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Acceptance & Commitment TherapyINTRODUCTORY Workshop with Russ Harris
PsychologicalFlexibility
Contact With The Present Moment
Defusion
Acceptance Values
Committed Action
Self-as-context
3
Workshop Aims
Theoretical overview Experiential overview Practical Tools Personal Growth Have Fun Inspiration
C B T
BEHAVIOUR→ANTECEDENT → CONSEQUENCE
physical environment
cognitiveinterpersonal
development and learning history
emotionalphysiological
genetic and epigenetic
social and
cultural
Slide courtesy of Jennifer Villatte
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Famous Quotes
Life is spelt H.A.S.S.L.E.—Albert EllisLife is difficult.—M. Scott PeckLife is suffering.—BuddhaMost men lead lives of quiet desperation and
go to the grave with the song still in them. –Henry Thoreau
Shit happens!—Anonymous
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The Big Question:
Why is it so hard to be happy?
PainFrom The Past
FearsAboutThe Future
ProblemsIn ThePresent
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The Challenge We Face
I. Life is difficultII. A full human life = the full
range of emotionsIII. The normal, healthy human
mind naturally amplifies pain
PsychologicalFlexibility
Contact with thePresent Moment
Defusion
Acceptance Values
Committed Action
Self-as-context
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Be Present
Open up Do What Matters
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PsychologicalFlexibility
Contact With The Present Moment
Defusion
Acceptance Values
Committed Action
Self-as-context
Distractibility, DisengagementDisconnection, Dissociation
Fusion with theconceptualised self
Fusion: past, future,reasons, rules, judgments
Experiential Avoidance
Unworkable action
Remoteness fromvalues
PsychologicalRigidity
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What Is Mindfulness?
Paying attention - with flexibility,openness, curiosity, kindness
Mindfulness is not …
MeditationDistractionRelaxationA way to get rid of unwanted thoughts and feelingsBuddhismReligion
How Do I “Sell” Mindfulness?
Don’t!
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Grounding, Centering, & Dropping anchor
Acceptance (expansion, opening up, making room,dropping the struggle)
Defusion
Self-compassion
Accessing the “observing self”
Savouring & appreciating
Observing thoughts
Engaging
Noticing &acknowledgingwhat is present
Narrowing & Broadening focus
Flexiblyshiftingfocus
Sustaining focus,Noticing you’re distracted & refocussing
What’s the point????
For any mindfulness skill, be clear: What is the purpose? Specifically, how will this help the client achieve
her therapy goals?
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Dodgy Language?
“Mindfulness”“Acceptance”“Values”“Self-compassion”
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PsychologicalFlexibility
Contact with thePresent Moment
Defusion
Acceptance Values
Committed Action
Self-as-context
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“WORKABILITY”
Is it working to give youa rich, full and meaningful life?
If yes, keep doing it.
If not, would you consider doing something different?
What works short term to get rid of unpleasant thoughts & feelings, often does not work long term
to give us a rich and full life
Setting Up
Informed consent Press pause Teamwork Freedom to say no
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INFORMED CONSENT• ACT is a very active form of therapy/coaching – not just talking about problems. • Learning skills to handle difficult thoughts and feelings more effectively, so they
have less impact and influence over you• Clarifying your ‘values’: what kind of person you want to be, how you want to
treat yourself and others, what you want to stand for in life, what gives you a sense of meaning or purpose
• Taking action: to solve problems, and do things that make life better• I want you to leave each session with an action plan – something you can do
between sessions to improve your life• NB Modify this as needs – e.g. in grief work, this would sound very different
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What I do that’s ineffective, behaving unlike the person I want to be
AWAY
Situation(s)Thoughts & Feelings
What I do (or want to do) that’s effective,behaving like the person I want to be
TOWARDS
Choice Point 2.0 © Russ Harris, 2016 adapted from the ‘Choice Point’ by Bailey Ciarrochi, Harris 2013
ooChoicePoint
Drawing it by hand …
oo
TowardsAway
Situation(s), Thoughts & Feelings
Choice Point 2.0 © Russ Harris, 2016 adapted from the ‘Choice Point’ by Bailey Ciarrochi, Harris 2013
SituationThoughts & Feelings
AWAY TOWARDS
1. What is (are) the challenging situation(s), thoughts & feelings in your life today?
4. So is it okay if we take some time to explore what matters to you & who you care about – to help figure out your towards moves -and also develop some unhooking skills, so these thoughts and feelings no longer hold you back or pull you off track?
2. When you get hooked by your thoughts & feelings, what kind of “away moves” do you do: acting ineffectively, behaving unlike the person you want to be?
3. What kind of towards moves do you already make or would you like to start making – acting effectively, behaving like the person you want to be?
Choice Point 2.0 © Russ Harris, 2016 adapted from the ‘Choice Point’ by Bailey Ciarrochi, Harris 2013
4 Areas To Explore
ooChoicePoint
2 Questions
Q: 1. What valued direction does the client want to move in?
Q: 2: What is getting in the way?
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So where do I start?
A: What’s the valued direction? -Values clarification -Goal Setting -Committed Action-Skills training
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TOWARDS
Values, Goals, SkillsWhat matters to you? Who do you care about? What do you want to do differently? What skills, values, strengths can you use?
What I want to do that’s effective,behaving like the personI want to be
HELPERS
B: What’s getting in the way?-Fusion => Defusion-Avoidance => Acceptance-Automaticity => Awareness
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AWAYWhat I do that’s ineffective, behaving unlike the person I want to be
Unhooking Skills
Contacting the present momentDefusionAcceptanceSelf-compassionThe “noticing self”
Where to start?
For clients in crisis/panic/dissociative states/overwhelmed by emotions: start with grounding/centering (dropping anchor)For clients with major grief/loss: Start with self-compassionFor the poorly motivated:Values & defusion from hopelessnessFor clients fixated on feeling good and avoiding pain: creative hopelessness
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The Resilience Formula
4 approaches to any problem situation:1. Leave 2. Stay & change what can be changed3. Stay & accept what can’t be changed & live
by your values4. Stay & give up & do stuff that makes it worse
44
PsychologicalFlexibility
Contact With The Present Moment
Defusion
Acceptance Values
Committed Action
Self-as-context
(Copy me) Imagine your hands are your thoughts and feelingsImagine in front of you is everything that matters: the people, places, activities you love
etc (give examples). And also the problems/challenges you need to face/deal with, and the important tasks you need to do. (give examples)
Now (copy me) see what happens when we get all caught up in our thoughts and feelings
Notice 3 things: 1) How much are you missing out on? 2) How disconnected and disengaged are you; how difficult to stay focused, keep your attention on the task? 3) How difficult is it to take action, to do the things that make your life work? (give examples)
Now (copy me) slowly separate from your thoughts & feelingsWhat’s your view of the room like now? How much easier is it to engage and connect;
to keep your attention focused on the task at hand? Move your arms around: how much easier is it to to do the things that make your life work (give examples)
Notice these things (i.e. hands) haven’t disappeared. If you can use them, do so. Many thoughts and feelings give us valuable information we can make good use of. But if you can’t make use of them, just let them sit there.
45
3 Tricky Reactions
- I feel safe behind here- How will that solve my problems?- I can’t do that with my real thoughts &
feelings
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47
48
49
50
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54
‘Cognitive’ Defusion
ACT textbooks emphasise defusion from ‘thoughts’ – including assumptions, attitudes, beliefs, judgments, etc.I personally tend to talk about defusion from ‘thoughts and feelings’ because cognition is such a huge ‘part’ of any emotional response.
55
FEELINGS
THOUGHTS SMELL
TASTE
TOUCHHEAR
SEE
PAINMEMORYFEELINGTHOUGHTSENSATIONURGECRAVINGEMOTIONHALLUCINATIONPAIN
FUSION
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PAIN
SMELL
TASTE
TOUCHHEAR
SEE
FEELINGS
THOUGHTS
SELF-COMPASSION
VALUES & ACTION
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Change the context
Thoughts & feelings function differently in different contexts
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PsychologicalFlexibility
Contact With The Present Moment
Defusion
Acceptance Values
Committed Action
Self-as-context
EXPANSIVE AWARENESS EXERCISE (Dropping anchor/grounding)
• I can see something very painful (e.g. thought/feeling/memory) has just shown up, for you, and I want to help you handle it
• Push your feet hard into the floor• Sit forward in your chair• Push your fingertips together, • As well as this painful thought/feeling/memory, notice your body in
the chair – hands, feet, back • Also look around – notice 5 things you can see• And notice 3 or 4 things you can hear• And also notice you and I, working together• So there is a painful thought/feeling/memory here• And your body in the chair• And a room around you• And you and I working together
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Dropping anchor - notes
Indication: if and when client is so fused that he is unable to effectively engage/participate in the session
If client wants to learn a valuable skill for dealing with dissociation or overwhelm
NB: If therapist uses dropping anchor to try to stop the client crying/ to distract her/ to reduce her anxiety etc, this is a misuse.
The aim is to help the client be present, regain control of his actions, engage, focus.
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Dropping anchor – notes – cont.
Modify script – use anything present (other than the storm itself) – e.g. glass of water, stretching arms, breathing, sound of air con
Goes for as long as needed Repeat as often as needed If client is ready and able to talk, identify the
elements of the storm first. If client is too overwhelmed to speak, just go
into the exercise. Debrief it afterwards
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Debrief
Do you notice any difference? Are you less caught up in the storm? Less swept away or pushed around?
Is it easier for you to engage with me, to be present, to focus?
Do you have more control over your actions? (Move your arms and legs – check it out.)
How could this be helpful outside the room? Can we do more of this in our sessions? Would you be willing to practise this?
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Cognitive Defusion
What’s your “I’m not good enough story”? How have you tried to get rid of it? How did that work, long term? Ready to try something different?
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Beliefs?
A ‘belief’ is simply a thought held as ‘true’ ACT does not traditionally classify cognitions
into types: attitudes, assumptions, schemas, core beliefs, automatic thoughts, categories of “dysfunctional thinking” etc..
But you can do this, if desired, for defusion: ‘There’s my schema showing up.’ ‘I’m noticing my core belief’ ‘There’s my mind making an assumption’ ‘I’m noticing “black and white thinking” again’
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Believability versus Fusion
Defusion usually leads to decreases in believability, but not always.
But we can defuse from thoughts even if we continue to believe them 100%, and even if they can never be disputed (e.g. ‘One day I will die’; ‘The plane might crash’)
In 2 RCTs of ACT versus CBT, defusionlead to significantly faster reductions of believability than disputation
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3 steps to defusion – mix & match
Notice Name Neutralise
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Psycho-education Exercises
Pop-up thoughts Lift your arm Delete a memory Make your leg go numb Don’t think about … “Falling in love” metaphor “Polygraph” metaphor Lemons, lemons, lemons
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PsychologicalFlexibility
Contact With The Present Moment
Defusion
Acceptance Values
Committed Action
Self-as-context
Establish Goals For Therapy
How will we know this is working? What will you be doing differently? What will you start/stop, do more/less? How will you treat yourself, others, the world
differently? What areas of life do you want to work on
improving? What relationships would you like to
improve?
These are NOT useful goals:
‘reduce depression’‘reduce anxiety’ ‘increase self-worth or build self-esteem’‘recover from DSM disorder X’‘get over what happened’‘get my old self back’‘feel happy’, ‘feel good’, ‘stop feeling like shit’‘have more confidence/ regain my confidence/ stop doubting myself’‘feel calmer’
(copyright) Russ Harris 2015 www.ImlearningACT.com
What I do that’s ineffective, behaving unlike the person I want to be
AWAY
Situation(s)Thoughts & Feelings
What I do (or want to do) that’s effective,behaving like the person I want to be
TOWARDS
Choice Point 2.0 © Russ Harris, 2016 adapted from the ‘Choice Point’ by Bailey Ciarrochi, Harris 2013
ooChoicePoint
To turn them into useful goals….
If I could wave a magic wand so your difficult thoughts and feelings are no longer an issue, like water off a duck’s back…..What would you stop doing or start doing, do more of or less of? How would you treat yourself, others, life, the world, differently? What goals would you pursue? What activities would you start or resume? What people, places, events, activities, challenges, would you approach, start, resume or contact - rather than avoid or withdraw?
(copyright) Russ Harris 2015 www.ImlearningACT.com
Naming What Matters
What matters to the client: people, places, activities, events, aspects of life, goals, values, desires, needs, and so on; anything the client cares about, considers important? Basically anything that triggers a strong negative reaction in the client – whether that be a person, a place, a problem, an event, a situation, a domain of life, a goal, a desire – is likely to be important.
(copyright) Russ Harris 2015 www.ImlearningACT.com
Naming What Matters
So as we take the history and validate the client’s suffering, we can repeatedly name the things that seem to matter most to the client. For example, if the client is worrying/stressing/complaining about her marriage we might say, “So your marriage really matters to you”
(copyright) Russ Harris 2015 www.ImlearningACT.com
Naming Who Matters?
Who, in your life today, matters to you most? Who is important to you? Who do you care about? Who do you look after, or take care of?Who would you like to care about more? Are there any relationships you’d like to improve, or conflicts you’d like to resolve? Are there any relationships you’d like to start?If our work here could improve just one relationship in your life, who would you pick? How would that relationship improve?
(copyright) Russ Harris 2015 www.ImlearningACT.com
From “What I’ll Stop” to “What I’ll Do Instead”
(copyright) Russ Harris 2015 www.ImlearningACT.com
From “What I can’t do” to “What I can do”If people keep talking about what they can't do any more …"So would you like to be able to do that again?“If “yes”: "Okay. So two things we need to look at then:a) if it's possible to start doing it again and b) if it's not possible to do exactly the same, to find out what was meaningful in doing that and find out if there are other ways to get that same sense of meaning.”
(copyright) Russ Harris 2015 www.ImlearningACT.com
From “What I don’t want to feel” to “Learning to handle feelings more effectively”
If people keep talking about what they DON’T want to feel? “So seems like it’s important to you to learn better ways of handling these difficult thoughts/ feelings/ emotions/ memories?”
(copyright) Russ Harris 2015 www.ImlearningACT.com
“What I DO want to feel”What if people keep talking about what they DO want to feel (e.g. happy, confident, high self-esteem, calm, in love)?“So right now, you don’t feel the way you want to? Can you tell me what kind of difficult thoughts and feelings are showing up for you?”“So seems like it’s important to you to learn better ways of handling these difficult thoughts & feelings?”
(copyright) Russ Harris 2015 www.ImlearningACT.com
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Values ‘Desired qualities of ongoing action’ Heart’s deepest desires for how you want to
behave How you want to treat anyone or anything What kind of person do you want to be? Can usually be said in one or two words
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Goals or Values?
Nurturing, maintaining and caring for my body
Lose 10 kg Get a great job Being helpful, friendly and responsible
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Goals or Values?
Buy a house Being supportive, protective, caring for my
family Get good grades Curiosity, learning, persistence
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Goals or Values?
Being sensual and intimate Have an orgasm Have children Being caring, kind, loving
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Goals or Values?
Win the match Playing enthusiastically, fairly, skillfully Being creative Write a book Why does this distinction matter?
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Trickier: Goals or Values?
Be respected Be respectful Be loved Be loving
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Needs & Values
‘Needs’ = ‘very important goals’ Values are: how I want to behave as I try to get my
needs met how I want to behave when I don’t get my
needs met how I want to behave when I do get my
needs met
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Mind-Reading Machine-What you stand for
-Your personal strengths and qualities
-The role you have played in their life
‘Stepping Stones’ to Values‘Good friend’, ‘Good mother’ etc.StrengthRole modelInspiring Mateship, friendshipHappiness
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Bull’s Eye: Values To GoalsPick a quadrant on the Bull’s Eye & identify 2 or 3 key valuesThen set a values-guided SMART goal for the next weekSpecific, Motivated by values, Adaptive, Realistic, Time-framedA “live person’s goal”0-10: How realistic? If <7, make it smaller/easier
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Bull’s Eye: Values To GoalsIn pairs, stand up and share your goalsBegin with: “Here is my commitment …”Notice what thoughts and feelings show upAfterwards share: a) What unhelpful things did your mind say? b) What uncomfortable feelings showed up in your body?
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I can’t do it because …
I shouldn’t have to do it because …
I shouldn’t do it because …
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PsychologicalFlexibility
Contact With The Present Moment
Defusion
Acceptance Values
Committed Action
Self-as-context
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Self-AcceptanceShe was so caring,
loving, kind. Always there for
me when I needed her!
She had a really high opinion of
herself!
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The Conceptualised Self
Your ‘conceptualised self’ is important and often useful. You wouldn’t want to get rid of it
You may even want to work on developing itBut hold it lightly – it is not you!=>The ‘I am’ exercise
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ACT
RFT
BA
Functional Contextualism
BEHAVIOUR→ANTECEDENT → CONSEQUENCE
physical environment
cognitiveinterpersonal
development and learning history
emotionalphysiological
genetic and epigenetic
social and
cultural
Slide courtesy of Jennifer Villatte
118
A – Antecedents B – Behaviour C- Consequences
C
Situation Thoughts Feelings
Immediate outcomesthat either increase ordecrease the behaviour
If consequences => lNCREASE in behaviour, they are ‘REINFORCING’
Something an organism does
- Public- Private
If consequences => DECREASE in behaviour, they are ‘PUNISHING’
DIFFERENTIAL REINFORCEMENT
POSITIVE REINFORCEMENT – ‘access something you want’NEGATIVE REINFORCEMENT – ‘avoid something you don’t want’
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A – Antecedents B – Behaviour C- Consequences (reinforcing)
Situation Thoughts Feelings
immediate outcomesthat maintain the behaviour
Situation: alone in house at night, tired
Thoughts & Feelings: ‘I have no friends’ ‘I wish I had a social life’Sadness, loneliness,Anxiety, boredomUrge to smoke dope
Feeling of relief; painful thoughts, feelings, urges disappear
Costs:Addiction worsens; stays home more & social isolation increases; more feelings of loneliness and sadness
Smokes marijuana
Present Moment,Defusion,Acceptance
Values & Committed action
Workability
Something an organism does
- Public- Private
‘TRIGGERS’ ‘PAYOFFS’
DIFFERENTIAL REINFORCEMENTOF A MORE WORKABLE BEHAVIOUR
payoffs VS costs
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A – Antecedents B – Behaviour C- Consequences (reinforcing)
Situation Thoughts Feelings
immediate outcomesthat maintain the behaviour
Situation: alone in house at night, tired
Thoughts & Feelings: ‘I have no friends’ ‘I wish I had a social life’Sadness, loneliness,Anxiety, boredomUrge to smoke dope
Painful thoughts, feelings, urges lose some of their impact and influence; switch off ‘automatic pilot’ & get present; experience a sense of greater self-control, more freedom to choose behaviour
Mindfulness(Defusion, acceptance contacting the present)
Something an organism does
- Public- Private
‘TRIGGERS’ ‘PAYOFFS’
DIFFERENTIAL REINFORCEMENTOF A MORE WORKABLE BEHAVIOUR
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A – Antecedents B – Behaviour C- Consequences (reinforcing)
Situation Thoughts Feelings
immediate outcomesthat maintain the behaviour
Situation: Alone in house at night, tired, and mindfully responding to painful thoughts, feelings, urges – defusing & accepting – surfing urges– dropping anchor
Sense of clarity and self-awareness; sense of purpose; making sense of this pain
Connects with values. “This painful loneliness reminds me that what I really want is to be engaging and connecting with my friends.”
Something an organism does
- Public- Private
‘TRIGGERS’ ‘PAYOFFS’
DIFFERENTIAL REINFORCEMENTOF A MORE WORKABLE BEHAVIOUR
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A – Antecedents B – Behaviour C- Consequences (reinforcing)
Situation Thoughts Feelings
immediate outcomesthat maintain the behaviour
Situation: Alone in house at night, tired, and mindfully responding to thoughts and feelings – and in touch with values of engaging and connecting
Feeling of vitality or satisfaction; sense of living by values & moving in a positive life direction; sense of self-empowerment or personal growth
Committed actionPicks up phone, calls a friend, arranges to go over to her house.
Something an organism does
- Public- Private
‘TRIGGERS’ ‘PAYOFFS’
DIFFERENTIAL REINFORCEMENTOF A MORE WORKABLE BEHAVIOUR
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Fusion with thoughts & feelings =>manifests in various ways‘Overwhelmed’, ‘Pushed around’ ,‘Lost in’,
‘Wallowing in’, ‘Consumed by’, ‘Dwelling on’, ‘Controlled by’, ‘Entangled in’, ‘Jerked around by’, ‘In the grip of’, ‘Ruled by’, ‘Dominated by’, ‘Held back’, ‘Pulled down’
Often we try to avoid/ get rid of them:‘Experiental avoidance’
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Higher Experiential Avoidance
–Higher anxiety levels–More depression –Drug and alcohol addiction–More overall pathology –Poorer work performance –Inability to learn–Lower quality of life –Long term disability
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Drop the struggle with itMake room for it/ give it spaceExpand around itOpen upLet it flow through youHold it gently/lightly/softly/kindlyBreathe into itLet it be/Allow itSit with itSoften up/loosen up around itWilling to have itLean into it
“Acceptance” – not a good word!
But why accept pain?
Pushing Away Paper
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(Copy me) Imagine this paper is all your difficult thoughts and feelingsImagine in front of you is everything that matters: the people, places, activities you love
etc. And also all the problems/challenges you need to solve/tackle, and the important tasks you need to do
Now push these thoughts and feelings away from you, hard as you canNotice 3 things: 1) How tiring is it? 2) How distracting is it; how difficult is it to fully
engage or connect; to stay focused, keep your attention on the task? 3) How difficult is it to take action, to do the things that make your life work? (give examples)
Now rest it on your lap.How much less effort is that? How much easier is it to engage and connect; stay
focused; keep your attention on the task? Move your arms around: how much easier is it now to take action?
Notice your thoughts and feelings (i.e. the paper) haven’t disappeared. But you have a new way of responding to them, so they don’t hold you back or tie you down or stop you engaging in your life. If there’s something useful you can do with them, use them; (thoughts and feelings often give you useful information). But if not, just let them sit there.
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Creative Hopelessness
What have you tried? How has it worked, long term? What has it cost you?
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NAME your feelings
Notice Acknowledge Make room Expand awareness
Self-compassion: 6 Elements1. Contact the present moment: notice & acknowledge your
painful thoughts & feelings 2. Kindness: pursue the value of kindness towards yourself –
(in words, thoughts, imagery & action)3. Defusion: defuse from harsh judgmental self-talk4. Acceptance: open up and make room for painful thoughts
and feelings5. Validation: validate your pain as a normal & natural part of
being human6. Connectedness with others: acknowledging and
empathizing with pain of others; recognizing your commonality; sharing your pain with others
Kindness To Self
Kind self-talk (in both content and tone) Kind imagery Kind self-touch Kind deeds
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What kind of ….?
Pick an important role – e.g. mother, father, son, daughter, therapist, coach
T: What kind of ___ do you want to be? T: Suppose we interviewed one of the
people you interact with in that role, live on national TV, and we say ‘What was he/she like? What were his/her three greatest qualities? How did he/she treat you?’ – if magic could happen, if dreams could come true - what would you like them to answer?
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Values Are Not:
Goals What you want or need from others Rules or commandments, codes of conduct ‘Shoulds’, ‘musts’, obligations
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Are These My Real Values?
The proof of the pudding is in the eating You won’t find out by analyzing and
pondering if these are your real values You will only find out by acting on them, and
noticing what happens when you do so.
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Properties of Values
Here and now Freely chosen Dynamic Evolving Never completed Intrinsically rewarding
139
Properties of Values
Often need prioritising Never need justifying Values ,Virtues & Strengths Pursue vigorously, but hold lightly
Useful Questions For Crisis/Loss
What do you want to stand for in the face of this?
10 years from now, if you were to look back at the way you dealt with this issue, what would you like to say about the way you behaved, the way you handled it, what you stood for?
NB – if client is terminally ill, might be ‘ten weeks’ or ‘ten days’ from now
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More Useful Questions
You are 80 years old, looking back on your life today; complete these sentences:
I spent too much time worrying about ….I did not spend enough time doing things such
as …If I could go back in time to today, what I’d do
differently from today onwards is …
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A Common Reply To Questions About Values:
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I DON’T KNOW!Consider the function of this behaviour
Is it a request for help, due to lack of knowledge?
If so, do briefpsychoeducation, give some examples of values, then do an experiential exercise
A far more common function of ‘I don’t know’:
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A – Antecedents B – Behaviour C- Consequences (reinforcing)
Situation Thoughts Feelings
immediate outcomesthat maintain the behaviour
Situation: therapy/coaching session – being asked about valuesThoughts & Feelings Oh shit!’ ‘I don’t know!’Anxiety, confusion. Urge to change the topic
Says ‘I don’t know’
Present Moment,Defusion,Acceptance
Values & Committed action
Workability
Something an organism does
- Public- Private
‘TRIGGERS’ ‘PAYOFFS’
DIFFERENTIAL REINFORCEMENTOF A MORE WORKABLE BEHAVIOUR
payoffs VS costs
Costs:Fail to clarify values, Fail to set meaningfulGoalsRemain stuck –nothing changes
Conversation endsFeeling of relief; anxiety/confusion disappears
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A – Antecedents B – Behaviour C- Consequences (reinforcing)
Situation Thoughts Feelings
immediate outcomesthat maintain the behaviour
Situation: therapy/coaching session – being asked about valuesThoughts & Feelings Oh shit!’ ‘I don’t know!’Anxiety, confusion. Urge to change the topic
Says ‘I don’t know’
Present Moment,Defusion,Acceptance
Values & Committed action
Workability
Something an organism does
- Public- Private
‘TRIGGERS’ ‘PAYOFFS’
DIFFERENTIAL REINFORCEMENTOF A MORE WORKABLE BEHAVIOUR
payoffs VS costs
Costs:Fail to clarify values, Fail to set meaningfulGoalsRemain stuck –nothing changes
Conversation endsFeeling of relief; anxiety/confusion disappears
Validate: yes, right now, you don’t know. So would you be willing to: Sit with the question a bit longer?Do an exercise? Fill in a worksheet? Do a card sort?
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Clues: Important Domains of Life
What does the client: Complain about? Worry about? Feel strongly about: e.g. feelings of guilt,
sadness, anger, fear, love, joy? Want to have, get, or achieve (i.e. goals)?
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Clues: Important Domains of Life
Explore pain in all its forms: what does this pain tell you really matters?
For suicidal clients: What has stopped you from killing yourself?
If these painful thoughts/feelings/memories were no longer a problem, what would you do differently?
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What Prevents Action?
FEAR Fusion Excessive goals Avoidance of discomfort Remoteness from values
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The Antidote
DARE Defusion Acceptance of discomfort Realistic goals Embracing values
What I do that’s ineffective, behaving unlike the person I want to be
AWAY
Situation(s)Thoughts & Feelings
What I do (or want to do) that’s effective,behaving like the person I want to be
TOWARDS
Choice Point 2.0 © Russ Harris, 2016 adapted from the ‘Choice Point’ by Bailey Ciarrochi, Harris 2013
ooChoicePoint
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The Resilience Formula
4 approaches to any problem situation:1. Leave 2. Stay & change what can be changed3. Stay & accept what can’t be changed & live
by your values4. Stay & give up & do stuff that makes it worse