ACT Matrix | A Cognitive Behavioral Tool to Address Anxiety and Depression

This episode was pre recorded as part of a live continuing education webinar on demand. CEUs are still available for this presentation through all CEUs. Register@Allce.com Counselortoolbox you I'd like to welcome everybody to today's presentation. The Act Matrix. What every Counselor Should Know over the next hour, we're going to talk about something called the ACT Matrix. And this is based on ACT Acceptance and Commitment therapy. But we're not really going to go real deep into act. There are other courses on that. I will be doing more courses in the future on that. Really what we're focusing on today is this particular tool and how we can use it to help clients kind of get unstuck or to keep that forward momentum going. We will review some of the main points of acceptance and commitment therapy. We'll review how to apply the ACT Matrix. And if you weren't here, I did say before the presentation it's helpful if you have some sort of piece of scrap paper that you can kind of go through this with me. You don't need a lot of room, half a sheet of paper, sticky note, something that'll be fine. And then we will identify the shortcut question. And this is the question that I give to my clients. And I say, if you can't sit down and go through the whole matrix and really think it out, keep this one question in your mind every time a situation arises before you act. So the main principles of Acceptance and Commitment therapy are to create a rich and meaningful life while accepting that pain is inevitable. We're going to hurt. You're going to wake up some mornings and you're going to be like, oh, I slept wrong. You're going to have pain in your joints. You're going to have, you know, aches and this sort of thing. But we're also going to have emotional pain that goes along with living. One of the phrases that a lot of my clients will kind of recount in early recovery is one of the greatest things about recovery is I get to feel feelings again. And one of the worst things about recovery is I have to feel feelings again. Because feelings can be painful. It doesn't mean that they're overwhelming. It doesn't mean that they are going to suffocate or hurt a person. But they can be unpleasant. We want to help people transform their relationship with difficult thoughts and feelings instead of trying to fight against them most of the time. They've probably found when they try to fight against them, it's a losing battle. Kind of like taking A look at you and go, whatever, I'm going to do it anyway. We don't want to fight with these feelings. It's going to be a power struggle and generally we lose. We want to learn to perceive our thoughts and feelings as harmless, although they may be uncomfortable, transient events. It's not going to kill us to feel angry. It sucks in the moment, don't get me wrong. But we can deal with it. And we've gotten angry before and it hasn't overwhelmed us, it hasn't overtaken us. And we can let it come and go, that ebb and flow like we talked about with the waves. And we want to take effective action guided by deepest values in which you are fully present and engaged. So what does that mean? That means you only have so much energy. It's like saying you've got a gallon of gas to get to your destination and you've got to choose. Are you going to follow Google's direction for the most effective route or fastest route? Or are you going to go off roading and stop at all these tourist attractions and everything? And which may end up meaning that you don't ever get to your destination. It may draw you further away from your destination. So we want people to figure out, how am I going to use my energy? Is this worth my energy? We talk about experiential avoidance and there's a whole metaphor for getting out of quicksand that's really appropriate to emotional distress. And I'm not going to go into it here, but you know, you can think about the fact that with quicksand, the more you struggle, the deeper you sink. And instead if you relax and kind of let your legs float to the top, you'll be able to roll out of it. So the more time and energy we spend trying to avoid or get rid of unwanted feelings in general, the more we are likely to suffer quicksand. If I wake up in the morning and you know I've got depression and I'm fighting against, I don't want to be depressed anymore and I fight against that. What happens if I'm looking at depression in general as this overarching all the time thing and I want it to go away all the time, I'm probably going to set myself up for frustration. What we want to start looking at is the context and we're going to get there. But emotional quicksand can be like anxiety, a fear that things won't get better. Well, when you fear things aren't going to get better, then what are you looking for? What are you on the. What are you going to pay attention to? Things that fulfill that idea that things aren't getting better. Instead of the few things that did happen to go better, you know it's not going to change overnight, but a few things got better. Anger. You can get angry about your anger and frustration that things aren't getting better fast enough because you wanted it to be better yesterday, thank you very much. And depression, hopelessness and helplessness can kick in and a resignation that things can't get better if you're stuck on focusing on eliminating something instead of focusing on what are we doing, instead focusing on adding, focusing on what are our goals and values and how am I using my energy to get towards those instead of using a lot of energy to run away from or avoid something painful. So control is the problem, not the solution. The more you try to control your depression, the more you try to control your drinking, the more you try to control whatever this symptom is, the less successful you're likely going to be. So in act, they talk about clean and dirty discomfort. Clean discomfort is when emotions and reactions are accepted and it leads to a natural level of physical and emotional discomfort. Something happens, your body goes threat. We're going to have that fight or flee reaction. We're going to have some sort of uncomfortable emotion. But then you can let that emotion go out. You can just let feelings come and go. You don't have to act on everyone. Dirty discomfort is when you start struggling with it. You get angry and you're like, oh, I'm going to do something about that. And you start struggling with being angry and trying to fix being angry. So your discomfort increases rapidly. They liken it to a struggle switch or being an emotional amplifier. If you switch it on, you can get angry about the fact that you're anxious. You can get anxious about the fact that you're always angry. You can get depressed about the fact that nothing seems to get better and you're always depressed. Or you can feel guilty about the fact that you have guilt and you're depressed. So we don't want to get stuck in these negative emotions. Negative emotions kind of keep us stuck. So what do we do about it? Well, the first thing is to recognize that we learn language through interactions with our environment. When my son was little. And if you've had kids, you've done this. When they get upset, we usually label it, you're sad or I'm sorry that hurt your feelings, or I can see you're angry. Let's talk about it. I Remember there was one day we were walking through, I brought my son to work. For some reason I was checking on something and he was about two and a half. And we're walking down the hall and out of the clear blue he just looks at me, goes mommy, I so angry. And I was like, okay, well let's talk about that. But he knew the physical sensations and the non verbals to put with the feeling that he was feeling. And at this point I don't remember what he was angry about, but he was able to label that. We learn to label our feelings when we're growing up. It doesn't mean they're good or bad. It doesn't just are. And anger and fear are two sides of fight or flight. That's our threat response. That's our brain going, there's a problem, I think there's a problem. And you either need to get rid of it or get out of there. It's a natural emotion. And you say, thank you very much Mr. Brain, let me figure out what to do. Because we can override the threat response. Sadness, that's one we kind of develop over time. And often that's linked to feeling hopeless and helpless. If you're angry for too long, if you feel powerless, if you're afraid for too long, you can start feeling depressed and hopeless and helpless. Is sadness a bad emotion? No. You know, when somebody passes, part of the grief process is depression, is sadness. Does it mean that that's a bad thing? It's just something we've got to go through in the realization that you can't control this part of life, you can't control and bring that person back. So you've got to learn how to affect your sense of hopelessness and helplessness. So emotions are just a natural way your body's prompting you to act. It's saying, there's a problem, we need to do something. Okay, so let's let it go at that. What we want to do is focus on the changeable variables in the context. What does that mean? Well, changeable variables, let's start there because that's the easiest part. Physical vulnerabilities, you can prevent yourself from being as vulnerable to anxiety and distress by making sure that you're taking care of yourself physically. Relationships, those can be changeable variables. Focusing on learning how to set effective boundaries, how to communicate assertively, developing positive, supportive relationships, those are all variables that are changeable. In one situation, you may feel anxious and isolated and angry and all alone, but you can change those variables. That doesn't have to continue. Thoughts are another changeable variable. You can have thoughts, and a lot of times they're automatic, that are negative and pessimistic and painful and take you away from where you want to be because most of us don't want to be there. Or you can have thoughts that are positive and hopeful, and we'll talk in a little while about the fact. And this kind of builds on cognitive, behavioral, that a lot of times our thoughts are automatic, and it's these automatic thoughts that we don't keep in check or that we're not mindfully aware of that can lead us down the wrong path. It's like somebody whispering in your ear. And behaviors are changeable variables. Say you're going to a family gathering, and you know that there's this one person at a family gathering that rubs you the wrong way, and they always make you angry and yada, yada, yada. Well, you can choose to go there and choose a whole host of behaviors, tolerance and boundaries and distress, tolerance, all kinds of stuff to deal with it. Or you can choose behaviors like getting a few drinks ahead of time to deal with it. But if you get a few drinks ahead of time to deal with it, knowing that alcohol is in disinhibitor and this person starts to rub you the wrong way, what's the ultimate outcome going to be? Is it going to get you closer to your goals of, you know, family harmony, or is it going to get you further away? So we want to focus on these variables in context. For example, if you have a patient who's depressed, depressed can be. It's most of the time, most days. Well, if you're focusing on something that big, it's like, where do I even begin? So if they wake up in the morning and they're feeling depressed, we say, okay, so let's look at that in context. What can you do right now, today that gets you closer to your goals of being happy, being a good employee, getting to work, passing your test, whatever it is that's important to you. What can you do today? Taking it in a mindful, in the moment sort of approach? The same thing is true with anger. Now let's take a behavior like smoking. Somebody is trying to quit smoking, and, you know, it just. It's really, really hard. Every time they get stressed, they have this urge to smoke. So we need to look instead of saying, well, every time you get stressed, because the intervention for stress is going to be different depending on what's causing the stress. So we need to look at what. What's Causing the stress in this situation? What changeable variables are there that we can address? So you don't feel stressed and the need to smoke, but we also want to look at the choices. You know, when you're feeling stressed. One of your away behaviors, one of your behaviors that you do to escape stress and just uncomfortable feelings is to smoke. Now, does smoking itself get you closer to or further away from your goals of being healthy and a non smoker? Helping them identify discrepancies between their thoughts and urges and their current behaviors is one thing that we're kind of doing here. So there are six core principles, and I put them in order from how I generally teach them. But obviously you can kind of mix and match in a way that seems meaningful to you and your group. Values, awareness. And I call this the destination. So if we're working towards a goal, I want to know what that goal is. Let's start there, figure out where we want to go and what we want to be different. Then we talk about contact with the present moment. Where you want to go is over here. Now, where are you right now? We're not talking about, you know, all the time. All I'm talking about is in this very moment, where are you? Then we move on to talking about the observing self. And that is sort of the fly on the wall or the scientist that steps back and says, let me, let me assess this situation and look at all the variables. We move on to acceptance. And acceptance says, yep, this is the situation. These are the uncomfortable things and these are the positive things. These are the positive actions we could take, and these are the escape actions we could take. It is what it is. And you start sorting behaviors and thoughts that way. And then you choose committed. Then you move to diffusion, where you separate yourself. And this kind of goes with being in the observing self you separate yourself from so that thoughts and feelings don't have to trigger behaviors. Thoughts and feelings are just that, thoughts and feelings. They don't mean you have to do anything. You can write it out, you can act on it negatively, you can act on it positively. There's a bunch of stuff you can do. So diffusion gives you the ability to step out of being intertwined with that emotion and go, okay, this is what's going on. This is kind of how it feels. Now, where do I want to go from here? Which takes us to committed action. You want to achieve your destination. So committed action means making a commitment to using that gallon of gas, using that limited energy you have to get towards your goals and not get Sidetracked by this irritant over here and this unpleasant feeling here, and yada, yada, yada, a lack of clarity about values underlie much of the distress that we see keeping people stuck because they don't know where they're going. They're just like, I don't want to be depressed, but they don't know what they do want. They don't know what's important to them. They just know they want to make the pain stop. You can get caught up spinning your wheels, trying to fight against something or use the same energy or use that same energy to work towards something else. So thinking about the gas analogy again, if you get stuck in a mud pit and you're trying to get out and you hit the gas and you spin your wheels and you throw mud up everywhere, but what happens, you also get more deeply entrenched in that mud because you've thrown the mud out and you've lost even more traction. So you could continue to spin your wheels, which is not going to get you out of the mud, or you can take that same energy and get out and find something to prop under the wheels to give you some traction so you can get unstuck. And we're finally onto the matrix. The first step, like I said, is what I call destination identification. What you have is basically two ends of a continuum, the goals and values that we're going to identify. And I'm going to walk you through some of the steps I use to help my clients identify where they're going. And it changes. You know, they do this once, and they may change their goals and values. They may add to them. And as life changes, their goals and values change. Values aren't static so much. I mean, your goals may change based on life circumstances, but we want to know right now what is most important to you. And then on the other side, you have distress and diversion. So something happens, and you notice that this something happened, and you choose thoughts and behaviors that either move you closer to what's important to you and your goals and values, or you choose behaviors that may temporarily make pain go away, but often just serve as a diversion from getting you towards your end goal. And a lot of times they end up causing additional distress. And we're going to see how all this plays out, I promise. So, clarifying. We want to help people clarify what their goals are, because I don't know about you, but I can start listing goals, and I've got a bunch of them. I've got a lot of things I want to do. However, I can't do them all. And sometimes one has to give way in order for another one to take place. For example, you know, if one of my goals and as a parent, one of the choices that we have made is to homeschool our kids, which, you know, that is a value that's important to us and their education. But there were other values that I had, like work and, you know, some of my hobbies and things like that that took my time, that had to give way because, you know, that was my kids education was a more important value to me. So people need to periodically balance things. We also go through this. When you're choosing a house, you know, you choose a house based on what's important to you. Do you want to be in the best school district? Do you? You know, for us we have chickens and donkeys and stuff. So, you know, I wouldn't dream of just telling the kids, well, you're not going to have your animals anymore. That's important to me. So we have need to be in a place where we can have those animals. Do you want to be in a neighborhood or do you want to be kind of out in the middle of the woods? There's a lot of things that are important values that you use in order to guide your decision making. So we say with relationships, you know, there are a lot of people that are important to you, but who is most important to you and who are the people that are really deep within your heart? And you know, generally it's spouse, kids, you know, parents, maybe a friend here or there. Most people can narrow it down to a small group of people that are imperative. What do you want these relationships to be like? You know, you can say that, you know, my relationship with my best friend is really important to me. But then if you don't do anything about it, if you don't invest energy in it, then that relationship is going to go away. So we need to know what is this relationship going to look like? What is it that you want to do to nurture this relationship? Because it's going to take energy. Then we talk about what events, things or experiences are meaningful to you. And if you have your paper, you know, kind of start jotting some things down right now about, you know, if this were me and I only had that gallon of gas, what are the things that would be most important to me to guide my actions and behaviors? So after we do relationships, we move down to work. You know, what parts of work? What's important about work to you? Is it just putting Food on the table to achieve your other goals? Or do you have certain goals that go along with work itself that are really important to you? And what about health? You know, you can't really be very functional in a relationship if you're not taking good care of yourself and you're not around. So health is probably a value, but for some people, you know, it's going to the doctor once a year and doing the minimum. And for other people it means, you know, going to the gym and doing things to sort of fight the aging process or fight the disease process. And then personal growth. What things are important to you for you? Your spirituality, your hobbies? What is it when you talk about your values and goals? What is your destination? What does happiness look like for you? And then I say, okay, we've talked about some goals that you've got, some things that you want to see. Now, if we're talking about relationships, for example, what values do you hold dear that you want to, you know, portray in those relationships? For example, family orientedness. If one of your relationships that's important to you is with your family, then that's probably one of the values that's going to be important. Reliability, creativity. What is it? Which of these are important to you? And I ask them to identify all of the values at first that are important to them. But then I say, all right, now we can't focus on everything all the time. If you had to choose just five, which would be the five most important values for you to spend your energy on? And that takes some talking and some discussing, and people usually cross one out and then uncross it and change their mind. But it gets people to clarify in their own minds, what do I want to dedicate my energy to? Because then when something comes up, they can say, you know, what? If family orientedness is one of my values and this opportunity for my career comes up, that's going to have me traveling 75% of the time. Is that how I envision my relationship with my family? And is that going to help me fulfill what I perceive as a family oriented value? Now, some people may be fine with Skype and all that kind of stuff. That's a personal decision. But that would be one that you would have to kind of look at and go, is this opportunity, is this choice I'm fixing to make going to help me fulfill these values? Once you've identified your values, and you know, I did mine over here, then you know that every time you choose, every time a situation comes up, you notice the fact that there's a crossroads here. And you choose the choice of thoughts and behaviors that are going to get you closer to your values and your goals, and you're going, well, that seems like common sense. It does. But you know what? A lot of times those automatic thoughts and stuff creep up on us and distract us, which takes us to the top and bottom. Think about what you've been doing today. You know, you probably got up, made breakfast, got in the car, drove to work, got out, you know, a whole bunch of stuff. How much of that stuff did you do on autopilot versus how much of it did you have to, like, think through and make a conscious choice? Breakfast. Did you have the same thing you have every morning for breakfast because that's just what you do, or did you get up and go, okay, today, you know, I'm feeling like I'm craving X, Y and Z, so I'm going to have this breakfast instead? You probably were on autopilot. Most of us are. That's kind of the way American culture is. Unfortunately, we do a lot of things on autopilot, so our thoughts and feelings. You know, you have this get up in the morning, your thought is got to get up. Your next thought is got to brush teeth or whatever your process is. And you just kind of go through life doing these things on autopilot. Unfortunately, if we're working with somebody who is depressed or anxious or angry, then evidently their autopilot has kind of navigated them into the rocks. And when we are driving, autopilot is great because it saves us some energy, but we need to be able to switch it off in order to avoid the rocks. Mindfulness is what happens when we switch it off. And we're going to talk about that in just a second. But mindfulness is when you stop and you go, ok, I am awake this morning. How do I feel? What do I want to have for breakfast? You know, sometimes if I am on autopilot, I will get up and I will eat breakfast, and I finish eating breakfast and I am like, you know what? I don't know why I did that because I wasn't even hungry. But it was just what I did. It was the next step. So becoming more mindful helps people choose actions that are more in line with what they're needing at that present time. So we want to turn into the fly on the wall. And some people don't like flies, and that's fine. And don't really know what a fly thinks about. If you are a science fiction geek like me, you might have Watched Star Trek, Next Generation, they have an Android and his name's Data. And he tries to understand humans. He wants to be human. So he is always very curious about what's going on. But he doesn't have the ability, he doesn't have an emotion chip to get fused with being angry or anxious or anything. So he's just very objective in his approach and non judgmental. You know, if something happens, he may go, well, that wasn't logical. But it's not. He's not passing judgment, he's just making a statement. And you can take the scientific approach where you are just scientist and you're kind of observing yourself as if you're your own little lab experiment. Whatever metaphor you want to use, I don't care. So bringing full awareness to your here and now, again, just for yourself, think about right now. How do you feel? What are your thoughts, wants and urges? You may be sitting there thinking, I really shouldn't have skipped lunch to stay here for this presentation. Hungry. Okay, that's not bad. That's not good. That just. You're hungry. That's what it is. What physical sensations are you experiencing? Are you too hot? Are you too cold? Are you uncomfortable? Are you just right? And then describe the environment. Think about what does it smell like, what's the temperature? Look around, get really grounded in the present moment. One of the reasons I have clients do this is so they can start to become more aware of the effect of their environment on their thoughts, feelings and behaviors. In counseling graduate school, we learned about transference. We learned about the fact that some people can remind us of people in our past and we may act toward them as if we would have act toward that person in our past. Smells are huge memory triggers. So if somebody becomes more antsy in a certain situation or with a certain smell, becoming aware of that, helping them become aware for themselves, that that's a trigger for them for anxiety or distress or negative thoughts. It doesn't mean they have to get hooked into those. It's just being aware of the fact that, yeah, when I walk into a place that has this kind of a blue gray walls, it feels kind of institutional to me. But it reminds me of the first place I worked and it was cold and it was stressful. So when I see that I have this sort of icky feeling, it comes out of nowhere, if you will, because it's those automatic thoughts coming in from the past going, yeah, this reminds me of a thing that we might want to be aware of. So encouraging our patients to be aware of the here and now and then making room for unpleasant feelings, sensations and urges. So they can come and they can go, allowing them to come and go without running from them or giving them undue attention. And I like Yoda, he says, talk to the hand you must. And what I mean by that is, is the fact that we don't want to get angry. If we feel anger and get hooked into it and then start trying to fight with it and nurture it and dwell on it, we just want to let it come in and go out. We don't want to pay it too much attention. So Yoda is kind of what I use to help people remember that when they feel angry, it doesn't mean they have to act on it, it doesn't mean they have to get stuck or involved in it. They can just be like, nope, just go on, go on about your business. Which takes us to cognitive diffusion, which means stepping back and recognizing that thoughts are just temporary automatic events. They happen and it doesn't mean they're going to stick. It doesn't necessarily mean they're right or wrong, it's just they are. It's the thought that you had. We want to help people perceive thoughts, images and memories as bits of language and pictures as opposed to what they can appear to be as threatening events or objective truths. So think about a time you had a nightmare and you woke up and you're kind of groggy and you sit up in bed and you're trying to get your bearings and at first it feels really, really real and it, you're still scared, you know, you're drenched in sweat and whatever. But as soon as you turn the light on and kind of get your bearings, you realize that it was your mind just having a bunch of thoughts and images and maybe some memories here and there from your life as well as from stuff you watched on TV kind of being mishmashed together. It wasn't an objective truth, it was just a dream, it was just a story. It was something that was there and it's gone now. In order to cope with these, you know, we have these thoughts, we have these feelings, we have this situation, whatever it is, we want to be able to unhook and step back so we're not stuck in the anxiety. When you are stuck in anxiety, you can't think clearly. You need to be able to step out into that wise mind, if you will. Thoughts and feelings don't have to lead to action. Just because you feel stressed doesn't mean you have to engage in self destructive behavior. So think of a behavior that you personally automatically do when you get stressed or angry. And all of us have something. And you know, because stress and anger are perfectly normal emotions. Some people may drink, eat, use drugs, self injure, withdraw, lash out, go take a bath, whatever it is you do when you're stressed or angry. I go outside and I do yard work. My kids know that the proportion of my stress is in direct proportion to the size of the lawn equipment I'm using. So if I've got the chainsaw out, best give mom a few minutes. But this is one of my behaviors. This is one of my sort of distraction behaviors. So how can you take a pause to become mindful and make an informed, committed decision? So when you feel that way, you can choose a behavior that moves you toward your goals. Now for me, landscaping, you know, is a toward behavior because it gets some of the yard work done. It keeps me from being irritable with people that I don't mean to be irritable with. You know, that's a two behavior for me. But we want to help people figure out what things can you do. And I mentioned take a bath, go on a walk, call a friend, play with your dog, something. And a lot of times in dialectical behavior therapy, we look at these as distress tolerance skills. But what can you do so you can pause, so you can then kind of get out of that emotional mind and make an informed, committed decision? Here's an exercise. Think of a negative behavior like I need to have a cigarette, I need to have a drink. We're going to stick with a drink here. I need to have a drink. Thinking about it, believing it as much as you can. And a lot of times I've worked with people with co occurring disorders for 20 years and this feeling that they need to have a drink is extremely powerful. And they believe it and notice how it affects them. They feel this almost uncontrollable urge to go get a drink. A compulsion, if you will. So now insert the phrase. Instead of saying I need to have a drink, insert the phrase, I'm having the thought that I need to have a drink. Well, yeah, it's a lot more words, so you've got some time in there. When you say I'm having the thought that I need to have a drink. In our language, we tend to emphasize the word thought, which, you know, helps a lot because you're identifying the fact that it's not something you have to do, it's a thought. And we know that thoughts can come and go, thoughts can Be changed. So encouraging somebody to say, I'm having the thought that I need to have a drink. So what other thoughts could you have? Another one would be, I am X. Like I am stupid. I am useless, I am unlovable. Say that to yourself enough times and think about it. Believe it as much as you can. You know, really try to internalize it, notice how it affects you and then do the same thing. Insert that phrase, I'm having the thought that I am stupid. When I am stupid. It's hard to change that because it's part of who I am. When I'm having the thought that I'm stupid. Well, I can change a thought, I can get rid of that, but it's hard to get rid of part of me. Think about telling a child, you're a very good boy or you're a very bad boy. Now is the child really a bad boy or was that particular behavior in that context a bad choice? So there is a lot of semantics to it, but our brain unfortunately really hangs on to semantics. So moving through this matrix, we know what our goals and values are. We know what our destination is and where we want to go. We know that every time an event comes up, we're going to have some automatic thoughts and feelings that just pop into our head. Some are going to be good, some are going to be bad. We also know that we can choose, we can be mindful of our thoughts and our behaviors. So the first thing you want to identify is in general. Now we're not talking about a specific situation here, but in general, in order to move you towards your goals and your values, what behaviors do you do or could you do that would move you toward those goals and values? And this, if you have your sheet here, kind of jot those down in this upper quadrant behaviors that you could do to move you toward your goals and values. For example, when we're talking about these goals and values, mine. So for me it would be assertive communication is a behavior that would get me closer to good relationships and success in the workplace. Goal setting, same thing, getting my work done, it's kind of a no brainer. Spending time with my family, It's a behavior that will get me closer to what I think is important, what makes me happy, working out and eating healthfully, that's important to me. And when I don't do that, I tend to be kind of unpleasant. So that's important for not only relationships but also for health and just being there and being able to focus at work and being able to be Productive and positive in a relationship. Gardening, that's one of my hobbies. So as far as personal development, that's important to me. And it's a behavior that gets me closer to being the kind of person I want to be. And then adequate sleep. You all know what a proponent I am of good, adequate, quality sleep helps in all of these areas. It's hard to be in a good mood and concentrate and have energy and be compassionate and interactive and all that stuff if you're pounding back the caffeine as fast as you can just to stay conscious. So these are activities in general that I can do to move me toward my goals and values. So the next thing is to look at thoughts and feelings that move you toward your goals and values. What kinds of internal events, what kinds of automatic things go on in my head, or maybe not so automatic that can help me do these behaviors to achieve my goals and values for me. Courage. Because sometimes doing the stuff that I have to do is not pleasant or is not as easy as I would expect it to be. So I've got to take risks. I've got to have some courage. It's a lot of dedication in order to achieve, for anyone to achieve their goals. Concentration. Those are things, internal things that I need to do. Thoughts, if you will, in order to be successful at goal setting and getting my work done, which helped me achieve my goals and values. Optimism and enthusiasm. If I'm going to be in a positive relationship, if I am going to be in a positive workplace, you know, there has to be a certain element of optimism and enthusiasm. If I'm a complete Debbie Downer all the time, then gonna have a hard time achieving as many of these goals. Patience, compassion with self and others. And compassion with self is important because some days you're gonna wake up and you're gonna be like, didn't sleep well? Or just not feeling it. And instead of fighting against it and saying, well, I just need to push through and get everything done anyway. Being compassionate with self and saying, you know what? Today is going to be a let's get the minimums done. Because that's all I've got the energy to really do so I can keep moving forward instead of starting to feel angry and frustrated and distressed. Compassion with others. Helping looking at some options, looking at some alternatives instead of necessarily getting angry and thinking the worst or having the first negative interpretation. Being compassionate and going, you know what? I have no idea what they're going through. And willingness to let stuff go because sometimes stuff comes up and it triggers an angry feeling or an angry thought or a negative thought. So you've got to ask yourself, is holding on to this and nurturing it, flipping it over in my mind, is this a good use of my energy and is it going to help me achieve my goals and values? Alright, hopefully you've had a chance to kind of write down your own thoughts and your own behaviors that will help you achieve your goals and values. So now let's move to away from. These are the things that a lot of times our clients are trying to deal with, whether it's smoking or overeating or any type of escape behavior they're using to distract from or eliminate distress. Most of the time it's not to get them toward their goals, but just to make the pain go away. Right now, sleeping too much, staying in the bed and just going, nope, I'm not going to face the day today, pulling the covers back up over your head, avoiding life by being a couch potato again, sitting on the couch, going, yeah, no, I don't have it in me. Today it's just going to be me and the Netflix remote. Self soothing with food is another escape behavior. Drinking, lashing out or being irritable or impatient or self handicapping. And this is an interesting behavior because it's one in which you basically create a situation that gives you an excuse to fail. A lot of times people will do this if they're anxious that they're going to fail. If they're fearful that they're going to fail, they'll set up a situation so they can point to other stuff. They can play the blame game and say, well, I failed because I had all these other commitments or because of all this other stuff that was dropped on me. So be aware of self handicapping in clients and things that they do that pretty much set themselves up for failure. And then you want to look at what are the motivations for that? What were they, what unpleasant feeling were they trying to escape? So now we're going to talk about thoughts and feelings that move you away from your goals and values. Most people I've never met anybody yet who's identified a goal and value of being depressed, anxious and angry and irritable all the time. That's just not something that most people put on their goals and values. So that's generally what falls in here when we're angry. Now you can feel that feeling and choose something proactive to get you closer to your goals, or you can choose that feeling and you can choose something reactive. Getting revenge or, you know, escaping from it that doesn't get you closer to your goals. So some thoughts that may go through your head, I can't do this. There is no way I can do this. People just suck. I'm helpless to change anything, so what's the point in even trying? Rule breakers always win, and no good deed goes unpunished. We've all heard different versions of these negative thoughts and do they pop into everyone's head every once in a while? Yeah. Can you counter them? Certainly. But first you've got to be aware of them. You've got to notice them and choose not to go down this road and get stuck with these thoughts, but say, okay, if I get caught up thinking about how people suck, I'm going to get all upset and I'm going to burn through a whole bunch of energy and I'm not going to get nowhere. So instead of focusing on that, what can I focus on that's important to me? What can I focus on that gets me toward my destination? So again, when we're looking at the matrix, behaviors that move you towards your goals and values reciprocally interact with your thoughts and feelings that move you toward your goals and values. So if you're doing things that move you toward your goals and values, you're probably going to have some feelings of positivity and motivation and momentum and whatever it is. And feelings of positivity and courage and determination are going to keep you doing those behaviors that move you towards your goals and values. So let's keep this cycle going over here. It's the same way though. When you have negative automatic thoughts and feelings, a lot of times people try to escape from them. And when you try to escape from them, what happens to those feelings? Generally, whatever was causing them is still there. And your thoughts and feelings, you get entrenched because you sober up or you quit hiding or whatever it is. And that negativity is still there and you haven't replaced it with anything else. So you're stuck spinning your wheels. What you want to do is figure out how you can encourage people to notice and choose. I'll give you a situational example. We just went through it and came up with the matrix for in general, how you act. And in general you know what your escape behaviors are in general, what your unpleasant feelings and thoughts are, in general, what your toward behaviors or proactive behaviors are, and, and your proactive thoughts. So let's put it in a particular scenario. So I'm self aware, I'm bebopping along, I'm going to the office and I'll share a personal example. I was working in a residential facility and I had to use the bathrooms up front because the staff bathrooms were closed. I'm like, okay, whatever. So I went up to the front and I, you know, did my business, wash my hands, walked out, walked down the hall. And this is a residential unit. We had about 20 people on staff during the day and 85 residents. So it wasn't like it was a deserted place. And I get about halfway down the hall, which is a long haul, and one of my staff pulls me into the office. She's like, dawn, come here. I'm like, what? And she pulls me and she's like, you tucked your dress into your britches. I was just like, oh, I'm mortified, you know, because I don't know how many people saw my britches that day. And I was mortified. Now what do I do with that? Some people, you know, you notice what's going on, you would feel embarrassed, felt stupid. I didn't want to hide out. That's true. Those negative thoughts and feelings popped right up automatically. What was my knee jerk reaction? How can I get out of this? How can I go hide so I don't have to ever see these people again? Well, that's not going to help me achieve my goals of being successful in business and my career and doing what I do. So noticing and choosing a little bit of positive self talk, I'm like, okay, thoughts. And other people have done embarrassing things and they've survived. I've done embarrassing things before and survived. It could have been worse. And I won't elaborate on that, but I looked at it as a humbler and a compassion grower because I won't make fun of anybody who has toilet paper on the back of their shoe or, you know, has their underwear sticking out or whatever it is. I've been there, I know what it's like. And I'll pull them aside and be like, you got something on your shoe. So it's a humbler, a compassion grower. It's not going to kill me. Now, what are my behaviors? I could either lash out if somebody brings it up and get really defensive about it, which isn't going to get me closer to being the person I want to be. Or I can continue my day serving the clients and doing what I love and model the fact that stuff happens and you can roll with it and laugh about it if it comes up. Now, those were the options. So ultimately I chose these. Obviously, that's why I chose this example. But we all do things embarrassing. And some people will toss them around in their head every single night for, like, weeks on end. And it's not part of the act model. But one of the things I do kind of point out to them and is the fact that, you know, at least in my experience, I really wasn't that important to anybody for them to remember it two weeks later. You know, it probably was scuttlebutt for a week or so, and they found it really amusing. But hey, you know, they're going through a really rough time. If they can laugh about something, laugh at me, laugh with me. I don't care. So help our clients use this when something happens to choose the behaviors and thoughts that they could have that would help them be the kind of person they want to be. Chronic illness. And we're going. I'm going to give the example. Either depression or chronic pain. This one fits for either one of them. Wake up in the morning and you feel depressed. Your pain is just, you know, really bad that day. You notice this. You're mindful of how you feel and what your thoughts and urges are. So we start sorting them. Some of my thoughts and urges are to stay in bed, maybe to drink, maybe to use pain pills excessively, maybe to lash out at others for not understanding how bad this really freaking feels. Okay, do any of those get me closer? No, but these are things I'm feeling right now. When I wake up and I notice that I hurt either emotionally or physically or both, I may feel helpless because, you know, that was the way it was yesterday and the day before that and the day before that. I may feel hopeless with a sense of depression that things are never going to get better. I may have some resentment at people who are healthy, anger at myself for being weak or lazy. You know, I should be able to just fight this and get up and do the next right thing. Well, it's not happening that way. I make it anxious that I will lose people and things important to me because I can't do the things I used to do because of the depression or the pain. And I may feel guilty that I can't do those things. So when I have all those negative feelings, am I really motivated to get out of bed and do the next right thing to get me towards my goals? Generally not. My first reaction is probably going to be to make that pain stop. So we're back to noticing and choosing, and we're saying, okay, now, you've done that in the past. It's worked for you in the short term. You Know it makes the pain stop for an hour, but how is it working for you in the long term? Is it helping? Are things getting better? And generally the answer is no. So we say, okay, let's look at some other things over here. What could you do instead? Notice and choose. Have good sleep habits, eat healthfully, do your therapy exercises. Focus your attention on things you can, control those changeable variables, get support from friends and set small achievable goals. Instead of saying I want the depression or the pain to be gone, saying I want to be able to have enough pain relief that I can get up and clean the house today or I can get up and clean the living room today. So set small achievable goals and instead of focusing on eliminating it forever, let's focus on getting it from being, you know, depression is as being a five on a scale of one to five every day, all the time, to maybe being a four today. Let's see how many times we can get it to be a four. And finally, with bullying, we want to notice and choose because it happens to adults and to kids. And this is the final one. I'll leave you with the away from behaviors when somebody is a bully and we'll say online bullying, you may want to drink, lash out, sleep, binge hurt them, whatever. A lot of the feelings that come up. What are your feelings when somebody bullies you? They could be anxiety and fear about rejection, resentment, being self critical, saying, you know, you really should be a better person or whatever it is. Feeling helpless. You can't deal with life because you can't control everybody else in the world and possibly anger at others for just being mean. And are those natural thoughts? Certainly. Are you going to want to use your energy to get stuck nurturing those thoughts? Are they going to help you in any way? So notice and choose. What are some alternatives? It doesn't mean you have to choose. Right now we're just going to brainstorm alternatives toward behaviors, prevent vulnerabilities and sleep, nutrition, pain management. It could also be things like don't go places like on social media where you may feel like you're being bullied. Is that fair? Not necessarily. But is it worth your energy to go onto social media? Is that important? Is social media important to your goals and values? Distress tolerance, learning skills to deal with it. When you see a news story or you hear something that's mean and hateful, learn to let it go and set boundaries so people's opinions of you don't necessarily affect your opinions of you. Do some self validation if somebody's being a bully and being ugly. My daughter told me yesterday that somebody had commented on one of her Instagram posts and shared a weight loss, a link to a weight loss site. And yeah, she was kind of devastated. So we talked about, you know, what does that mean for you? What does that mean to you? And doing some self validating, reminding yourself of positive things toward thoughts and feelings. The courage that you can do, you can handle this. You don't have to get caught up in fighting with a bully. Self compassion, you know, giving yourself a break. It's like, okay, that hurt, that smarted, and it's okay to be angry about it for a minute. Acceptance can't control everybody. Can't control how you initially felt, determination to do the next right thing for you and willingness to do it. So my shortcut question, if you don't have time to do all of the quadrants, just ask yourself, when something comes up, are my current thoughts, feelings and actions getting me closer to or further away from my goals and values? So when I do this, is this positive and moving me in the right direction? Now, that doesn't mean that you can just wake up one morning and go, well, I'm not going to be angry anymore. There's some stuff you got to deal with in therapy, possibly for your anger and depression and anxiety. But once you recognize that you don't have to get hooked in and sucked under by those negative thoughts and feelings, then you have more of a choice to say, okay, well, instead of getting sucked under by those thoughts and feelings, I'm going to choose the behavior of going to therapy, or I'm going to choose the behavior of going to see my priest or whatever it is so you can make more educated or informed choices. For you, every event is an opportunity to choose thoughts and behaviors that will help you use your energy and move toward your goals and values. Acceptance means accepting without judgment how you feel and the situation as it is. It just is what it is. It's good, it's bad, it sucks. It is. And commitment and purposeful action mean that you choose to use your energy on thoughts and behaviors that move you closer to your goals. Okay, are there any questions for me? And I encourage you to take this matrix and try to apply it for yourself a little bit. If you have any questions, feel free to email me. My email is drperiodsnipeslce.com the part of the matrix that's most difficult in my experience for adult clients to identify and implement is the whole choosing a different action when they are angry, they don't want to let go of that anger. They are invested in that anger and and letting go of that anger feels like they're giving up or letting someone else win. So having that shift into are you forgiving? Are you letting it go for them? Are you letting them win or are you choosing to not let them have control over your energy and your power? Semantics. It really comes down to semantics, but helping them switch into saying, okay, I can see where I actually do have some energy I could free up and use over on the towards side. For adolescents, identifying those goals and values tends to be more difficult and it's really about for them focusing on what kind of person do you want to be? What kind of what do you want your friends to know you as? Does that does that answer your question? And if you've used this, I would pose the same questions to you guys. What part of the matrix seems to be the most difficult for you to communicate to your clients? If you enjoy this podcast, please like and subscribe either in your podcast player or on YouTube. You can attend and participate in our live webinars with Dr. Snipes by subscribing at allceus.com counselortoolbox this episode has been brought to you in part by allce.com, providing 24. 7 multimedia continuing education and pre certification training to counselors, therapists and nurses since 2006. Use coupon code counselortoolbox to get a 20% discount off your order this month.