Developing Meaning and Purpose with ACT

Acceptance and Commitment
Therapy Skills
Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC
Executive Director, AllCEUs
AllCEUs.com Unlimited CEUs $59 | Specialty Certificates $89 | Live Webinars $5

Objectives
 The Goal of ACT
 What is Mindfulness?
 How Does ACT Differ from Other Mindfulness-based
Approaches?
 What is Unique to Act?
 Destructive Normality
 Experiential Avoidance
 Therapeutic Interventions
 Confronting the Agenda
 Control is the Problem, Not the Solution
 Six Core Principles of ACT

Why I Care/How It Impacts
Recovery
 "You can't stop the waves, but you can learn
to surf" Kabat-Zinn 2004
 Distracting oneself from distress is akin to
constantly running away from one’s shadow.
In the attempt to control the negative
thoughts and feelings, one is at a loss for
control in other life situations.

ACT Acronym
 Accept your reactions and be present
 Choose a valued direction
 Take action

Overview
 ACT is based on relational frame theory (RFT)
 a psychological theory of human language.
 developed largely through the efforts of Steven C.
Hayes of University of Nevada, Reno and Dermot
Barnes-Holmes of National University of Ireland,
Maynooth.
 Relational frame theory argues that the
building block of higher cognition (reasoning)
is 'relating', i.e. the human ability to create
links between things.

Overview
 Contextualists seek to understand the
complexity and richness of a whole event
through appreciation of its participants and
features.
 Functional contextualism emphasizes:
 Humans learn language (i.e., communication)
through interactions with the environment
 We must focus on changeable variables in the
context in which these events occur in order create
general rules to predict and influence psychological
events such as thoughts, feelings, and behaviors.

The Goal of ACT
 The goal of ACT is to create a rich and
meaningful life, while accepting the pain that
inevitably goes with it.
 Who is important?
 What is important to me? (Values, things,
experiences)
 How can I move toward those goals?
 “ACT” is a good abbreviation, because this
therapy is about taking effective action guided
by our deepest values and in which we are
fully present and engaged.

What is Mindfulness?
 “Consciously bringing awareness to your here-
and-now experience with openness, interest
and receptiveness.
 Facets to mindfulness
 Living in the present moment
 Engaging fully in what you are doing rather than
“getting lost” in your thoughts
 Allowing your feelings to be as they are, rather than
trying to control them
 Mindfulness does not require meditation

What is Mindfulness?
 Mindfulness skills are “divided” into four
subsets:
 Acceptance
 Cognitive diffusion
 Contact with the present moment
 The Observing Self

How Does ACT Differ
 ACT can be used in a wide range of clinical
populations and settings
 Not manualized
 ACT allows the therapist to create and
individualize their own mindfulness
techniques, or even to co-create them with
clients.

What is Unique to Act?
 ACT does not have symptom reduction as a goal.
 The ongoing attempt to get rid of “symptoms”
actually creates a clinical disorder
 Private experience is labeled a symptom  a struggle with
the symptom
 A “symptom” is by definition something “pathological” and
something we should try to get rid of.
 In ACT, the aim is to transform our relationship with
our difficult thoughts and feelings, learn to perceive
them as harmless, even if uncomfortable, transient
psychological events.

Destructive Normality
 ACT assumes that the psychological processes of a
normal human mind are often destructive, and
create psychological suffering for us all, sooner or
later.
 ACT postulates that the root of this suffering is
human language itself.
 Memories/perceptions/schemas are created
through analyzing, comparing, evaluating, planning,
remembering, visualizing—and all of these
processes rely on human language.
 I am stupid vs. I have the thought that I am stupid
 I cannot go on vs. I am feeling like I cannot go on

Experiential Avoidance
 ACT asserts that human language naturally creates
psychological suffering by setting us up for a struggle with
our thoughts and feelings, through experiential avoidance.
 Problem = something we don't want.
 Solution = figure out how to get rid of it, or avoid it.
 The more time and energy we spend trying to avoid or get
rid of unwanted private experiences, the more we are
likely to suffer “Quicksand”
 Addiction
 Anxiety
 Depression

Experiential Avoidance
 The ACT interventions focus around two
main processes:
 Developing acceptance of unwanted private
experiences which are out of personal control.
 Commitment and action toward living a valued
life.

First Step: Confronting the Agenda
 The client's agenda of emotional control is
gently and respectfully undermined
 Clients identify the ways they have tried to
get rid of or avoid unwanted private
experiences. (Creative hopelessness)
 They are then asked to assess for each method:
“Did this reduce your symptoms in the long term?
What did this strategy cost you in terms of time,
energy, health, vitality, relationships?
Did it bring you closer to the life you want?”

Confronting the Agenda
 Control is the Problem, Not the Solution
 Clean Discomfort: When emotions and
reactions are accepted, it leads to a natural
level of physical and emotional discomfort
 Dirty Discomfort: Once we start struggling with
it, your “struggle switch is turned on” and
discomfort increases rapidly.
 Struggle switch is like an emotional amplifier—switch
it on, and we can have anger about our anxiety,
anxiety about our anger, depression about our
depression, or guilt about our guilt.

Six Core Principles of ACT
 Once the emotional control agenda is
undermined, we then introduce the six core
principles of ACT to help clients develop
psychological flexibility:
 Diffusion
 Acceptance
 Contact with the present moment
 Values
 Committed action

Cognitive Diffusion
 Learning to perceive thoughts, images, and
memories as bits of language, and pictures—as
opposed to what they can appear to be—
threatening events, objective truths
 Cognitive diffusion means “stepping back” and
recognizing that thoughts are just transient
private (subjective) events
 DARE-ing to separate yourself from your
thoughts and FEARs

Unhooking/Diffusion
 FEARs
 F = Fusion
 E = Excessive goals (your goal is too big, or you
lack the skills or resources)
 A = Avoidance of discomfort (unwillingness to
make room for the discomfort)
 R = Remoteness from values
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Unhooking/Diffusion
 The antidote to F.E.A.R. is D.A.R.E.
 D = Diffusion
I am having the thought that…
I am having feelings of…
My behaviors were…
 A = Acceptance of discomfort
 R = Realistic goals
 E = Embracing values
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Diffusion Activity
 Here’s a simple exercise in cognitive diffusion for
yourself:
 Think of a negative self-judgment that takes the form “I
am X” such as “I’m stupid.” Think about it. Believe it as
much as you can. Notice how it affects you.
 Now insert the phrase “I’m having the thought that….” in
front of “I am X.” Think about it. Notice what happens.
 In step 2, most people notice a “distance” from the thought, such that it has much less
impact. Notice there has been no effort to get rid of the thought, nor to change it. Instead
the relationship with the thought has changed—it can be seen as just words.

Other Diffusion Techniques
 ‘The Mind” Treat “the mind” as an
external event; almost as a separate person
 Thoughts are not causes “Is it possible to
think that thought, as a thought, AND do
x?”
 Who is in charge here? Treat thoughts as
bullies
 OK, you are right. Now what?

Acceptance
 Make room for unpleasant feelings, sensations, urges, and other
private experiences
 Allow them to come and go without struggling with them, or
giving them undue attention.
 Thoughts/feelings don’t always lead to action
 Identify the problem: When we battle with our inner
experience, it distracts and derails us.
 Explore effects of avoidance. Has it worked in your life?
 Define the problem. What you struggle against = barriers
toward heading in the direction of your goals
 The Serenity Prayer: Change what you can, accept what you
can’t.

Contact with the Present Moment
 Bringing full awareness to your here-and-now
experience, with openness, interest, and
receptiveness; focusing on, and engaging fully in
whatever you are doing.
 How do I feel
 What am I thinking
 What physical sensations am I experiencing
 Describe the environment—smell, temperature, colors,
objects, people, sounds, etc…
 I (see, hear, smell) ______ It reminds me of _____

Contact with the Present Moment
 Accessing a continuity of consciousness that is
unchanging, ever-present, and impervious to
harm.
 From this perspective, it is possible to experience
directly that you are not your thoughts, feelings,
memories, urges, sensations, images, roles, or
physical body.
These phenomena change constantly and are
peripheral aspects of you, but they are not the
essence of who you are.

Values
 Clarifying
 What is most important, deep in your heart
 What sort of person you want to be
 What is significant and meaningful to you
 What you want to stand for in this life
 A lack of values or a confusion of goals
with values can underlie the inability to
be psychologically flexible.

Values
 The next step in the ACT process is
 Choose a direction
 Identifying motivating values
 Establish a willingness to regain control of life,
not necessarily just to control thoughts and
feelings.

Committed Action
 Setting goals, guided by your values, and
taking effective action to achieve them.

Toward my
goals & values
Away from my
goals & values
Behaviors & 5 sense
experiencing (observable)
Thoughts, Emotions and
Internal (mind) experiences
• What do I do that moves me away
from discomfort?
• How is this moving me away from
my goals or values?
• What am I thinking or emotionally
experiencing right now that is
moving me away from my goals or
values?
• Fear, Depression, Helplessness,
Hopelessness, Anger, Self-Doubt,
Shame
• What could I do to move me
toward who and what is important
to me?
• What am I doing right now that is
moving me TOWARD my goals or
values?
• What am I thinking or emotionally
experiencing that is moving me
TOWARD my goals or values?
• Accomplishment, success,
happiness

Summary
 The goal of ACT is to create a rich and meaningful life, while
accepting the pain that inevitably goes with it
 Being aware and present in the moment
 Destructive Normality the psychological processes of a normal
human mind are often destructive, and create psychological
suffering. “This is depressing. I am helpless”
 Actions designed to avoid the experience in the present
 Therapeutic Interventions focus around two main processes:
 Developing acceptance of unwanted private experiences which are out of
personal control.
 Commitment and action toward living a valued life.

Summary
 Confronting the Agenda (to eliminate distress)
 Explore sources of distress
 Explore prior attempts at removing distress
 Explore effectiveness
 In the short and long term
 Specific to the problem and other areas of life
 Six Core Principles of ACT
 Diffusion– Separate self from feelings/experience
 Acceptance—Accept what is
 Contact with the present moment– Mindfulness
 The Observing Self– Fly on the wall
 Values Identification
 Committed Action

Developing Meaning and Purpose with ACT

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