ACT to Improve the Relationship with Ourselves

Written by Paul Paris, Ph.D.

Doesn’t it seem like certain problems in life never go away? Or, if anything, they seem to get worse? Do you suffer from chronic depression, anxiety, feelings of inadequacy…those unpleasant experiences that become even more frustrating when nothing you’ve done seems to help?

When such problems do not go away, even with therapy, I call this the “Russian Doll” effect. We get this effect when a negative experience is amplified by negative feelings, thoughts, or actions around our inability to reduce or remove that experience. For example, in chronic depression, individuals become discouraged with themselves for their inability to break the cycle of depression, which makes them feel even more depressed. Layers of suffering build on one another. As a therapist, I see guilt and shame as common emotions associated with this dynamic.

Interestingly, the effort to change or remove these uncomfortable inner experiences is what may maintain or worsen the problem. Like being thrown into the deep end of a pool when I’m not a good swimmer, I thrash around trying to keep my head above water. The more I thrash the more exhausted I get and the more I feel myself sinking. What if I were to stop thrashing and relax my body so that I can float instead of swim? Letting go to “go with the flow” can be more helpful than continuing the struggle.

This is a main principle of ACT, or Acceptance and Commitment Therapy.^[1] Changing the relationship we have with our problem rather than changing the problem is a tool toward living a better life with less suffering. Because the purpose of emotions is adaptive; their function is to move us towards action after notifying us that something is wrong. In the case of positive emotions such as contentment, their function is to notify us that something is right. However, when we get stuck in negative emotions, especially when nothing we’ve tried changes them, to “float” is often better than to thrash around trying to keep our heads above water.

Components of ACT that may help break the cycle of chronic suffering: ^[2]

• Cognitive Defusion defines the idea that part of chronic problems become “fused” with our thoughts and feelings, that is, that we tend to forget a thought is just a thought, and a feeling is just a feeling. The thought or feeling may be so strong or compelling that we act on them because we become part of them. It’s like the ocean steering a ship as the ship becomes one with the currents and waves. When an unpleasant thought or emotion arises, tell yourself “It’s just a thought” or “It’s just an emotion,” then observe it as it ebbs and flows in your awareness.
• Self-as-Process or Context suggests that not only can we become fused with our thoughts or emotions, we can become fused with our “conceptualized self,” the idea that our perceived attributes or achievements, or lack thereof, are part of our “true” self. We are often more dynamic and complex than we realize. (This is self-as-process.) At a deeper level, we can forget the connection to our own consciousness or awareness as an “observing self.” (This is self-context.) We might reconnect with the deeper aspects of ourselves by imagining ourselves as an unbreakable container or vessel for life experience rather than being that experience. We might say to ourselves, “I’ve had depressing experiences but I am not a depressed person.”
• Committed Action reveals the most important aspect of ACT. My view of therapy’s goal is to live a meaningful, fulfilling life despite the painful experiences we may have. Examples: the person with stage fright who delivers an important speech despite their anxiety; the depressed person who gets out of bed and showers despite the lethargic sensation, sad mood, and thoughts to just stay in bed. This is often the toughest step to take, but can be the most rewarding.

Other ACTions to try that can help reduce suffering include:

• Use your five senses to anchor yourself to the present moment for about one minute per day. This can be as simple as paying attention to your breath coming in and out of your body, or feeling the weight of gravity on your body in its current position.
• Pay attention to the language of your thoughts. For example, it’s amazing how subtle “should” thoughts and “I am…” verses “I feel…” can change the content of our thoughts in potentially negative ways. Try to notice how language affects your emotions and physical sensations. Journaling can be a helpful practice to explore this further.
• Clarify your values as best you can. This can help lead to a more fulfilling life experience. Some people find it’s helpful to write their own eulogy or epitaph, or write down what they think others might say at a lifetime achievement award ceremony for you.
• If you are dealing with a difficult life situation, write down the pros and cons of addressing a particular course of action verses not addressing it. This can help clarify not only the course of action itself, but the potential benefits and barriers involved, so that you are better prepared for it. Allow yourself to think and feel however you want, while focusing on the reasons for your decision, and then do your best to follow-through on that action.

ACT is unique in that it focuses on changing how you relate to life experiences for reducing suffering rather than reducing the symptoms of suffering such as depression. In fact, research shows that symptoms reduce in severity over time. So if you just can’t seem to let go, if you’ve tried everything you can think of to address a problem and just can’t seem to address it effectively or the problem continues over a long period of time, an ACT approach may be right for you.

For more information about ACT, I recommend visiting the Association for Contextual Behavioral Sciences (ACBS) website at https://contextualscience.org/.

^[1] Developed by Stephen Hayes. Specific ACT content herein is based upon his work and development of the therapy.

^[2] Acknowledgement goes to both Hayes and Daniel Moran for developing elaborating upon the clinical application of these facets.

Image: Guillaume Seguin on flickr and reproduced under Creative Commons 2.0