Week Eleven (208) Flashcards
mindfulness
- Creates awareness of the present moment.
- About being present.
acceptance and commitment therapy (ACT)
Third Wave” of Cognitive-Behavioural Therapy (CBT).
• Behavioural therapy focused on behaviours, CBT focused on thinking.
• Focuses on private events.
• Does not attempt to alter private events. Comparative to CBT that aims to alter thinking patterns.
• Introduced by Steven Hayes in 1999.
• Six core components to the theory and therapeutic approach applied across a range of psychological difficulties.
Foundation of ACT: Relational Frame Theory
• Developing for around 25 years by Steven Hayes.
• Based on earlier behavioural ideas: Thus, there is a behavioural component to ACT.
• Thoughts are the learned behaviour over time, rather than observable behaviours.
• We create meanings for words.
○ We, as humans, create the meaning for words.
• We engage with events by prescribing meaning through language, while being unaware of this process of language.
○ This is an unconscious process as we have learned how to speak and convey meaning.
• Words can elicit pain – so changing our approach and response to our inner world, rather than changing the inner world itself, is the goal.
○ Words are blank until we create meaning.
○ Words can be helpful but can also be painful.
○ As we have the basic attachment to the meaning of words, we believe them and thus they can elicit pain.
○ WE ARE NOT AIMING TO CHANGE THOUGHTS BUT RATHER OUR RESPONSE TO THEM. - THIS IS THE MAIN INFORMATION NEEDED ABOUR RFT.
basic ideas of ACT
• Difficulties occur due to a “narrowing behavioural repertoire” that is gradually created due to unhelpful strategies to cope with thoughts and emotions.
• A restricted repertoire can occur due to the following:
• Cognitive Fusion – being ‘tangled’ in our thoughts and beliefs, and responding to the world according to these.
○ The thought and the person thinking the thought become one, so the situation feels real, rather than being based in language.
○ Very connected with thoughts, drives behaviours and emotions. The way we respond is based on these thoughts.
• Experiential Avoidance – when the pain brought on by thinking is avoided or suppressed.
○ Escaping private events (thinking, emotions, thoughts), feelings, and sensations.
○ If someone is experiencing anxiety, then wants to avoid anxiety it will prevent the person from engaging in activities that may trigger anxiety.
therapeutic aims of ACT
- The main aim of ACT is “To create a rich, full, and meaningful life while accepting the pain that inevitably goes with it.” (Harris, 2009).
- Approaching sessions in an experiential way, rather than theoretically explaining concepts and processes.
- The client and therapist can be creative with the process.
- Different process to other therapies. Is based on experimenting.
- Increase psychological flexibility.
- Having different ways to deal with thoughts.
- Broaden behavioural repertiore and responses.
Component 1: Acceptance (Open Up)
• Difficulties occur when struggle happens with internal experiences.
• Trying to “get rid of” experiences causes struggle.
• Takes energy away that could be used for important parts of life.
• https://www.youtube.com/watch?v=rCp1l16GCXI
○ Struggle switch: when we are distressed, the stressed switch is on and is therefore using up energy. If the switch is off, the client notices the anxiety but energy is not expelled and therefore it eventually subsides.
• Acceptance - ”making room for” or “dropping the struggle with” painful feelings, sensations, urges, and emotions.
• 1. Drop struggle.
• 2. Give space.
• 3. Allow experiences to be as they are.
• Therapeutic Processes:
• Acceptance is a process, not a technique.
• Check language – e.g., “stop fighting with it”, “allow it to be there”, “give it some space”.
• Psychoeducation about emotions.
○ If people do not understand where emotions come from and why they are present they are less likely to accept them.
• Experiential exercises to practise full, non-judgmental contact with unpleasant private experiences.
• Acceptance of emotions process:
○ Main idea is to notice where they are experiencing the emotion.
§ Where is it?
§ How big is it?
§ Observing this emotion as a curious scientist.
§ Concluding that this feeling tells people they are a real person.
§ Understanding that they are bigger than the emotion.
○ “The Curious Scientist”
○ “This feeling tells you are a normal human being”.
○ Healing hand.
§ Used less frquently
§ Only for regular clients
§ Lets the client know that people care for them.
Component 2: Defusion (Watch Your Thinking)
• Difficulties occur when we are “fused” with our thoughts – the thought and the person thinking the thought become the same.
• We get caught up in thoughts and are pushed around by them.
• We lose contact with actual events, so thoughts become self-confirming.
• Exercise
○ Hands symbolise thoughts.
○ Put hands in front of eyes - demonstrates how being caught up in emotions can stop us from engaging in the world
○ Consider how it would be to experience certain events.
○ Leave hands in lap. - separate our thought so that we can engage in our world and are no longer caught up in our own experience.
§ We cannot stop the emotions but rather we need to be able to live with them.
• Defusion - ”step back” or separate from thoughts, images and memories.
• Watch our thinking, rather than getting tangled in it.
• Therapeutic Processes:
• Again, a process, not a technique.
• Notice the process of thinking – nothing more than words and images.
• Look at how “workable” thoughts are. Rather than good or bad, are they “helpful” for living a valued life or “unhelpful” for this?
○ Is your anxiety helpful to your life or not?
• Learn that thoughts do not control actions.
○ Just because we think something doesn’t mean we have to do it.
• Distance from thoughts:
○ ”I’m having the thought that…”
§ Rather than believing the thought, if we see it as words it becomes less destructive.
○ Repetition.
§ The more you say something the less meaning it has.
○ Silly voices or songs.
○ Leaves on a stream.
§ Mindfulness exercise
§ Noticing what thoughts are going through your mind, put each thought on a left on a stream and eventually we will be distanced from the thought.
Component 3: Contact with the present moment (be here now)
• Being occupied with the past or the future can cause mindless actions, disconnection with others, and a lack of self-awareness.
• Can reduce valued behaviour.
• Being focused on the here-and-now – paying attention to the inner world and external world with flexibility.
• Instead of being “lost in our thoughts”.
• If we think too much about the past we can experience sadness, thinking about the future can experience anxiety.
• While we do need to think of the past (to learn from mistakes) and the future (to goal), we need to do it in the most helpful way for the present moment.
• Can also help us reduce experiential avoidance.
• Increase accurate perception of our world to gather information about whether to change or maintain behaviour.
• Therapeutic Processes:
• Simply notice what is happening here and now (mindfulness).
• Discriminate between noticing and thinking (judgment).
• Mindfulness:
○ Therapist to be mindful in session – noticing with curiosity.
○ Formal mindfulness in session – process, not technique.
○ Involves 2 previous components:
1. Notice X (Noticing/Observing).
i. Noticing when the client is uncomfortable and how they are reacting.
2. Let go of your thoughts (Defusion).
3. Let your feelings be (Acceptance).
Component 4: Self-as- context (pure awareness)
• Some people experience distress when they consider facing inner experiences or are overly attached to their thoughts.
• This causes difficulty with acceptance and defusion.
• For example, becoming overly attached to thoughts about the self: “I’m worthless”.
• Self-As-Context – a “viewpoint” where we can observe thoughts and feelings.
• Noticing what we are noticing.
○ By noticing one thing and understanding that this is resulting in anxiety, we can aim to separate these emotions and be aware of what is occurring.
• Awareness of our own ability to be aware.
• Obtaining a sense of self that is separate from our thoughts and feelings.
Stops “running” from pain.
herapeutic Process:
• Within mindfulness exercises – “take a moment to noticing who’s noticing”.
• Notice the thinking self – part of your mind that talks, and the observing self – part that listens.
• Disconnecting from fusion about a “good self” or “bad self”.
• ”The Continuous You”:
1. Notice X.
2. There’s X – and there you are noticing X.
3. If you can notice X, you cannot be X.
i. If you are noticing that you feel ‘worthless’ you cannot be ‘worthless’
4. X changes continuously, the you who notices X does not change.
Component 5: Values (know what matters)
• When we are unaware of what is important to us, we can feel lost, lack motivation, not act in ways important to us, and feel life has less meaning.
• May be instead living aligned with social expectations.
• Contributes to life dissatisfaction.
• Values – statements about who we want to be and what we want to do with our life.
• There is a difference between a goal driven life and a value driven life.
• Values living links with mindfulness.
○ You notice things, and live day by day.
• Goal living is focused on achievements and can result in issues if it is not achieved.
• https://www.youtube.com/watch?v=T-lRbuy4XtA
• Therapeutic Processes:
• Distinguishing values from goals.
• Identifying:
○ Desired ongoing action – what you want to do.
§ What do you want to do in your social/personal life.
○ Global qualities – how you do things.
○ “If _____ wasn’t a problem, how would you be acting?”
○ “If it was your birthday and three people were making a speech, and you were living your most desired life, what would they say about you?
• Determine how much person lives aligned with each value – see where change is needed.
Component 6: Committed Action (do what it takes)
• High levels of avoidance or cognitive fusion can limit valued-living and doing what is most important.
• Difficulty occurs when one does not know how to put values into action or we have stopped living aligned with our values.
• Committed action –A pattern of repeatedly considering values when deciding how to act.
• Mindfulness and defusion are important components of this:
○ Stop and think in the moment, to then determine how to act. This is a point of choice.
• Therapeutic process:
• Set goals, then break these down into specific actions.
• Ask the client to commit to the action.
• Identify any barriers to taking steps (e.g., cognitive fusion, experiential avoidance).
• Steps:
1. Choose area of life that has a high priority for change.
2. Choose the value to focus on.
3. Develop goals guided by value.
4. Take action mindfully.
ACT summary
- “Accept your thoughts and feelings, and be present.”
- ”Choose a valued direction.”
- “Take action.” (Hayes, 2009)
- = A.C.T.!
