Acceptance and Commitment Therapy

Cognitive Behaviour Therapy vs. Acceptance and Commitment Therapy

I think one of the best ways to sum up CBT vs. ACT is to talk about the radio analogy. As you go about your day, your mind is constantly chattering away in the background, kind of like an annoying, often negative, radio station. If you are frequently tuned into that radio station, it interferes with your ability to focus on what you’re currently trying to do, which brings you into a state of disconnection with your current life. It can also foster negative emotions and trigger behaviours that include escape and avoidance. So what are your options? You could try to turn the radio off…but this particular radio station, unfortunately, can’t be turned off completely. You could bring in another, bigger radio station full of positive thoughts and messages and try to out-blast the negative radio station, but often that means trying to go about your day with TWO loud radio stations blasting in competition in the background. The third option is to allow the negative radio station to play quietly in the background, without fighting it. You commit to your everyday, current life, but every once in a while, listen to one of the songs if it is playing something that might be useful to you in your current life. The two-radio analogy is similar to traditional CBT techniques, which try to replace negative thoughts with more positive or constructive thoughts. The quiet background analogy is similar to ACT, where it is accepted that the mind, due to evolution and conditioning, is automatically programmed to re-hash old stressors, anticipate anxiety-provoking events, and generally worry about everything. Once it is accepted that these kinds of thoughts are normal and experienced by everyone, the focus becomes two-fold – “un- hooking” those thoughts so that they lose the ability to pull on your emotions and behaviours, and once again become part of an inconsequential background, and putting energy and focus into behaviours that bring you closer to your values and goals. ACT is a complex, multi-layered approach, and well outside the confines of this course, but I wanted to introduce you to some of its tools so that you can get a sense of how to use it in your life. First…a little video about our “survival” brain that we inherited from our ancestors, that helps to explain why we are programmed to have this constant, negative radio station in the background. ? https://www.youtube.com/watch?v=kv6HkipQcfA

The Happiness Myth

In our modern day world, our society holds collective ideas about how we should behave, what we should think and how we should live to be “happy.” It dictates what we “need” to be happy, successful and what it is to lead “meaningful” lives. By now, I’m hoping you recognize that those terms mean something different to each person, and what is considered “meaningful” changes depending on the perspective. For some, the desire to have close, fulfilling relationships is “meaningful”, for others it might be having a successful career with financial security, or for some it might mean reaching a physical goal such as completing a marathon. The thing is, our goals don’t have to be big to be meaningful. So, part of ACT is recognizing that the need to be happy all the time is a myth – it isn’t possible and isn’t really much of a goal. Instead, the focus is on values, and how to live in a way that is closer to our own personal values, without judgment and constant comparison to a society that is trying to tell everyone how to live. There are no real “shoulds.” Figuring out what you want, what you value, what would be

“meaningful” to you is step number one. Then figuring out the behaviours that bring you closer to those values, while allowing the “should” statements to play quietly in the background on the negative radio station is step number two. This next video gives you a little message about the happiness myth. ?

Defining your Values and Goals

Start by taking a look at your life. Let’s pretend we’re doing a before and after ACT documentary on you. What would the camera crew record at present? What would you be doing? How would you be feeling? What would they see? Now let’s imagine you’ve successfully taken steps to quieten and unhook from your negative radio station thoughts and feelings, and you’ve reached your goals and are living a life that is aligned with your values. What would that look like? What would you be doing differently? What would you have stopped doing? What would you have started doing? How will you be treating yourself differently? What people would be in your life? How will you be interacting with the world? In doing this exercise, you start to get a sense of where you’re at in various parts of your life: relationships, meaningful work/school, creative endeavors, etc. and where you want to end up. And now that you have some of that defined, you can start the work to help you get there.

Introducing the Choice Point

So the choice point is an ongoing check-point you can use to help you identify when you’re engaging in thoughts and behaviours that are taking you further away from your values and a fulfilling, meaningful life, or when you’re engaging in thoughts and behaviours that are moving you toward your goals and values. To help you conceptualize this, you can use this diagram:

Behaviours, thoughts Values you want to live by and

and feelings moving you strengths and skills you can use

away from values and goals

Value Consistent: moving toward the life outcome you want, acting effectively, behaving like the person you want to be

Value Inconsistent: moving away from the life outcome you want, acting ineffectively, behaving unlike the person you want to be

Choice Point

So, let’s say we have a person who has been struggling with social anxiety for quite some time. The current thoughts, feelings and behaviours of this person are consistently moving her away from values she wants to live by and the life she wants to lead. First, we ask her to reflect on the documentary crew before and after, asking her to concentrate on “after.” This is how she sees herself leading a full, meaningful life:

I go out with friends on weekends to movies, concerts, and clubs

I go to the bookstore on my own at least once a week

I have a close relationship with my mom

I have a job related to books

I have a long-term partnership with someone

For this person, this currently defines a fulfilling, meaningful life. Now we ask her what she is currently doing to move herself closer to those values.

I’m taking online courses toward an English literature degree

I’m on dating apps to try and meet someone

The items from these two lists would be placed on the right side. Now we ask what behaviours, thoughts, etc. are moving her away from her values list.

I avoid talking to or seeing my mom

I order books online and take all online classes so I don’t have to see anyone

I have a few close friends that come over here for movie nights

I feel like people are always looking at me and judging me to be boring, or ugly

I don’t feel like I have anything to offer anyone

These items would go beside the left arrow. Now we have a current snapshot of what the person values, and things they are currently doing or thinking that are moving them toward or away from their values and the life they want to lead.

A two-fold approach

Now we need to do two things: Help her understand that her thoughts and feelings that are taking her away from her values are “hooking” her, because she is listening to them and giving them power and influence, and to develop some behavioural skills that she can practice that will lead her toward her values. For her, this might include social skills training if she has difficulty starting and maintaining conversations, giving her skills in resolving conflict so that she might find strategies to open up a dialogue with her mother, etc. This goals/skills/training will be added to the right side of the diagram as new behaviours leading her toward her values and the life she wants to lead.

Unhooking from the Negative Radio Station

Often, when people think about “unhooking”, they try to escape or avoid negative thoughts by actively pushing them out of their mind. As you’ve probably experienced, as soon as you try to do this, you’ve given that thought all kinds of power. Taking a step back, try to observe your thoughts as they come up, much like you’re watching some kind of new reality show. Don’t try to stop them, don’t judge them, just label them as “thinking” and observe them from a dispassionate place. If you start to get sucked in by one of them, again, take on the role of observer or witness, and saying, “hmm, I notice that I’m thinking this…” – this puts a little distance between you and the thought. Because ultimately, thoughts come and go – just because they’re there, doesn’t make them true or worthy of being influential or taken seriously. You can ultimately choose which of these thoughts have influence over you and which ones you can readily dismiss as “brain chatter.” Part of the problem with “hooking” is that we identify with all of our thoughts as though they’re real, and this gives them the power to influence our emotional states and our behaviour. So approaching our thoughts from a place of observation and detached curiousity allows us to remove ourselves (or unhook) from their influence. The better we get at doing this, the more time and energy we have to devote to behaviours that commit to our values and the way we want to live our lives. https://www.youtube.com/watch?v=gBT5ExDDwOg

Committing to Values-Based Behaviours

If you look at your values and some of the behaviours you’re already engaging in that are consistent with or moving you toward your values, what other skills or behaviours would be helpful to implement to move you even closer? Are there relationships you need to mend? Are there skill sets (job skills, social skills, skills related to a hobby) that you need to learn? Where could you go to learn those skills? Are there obstacles (financial, emotional, etc.) that get in the way of you acquiring those skills? Are there ways around that? (For example, if you wanted to learn how to do pottery but didn’t have the money to spend on classes, is there a local artist that might let you hang out and watch them and do a little practice at their studio). Are there free groups in your community that help with substance abuse, or social anxiety, or dealing with depression? Can you learn the skill by looking online? For example, I wanted to learn how to make my own soaps, lotions, shampoo, etc. that were free of harmful chemicals, so I used online tutorials and web-sites to learn everything I needed to know about how to do that. It didn’t cost anything – and my first soaps were made from ingredients I already had. Once those successfully sold, I was able to branch out a little more and buy different supplies and expand the inventory. I’m sounding like an infomercial now, so I’ll stop, but the point is, many skills related to your values can be acquired by being creative and reaching out. Start by choosing one or two behaviours you could engage in to get closer to your values, and set a goal to try those. Engage a support network. By unhooking from thoughts that lead you away from your values and committing to behaviours that lead you closer to your values, those thoughts no longer have the ability to control or influence you, resulting in better mental health and a life that is more fulfilling, meaningful and joyful.

Summary

As I mentioned earlier, this is by no means an exhaustive look at acceptance and commitment therapy. I tried to distill the practice down to essential elements to get you started. If you want more information about this technique, there are many web-sites, books and youtube videos devoted to the topic. Just a reminder that there is an assignment attached to this learning unit. ?