Acceptance and Commitment Therapy – Part II

We can find great examples of those who found meaning, purpose and vitality in the midst of suffering in Mandela’s biography or those about holocaust prisoners. They, like people with long term pain or fatigue, are stuck but not broken.

So when we look at people’s behaviours and thoughts, we don’t ask whether they are good or bad, true or false; we ask whether they are helpful, whether they are making our life rich, full and meaningful.

Shakespeare: “There is nothing either good or bad, but thinking makes it so”

One aspect of ACT is to use mindfulness which is, essentially, “paying attention with flexibility, openness and curiosity”.

You can’t be mindful all the time, and we don’t need to be because sometimes the way we think is not too bad in the long run. Sometimes we can control our thoughts and if that assists in leading a valued life then carry on. 

But when people are struggling they tend to display:

  • Dwelling in past or future or lack of insight into own thoughts and feelings
  • Limiting Negative Automatic Thoughts 
  • Experiential avoidance
  • Attachment to their own idea of themselves (i.e. their diagnosis, body image etc)
  • Lack of living a valued life
  • Unworkable action

Try this exercise which illustrates all of ACT in one go:

  • Sit and reflect on what you can sense (go through each sense and thoughts and feelings and pause) = Present moment / mindfulness
  • Notice that there’s a part of you which can observe all of the above, like on a stage, it’s the observing self = self as context / our attention
  • Reflect on why you came here today, what do you want to improve? = values
  • How did you get here (i.e. With action despite some crap going on) = do what it takes
  • Focus on your breath, empty lungs then notice how it automatically refills = mindfulness again
  • Let thoughts come and go (like cars, like a storyteller, like it’s a radio playing, like a screaming child, dictator) but focus on breath again = defusion
  • Notice feelings and physical sensations but refocus on breath after saying “here’s a feeling of frustration” = acceptance
  • Life is like a stage show and just now you dimmed the lights to focus on breathing, now turn up the lights onto the rest of your body then the room, and senses and thoughts and feelings

Reducing inclination to control

It is important to understand that attempts to control our feelings (through distraction or avoidance or Cognitive Restructuring or Thought Challenging) can negatively affect our quality of life. Actions are better when they are led by our values i.e, exercise for health if it’s one of our values but not for distraction.

Ask:
1. What have you tried? 

  • D:istraction
  • O:pting out
  • T:hinking
  • S:ubstances, self harm, strategies
  • 2. How has it worked? 
    3. What has it cost?

    Metaphors to understand why battling your experience isn’t the way forward:

    • Quicksand
    • Tug of war with monster pulling you towards pit; you’re losing, what do you do? Our instinct is to pull harder but it’s not working, so let go.

    Exercise examples of how we can’t control these things anyway:

    • Try to forget a memory
    • Try to make your leg numb
    • Try to fall in love
    • Don’t think about ice cream

    Homework:

    Notice what you’re trying and what effect it has and at what cost. Write it down. 

    www.happii.uk is a website providing information about mental health and wellbeing. Happii.uk is provided by Anna Batho, a therapist working in High Wycombe and providing therapy in Amersham and the wider Buckinghamshire (Bucks) region.

    You can contact her here.

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