Finding Meaning and Purpose with CBT | Webinar for Counselors

Accepting situations that we have no control over is really challenging. And I will try to remember to bring that up when we're talking about the different acceptance and commitment therapy tools. It's one of the things that I've talked about in a lot of my videos is defining your rich and meaningful life. And I actually have a video specifically on doing that. Defining your rich and meaningful life. So you know what you want and you know what you want to do, what your path forward you want it to look like. And then reflecting on your thoughts and your behaviors when things get difficult and asking yourself, is being angry about the fact that this happened helping me move toward my rich and meaningful life or just draining my energy? Is being afraid of whatever I'm afraid of? Number one, is it based in facts in context? And you're going to get another mnemonic, which is a little weird, but it's called Fit Cat that we'll talk about today. Facts in context at this time. And it's really important to recognize that our expectations of things can be very different than what things are based on our prior experiences. And that's one of the things Hayes talks about is a of our distress is actually caused by schema that were formed in the past with language that is not conducive to the present situation. And I've taken it a little bit further to try to help you understand some of the things that I talk about when I talk about inner child and how schema that are formed in childhood are often inaccurate when we look back because children think differently. It's not that they're wrong, but they understand the world differently and cognitively they just think differently. And I, I agree, Teresa. Finding meaning is important in order to know yourself and know what it is that's important in your life. What are your values? Not what are you going to do? And that's another thing that Hayes talks about. So we're going to hit on a lot of these things today, which is awesome. All right, I am going to go ahead and get started because I've got a lot of slides to cover today and I want to make sure we get you out of here on time. And most people don't care about hearing the objectives foreign I'd like to welcome everybody to today's presentation on acceptance and commitment therapy skills. Cognitive behavioral tools to help you find meaning. I'm your host, Dr. Donnelly Snipes. In this presentation, we're going to talk about the goals of acceptance and commitment therapy. What's unique to act, what destructive normality means. We'll talk about experiential avoidance, cognitive behavioral therapeutic interventions, and the six core principles of act. It's important to understand that acceptance and commitment therapy, like dialectical behavior therapy, is a form of cognitive behavioral therapy. So when we talk about cbt, we can be also including ACT because it's a form of it. Why do we care? Well, Kabat Zinn in 2004 said, you can't stop the waves, but you can learn to surf. You can't stop life, but you can learn how to deal with life on life's terms. The acronym ACT stands for accept your reactions and be present. Oh my gosh, what a concept. Choose a value direction and take action. A lot of times we not only feel our feelings and either ignore them or struggle with them instead of accepting them, but we're also not present. We're not looking at that fit cat the facts in context at this time. Then you're going to choose a value direction that's based on how you define your rich and meaningful life and decide what is the best response in this situation at this time to use my energy to move toward my rich and meaningful life. ACT is based on relational frame theory and contextualism. Relational frame theory is a psychological theory of human language. It frames our language, frames how we relate things. It developed largely through the efforts of Stephen Hayes and Dermot Barnd Homes. Relational frame theory argues that the building block of expectation and understanding, or higher cognition is relating. That means creating links between things. And that makes sense when you think about your life as you learn things, you're not just picking something up and going, have no clue. Never seen this before. I have no frame of reference. You know, I get a new mobile device, I get a new iPhone, and I know that it is going to function similarly to the one that I just had, whatever one I'm moving on from, but not the same. So I am using information based on schema that I formed and described using language in order to help myself anticipate and integrate my old knowledge with my new knowledge about how to operate my phone. Contextualists understand the complexity and richness of a whole event through appreciation of all of the facts in context. And here's that mnemonic fit CAT facts in this context at this time. And it is so important to drop back to that fit cat because were our automatic reactions. If you feel angry, if you feel anxious, even if you feel happy, those gut reactions or instantaneous reactions are based on schema that we formed that have helped us anticipate what might or probably is going to happen. It doesn't necessarily mean it is going to happen. Yes, you feel anxious. We don't want to ignore that. But acknowledging that anxiety and then engaging the fit cat and saying, all right, I feel anxious right now based on the facts in this context at this time, is there something I need to feel anxious about? Contextualism helps us understand why we respond to things in different situations. Someone wearing a ski mask on a ski slope, you're going to look at that and go, yeah, fits the context. If somebody's wearing a ski mask in a bank, not going to have the same reaction. If you hear the sounds of screaming at an amusement park, well, people are probably riding a roller coaster. If you hear the sounds of screaming in the woods, you're going to be looking around for the bear. People's reactions to hyperactive behavior in children is often different when they are being, quote, hyperactive in church or in school, because that is a inappropriate context, if you will, as opposed to if they're being hyperactive, if they're doing the same exact thing, but they're doing it on the playground or in their room at home. Another example of context is if you're in a relationship with somebody and your significant other is being irritable and withdrawn or okay, well, in this context, at this time with this person, what does that behavior mean? Maybe your significant other is starting to get sick or maybe they are overwhelmed at work, I don't know. We have to look at the facts in this context at this time as opposed to assuming based on prior relationships. When somebody started being irritable and withdrawn, they were getting ready to abandon me or they were angry at me about something. You don't know. It's important not to engage in that mind reading. It's important to fit cat. Functional contextualism emphasizes that behavior is communication. When people do things, they're communicating to us non verbally sometimes because they don't have the verbals to communicate. Humans learn language, learn how to communicate verbally through interactions with the environment and observing others behaviors. So let's go back to that amusement park, fear versus excitement riding on a roller coaster. If y' all have watched my other videos, you know I'm terrified of roller coasters. But I've done it a couple of times to prove a point, sadly to my cousin. But I was terrified. And when we were going down that really steep hill and picking up speed, I was screaming and it was not excitement. Other people were screaming and it was excitement. Fear and excitement have very similar neurological neurochemical reactions in the body. So we need to be able to use context to go, ooh, I'm feeling really revved right now. Am I afraid of something or am I excited? Now that's something that most of us, it's kind of automatic for us. But it is important to recognize that context definitely does play a part. Context is essential to accurately assign meaning. I've talked in other videos about the smoke alarm. When our smoke alarm goes off, okay, it's going off for a reason. I may not know why. It could be that somebody took too steamy of a shower, it could be that I'm burning something on the stove, or it could be that there's a fire, but it doesn't. Just because the smoke alarm's going off doesn't mean that there is a fire. It means I need to check it out. Slamming doors. People who have been in abusive or chaotic environments, they hear slamming doors. It may trigger their stress response. Because that schema that those experiences that they've had that have involved slamming doors in the past have been unpleasant at best and dangerous at worst. So when they hear slamming doors now, it may still trigger that reaction. And it's important for them to be able to tolerate the distress, get grounded, and then ask themselves, what are the facts in this context at this time? People who have a runny nose and I've got allergies, I have allergies to cats, yet I let my cat sleep in the bed. I know I'm not supposed to, but I do. So runny nose, does it mean that I'm sick and I'm contagious and oh my gosh, stay away from her? Or does it mean that I need to change my sheets? Context is really important. And when people start to get a runny nose or start to feel sick these days, there's a lot of health anxiety. So it's important for us to help them stop and say, okay, let's look at the context right now. Who have I been around lately? Or where have I been that I could have gotten sick? You know, what is the most likely explanation based on this context at this time for why my nose is running? It's probably not the worst case scenario. And then dogs, you know, I use dogs a lot because people can be very polarized about dogs. And when I see a dog that is got his hackles up and he's barking and he's, you know, just being kind of crazy, I think to myself, oh, that poor puppy's scared. Other people are going to want to get, get out of there as fast as they can because they're going to say, that dog is dangerous. Two different words, language. I see the puppy, I empathize with it. Somebody else may see the puppy and go, dangerous. Got to get out of here. And it's important when we're working with people to help them evaluate how the context impacts their perception of things and what we might be able to change in context. Oh, well, there we go. Pieces of the puzzle in that fit cat facts in context. At this time, we must focus on changeable variables in context, Remembering that the variables are going to differ between contexts. If you're at home, there's one set of rules or expectations. If you're at school or at work or in treatment, it's another set. If you're in the car, if you're in the store, or if you're doing recreational or extracurricular activities. When my kids were in taekwondo, there were certain expectations for how they dressed, how they behaved, what they did. And so the rules changed based on the environment that the person was in. The person's sense of stress, I guess, if you will, may change based on what environment they're in. And we need to recognize these things. And when we're considering context, we want to consider all pieces of the puzzle. You all know I am very big on integrative behavioral health. We need to look at the context and say, in this context, at this time, is the person experiencing pain, discomfort? Are they sleep deprived? Are they malnourished? Studies have shown for years, decades even, that children who. Who are hungry or malnourished are going to tend to have more behavioral problems. They're going to have more difficulty learning if they're sleep deprived. Same thing. We know that people who are sleep deprived also tend to have more ruminations. So we want to consider what's going on right now with this person that is contributing to this. Another way we can look at it is say, all right, let's talk about what's different when you're not having these symptoms and versus now and what's the same. So we can start looking at what's different in the context, Whether it is the environment itself or the person. Interpersonal aspects of the environment, if you will. If you walk into an environment and you see somebody that reminds you of your best friend from elementary school, you may experience transference and see them and just automatically have this warm, fuzzy feeling. You don't know them from Adam's house cat, but you have this feeling and recognizing that you're projecting that onto Them what are the facts in this context at this time? Same thing with counter transference. But a lot of people in the workplace or even in school or or treatment centers or wherever encounter others that trigger transference and they may not understand why they feel so stressed or uneasy or happy around a particular person and helping them understand it's not that person but it's the memories that they're arousing that may be triggering that feeling. Now that person may be able to trigger the same feelings eventually, but we need to look in what's going on right now. People who have high self esteem versus low self esteem, that may be part of the environment. If they're in a situation where they feel confident, they may react much differently to stressors and other things than if they're in a situation in which they don't feel confident, in which they feel bad about themselves. Their verbal and non verbal communication skills, this is another piece of the puzzle. If they are not able to effectively communicate to another person what's going on, then it's going to be more distressful. They're going to feel more powerless, more helpless, more hopeless. Their ability to set boundaries, and that includes physical boundaries, but also emotional boundaries, cognitive boundaries, environmental boundaries, whole video on boundaries. But people being able to say these are my thoughts, these are my preferences, this is what I feel, think and believe and being able to retain control when people feel invalidated, that's another boundary violation. And when people are bullied and you see I have some of these that are bold down here, control invalidation, being overwhelmed, a lack of skills and expectations and all five of those things are situations that contribute to the word that I hate not the most, but one that I really dislike strongly to resistance. Well, people's behavior is telling us something. If they are being resistant to implementing something that are asking them to implement, they may feel like they're being forced to do it. Boundary violation. They may be feeling like their preferences for treatment that they've already expressed or their preferences for something that they've already expressed are being invalidated. They may just have so much going on in life right now that doing whatever it is we're asking them to do is just freaking overwhelming. We may be asking them to do something that they don't yet have the skills to do. In theory they might be able to apply the ABCs or FitCat or something. But if we ask them to do it and they don't do it, it may be because taking it from book knowledge to implementation, it's a big step and we May need to help people actually practice it and use it and expectations. If people don't think something's going to help, or worse yet, they think it's going to hurt, they ain't going to do it. If they've already tried treatment, if they've already tried journaling or what have you and you tell them to do it again, they're going to probably be resistant. In recovery circles, we say repeatedly doing the same thing and expecting different results is the definition of insanity. So it makes sense that they wouldn't want to or be motivated to use their energy to do something that they expect is going to fail. We need to address those things. Those are aspects of the context. Again, we don't want to just look at the physical environment. Emotionally, if somebody is dysphoric, angry, anxious, depressed, grieving, then they're probably going to be react differently than if they're happy, confident, elated. We already talked about being overwhelmed if they're anticipatory. Think about times when you know, you have got this great vacation coming up and you're sitting there trying to focus on your doing your chart notes or whatever and you just can't. Your mind keeps going off to that vacation place, all right? Context, you have something you're looking forward to that's a whole lot more fun than doing chart notes. So yeah, that makes sense. Whereas when you don't have that looming coming up next week or something, you may be more able to focus because there isn't something you're looking forward to as much environmentally. We want to be aware of sensory triggers when people are hot or cold, but definitely hot, they tend to be more irritable, more impulsive, when there are other sensory overloads or underloads for that person. And remember, not all of us is neurotypical and there are a lot of people who are neuro atypical. What is going on in that environment? My son, when he was young and even today, yes, adhd and he requires very limited sensory stimulation when he's trying to focus. When it gets to be too much. He used to go to daycare and everywhere that they had in this building was just these bright fluorescent colors. And it was exciting and wonderful, but it was just totally over stimulating for him. And it was important for his teachers to understand that, that he needed some time where he could go literally just look at a white wall where he wasn't having fluorescent colors bombarding him all the time. Sometimes in environments, one of the issues that leads to people feeling unsafe or irritable or Doing things that we don't want them to do is they just don't know the rules or they don't remember the rules. So we need to clarify them. If you go to a new office, if you go to a new church, if you join a new gym, it's a different environment. And it's going to take you a minute to figure out, okay, how does everything work here? What are the niceties that everybody does? And then spiritually, a sense of connection and meaning is also part of the context, if you will. Is what I'm doing meaningful? And we'll go back to chart notes. Most of us really detest doing chart notes, but they're necessary. And one of the things I have to remind myself of so I don't get grumpy about doing them is in order for me to fulfill my calling to be a good therapist, I need to do these chart notes. If I don't do them, then I am not living up to my ethical responsibilities. The goal of ACT is to create a rich and meaningful life while accepting that pain inevitably goes with it. You're not going to be pain free all the time, and that can be emotional pain, that can be physical pain. Determining your rich and meaningful life means identifying who is important to you in your life, what is important to you in your life, what values, what things, what experiences, and what do you need to do to move toward those goals. And as I said, I have another video that I go into depth on actually how to create a vision board of your rich and meaningful life. But that's the highlights. ACT is about taking effective action guided by one's deepest values, while being fully present and engaged. In order to be fully present and engaged, we need to be mindful. So what is mindfulness? It's consciously bringing awareness of your here and now experience with openness, interest, and receptiveness. Not ignoring how you're feeling, being aware of how you're feeling and what you're thinking and needing in different points in time. Facets to the mindfulness include living in the present moment. And most of us don't do that. We're thinking or our bodies are in the present moment, but our minds are thinking about what we're going to do as soon as this presentation is over, or what we forgot to do this morning that we're going to have to do this afternoon. So our, our brain is often in the past and in the, in the future, but very rarely actually in the present. So mindfulness says, hey, let's, let's check in, let's see what's going on right now. Engaging fully in what you're doing rather than getting lost in your thoughts. One of two of the things that I do, gardening and hiking. I call them my blank mind or my blank slate activities because they require just enough attention, I guess, that I'm not thinking about other things. When I'm gardening, I. I'm looking for weeds and I'm thinking about what I'm doing, making sure I don't accidentally pull a, you know, little baby spinach out when I'm trying to pull the weeds. When I'm hiking, I'm looking for chipmunks. I'll be honest, I'm looking for chipmunks. But I'm also trying to identify all the different birds that I'm hearing at that point in time. So those are activities where I know that I am fully engaged in the present moment. Ideally, I would be fully engaged in the present moment in everything I do. But I'm a work in progress. And mindfulness also means allowing your feelings to be as they are rather than trying to control them. It is what it is. I feel anxious, I. I feel angry. I feel depressed. Well, that's how I feel. Now. Let's get curious about why I feel that way and figure out what the best response is. As Linehan would say, to improve moment, to help me move toward my rich and meaningful life. Some people kind of bristle when I talk about mindfulness because they think meditation. And meditation in and of itself is wonderful too. But it's important to understand that mindfulness just means being aware, being present. Mindfulness skills are divided into four subsets. Acceptance, cognitive diffusion, contact with the present moment, and the observing self. ACT can be used in a wide range of clinical populations and settings, and it's not manualized, which is really awesome. I teach several different classes on dialectical behavior therapy skills, but I always put the word skills at the end because I'm not teaching dbt, I'm teaching the skills that they use in dbt. DBT is a manualized program that has a lot of expectations and rules. I guess if you will ACT is different than that. It's much more loosey goosey, if you will ACT allows the therapist to create and individualize their own mindfulness techniques or even co create them with clients. ACT does not have symptom reduction as the goal. I know what it doesn't. No. The ongoing attempt to get rid of symptoms actually creates the disorder. When you have this private experience like anxiety and we call it a symptom, then we struggle with that symptom. I don't want to be anxious. Well, sorry. The symptom is by definition, something pathological and something we should try to get rid of when we're happy and we're laughing. We don't call that a symptom, do we? We only call things that we want to get rid of a symptom, thereby making them disorders or pathological. In act, the aim is to transform the relationship with the difficult thoughts and feelings, learn to perceive them as harmless, even if uncomfortable, transient psychological events. And I have here, like a bad movie. Sometimes you're watching a bad movie and you just, you need to see it through because whoever you're watching it with is enjoying it or there's a reason for it. Sometimes there's a bad movie that comes on or you remember a bad movie and you're like, yeah, I don't want to watch that again. I'm not going to select that channel. I'm not. I'm not going to keep it on or I'm going to turn it off. ACT assumes that the typical human mind creates psychological suffering for us all sooner or later, as a result of language itself. I'll get to explaining that in just a second. Memories, perceptions, or schemas, people call them different things. All of these things are created by analyzing, comparing, evaluating, and visualizing what happened in the past and what may happen in the future. All of these processes rely on human language. You're talking to yourself, even if you're not hearing the words going, I expect this is what's happening, or I know this is what's happening. Those are words. That's language. All right, well, where does this start to break down? A lot of our schema and memories and perceptions are formed when we're children and, and children perceive, describe, and form schema about themselves in the. And the world. Using a whole different method than adult cognition, Children think in concrete. That's right. What's going on? What I see right now is what is egocentric. Everybody understands it the way I do. Personalized, my fault or I did it, and dichotomous, all or nothing. Children, through their experiences, through their life, form these schema, and I call them foundational schema because they're the beliefs and the expectations. Children form that form the foundation and help them anticipate and interpret what's going to come. If they start to anticipate and interpret something as dangerous, as fearful, as, you know, whatever, then they're going to continue to reinforce that schema. It's not something that we think about until you start learning to fit cat and examining is this schema, Is this expectation or belief accurate in this context at this time? Distress can be caused by schema formed using immature cognitive abilities. The child that thinks instead of thinking, I made a bad choice, they think I am bad or I made a bad choice, therefore I am bad. That's concrete. I did this, so I must be bad. I was scared. Therefore doing this must be dangerous. If I'm scared, that means everybody else is scared, which means this is dangerous. You were really angry. It must be because I did not do my chores well enough. So a child that is in an environment where the caregivers are angry all the time, they personalize that it must be something I'm doing and I was bad and made you angry. So you hate me. You either love me or you hate me. And I was. I was bad. I am bad. You're angry. You hate me. So you can see how these schema can kind of build up in somebody's brain and create some faulty interpretations in situations. Distress can also be caused by embracing thoughts and feelings as facts. Feelings are not facts. Thoughts are not facts. Thoughts are interpretations of facts. Facts are facts. A person may say, I am stupid versus I have the thought that I'm stupid. Very different. I can think of something and forget it. Two minutes later somebody may say, I cannot go on versus I am feeling like I cannot go on. Doesn't mean it is. It just means that's what I'm feeling right now. ACT asserts that human language naturally creates psychological suffering by setting us up for our struggle with our thoughts and feelings through experiential avoidance. We have a problem. We feel angry or anxious. It's something we don't want. We don't want to feel that way. Our solution is to figure out how to get rid of it or avoid it. Instead of saying, all right, I wonder where that's coming from, and addressing the underlying issue and recognizing the difference or the similarities between what's going on now, facts in this context at this time versus prior experiences. The ACT interventions focus around two main processes. Developing acceptance of unwanted private experiences which are out of personal control. Guess what? Your feelings are out of personal control. What you do with them is not. But your feelings are a relatively automatic reaction based on prior experiences based on those schema. Now can we start modifying those schema and doing some cognitive restructuring? Sure. But until that happens, your feelings are your body's way of saying, hey, I want to survive and I think this might be dangerous. So that's good. We don't want to turn that system off. We just want to fine tune it so it doesn't go off unnecessarily. And we want people to have commitment and action toward living a valued life. The first step, remember I already said getting rid of the symptoms is not the goal of act when, which probably not what you're going to lead with in your first session with somebody. The first step in in ACT is confronting the agenda. The person's agenda of emotional control is gently and respectfully undermined. And, and that goes back to that smoke alarm analogy. We're not going to tell them you're wrong for feeling this way or you're wrong for not wanting to feel this way. But we want to talk with clients and say, okay, you feel anxious. Let's talk about the ways that you've tried to get rid of or avoid this anxiety. And that's what Hayes calls creative hopelessness. Then, for every way that you've tried to get rid of or avoid this feeling, did it reduce your symptoms in the long term? What did the strategy cost you in terms of time, energy, health, vitality and relationships? And did it bring you closer to your rich and meaningful life? Did it bring you closer to that life? You want Dr. Phil? Cut it down into a short question. How's that working for you? When we confront the agenda, we need to help people recognize that control is the problem, not the solution. Trying to control how I feel in these situations. If I'm going to do public speaking and I'm afraid of public speaking, trying to tell myself that I need to get through it and it'll be fine and control how I'm feeling. Well, we got to understand why you're afraid of public speaking and explore some of those schema. And sometimes it may be anxiety provoking and that's okay. That's your brain going, okay, this is a situation you don't have a lot of control over and you responding back going, yeah, you're right and I'm going to do it anyway. Clean discomfort is when emotions and reactions are accepted. When this happens, it leads to a natural level of physical and emotional discomfort. If I accept that, hey, I'm anxious about this and I'm going to have to sit with this anxiety for a minute because I'm going to do this, I acknowledge it instead of fighting with it or trying to get rid of it. When you try to get rid of something, that's what they call dirty discomfort or quicksand. Once we start struggling with our unpleasant Feelings with our discomfort, the struggle switch is turned on and discomfort increases rapid, rapidly. The struggle switch is like a battle cry for all of the dysphoric emotions. Buddies, instead of fighting with, fighting with anxiety, one on one going, all right, I feel anxious. Let's figure out what's going on here. Now you're feeling anxious, and anxiety's calling all of his buddies in. People who are depressed often also experience anger. They wake up, they're depressed, they get angry that they're still depressed. They get angry that other people are happy. They may feel guilty because they don't have the energy to be present the way they want to. They may have anxiety that the depression will never go away or they're going to be abandoned because they are depressed and not able to do what they want. And they may grieve because their depression is preventing them from having the life that they want. So now, instead of dealing with singular depression, you've got all these other things because this person is using so much energy to fight with the feeling instead of addressing the underlying issue. Anger is the same way. People can feel angry, and then they may feel guilty about feeling angry or getting angry. They may may feel anxious that they're going to be rejected because of their temper. And then they may feel grief and depression because they're so angry about things. Then they start recognizing what they've lost because of their anger. The six core principles of act. Once the emotional control agenda is undermined, and I don't like that word undermined, but it's what Hayes uses. Once we've helped people stop trying to just control their emotions. I feel this way right now. I want to change it right now and help them see the bigger picture, the context, and the framing. Then we introduce the six core concepts and principles of act, diffusion, acceptance, contact with the present moment, the observing self, values, and committed action. Cognitive defusion is learning to perceive thoughts, images and memories as bits of language, as pictures, as opposed to what they can appear to be threatening events or objective truths. I feel this way, therefore it must be. No, not necessarily. You feel this way, therefore you're having a feeling. Let's look at the facts in this context at this time to see it what the objective truth is. Cognitive defusion means stepping back and recognizing that thoughts are just transient, private, subjective events. Five different people can experience something, and five different people may have five different reactions to that something based on how they interpret it, based on their thoughts and feelings and perceptions of the situation. Daring to separate yourself from your thoughts and fears is the Goal of cognitive diffusion. So it actually is backwards. Fears is the problem, daring is the solution. Fears stands for fusion. When we believe that if we have a feeling, we are that feeling. If I'm anxious, then this, then this is scary. If I am having this thought, then that thought is me. I am stupid versus I'm having the thought. We'll practice with this in a minute. E stands for excessive goals. When people's goals are too big or they lack the skills or resources, it keeps them from achieving their goals. It can also contribute to them feeling hopeless and powerless. It's like I've been trying to do this and it's not working. A stands for avoidance of discomfort and unwillingness to make room for the discomfort. They don't want to ever feel bad. Well, it's not realistic now how they handle it when they feel bad that they do have some control over. And R is a remoteness from values. People tend to feel more distress and more anxiety when what they're doing and the way they're reacting and behaving is completely remote from their values. If they want to be a loving, compassionate, patient person and they have a patience fuse that's about this long, then that's remoteness from values. If they tend to bite people's head off at the drop of a hat, but they want to be that patient, compassionate person. Remoteness from values. So we want to help people unhook from what's going on and start exploring what may be contributing to their distress. The antidote to fear is dare. D stands for diffusion. I'm having the thought that this is terrifying. I'm having the feeling that this is going to be dreadfully boring. My behaviors were unpleasant just because I bit somebody's head off. Because. Just because my behaviors may have been unpleasant or even inappropriate doesn't mean that I as a human being am unpleasant. It means what I did was was unpleasant. A stands for acceptance of discomfort. When I realize that I'm having this thought or this feeling or that I did a bad thing, accepting that discomfort and going, all right, well, where do we go from here? Setting realistic goals to address it and embracing my values. This is what I want. This is my rich and meaningful life. How can I use my energy effectively in this situation to help me move toward being the person I want to be and achieving the life I want to achieve. Think of a negative self judgment that takes the form as I am X and I've been saying stupid all day and I know that's not a nice word, but think of it when you tell yourself I'm stupid, believe it as much as you can. Notice how it affects you. You know, when you start saying, I am this. I am lazy. I am stupid. I am worthless. Oh, that cuts to the core. You know, that's. I feels heavy, me just saying it without even trying to convince myself to believe it. Now insert the phrase, I'm having the thought that. I'm having the thought that I am lazy. All right, well, where's that thought coming from? I am having the thought that I am stupid. All right, well, I may have done something that was stupid, but am I stupid? So we want to start evaluating that thought. I've got this. Now what do I do with it? Is it accurate? Is it inaccurate? How do I proceed? The same thing can apply for substance abuse. For example, I have to have a drink. No, no, not necessarily. I. I'm having the thought that I have to have a drink. Okay, well, that's true. Now you've got this thought. What are you going to do with it? Thoughts and feelings do not have to lead to actions. The feeling, I cannot deal with this. I think we've all said that a time or two. Change the verbiage. I'm having the feeling that I cannot deal with this, or I feel like I cannot deal with this. So I've got this. Okay, let's acknowledge the feeling. This sucks right now. What are the facts in this context at this time? Other diffusion techniques include treating the mind as an external event. And I tell people, it's kind of like you're the CEO and your mind is the coo. And the COO comes to you with some stuff and says, all right, boss, this is falling apart. And you sit back and you go, yeah, you're right. Now what? Sometimes the COO is going to bring you useful information. Sometimes anxiety or anger or depression is there for a reason. And that's when the CEO says, all right, you're right. Now what do we do about it? We don't want to just sit there and go, yeah, business is falling apart. The same thing is true if the COO brings you in inaccurate knowledge. Why don't you go back and check your database again? Because I'm not thinking that that's actually jibing with what I'm seeing in the reports. Thoughts are not causes. It is possible to think a thought and not do it. I can think that I want to have a drink and not do it. I'm having the thought that this is scary and I'll do it anyway. And I think we've all had to do that occasionally. I'm having the thought that I have to smoke, but I'll get some coffee instead. So my thought is, I'm thinking that I have to do this but and I'm going to do this instead. So the thought does not dictate the action. You can also treat your thoughts like bullies, asking your brain if your brain starts telling you, you got to do this or you are this, who's in charge? The next step is acceptance. Make room for unpleasant feelings, sensations, urges and other private experiences. It's going to happen. Some days you're not going to have an A day and instead of getting all irritable and dirty discomforted about it, okay, today I'm feeling kind of sluggish. How do I deal with that? What's the best response given the facts in this context? Allow feelings and thoughts to come and go without struggling with them or giving them undue attention. If I'm having back pain, I can focus on it and I can whine about it all day long. It ain't gonna make the back pain go away and it's gonna distract me. That's using a lot of energy. Complaining when I could be using that energy to move toward my rich and meaningful life. May not be moving as fast as the days. My back doesn't hurt, but I can use the energy more effectively. Thoughts and feelings don't have to lead to action. People need to identify and define the problem when they're feeling a certain way or thinking a certain way. Then it's important to understand why. What's causing this? Is there unresolved baggage that I need to unpack? Or. Or is there something going on that I need to address? Explore the effects of avoidance on moving toward your rich and meaningful life. And then the Serenity Prayer focuses on changing what you can and accepting what you can't. The next step is contact with the present moment, and we've talked about grounding and mindfulness and a lot of other activities. Bring full awareness to your here and now experience with openness and interest. How do I feel right now? What am I thinking about? What physical sensations am I experiencing? And even describing the environment like the smell, temperatures, colors, objects. Sometimes when people are feeling distressed, I help them get grounded in the present moment. I say, okay, I want you to look around my office and identify five things you see that are green. Or tell me five things that you see, four things you hear, three things you smell, two things you feel, and maybe one thing you can taste. There are a lot of different grounding activities out there. But contact with the present moment is so important because it brings us to now. We're not thinking about the past, we're not thinking about the future. We're looking at what's right in front of us. Not only are we looking at what's right in front of us, but we're looking at something theoretically non stressful that's right in front of us. Why is this important? Because our brain needs a minute to get out of that stress response. So you can get out of fight or flight and into executive functioning. Grounding is super important. The part of the mind that is the manager or the scientist is the observing self. From this perspective, it's possible to experience directly that you're not your thoughts, feelings, memories, urges, sensations, images, roles or physical body. These phenomena change constantly, but they're not the essence of who you are. You may feel pain, but it's not who you are. I'm scared right now, but that's not who I am. I wonder why I'm feeling scared or why I'm feeling depressed right now. Being curious about those thoughts and those feelings. But they're not who you are, they're what you're experiencing. And clarifying values is also important in defining that rich and meaningful life. What is most important deep in your heart? What sort of person do you want to be? What is significant and meaningful to you? And what do you want to stand for in this life? It's not asking what your goals are, it's asking what are your values? What are you driven by? And then you can figure out if your goals align with your values. After you figure out what your values are, a lack of clarity about values or a confusion of goals with values can underlie the inability to be psychologically flexible. If my goal is to be a CEO, but my values are to be compassionate and to be a good friend and to be available to people. They may not go hand in hand. My goal may say, you've got to work 60, 70 hour weeks. My values say, but there are other things that are important in your life. So I've got to figure out, am I acting in accordance? Am I pursuing a goal that's in alignment with my values? The next step in act is choosing a direction. Figure out, all right, what do I do? What's the best use of my energy to move toward my rich and meaningful life? What are my motivating values? And establishing willingness to to regain control of life but not necessarily thoughts and feelings. And that is a a tricky thing. Helping People recognize that they have the ability to implement these tools so they can stop wasting so much energy struggling with dirty discomfort. And even though they may still have unpleasant thoughts and feelings at times, setting goals, guided by your values and taking effective action to achieve them is the definition of committed action. And that's where we want people to move. One of the activities I do with my clients is I have them create this line, I guess. And on one end, they're the behaviors, thoughts, and feelings that move me away from my rich and meaningful life. And on the other end are the behaviors, thoughts, and feelings that move me toward my rich and meaningful life. And it's important to help people identify. Again, anger in. In and of itself is neutral. What I do with that anger, if I dwell on it and I stew on it and I nurture it, is that a good use of my energy and helping me move toward the person I want to be or is acknowledging it and figuring out, okay, what can I do? My behaviors. If I'm not getting adequate sleep? Y' all know I love my sleep. If I'm not getting adequate sleep, is that a behavior that is helpful to me in my life to have the energy and focus and all that other stuff to move toward my rich and meaningful life? So if I'm looking at, do I stay up and watch three more episodes of this series that I'm watching, or do I actually go to bed? You know, that's what I'm looking at. And I say, is this moving me toward or away from my rich and meaningful life? The goal of ACT is to create a rich and meaningful life while accepting that pain inevitably goes with it. And accepting pain doesn't mean you're saying it's okay, you know, this. This happened, and, hey, whatever it means, yeah, this sucks. And it's important to figure out how I am going to accept this pain in my life. My. My mother passed away from cancer. So did my father. Okay, well, both of those were really sucky things. And they hurt. Don't get me wrong, they hurt like crap. And I didn't want to accept it, but I had to move through that grieving process. Remember denial, anger, bargaining, depression, and acceptance. We're not telling people to get rid of their grief. That's not my. My job or my purpose or my place. My goal is to help them figure out how to live with their grief. That is somewhat indelible. I mean, there's a certain amount grief gets easier to deal with as time goes by, but it doesn't go away for a lot of us and helping people accept that, okay, there's this feeling, and yeah, it's unfortunate. I still miss my mom and dad. And it's okay. When I think about them, if I have a moment of, you know, if I have a moment of sadness, that's okay. I don't have to struggle with it and say, well, you shouldn't feel that way. They've been dead for 10 years. Well, I do. And it is what it is. Struggling with it is not helping me move towards my rich and meaningful life. And ignoring it is not helping me move toward my rich and meaning of meaningful life either, because they were important to me. Saying it's all right, come on, bring means recognizing it is what it is and deciding how I'm going to use my energy to move forward, whether I'm going to give it attention at all or I am going to address it in some way. We want people to be aware and present in the moment. Act recognizes that destructive normality is the psychological process of a normal human mind that is often destructive and creates suffering. Because people, instead of saying, I'm having the feeling that I'm depressed, they're saying, I'm depressed, or, this is depressing and I'm helpless and hopeless. Well, if I'm saying that, I feel pretty powerless. If I say this situation feels depressing, okay, well, that's distancing it from myself. So I'm stepping back and I can take a look at it and say, all right, what do I do about it? Actions are often designed to avoid the experience in the present moment, and we need to help people evaluate their actions. How's that working for you? And therapeutic interventions focus around two main processes. Developing acceptance of unwanted private experiences which are out of your personal control. Whether it is a pain in your back or a pain in your neck or anxiety or depression, people can't see those that's going on inside your own head, inside your own body, okay, I don't want it. And it's unpleasant, but it's not totally within my control. There are things I can do about it. When my back hurts, I can stretch and, you know, do other things. But accepting that it is what it is, and then having commitment and action toward living a valued life. Are there any questions? And it's important to remember that anger and anxiety, those are normal emotions. We don't want to turn those off. We want to be able to recognize them and we want to be able to understand where they're coming from and if they are accurate with the facts. In this context, at this time. All right, everybody, have an amazing day and I will see you next Wednesday. What am I doing for the rest of the day? I'm going to be going to the gym in a little while and then I probably need to work on some more of the addiction counselor exam review. So lots more computer work and a little bit of activity. What are you doing, Chris? You're quite welcome, Lisa. Always glad to see you. I hope you're keeping warm up there. I making the assumption that you are in Maryland, but maybe you got lucky and you're down in Florida again. Okay. Well, you are all very welcome. I'm always glad to see you. Please remember to like and share and I will see you next week.