EP 179: Psychological Flexibility through ACT | Steven C.Hayes PhD

Welcome to Radical Responsibility, the podcast dedicated to ridding the world of blame and shame, where we explore the issues you care about from a unique perspective. 100% ownership for each and every circumstance we face in life, day in and day out. Hi, welcome to the Radical Responsibility podcast. This is Fleet Mall, your host. And today I'm having a conversation with the renowned developer of the acceptance commitment therapy model, Dr. Stephen C. Hayes. This is an extraordinary model which has become one of the predominant therapeutic models that integrates cognitive behavioral therapy with mindfulness and awareness and one that has actually a really strong spiritual foundation. Even though it's a completely secular model, it really, on the inner level, has a strong spiritual, spiritual foundation. And Stephen Hayes has, I believe, published more peer reviewed professional journal articles in psychology than any living human being. He's an incredible thought leader, scientist, researcher and healer. Dr. Stephen C. Hayes. Welcome, Dr. Hayes.

I'm really, really glad to be here with you. Sleep well.

We're really excited to have this conversation with you on this day where we're focused on preparation and integration. So first I want to share a bit of your bio to familiarize people with you who may not be familiar and then we'll jump right into the conversation. Sound good?

Awesome. And please call me Steve.

Okay, Will do.

Look over my shoulder when I hear Dr. Hayes.

Who's that? Okay. Stephen C. Hayes, Ph.D. is a foundation professor of Psychology Emeritus at the University of Nevada, Reno and is president of the Institute for Behavioral Health and author of 48 books and over 700 scientific articles. His career has focused on analysis of human language and cognition and the application of this to the understanding and alleviation of human suffering. Dr. Hayes is the originator of Relational Frame Theory, an account of human higher cognition and acceptance and commitment therapy known as act. One of the most widely researched and used forms of psychological intervention over the last 20 years, ACT takes a process based approach with a particular emphasis on mindfulness acceptance and values as aspects of a core set of skills called psychological flexibility. His TEDx talks and blogs have been seen by over 3 1/2 million people and he is ranked among the top 10 most cited clinical psychologists in the world.

That sounds good.

Let's see if I can be useful to people.

I'm sure, I'm quite sure you're going to be. Yeah, so you know, you're, you're really well known for having developed act and, and so it's really one of the most respected psychotherapeutic models, psychological intervention models of our time. So I wonder if you could just familiarize our audience a little bit with some of the basic principles of act.

Yeah, I'm happy to do that. And you know, our best way to think about ACT is not just in terms of techniques or something, but the underlying model. And it was built that way over a 40 year period. My first ACT workshop was in 1982 and here we are 2040 one years later and we from the beginning never really fully brought into, bought in the idea we should think of people just in terms of these normative top down categories. You know, you have this disorder or that disorder like people are walking around as latent diseases is. Now we, we were thinking about what are the processes that most empower people to live the kind of lives they want to live. And so we've spent first 20 years really in obscurity digging down into the psychological flexibility model, even having to create a theory which is not just a theory. It's a live research program on language and higher cognition. It's very widely used for things like children who can't speak or helping you increase your IQ or things like that. But also informs what's going on with the mind that creates wonderful things and things, some of which psychedelic assisted therapy is really all about. And we were able to distill all that down into the smallest set of processes that do the most things. And I've actually will explain a study where we've looked to see is this really true, that this is the smallest set that does most things? I think I could defend that. And we came down to six things at the psychological level. And then you need to add the social and cultural level and also the biophysiological level. But at the psychological level, learning to be more open, aware and actively engaged is what makes a difference in life. And what do you need to open up to your own history and how it shows up in the moment with the emotions that you feel, the thoughts that you have. What do you need to be aware of the present moment and what it affords. And this more spiritual sense of consciousness awareness, period. End of story. Not you as a concept, but you as this dimensionless point of awareness that's was brought into consciousness by your social community when mama's eyes first met yours and you dumped natural opiates in your brain because you're the social primate who recognized that I'm here and I belong. And what does it mean to be actively engaged? Well, now that you've shown up and now that you're here, what do you want to do and what do you want it to be? About and so. And I'm not just talking about goals. Yeah, we probably all want to earn a living and be able to support our family and so forth. But right inside that be able to support our family. Well, okay, so part of what you're about might be others, might be what you want to do that is intrinsic to your behavior and then getting your feet in align with that. So it has six features that is talked about emotional cognitive openness and awareness of the present moment from a witnessing, noticing beyond words, sense of self and values that are intrinsic and chosen and that are put into real life work. And then scale that into your relationships and to your families, communities, work sites and nation and world. And you have a body to take care of. So diet, sleep, exercise, brain health, etc really matters. That's it. And it turns out, I think a pretty fair examination of everything we know about how change happens. Even the studies on psychedelic assisted therapy. 98 of everything we know fits inside what I just said. And I don't want to be grabby about it. I don't want to say and therefore everything is act. That's not the point. ACT will die. It'll go away. It's just a word. But these processes won't because they're built into our heads and hearts and hands as the kind of creatures that we are.

So.

I'm most familiar with ACT because of my involvement in. In prison work, in the criminal justice system and creating programs for.

Returning youth. Yeah. For a long time. And ACT has been used a lot in prisons.

It has indeed. More and more for reasons I can explain that are relevant here.

Yeah. And we have a model through our organization we call the Path of Freedom. We sometimes call that a mindfulness based emotional intelligence program with some cognitive elements. Act, I usually have heard it described as. As a cognitive behavioral program that's on the acceptance end of that spectrum along with things like DBT and other things. And so in that light, it seems like often those six elements you spoke of sometimes seems to get boiled down to mindfulness, acceptance and values. And those also come up when we. I think you were alluding to when we started talking about both preparation for and integration of psychedelic experiences. So I wonder if you could talk more particularly about the mindfulness aspect of.

ACT and how also it really incorporates a. You know, there's the other end of the cognitive behavioral spectrum where you're just going to find the bad thoughts, replace them with the good thoughts and get different results. Somewhat simplistic. Right? But being mindfulness based, the way we understand mindfulness and one of the core values of mindfulness is acceptance and befriending yourself, befriending your parents.

Exactly.

So I wonder if you could talk about those elements a little bit, and that's going to maybe lead into how we start bringing this into talking about psychedelic assisted psychotherapy.

Yeah, I'm delighted to do that. But I just have to say, Fleet, I mean, my first applied job as a student was in a federal prison. I for a long time thought I would become a psychologist in corrections. And my first self help book, get out of your mind into your life was written originally for incarcerated populations. And it was only when the bureau prisons director here in Nevada said changed and a new person came in, said, all we do is lock, feed and count, that I said, oh, well, I don't think I want to be part of that. Yeah, but you know, there, and there's a history, as you know, with psychedelics of reaching out to incarcerated populations and looking at going all the way back to the earliest days.

Absolutely.

To answer your question.

Mindfulness.

You know, when you use the M word, it pulls for a particular spiritual religious tradition. But if you look at the core of it, process wise, it's in all our spiritual and wisdom traditions and it's in all of the indigenous use of psychedelic substances because it taps into what human beings need to be able to show up. And so mindfulness helps us show up with the echoes of our past sometimes, which are emotional, could be painful, emotions could be very positive emotions. But you know, emotions will pass away. And so if you cling and hold on, away it goes. If you run in fear, away it comes. I mean, it's a real paradoxical thing that a, you know, if you're not willing to have it, you've got it. If you're not willing to lose it, you've lost it. You know, so how do you kind of show up in the present moment with a history that gives you painful and pleasant things that you could either avoid or cling to, with thoughts that are in all directions even three or four or five year olds understand, goofy with horns on one shoulder and goofy with a halo on another, which means they know inside their head they're already getting the cacophony going. You just say the words to yourself, I'm a wonderful person, and listen and you'll hear it. No, you're not. If you said, I'm the worst of the worst, the lowest of the low, you'd say, I'm not that bad. You know, so the mind does not set up for peace of mind. That's not what I came here to do. And so you better learn how to. And in mindfulness, that's teach you those skills to be able to be open, to allow emotions to come and go, to allow thoughts and to allow them be diff of different forms, but to see them, learn from them, you don't ignore them, but learn from them. Sort of the way you might learn watching the clouds in the sky. Oh, one looks like that. One looks like that. To do that you need to come into the present moment in a way that's open and, and, and flexible and fluid and voluntary. It can't be rigid. Isn't just being in the present moment, you know, look, I've got a soon to be 18 year old in the house who's a wonderful boy, I'm so proud of him. But boy does he love his video games. And if you get him in front of a video game, you could go behind him and slap your hands as loud as you want. He's not even going to turn his head. He's in the present moment, but he's gone. And whatever's in there.

Which is fine for recreation, it's not so fine that if you've disappeared into the hell of your own history, into your worries about the future, into the fact that you know you're going to die, about the betrayal that happened long ago with somebody you love disappointing you or even rejecting you. And so mindfulness has this attentional flexibility process built in. And the simplest mindfulness practice, which is in every wisdom tradition, means reigning in the excesses of language. Whether it's through chance, dances, silence, coands, you know, repeatedly saying particular words, whether it's simply watching your mind in a sort of vipassana type style, while as you follow the breaths and then pulling back your attention to the breath, whatever it is, there's training into helping you have your attention. Be a flexible fluid and voluntary and the one that's usually missed in mindfulness. But I insist be in there. I know it contains an S word that people don't like, but there's also self, sense of self. And I'm not talking about the categories of I'm like this and I'm like that. No, I'm talking about your personhood, your agency, this dimensionless point of I here now witnessing and noticing and as I said, connecting you in consciousness with others. When your eyes met your loving mama's eyes at the first day of birth, you connected in consciousness for just a moment and your brain reacted to it. And well, in the same way, when we can bring, build this spiritual sense of self that's beyond words.

And to see that there's a continuity there and there's a participation there. I mean, if you look in psychedelic work on things like a sense of oceanic awareness, always what breaks down is the aloneness of me cut off as as opposed to being connected or just here, as opposed to the vast universe or just now, as opposed to what happens when time expands. And that sense of expanding across time, place and person is not a delusion. It's waking up to the fact that you're part of something. You're in something, you're with something, you're an aspect of something that goes beyond time, place and person. And so mindfulness work contains within it these four processes, this expansive sense of self bringing you into the present moment voluntarily, where you can open up to your history and the chatter that's in there. Take what's useful, leave the rest, show up here. And then what in all the mindfulness traditions, in wisdom traditions, and then what is right action? What are your values? What are you up to? And then how are you going to build that? And if you're doing a mindfulness retreat and they see you using these earlier skills for selfish purposes, you're going to be asked to do the dishes.

Why? Because a good trainer in those traditions knows that there is a selfish form of that this is all just self soothing. It feels great. Well, that happened to psychedelics too. We saw that in the 60s and 70s. I lived that. I was sitting on Hippie Hill in the Summer of Love. Hello. I lived on the Panhandle and 406 Cole St. In one of those wonderful San Francisco houses. I went back to the land. I lived on a rural commune. I, you know. And inside that generational experience was also how it can go awry when you forget that it's connected to values and about something bigger than yourself. So mindfulness, acceptance and values don't forget values. Don't be just telling people, you know, the, the mushrooms will talk to you. No, without orientation. And in all our indigenous populations, if they're going to use these substances, they're going to use them with a metaphor that allows people to be oriented towards a process of self exploration that is not about me, me, me, me, me, but is about showing up in the world and having a life worth living. So let's not make the mistakes of the past, but let's not be afraid either. And let's use what the best of science tells us about how change Happens.

Well, you went from kind of zeroing in on, on, I think, what we need to explore here. And also you took us into the deep end of the pool, I think. So.

You know, first of all, we have some very shared narrative going back in the 60s and 70s. Maybe we want to have a side conversation about someday. But.

You know, it seems like most self awareness mindfulness practices.

Begin, you could say they begin with some kind of self directed self regulation, some kind of attention, intentional attention switching is sometimes a technical turn of choose, but being able to direct our attention and then it seems like that then moves into getting access to what we might call the witness, the watcher, the observer. But some kind of witness. Yeah, yeah, Step out of our experience a little bit and actually, actually observe it. Right. And, and it's from that witness mind that we can connect with a. A sense of self that's not so caught in particular narratives and particular things and particularly reactive habitual patterns. Right. So in terms of preparation and integration, I think, you know, a pretty good portion of the population.

Is not walking around every day with a very expansive sense of self and is not very well prepared for that expansion, much less any kind of what's sometimes called ego dissolution. Some immediate abrupt experience of an expansive self and pretty identified with particular narratives and so forth. And often I think one of the things that keeps people stuck in, in lifestyle patterns and behaviors that are not helping them, that are not in their own enlightened self interest or maybe even really perpetuating tremendous suffering for themselves and others is the sense of, well, that's just the way I am. That's just the way the world is. You know, there's very little sense that things could be any different than they are. Right. And of course, all that's actually been conditioned into our neurobiology and so forth. So in terms of preparation, it would seem like. And you know, in terms of psychological flexibility, it seems like that, that some access to that witness consciousness is really the foundation of having that flexibility. And so it would seem like what you're talking about in terms of preparation for psychedelic citizens, which may bring about, depending on the dosage and the medicine, but may bring about some rather abrupt shifts.

Yes.

In self orientation or abrupt experiences of expansive self oceanic awareness, interconnectedness, or some kind of dissolution of our normal sense of limited self, that, that then act and mindfulness in general could be an ideal preparation to prepare someone for that experience.

Boy, I really do believe that. And you know, I think that that quality of this witnessing, noticing kind of everything, nothing no sense. It has these qualities that are difficult to talk about because it's not thing like. It's just the fromness of awareness that connects you in consciousness with others. And that isn't what we need to get into our clients in terms of a language. What we need is metaphors or language that within their history, their cultural group, their religious background, whatever it is that connects you with the possibility that there's a deeper sense of self or a true sense of self. And you don't have to use the self word, but that is deeply known to you. It isn't new. It's that your mind will never get it because your mind is a categorical symbolic tool. And you started looking at mama's eyes and dumping those endorphins. And then you then had language for I and you and here and there and now and then. And you kind of defined yourself. But with. Even within that there's the seeds. And I think, you know, consciousness itself is just gradually increase from you know, planaria forward of being able to notice the regularities within yourself and the world and between them. But there's a break that happens in human consciousness when you're able to step outside and look back at yourself. And that comes, I think is almost built into us as. As human beings. But language then gives you the tools. You hit that age of reason, you know, where we even have ways of talking about it. Insider or spiritual and religious traditions where there's a break and you're now a human being in a different way. Yeah. But that same break starts allowing you to torture yourself with your past or.

Your future by yourself.

You begin to say I'm a person who. And you fill in the blank and then you hold on to it and it often things that you actually don't want. You know, I'm a person who can't be trusted. I'm a person who lies. I'm a person who should be ashamed. I should personally have done. But you know, it isn't just I'm great and grand. A lot of those fill in the blank things are. And I think we do need to prepare people for that. And act does it but allows you to as a therapist or as a guide to know what the science says and integrate that. But then to make it fit the individual and their history. And indigenous peoples do it inside their traditions, but they vary from each one. You can't take, you know, the things that come from Native American culture, for example, and this plop it inside, let's say the Deep South. It's not going to work that way. So how do we talk about.

Often people do have words in their tradition like this more spiritual sense of self, depending on the religious background. You can use that if it's safe for that person. And so I think the preparation should be. And I kind of like, can I say I like the, the ACE model that Watson Loma developed, which is another form of the psychological flexibility model. It's published in 2020. I think it's publicly available, I think it's open access, but it's a reformulation of the six things I just said into accepting, connecting and embodying. And the idea is that you, you need to be oriented to letting go, to showing up with your own senses in your body, showing up with your own emotion. And some of that's going to be painful and difficult, but then coming up into a sense of self that expands out like the sun rising, where you can connect with others and your deepest purpose. And you can choose where you're going to carry that going forward and how you're going to put that into your life. And that kind of down, down into your history, up into your consciousness and out into the kind of life you want to live and the kind of world you want to help create. Is why I think we see over and over again in these early psychedelic system therapy trials across all of these diagnostic groups and these things we make up with our DSMs and all of which should be put with a huge asterisk. None of these things are real latent diseases. They're just our best attempts to categorize. Far better to categorize the individual journeys and empower it than to shove people into cubby holes of symptoms and signs. And when you expand out, I think you need some orientation towards the importance of letting go. For the roller coaster you may experience, but for the, the deep sense of trust in yourself, fidelity to yourself. You might even say con, the word with in Latin fides, the word faith in Latin with the convenience, faith, with the confidence that your, your experience is valid, you belong here, you're meant to be here. And you can have a life worth living. And not because you just believe it and I told it to you, but because it's in your core. And somehow or another these. And I think I, we know a bit about why these chemicals can assist you in that because they chemically break down the barriers that you were just talking about. I'm a person who, and I'll always be like that. I know it doesn't work, but it's true or Whatever. Boy, it looks a lot different when you know these midbrain structures that have been harnessed almost like a parasite for your narrative sense of self and won't even allow you to see things that contradict your own story. To see that your story in you're here and you're part of something across time, place and person. That's big. And you belong, which is why your. Those endorphins happened in the first place. When those eyes met, what they said is you belong. Well, I think that's what we need to create in our clients.

Well, that beautiful description you just gave would seem to be the ideal outcome of any therapeutic modality. Absolutely. And I want to explore the mechanisms of this a little bit, possibly neurobiologically as well as psychologically, and also moving to talking about the other side of the psycho accession integration as well. But just as you were describing that, I think a lot of people who have transpersonal experiences of some kind of, whether they're spontaneous or through meditative or mindfulness disciplines, or whether they're through some kind of performance or whether they're based on psychedelic experiences or breath work experiences, they often, or even within the religious traditions of mystical experiences, you often hear them talk about that, what they contact, that deeper, vaster sense of consciousness. However people describe it in so many different ways that it's not completely unfamiliar that they, that they've always. They may have forgotten that they knew about it, but they have memories of being in touch with that in childhood in some way or another. And that. That in some way, some part of us has always known that we're fundamentally okay, that we're fundamentally whole, that we belong here, that we're included, that we're valued, that we are valuable. There's some part of this that's always known that. Now we may have lost access to that in many ways it may have gotten wal off through our life experiences, but there's some level of. We're returning to what our being at some depth of our being already knows.

Boy, do I really. I really believe that. I think we can see it. And almost universally, if you do qualitative research on the other side of psychedelic experiences that have been uplifting, people will use words exactly like you had just said. There's a sense of recognition. It's like you're finding something that has been with you all along but you just couldn't see and then you see it. And we have data now that, for example, that spiritual experience which is sometimes talked about in this objective like, oh, some People have in the early work, you know, the. Some of the work on, you know, with people like Maslow and so forth. It was, it was thought who's a hero of mine? My first heroes. The psychologist was Maslam Peak experience. But it was talked about as if it was almost other. You know, only Eleanor Roosevelt would have that. Or you know, people who are heroes of the time when these things first. No, if you ask the question correctly, it's something like 95% of the human population at a reasonable age and of course not necessarily children have had spiritual experiences. If you ask questions that really talk about this transpersonal across time, across space moments. It could have been when you're. You met the eyes of your lover. It could have been when you looked at a sunset. It could have been in a deep meditative prayer. It could have been at a Zen retreat. It could have in. It's a hundred thousands of different ways it could have been. It could have been in a psychedelic experience.

But what we've learned is what, what is the mediator? And there's several studies now showing this the mediator from these spiritual experiences and awakenings to things like real fundamental change and frequency of depression or anxiety or an addiction problem or so forth. What mediates that? Two or three studies have shown that the psychological flexibility processes. However you language about them and measure them. There's a lot of different ways mediate that now it's a means to an end. But. But when? Why? Because when you have that expansive experience.

Contained within it is your own emotions are not your enemy. You can hold all these thoughts and still move forward intrinsically. It invites you to come into the present moment. It's like, you know, you talk to people about the trips they've had and these ones that really have long term effect. It's like people open fresh eyes and that thing that they've been looking at for years. Suddenly I was seen in a different way. We have data actually coming out, it's not published yet. But doing high density longitudinal data that if you're able to relive those experiences as part of your journey, that's part of the integration that allows you to maintain the impact on psychological flexibility processes, which is the process of change that gives the impact on things like addiction or depression or anxiety or. And I don't like saying just those because people have goals with things like relationships and having a business that really matters or just being able to feel whole and free. I don't like thinking just about health as a removal of disease, some latent disease Entity? No, it's about being able to be you fully and do things intentionally. And yeah, that might include cleaning up. Some things about that are called mental health problems. But it also includes building things, creating things, doing things, contributing things, you know, diet, sleep, exercise, all kinds of important things. So.

Your, your sense there that we're awakening.

I go back to this thing I was saying that your first moments of consciousness included it. Your ability to put that into symbolic form that allowed you to sort of step outside deliberately and look back included it. Your life history. When you've had peak experience like this, you sometimes have little glimpses. Oh yeah, this was like that sunset. Or oh yeah, this was like that time when I looked in my lover's eyes and it was not just me, it was we almost in a blending where I couldn't say where it began and end, but not in a way that's, oh my God, I'm losing my mind. If you don't prepare people, they go in and you're neurobiologically removing these artificial filters on our sensory and sensory motor information, our access to our own history. People can feel like I'm losing my mind. I'm becoming nothing. Oh my God, no, you're becoming not a thing. Yeah, that's no thing. That's not scary. Means the boundaries are breaking down. You're bigger than this little ball that your words told you you had to live inside. That often is more of a cage than a foundation to live a successful Life. So I'm 100% with you, Fleet. And I think our processes have changed, both self reported and neurobiological. Measured, or I'd add also behaviorally measured. You know, how much time do you spend with friends or where do you go or do you move? There's now new studies showing with wearables and things like that, that it's not just words that change. It's not just your brain that changes. Your behavior starts to change. And if you can figure out a way to pick the winners and allow that to be sustained, okay, now you're on a journey that will never be finished. You're never going to get a prize. Your life is not done. But on a journey of learning to be more and more wholly you.

So I, I know you've looked at the data with the clinical trials that are going on with MDMA and psilocybin and so forth and probably you've watched some of the videos. I've watched quite a few videos from the clinical trials and I like talk some of some of the things I've recognized.

There. And you know, but just to preface that, you know, one way you could look at all of human suffering and, and what ends up getting, you know, categorized into these not so helpful diagnoses. The DSM 5 stuff are adaptations and in some cases maladaptations that begin with our sense of separateness, that begin with that sense of disconnectedness. And you know, then we're, we're in a situation of threat and we may do that at a highly functional level or with a lot of trauma at a very dysregulated level. And, and so what these experiences give us that we were referencing a moment ago is that experience that I'm not alone.

Yeah.

And initially people access that in lots of ways through. Well initially when consciousness shows up in a body, in an infant, you know, the gaze of the mother, the gaze of the parent seems how it allow consciousness to begin to flow in an embodied form that works. But then throughout our life various ways we get affirmed, confirmed the role of the therapist and a therapeutic relationship and so forth with you know, healthy transference, countertransference used consciously that.

That we can. And then sometimes in the faith traditions and mystical tradition, indigenous troops, it may be an ally, it may be a deep faith relationship with, with Jesus sometimes talk about I, I finally realized that he'd been walking by my side all through my life. Right. And, and not to diminish any of the reality of these more dualistic firms of connecting with something but people that tend to look about those experiences then in a more non. Dual way that all those things are actually getting us in touch with what you might call our higher self, which, which kind of when we experience that it's, it's even though we may be experiencing it, you know, in a sense of being alone, but because it's not limited, we're no longer alone. Alone is not an issue anymore. It's, it's, you know, that, that transpersonal quality expanded sense of self is, is owned by definition not alone alone. This is not so there's such a wonderful healing and confirmation there. So that's just a preference. So what I've noticed in some of the.

Videos of the clinical trials is people having some fairly rough journeys with their psycho experience because you know, but the people in the trials are suffering from severe depression, ptsd, some of these diagnosis anyways categories anxiety disorders and so forth. And you know, so stuff is being triggered, stuff is coming up and some of them are having some pretty, maybe surfacing even memories they didn't. Weren't aware of or revisiting traumatic episodes. But then you hear them being interviewed post session and they seem to be able to talk about this in a fairly objective way with a sense of kind of an innate. They would maybe not using this language, but you just feel the sense of bravery and courage. And obviously they've connected with the witness mind in some way. So they were able to go through this experience, not be re traumatized because they're experiencing it from this, this witness mind, which gives them the perspective, gives them the insights. And you know, and you know, obviously there's a whole integration process, especially if they had some strong ego dissolution experiences. There's going to be a whole unnecessary integration process. But it seems to be here that that's part of the mechanism. And one of the ways that's sometimes talked about neurobiologically, although I think we have to be really careful that we don't really know what's going on. We have ideas about what's going on. But this whole issue of it seems like certain types of meditation and breath work and other transpersonal practices and psychedelic medicines seem at least one way of looking at it is they seem to diminish the activity of the default mode network, which is full of self referencing and very tied into our stress response and the not so healthy mechanisms in our midbrain. And it seems to go offline to a degree which then starts to give us these experiences that are no longer dominated by that. So we get, we get, we get a window into something different. We get a window into a different experience. So I'm wondering if that resonates with you in terms of the pathway of act as well as how that would show up in psychedelics.

Yeah, I'm not. I definitely agree with that. And I've written a scholarly article some years ago of looking at mindfulness meditation and what happens neurobiologically. I've written one that's in a special issue of Journal of Contextual Behavioral Science on psychedelics, on what's happening in psychedelic treatment as well. And you can definitely see the parallels. And you see some of these things you're talking about in the default mode networks. For example, now in the FMRI studies of act per se, and not just act, you also see it in mindfulness based cognitive therapy. You see mindfulness based direct reduction. You see it in successful cases of dbt. You see it. So, you know, and that confluence of all these different things sort of says to me that, you know, the default mode network, not just the narrative sense of self, I think of it. Also these kind of attentional processes that are defensive and kind of constantly over activated. When you're in a safe environment, you know, it's just not necessary to be watching out all the time. But unlike our non verbal.

Non human, animal peers.

You know, we're in a place where you can have this narrative sense of self that can be threatened constantly by the least little thing. You know, somebody disagrees with you or you know, has a different opinion or you know, and we're building it out on steroids with pushing people into different groups with what we're doing with the Internet and all the rest. And we're reaping the wind with that. We can just look around and see. So on the one hand we're affording a more individual focused and broader, more culturally sensitive journey. And on the other hand, people are being feeling more and more safe as they are threatening us. You know, the. Each of these flexibility processes extends and you know, emotional openness means you can have genuine compassion for an interest in the emotional experience of others. Cognitive openness means you can have a genuine conversation with others and you can hear their opinions even if they disagree with yours, and still explore it. You know, flexible sense of attention means we can have joint attention on things that matter between us as a group, as a couple, as a family, as a community.

Values can be shared values or commitments can be cooperative. Joint commitments. Well, how about sense of self? Well, the sense of self we're talking about is the one that affords genuine connection, that affords attachment, a healthy attachment that affords the creation of a we that is bigger than me. And that is not purely content defined, but is defined as fellow beings whose well being is part of your well being. You know, if anywhere, anywhere suffering or spiritual leaders tell us anywhere in the world, we're diminished by that. And that's just not airy fairy stuff. You can look at the war in Ukraine videos and you can feel it, you know, and it's not just the Ukrainians, it's the Russian soldiers doing those things. It's all of us, right? Was it Technot Hahn who said when the pirates were taken over the ships and so forth that you know what he said? I am the pirate. You know that we.

Need to help humanity come into a space where we can create modern minds for this modern world, where we're in 24, seven contact with everything that's going on everywhere in the world or the, whether the person's wearing a burqa or a turban or you know, is sitting under A gum, gum tree or it's all a we that we're part of.

Now. The words can be said, but the experience of that and the place where, you know, why do our spiritual leaders universally talk like that? Why do they universally talk about love as the core and this.

Treating others as you want to be treated, etc. They're universally. They've had mystical and spiritual experiences themselves and then they start saying words and then sometimes people turn into dogma and then they have wars about who thinks the right thing. But that's not what it really was about ever. So I think we have a chance right here to use Western science, to use medicines that have been helpful for people for thousands of years, but to do it in a careful and cautious and deliberate way that is not necessarily shoved into whatever dreams Big Pharma has or the categories that are in our dsdsm, but put into a cultural change that will help us empower people to be more holy themselves as part of a process of humanizing this world.

So that safety, love, connection, compassion becomes an essential quality of what civilization demands of its culture, its leaders, its political systems, its economic systems. And how we treat the world and the other creatures that live with us.

Is quite a vision.

So it's real. And, you know, people come out of our. Of the psychedelic experiences, no matter how humble, their backgrounds or whatever, and they start talking sometimes like that. So I think we need to be prepared not to put that on top of them and say, this is what you have to do. No, to listen and to put inside. Guided by the science, but in words with images, metaphors, etc, that fit because the artists have known this, the musicians have known this, our best literature has known this. We got to catch up. The helping professionals need to. Our wisdom traditions know this. Our helping professionals need to catch up and figure out a way to empower these processes and the people we serve.

Well, let's talk a little bit with the time we have left about integration.

Yeah.

And the role of the therapist in integration. You know, within the clinical trials and there's kind of been two camps. There's one camp that's leaning more towards what the therapist can bring to the table. And there's some. Just trust the medicine, let the medicine do the work. And the sitter is really there just to hold the safe space that seems to be the dominant view within the session itself. But then there's a lot of room in preparation and in integration to use various models and to use various therapeutic skills. So in integration, ideally, we're helping someone learn to reorient themselves with perhaps a more expanded sense of self, a less narrative driven sense of self, to be open to insights about kind of how their life has unfolded to date and how it could be different.

And further to be a value shift. And the way you were talking about values, it's almost, we can talk about values like that's a good value. I'd like to have that. But actually values really arise out of experience ultimately and you know, within, you know, when we have an experience of deep interconnectedness, that changes our value system. Right. Quite, quite naturally. So, and I would think therapists, regardless of the level of intervention or lack thereof or how they're holding space, but I think if we think of the psychedelic session in a bigger trajectory of a person's development and therapeutic processes, ideally the therapist would be an exemplar of psychological flexibility, would be an exemplar of holding what we think of as some of the more admirable human values. Right. I love Dan Siegel's work, you know, in interpersonal neurobiology. And he's coming. Can we take a more transpersonal self and marry that to the we? And he calls it we? I don't think that's going to catch fire because it doesn't exactly roll up the tongue, but you can see what he's getting at. So the role of the therapist in helping someone who's had a psychedelic experience, which could have been very rough, could have been very blissful or somewhere in between, but may have opened up some new windows at the very least.

And helping them then integrate that into their life in a way that's going to lead to healing and lead to some of the outcomes in which you described it, how we could feel whole, feel included, feel that our life is valuable and has meaning and we're connected and, and we're here, you know, for a purpose and so forth.

Yeah, I'd say a few, few things about that one. On. Let me just take off this thing you're saying with values, because I was saying, you know, you could have share values, etc, but it's not just that your values come from your living in a human community. And one of the quickest ways to touch with it is say, okay, so with regard to this issue, could you pick a hero or a guide or somebod up to anybody, ideally somebody you've met, but it could be a spiritual leader is long gone, you read a lot about them, etc, and people will pick Jesus and things like that. I'd say, okay, and what do you Admire about them, what do you look up to about them? And universally what they're going to say is what their values are that they want to put into their own life. Universally, that's why they're a hero, that's why they're a guide. And so can we build on that in therapy? And like one of the things I would start with to say to people who are interested in this work, be, be guided by the fact. And I can give you the link and we can put it in the, you know, in the notes. When we did a meta analysis of every mediational study ever done in the history of humanity, on every psychosocial method ever tested in the history of humanity with mental health outcomes, I could show you that learning to be more open, aware and actively engaged and extending that to relationships in your body accounts for virtually everything we know about how change happens. Just the measures of mindfulness and psychological flexibility and a few little add ons that are obviously part of the same concept accounted for 55% of all the successful statistically done properly mediators of change. Okay, so that doesn't mean you have to all be ACT folks, but it does mean because you'll find it in your clinical traditions, especially the deeper ones, your wisdom traditions, you'll find it. You don't. You could put it in your own words. This is not about actualis that I'm saying this. I'm saying learning to help people be more emotionally and cognitively flexible in the present moment from a sense of self that is not narrow and confining. So you can focus on your values and build behavior around that and put it into your relationships and also take care of your body, knowing what the winners are, knowing when you take a step forward and through habits and practice, putting that into your actual repeat, repeating that and fitting it to context. Because nothing you do good, better and different is always good, bad and different. Some things are helped and hurtful in different contexts. So you need to keep your eyes wide now socially what this means to everybody listening. You should learn what those flexibility processes are, put them into a language that you understand. There's lots of things that you can do to sort of get there. ACT is not a bad way. There are a hundred and ten forty one randomized trials on ACT right now and this is more than almost anything I can mention. And I've looked at where they are and only about a third of them are in traditional dsm. They're in behavioral health stepping up to the challenges of physical disease in social wellness. They're justice they're in performance, they're in, you know, building relationships at work. So if they're important, put them into your own hearts and into your own heads, your own hands as a therapist.

Why?

Because your clients are watching you. You actually were use the word. And I hope they're really good at. Here's what I hope. Not that you're the shining star of psychological flexibility. I'm not. Ask my wife. Know that I know it matters and I'm in my own, as my mother used to say in Yiddish, for stunking away one step at a time. Learning to be a little better at learning how to be open, aware and actively engaged and extending that socially and taking care of my body. That's the journey I'm on because that's what life asks of me. Now if you do that, here's what the data show and make this give concrete form. It means in your actions with your clients, in session with the folks who are sitting and so forth. But also in integration. Work on the gerunds on you yourself being accepting and non judgmental, being in the present moment, consciously interconnecting with your clients. Don't be looking at your watch.

For your clients values to matter to you, their deepest values and to be willing to be within in any way that needs that they need based on you can bring your skills to it that empower those processes and allow it to be put into the world of behavior of that client, scaled to their relationships and community and also remembering they have a body, it needs to be taken care of. It's not that complicated. And if they see you, even if it's hard, let's say you have a client in integration who's talking about abuse history they didn't even know was fully this bad or this much like that. And it opened that door to, you know, a hellacious vision. And let's say some of that touches your own history, pushes your buttons. You can say things like this is really, really hard for me to hear. And part of my mind says saying I'm not going to be good enough or.

But I'll tell you what, you know, I'll walk through the hell of your own history if that's what it takes. So let's take a breath and let's walk in and do what we did in our preparation session of letting go, of getting in touch with our senses, of opening up to our emotions, of coming into a new sense of self that allow our values to be seen and for us to build a life around them. And so.

I think you can do it humbly, you can do it imperfectly, you can admit how hard it is. And your clients will walk with you because you're walking with them.

You're not some great grand star. Look at me, be like me. You're horizontal and out of that space using the techniques and methods that you know about that are useful to you. But yeah, know about these processes. There's a thousand different ways to open up, to show up and to get moving. Let's not fight about the technology. You know, like, oh, this treatment is better than that treatment. Oh please. What's inside those treatments are methods to move processes. Focus on the process, use the methods that you know fit you and move you well. Listen to your clients and let them speak. Have it fit their culture, their background, their religious commitments, their purposes, what they want out of this. And if you do that and you're guided by data over time, that shows that the processes move, not just the outcome. Your clients will be your teacher. They'll teach you how to do this well, to fit each person one at a time, not as a. A walking latent disease and a normative category that has five out of nine symptoms or four out of seven and it's always 50 plus one. So you can cling to some idea that's the same thing. It's nonsense. We're working with whole human beings and their aspirations go far beyond our diagnostic systems. Just listen, learn and allow yourself to channel change processes that are put on steroids with some, I think the data show with some ancient medicines that have been used for thousands of years.

Absolutely. And that's, wow, just such wonderful guidance and wisdom. You know, we were talking a little bit before we got started today and, and you talked about envisioning a really transformed healthcare system in which, you know, healers, physicians, therapists and so forth, seeing ourselves more as agents of change that are walking alongside, journeying with the person, the client and so forth. And when I was originally doing some of my first dissertation paper was going to be on a very different topic than what it ended up being on. But I was doing a lot of research and end of life care and hospice care and in the nursing literature, I ran into a wonderful article where a nurse practitioner talks about the role of the caregiver being to come alongside, which is a nautical term, two boats come along, they tie up together and they journey together to come alongside with the patient, the client, the friend, the person, and take that journey with someone. And I hear that's what you're describing. And as you Mentioned these psychedelic medicines, whether the traditional plant medicines or some of the synthesized versions are, whether it's steroids or in some cases, like rocket fuel. You know, I think it's all for all therapy. It's so important that therapists do their own work and obviously so they can be exemplars of values and psychological flexibility. Not perfect, but they're on the path.

Exactly.

It seems like with psychedelic assisted therapy, the, the need for that is ramped up quite a bit. Like we really need to do our work if we're going to enter into that space with our clients.

Well, can I just say, Fleet, we must be brothers from another mother, because in addition to this early work and incarcerated populations, I actually, as a student created a whole thing that still exists to this day at West Virginia University on trying to put some of these things into aging populations. And I created a rotation that of working in a, you know, in a care facility for. For aging patients and with also, you know, people who are facing death. And that is a part of life and not cut off, you know, that I don't want to see that. And no, no, no, this is coming, my friend. I'm 75 years old. I know how close it is. And this is part of life. This is not something foreign. It's part of the circle. And when you see yourself as being broader than just this narrow little self, you know, the things that we're doing, no, we're not going to be famous forever. There's not going to be castles in the sky. You know, we look at those pyramids with the things saying, here it lies. Be afraid. You know, and we laugh because we don't know who that pharaoh was. We had to, you know, really work hard to even figure out when that was happening. You know, the prideful human mind wants to grasp at immortality, but our physical sciences tell us that the Earth will eventually be a. A red dwarf and the earth will be inside the sun. Hello. Does that sound like immortality? Wake up. You're here to empower this process of living. And, you know, I think if we can bring that spirit of growth and the focusing on the individual and not the individual alone and cut off. I don't mean the individual as opposed to the couple. I mean the people we're working with as who they really are. Whole and free, you know, we can come alongside and I have to say, you know, developed. I'm president of a charitable organization. It's been existence for 45 years. Institute for Better Health, you mentioned it, where we're developing an app in that charitable organization of how to map people individually over time and actually say what processes are most important for them. And our early, early work, be prepared to be surprised because boy is it not one size fits all. You know, you can pick anything. Mindfulness, for example, 90% of the time for 90% of the people, it's helpful. I'll show you the studies where all the analysis we've done that 5% of time, 5% of the people, it's significantly not helpful. So you, you know, everything has under the sun has a time and a place. And so how do we do that? Well, not by normal top line categories, looking within persons and then learning how to reach out. And forgive me for mentioning, I do have another app called Psych Flex that just only released last month that includes this new one called Mind Grapher that our charitable organization developed where we're trying to figure out how to reach out into the 167 hours a week that isn't the one hour you have with them. And to the 24, 7 world where we are guides and fellow travelers, we are change agents and our journeys go on with our clients. It's not a one and done and they can come back and we can help them again. And that thing I mentioned earlier, when people can remember their psychedelic sessions and use what they learned there to focus on the processes, you know, of change that were important. Not by going back and holding it like a professor's stone in the box, like, oh, I wish I could have it. You know, that's was part of the what happened on Hippie Hill. You know, let's do that again and again and again again. Pretty soon it's people lying on the sidewalk and I'm stepping over them and there's needles next to them. You know, that turned into a nightmare really fast. And then we ran back to the land, but we didn't know what we were doing. And then next thing you know, you're coming out with a shotgun because you know, you know somebody's going to look in the bed back 40 and find that you're growing marijuana there. I mean, I don't want that to happen again to the culture. Let's figure out a way to make this lasting, permanent. That doesn't mean biomedicalizing, doesn't mean Big pharma gets to have the say. We get to have the say. So how these tools are used, but then keep our eye on what we're trying to do here, which is intensely social.

Intensely.

Individual. Again, not cut off, but this person with that history and that purpose and that culture needs to be treated in a way that allows them to be seen by us. I'm back to that thing of you at 24 hours and mama looked. You get into session and you see your client.

And boy, that whole safety system engages that polyvagal thing, you know, that default money and all kinds of. And people start showing up. And I think we can use our interventions aided by these ancient medications and new forms that we've discovered and let that be a face of modern culture where every voice matters, where everyone is heard, everyone is important, and nobody needs to be shoved into a box and treated as an error term or some bell curve.

Wow. Thank you so much. Stephen C. Hayes has been incredibly valuable and inspirational. Both that, you know, I think for anyone who's thinking about psychedelic assisted therapy as a client or for a loved one, as well as clearly so much guidance and wisdom for the practitioners and also seeing the possibility that this, what's being called the psychedelic renaissance, could lead to different outcomes than, than the first, whatever that wave was you and I were part of back in the 60s, second wave or first wave. But you know, it lost its way a little bit. But I think there's, there's so many more people involved today and approaching it in such a more thoughtful way that I actually have a lot of confidence that the promise that these medicines often not only for individual change, but for cultural and social change, that there's a chance we might be onto something here, we might get it at least a little more right this time and see some real benefits. Yeah.

And if I could end with this, what that opportunity affords is the same thing that was afforded back in those early days where one at a time people saw possibility and that's still in the culture. It didn't, wasn't all about stepping over people on sidewalks. It really wasn't. I mean the heart of it was about love, it was about peace of mind, it was about making contributions that mattered. Can we use the best of behavioral science and our biological sciences to focus on the processes of change that really matter? I've mentioned some. Put it into our preparation and integration, but start with putting it into your own heart and head and hands and then allow these glimpses that people have that are inherently more accepting in the present moment, non judgmental, inherently more connected in consciousness with others and making it easier to really, all of this has been researched already in the psychedelic space and making it easy to say, okay, this is, these are what my values are and this is the commitment I have. I mean the reason why people are able to stop smoking or to be able to let go of an addiction of other forms or to step forward even though depression is telling them to step back or anxiety. The reason is, is that they've had these glimpses. We can build on that not by necessarily having a trip after trip after trip after trip, but take the window that allowed you to see the landscape before in front of you to navigate a journey that avoids some of the cul de sacs, some of the swamps, some of the places you can go that aren't helpful and that empowers you to be part of something that will transform human culture for the good. We have another SWAT chance. We now have another time at the plate. And for me, I just share. You know, I was at a session on this Jason Lone Mothers had organized at a conference the first time I had been a discussant of it and I got up and I suddenly was overwhelmed with emotion and openly wept and told the surprised audience there we have another chance to put love into people's hearts and into the world. And is that worth some effort of us as a community?

I think it's worth some effort. Let's do it right.

Absolutely. Let's do it right. Thank you so much. Stephen C. Hayes. So just wonderful to have you be part of our summit in this conversation. Incredibly inspiring and nurturing and empowering in so many ways. So thank you so much and we wishing you all the best.

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