can be really useful. But how you relate to language can cause problems, and it’s these problems that ACT seeks to address. The rest of this chapter looks at how you relate to language in more detail and, in particular, how your capacity to evaluate the world can cause you difficulties.