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Acceptance & Commitment Therapy


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Josue Guadarrama, MA Presentation at 2016 Science of HOPE

Developed within a coherent theoretical and philosophical framework, Acceptance and Commitment Therapy (ACT) is a unique, empirically based psychological intervention that uses acceptance and mindfulness strategies, together with value driven commitment and behavior change strategies, to increase psychological flexibility. ACT uses three broad categories of techniques: mindfulness, including being present in the moment and defusion techniques; acceptance; and commitment to values-based living. Participants in this seminar will learn mindfulness as a way of observing ones experience, in the present moment, without judgment and “defuse,” or distancing oneself from unhelpful thoughts, reactions and sensations. Aside from a didactic approach, there will be video examples, and skill practice. Audience participation is highly encouraged.

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Acceptance & Commitment Therapy

  1. 1. Acceptance Commitment Therapy ACT Josue Guadarrama Washington State University
  2. 2. Reflection – Think about the last time something incredibly painful, hurtful, or stressful happened in your life. – What kind of responses did you get that made you feel truly cared for, supported, accepted, and understood?
  3. 3. Typical Type of Responses – Quoting proverbs at you: “Plenty more fish in the sea,” “Time heals all wounds,” “Every cloud has a silver lining” – Telling you to “think positively” – Asking about your situation but then quickly changing the subject – Giving advice: “What you should do is this,” “Have you thought about doing such and such?” – Trumping your pain: “Oh yes, I’ve been through this many a time myself. Here’s what worked for me.” – Telling you to get over it: “Build a bridge,” “Move on,” “Let it go,” “Isn’t it time you got over this?”
  4. 4. Typical Type of Responses – Discounting your feelings: “No use crying over spilt milk,” “It’s not that bad,” “Cheer up!” “Stiff upper lip” – Telling you your thoughts are irrational or that you do too much negative thinking – Trivializing or diminishing your pain: “Put it into perspective— there are kids starving in Africa.” – Trying to distract you from your pain: “Let’s get drunk!” “Let’s go out and have some fun,” “Let’s eat some chocolate,” or “Let’s watch a movie.”
  5. 5. Typical Type of Responses – Not coming to visit or spend time with you or even actively avoiding you. – Playing “Mr. Fix-it”: Coming up with all sorts of helpful solutions for your problem. – Saying they want to help but not following up – Listening impatiently . – Putting up with or tolerating your distress but not truly accepting it.
  6. 6. Typical Type of Responses – Reassuring you: “It’ll be all right, you’ll see,” “It’s not as bad as you think,” “You’ll get through this.” (Note: Many people see reassurance as a compassionate act—and it can be at times—but the problem is that it easily puts the reassurer in a one-up position, like a parent reassuring a young child.) – How is it to get these responses?
  7. 7. Our Reactions – Feel hurt Irritated Rejected – Invalidated Unappreciated Misunderstood – Offended ??????? – Timing – Preceded by Caring & Empathy – When we are hurting, all us want to feel understood, accepted, and cared for before we are ready to start looking for solutions or strategies
  8. 8. Understood, Accepted, & Cared – Giving you a hug, embrace, or a cuddle – Holding your hand – Placing an arm around you – Validating your pain: “This must be so hard for you” or “I can’t begin to imagine what you’re going through” or “I can see you’re in terrible pain.” – Saying nothing, just sitting with you and allowing you to be – Holding you while you cry or even crying with you – Offering support: “Is there anything I can do to help?”
  9. 9. Understood, Accepted, & Cared – Asking how you feel – Sharing their own reactions: “I’m so sorry,” “I’m so angry,” “I feel so helpless; I wish there was something I could do,” or even “I don’t know what to say” – Creating space for your pain: “Do you want to talk about it?” “It’s okay to cry,” or “We don’t have to talk; I’m happy just to sit here with you” – Giving support unconditionally, such as making dinner for you, or taking care of your kids, or helping you out with your daily tasks – Making the effort to visit and spend some time with you in person
  10. 10. Understood, Accepted, & Cared – Genuinely listening as you tell them about what you’re going through – Saying something like “I’m here for you” and meaning it – These sorts of responses all send the same message: I’m here for you, I care about you, I accept you, I understand you, I see you’re in pain, and I want to help.
  11. 11. Who is the Person in Your Life: – Who can always be there for you, in any moment, no matter what happens? – Who can understand, validate, and empathize with your pain better than anyone else on the planet? – Who can truly know just how much you are suffering?
  12. 12. YOU ARE
  13. 13. TWO ELEMENTS – 1. BUILDING SELF-COMPASSION!! Building a good relationship with ourselves is essential for inner fulfillment, especially when we run into a challenging problem or situation. – 2. BEING PRESENT
  14. 14. Acceptance Commitment Therapy (ACT) – 1. Connecting with the Present Moment (Be Here Now) – 2. Cognitive Defusion (Watch Your Thinking) – 3. Acceptance (Open Up) – 4. Self-as-Context (Pure Awareness or the Thinking-Self) – 5. Values (Know What Matters) – 6. Committed Action (Do What It Takes)
  15. 15. 1. Connecting w/the Present Moment (Be Here Now) – Present means: consciously connecting with and engaging in whatever is happening in this moment. Here-and-now experience. – Humans find it very hard to stay present, absorbed in the past or the future* – It is easy to get caught up in our thoughts and lose touch with the world around us. – Most of the time we tend to operate on automatic pilot, merely “going through the motions.” – Awareness to either the physical world around us or the psychological world within us, or to both simultaneously.
  16. 16. Why be Present? (Be Here Now) 3 Main Reasons – To truly appreciate the richness and fullness of life, you have to be here while it’s happening!* – The power to act exists only in this moment – To act effectively Happening, Reacting, & how we wish to respond
  17. 17. Being Present Involves Connecting – Paying full attention, with openness & curiosity – Connection is essential for effective action. – The more we get entangled in our thoughts, the less attention we pay.
  18. 18. Getting Disconnected from the Present – The more we focus on unpleasant thoughts and feelings, the more we disconnect from the present moment. – The Not Good Enough Story (NGE) – The Past – Replay old hurts and disappointments, – We relive old losses and grievances, – We reignite old resentments and ancient grudges, and – We stew over painful events that can never be undone.
  19. 19. The Not Good Enough Story (NGE) – The Future – We see all sorts of scary scenarios, things that might and could go horribly wrong. – We get bogged down in fears, worries, and anxieties: – Fear of failure, fear of rejection, – Fear of getting old or sick, fear of screwing up the kids, – Fear of loneliness or poverty or injury, or – Fear of the uncertain and the unknown.
  20. 20. ACT Exercise 1. Connecting w/the Present Moment (Be Here Now)
  21. 21. 2. Cognitive Defusion (Watch Your Thinking) – Defusion means learning to “step back” and separate or detach from our thoughts, images, and memories. – We watch our thinking instead of getting tangled up in it. – We see our thoughts for what they are—nothing more or less than words or pictures. – What is Fusion? – A thought & the thing it refers to—the story and the event— become stuck together, as one.
  22. 22. What is Fusion? – We become fused with our thoughts. – Thoughts may seem to be the absolute truth, or – Commands we must obey, or – Threats we must eliminate, or – Something we have to give all our attention to
  23. 23. What is Fusion? – When we defuse from our thoughts, they lose all their power over us. – Negative stories are not seen as a problem or the enemy in their own right.* – The aim is to increase our self-awareness & acting. – Whether a thought is true is not that important. – Suppose you are making some serious mistakes in your work
  24. 24. Thought Discernment – Does it help me to be the person I want to be? – Does it help me to build the sort of relationships I’d like? – Does it help me to connect with what I truly value? – Does it help me, in the long term, to create a rich, full, and meaningful life?
  25. 25. Cognitive Defusion – Control Strategy Vs. Acceptance Strategy – Acceptance: uncomfortable thoughts and feelings* – Stop the struggle & refocus on something useful – Defusion means we separate from our thoughts – Thoughts may or may not be true – Step back from our thoughts & disentangle ourselves from them* – If our thoughts are helpful then we make good use of them
  26. 26. Cognitive Defusion Paradox – The aim of defusion is not to get rid of unpleasant thoughts, but rather to see them for what they are—just words—and to let go of struggling with them – Helpful We Use; Unhelpful We Defuse
  27. 27. ACT Exercise 2. Cognitive Defusion (Watch Your Thinking)
  28. 28. Cognitive Defusion Name & Label Your Thoughts – For example, we could silently say to ourselves, “Thinking” – Naming the process of thinking helps us to separate a little from all those words—to step back and get a little distance – The & Story – Create a distance by producing a title that begins with the word “The” and ends with the word “Story,” for example, – “The ‘My Life Is Over’ Story” or – “The ‘Old and Lonely’ Story.”
  29. 29. 2. Cognitive Defusion (Watch Your Thinking) More Practice
  30. 30. 3. Acceptance (Open Up) – Acceptance means opening up and making room for painful feelings, sensations, urges, and emotions. – We drop the struggle with them, give them some breathing space, and allow them to be as they are. – This doesn’t mean liking, wanting, or holding them – Fighting or avoiding our feelings does not create room for them; expansion does.
  31. 31. 3. Acceptance (Open Up) Observing-Self – In practicing expansion connect with our emotions through the observing self. – This enables us to experience our emotions directly, to see them as they actually are, rather than as the thinking-self claims they are. – View negative emotions for what they are: relatively small and harmless (even if they’re ugly) Thinking-Self – Views negative emotions as giants, and dangerous demons that must avoided
  32. 32. 3. Acceptance (Open Up) When We Take a Look We Learn that: – it is not as big as it seems—that we can make room for it. – it cannot harm us, even though it feels unpleasant. – it cannot control our arms and legs, even though it may make us shiver and shake. – there is no need to run and hide from it, nor to fight and struggle with it.
  33. 33. ACT Exercise 3. Acceptance (Open Up)
  34. 34. The story Line Defusion – A bunch of words & pictures inside our head: – beliefs, ideas, – assumptions, reasons, – judgments, impressions, – images, memories, – & interpretations, What Our Body Senses Expansion – All the different feelings and sensations inside our body. – We observe the negative feelings and sensations and make room for them. 5. Self-as-Context Two major components
  35. 35. 5. Self-as-Context Qualities of the Observing-Self – Can’t be judged as good or bad, right or wrong, because all it does is observe. – Sees things as they are, without judging, criticizing, or doing any of the other thinking processes that set us up for a struggle with reality. – Therefore, it gives acceptance in its truest, purest form.
  36. 36. ACT Exercise 4. Self-as-Context
  37. 37. 5. Values (Know What Matters) – Deep in your heart, what do you want your life to be about? – What do you want to stand for as you use your time on this planet? – What do you want to do with your brief time on this planet? – What truly matters to you in the big picture? – What sort of personal qualities do you want to cultivate? – How do you want to behave toward yourself, others, and the world around you? – What personal qualities do you want to cultivate?
  38. 38. 5. Values (Know What Matters) – Purpose gives our life direction, and presence allows us to make the most of our journey. – Values are about how you want to behave – Values describe how we want to behave on an ongoing basis. – Are your “chosen life directions.” – Values are like a compass because they give us direction and guide our ongoing journey. – Help us find vitality through meaningful action despite all the pain.
  39. 39. 6. Committed Action (Do What It Takes) – Taking effective action, guided by our values. – Committed action means “doing what it takes” to live by our values even if that brings up pain and discomfort.
  40. 40. ACT Exercise Self-Compassion
  41. 41. Thank You Josue Guadarrama Go Cougs