A quick (oops! long) observation on using ACT

The last few weeks and months I’ve been starting to work with people using some of the ACT approach.  For those of you who are unfamiliar with ACT, it involves

• developing an awareness that what we think and feel is not who we are,
• that if we are open to experiences (even negative ones) they seem to be less distressing,
• that being present in the ‘here and now’ helps us to live fully,
• and by being committed to doing what it takes to live out our values in the real world

we will be more able to have the life we really want.

This site gives you some great information on ACT (Thanks to Russ Harris, who wrote one of the books on ACT that I’ve found exceptionally helpful ‘Act Made Simple’ published by Harbinger Press)

Anyway, back to what I’ve been learning.  One of the major differences I’ve noticed is the pace at which I work using ACT. It’s an experiential process and to experience means being present.  So there is much less talking in the sessions I’ve been taking.  Much more emotional content – for both the person I’m working with, and myself.  There is more silence.  I’d noticed that in ‘typical’ CBT sessions I’d been skirting around intense feelings, especially sadness.  In ACT it’s so much easier to allow those precious moments to be there.  This is an incredible privilege.

And by working in this way, people are more able to access what they really value and how much they want to live a life where these incredibly important things are honoured.  To be present with a man’s sadness when he acknowledges how he has avoided showing vulnerability and disappeared into ‘the shed’ during pain flare-ups, violating his values because of the way his mind has been telling him that it’s ‘not OK to be weak in front of the kids’.  It is profoundly affecting to hear this man say how much he wants to be a good Dad, to be there for his kids – and how willing he is to experience difficult thoughts and emotions to make the commitment to act according to these values, one step at a time.

Someone yesterday said that ‘Acceptance is a process’. I couldn’t agree more.  In fact I worry when people say to me ‘Oh I’ve accepted my pain’ – I feel uneasy because living truly with pain is an ongoing process of being willing to do what it takes to live the values that are important. And that’s not a singular action.  I don’t think you can tick it off a list and say ‘Now I’ve done acceptance’ – it’s about being willing to bring the pain (or any other negative experience) with you on the journey towards the values that are important.

Because ACT is experiential, these moments have long-lasting impact on people. I caught up with someone I’d been working with some months ago who reminded me of a session in which we’d discussed what it was like for them as a child.  One of the metaphors I’d used for working with her thoughts was of dropping ‘Poohsticks‘ in the stream she’d described in her back yard.

When I was a kid, my grandparents had a big old homestead on three sections – two of the sections were orchard and were ‘over the creek’, and there was a wooden bridge built over the creek and yes, I used to play Poohsticks there.  If you don’t know Poohsticks, it involves dropping a leaf or twig on one side of the bridge then racing to the other side to see if it comes out – if you’re with someone else, then you each drop a twig and run to the other side to see who wins.  Such fun!

The image we used for thoughts was to recognise the thoughts then place them on the twig and drop them over the side of the bridge and into the creek.  The thoughts then float off down the creek, swirling and drifting as thoughts do.

This woman told me how she’d used this image when going off to sleep to not only allow her thoughts to be present and then drift away, but also to remind herself of the fun she’d had then of letting go to ‘see what happened’.  When she was a child, this was a releasing, exciting, freeing experience – but at times it was frustrating and irritating when the twigs got caught up in rocks or other debris.  She was able to be present to both these emotions when her mind was thinking thoughts about her pain – and she found this had been a turning point to starting to think about what had been important to her as a child, and how she could as an adult take action to live those things now.

Someone challenged me about whether I was prepared only to help people cope with pain, or whether I would also try to address the pain itself.  I’ve been pondering this for quite a while now and so far this is where I’ve got.

Life has both happy and sad in it.  I think one reason, paradoxically, we have so much unhappiness around us is that our culture (at least, my Western culture) promotes the idea that we must be happy to be fulfilled. When we’re disappointed or fail at something, or have a sad event happen, we end up with a double whammy of both the sad event AND the judgement that we must either pass through it quickly (lest the sadness turn into depression) or we must resist it and defend ourselves (and be energised and angry to do so).  If we don’t manage to defend or whip through it we end up with ANOTHER whammy of guilt that we’ve failed to ‘get over it’.

Does this mean that we’re ill-prepared to recognise that no emotion lasts forever? Both sadness and joy are transient – in seeking permanent happiness, but failing to retain it, are we training ourselves to fear both?  So perhaps learning that being present to the whole range of emotions allows the freedom of being able to carry on with what is important and valuable and is a good thing for everyone…

I also recognise that our fabulous brain and central nervous system contain all that makes us human. The way our nervous system works means that these psychological and experiential process have a neurobiological substrate. I don’t believe there is a ‘spirit’ or etheric ‘other’ that infuses my blood, bone, muscle and tissue.   I think that it’s far more likely that our sense of ‘spirit’ is a product of this awesome body that we are.  So I consider that by helping people learn to be ‘psychologically flexible’ I am probably changing the central nervous system.  From top down rather than bottom up.  And this might be just as powerful at changing our experience as bottom up, or outward in.  Imagine what it would be like if we could integrate both!

I’m not a hands-on therapist.  I have the privilege and responsibility of helping people sift through what is important to them and how they can get on and live these values.  In the end it’s up to them to do the things they want.  I think it’s just great that as a team working together we can help people be who they want to be.