The Six Core Processes of ACT

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The Psychological Flexibility Model

The general goal of ACT is to increase psychological flexibility – the ability to contact the present moment more fully as a conscious human being, and to change or persist in behavior when doing so serves valued ends. Psychological flexibility is established through six core ACT processes. Each of these areas are conceptualized as a positive psychological skill, not merely a method of avoiding psychopathology.

Acceptance

Acceptance is taught as an alternative to experiential avoidance. Acceptance involves the active and aware embrace of those private events occasioned by one’s history without unnecessary attempts to change their frequency or form, especially when doing so would cause psychological harm. For example, anxiety patients are taught to feel anxiety, as a feeling, fully and without defense; pain patients are given methods that encourage them to let go of a struggle with pain, and so on. Acceptance (and defusion) in ACT is not an end in itself. Rather acceptance is fostered as a method of increasing values-based action.

Cognitive Fusion

Cognitive defusion techniques attempt to alter the undesirable functions of thoughts and other private events, rather than trying to alter their form, frequency or situational sensitivity. Said another way, ACT attempts to change the way one interacts with or relates to thoughts by creating contexts in which their unhelpful functions are diminished. There are scores of such techniques that have been developed for a wide variety of clinical presentations. For example, a negative thought could be watched dispassionately, repeated out loud until only its sound remains, or treated as an externally observed event by giving it a shape, size, color, speed, or form. A person could thank their mind for such an interesting thought, label the process of thinking (“I am having the thought that I am no good”), or examine the historical thoughts, feelings, and memories that occur while they experience that thought. Such procedures attempt to reduce the literal quality of the thought, weakening the tendency to treat the thought as what it refers to (“I am no good”) rather than what it is directly experienced to be (e.g., the thought “I am no good”). The result of defusion is usually a decrease in believability of, or attachment to, private events rather than an immediate change in their frequency.

Being Present

ACT promotes ongoing non-judgmental contact with psychological and environmental events as they occur. The goal is to have clients experience the world more directly so that their behavior is more flexible and thus their actions more consistent with the values that they hold. This is accomplished by allowing workability to exert more control over behavior; and by using language more as a tool to note and describe events, not simply to predict and judge them. A sense of self called “self as process” is actively encouraged: the defused, non-judgmental ongoing description of thoughts, feelings, and other private events.

Self as Context

As a result of relational frames such as I versus You, Now versus Then, and Here versus There, human language leads to a sense of self as a locus or perspective, and provides a transcendent, spiritual side to normal verbal humans. This idea was one of the seeds from which both ACT and RFT grew and there is now growing evidence of its importance to language functions such as empathy, theory of mind, sense of self, and the like. In brief the idea is that “I” emerges over large sets of exemplars of perspective-taking relations (what are termed in RFT “deictic relations”), but since this sense of self is a context for verbal knowing, not the content of that knowing, it’s limits cannot be consciously known. Self as context is important in part because from this standpoint, one can be aware of one’s own flow of experiences without attachment to them or an investment in which particular experiences occur: thus defusion and acceptance is fostered. Self as context is fostered in ACT by mindfulness exercises, metaphors, and experiential processes.

Values

Values are chosen qualities of purposive action that can never be obtained as an object but can be instantiated moment by moment. ACT uses a variety of exercises to help a client choose life directions in various domains (e.g. family, career, spirituality) while undermining verbal processes that might lead to choices based on avoidance, social compliance, or fusion (e.g. “I should value X” or “A good person would value Y” or “My mother wants me to value Z”). In ACT, acceptance, defusion, being present, and so on are not ends in themselves; rather they clear the path for a more vital, values consistent life.

Committed Action

Finally, ACT encourages the development of larger and larger patterns of effective action linked to chosen values. In this regard, ACT looks very much like traditional behavior therapy, and almost any behaviorally coherent behavior change method can be fitted into an ACT protocol, including exposure, skills acquisition, shaping methods, goal setting, and the like. Unlike values, which are constantly instantiated but never achieved as an object, concrete goals that are values consistent can be achieved and ACT protocols almost always involve therapy work and homework linked to short, medium, and long-term behavior change goals. Behavior change efforts in turn lead to contact with psychological barriers that are addressed through other ACT processes (acceptance, defusion, and so on).

Taken as a whole, each of these processes supports the other and all target psychological flexibility: the process of contacting the present moment fully as a conscious human being and persisting or changing behavior in the service of chosen values. The six processes can be chunked into two groupings. Mindfulness and acceptance processes involve acceptance, defusion, contact with the present moment, and self as context. Indeed, these four processes provide a workable behavioral definition of mindfulness (see the Fletcher & Hayes, in press in the publications section). Commitment and behavior change processes involve contact with the present moment, self as context, values, and committed action. Contact with the present moment and self as context occur in both groupings because all psychological activity of conscious human beings involves the now as known.

A Definition of ACT

ACT is an approach to psychological intervention defined in terms of certain theoretical processes, not a specific technology. In theoretical and process terms we can define ACT as a psychological intervention based on modern behavioral psychology, including Relational Frame Theory, that applies mindfulness and acceptance processes, and commitment and behavior change processes, to the creation of psychological flexibility.

Comments

Square instead of Hexagon?

I want to make an argument for four key concepts in ACT instead of six. Along the way, I want to help clarify some of the six key concepts as described above.

First, I am having trouble differentiating between "acceptance" and "being present." Acceptance, as described above above, is allowing yourself to feel fully without defense. It's opposite is experiential avoidance--trying to change frequency or form of experience. Being present, above, is contact with ones inner states and environment as they occur. It's descriptive. Its opposite is judgment, prediction, evaluation.

In the hexaflex powerpoint things are portrayed differently than above. Acceptance is compared to defusion, it is about undermining literality (colloquially "letting go"). (Which seems more like the description of being present above.) Being present is about being in the here and now (colloquially "showing up").

So, with the hexaflex, the question one asks before moving forward is: Are you willing to have the stuff you are struggling without trying to change it (i.e. accept it) at this time in this situation (i.e. contact with present moment)?

What exactly is the difference between acceptance and being present, and why is it important?

Can't we get by with a pentagon...or even a square? Let's look at the minimum concepts needed.

ACT clearly requires de-fusion. Fusion cab take one away from direct experience and valued action by (a) excessive evaluation and other analysis, and also (b) temporal manipulation (imagining the future, remembering the past). In contrast to verbal relations is experience itself... life itself. If you're never present (i.e. if you avoid) you'll never have a life, you'll never accomplish valued ends. Living life fully involves both showing up (i.e. being present) and not verbalizing it in ways that hinder one's larger aims (defusion). So far we have Being Present and Defusion. Now comes the "get moving" part of the pentaflex... Take committed action toward what you value. So we add Value and Commitment. That's four key concepts.

How about self-as-context? Isn't that already covered by Showing Up and not Fusing with concepts? Fusion can "mess" up experience by confusing us with verbal constructs. It can (a) introduce unproductive evaluation, (b) introduce excessive analysis, (c) it can take us unproductively into the future (excess worry) or (d) ruminating on the past. We can sometimes also (e) fuse with the "self" as a verbal construct. We think there is an "I" which is locked into certain properties, instead of being the carrier of those properties. The alternative to all this is being fully present and conceptualizing this presence in ways that are productive (i.e. valued action).

So, at base, we only need four major concepts, a square. Or a Quadroflex. Or Quadrophenia. :-) Joking aside, what exactly do we lose by giving up acceptance and giving up self-as-context since those are already covered by de-fusion and being present?

Jonathan Kandell
Tucson AZ

Flexibility and the Hexaflex

You can actually get it down to one process (psychological flexibility).

Or down to one word ("love" works).

Or down to one letter. ("B" does it).

But the hexagon model still feel solid to me. All of these six are related and in their full expression contain all of the others. But they seem distinct enough to be worth tracking.

In answer to "what are the differences?" contact with the present moment entails actively seeking out a multidimentional experience of now in the service of valued action.

That goes beyond how folks use the term acceptance. For example, accepting a feeling of fear might then enable an appreciation of a piece of art, but we would not usually thing of accepting ones appreciation. Etymologically acceptance means taking in what is offered -- contact with the moment expands what is offered in the first place.

As for self as context, it was actually the first point of emphasis on the hexaflex. You might want to read the 1984 "Making Sense of Spirituality" paper if you haven't before. I argued then (and I still think it is right) that acceptance is not possible without a sense of self that is not threatened by what is accepted. Mindfulness traditions have long emphasized the importance of "no self" and I think this is part of the reason.

Besides, as an ex-hippy being square was really bad
and the pentagon was something you demonstrated in from of, but hexagons were cool -- bees made them, they were a good floor
plan for domes, and you can create an entire field of them fitting them all together. If you pack a bunch of soap bubbles together in a plane they naturally form hexagons.

So its just organic, man

: )

Actually, all of this is just words -- so the best way to decide is pragmatically (the usual mantra -- prediction and influence with precision, scope, and depth). So far so good on that front -- the basic labs are busy finding ways to look at what is impactful and thus pragmatically distinguishable

- S

Steven C. Hayes, University of Nevada

Self-as-perspective

I am in total agreement about the coolness of the Hex, particularly when compared to the square. If it was a square, we would have to turn it on it's corner, and call it a diamond (how's that for perspective?).

But, speaking of perspective... I am also in total agreement regarding the importance of distinguishing self-as-perspective from thoughts, feelings and other content. I also agree that this distinction is important for the therapy model.

There is just one little point... I do not agree that the self-as-perspective is "unchanging."

Thay uses two candles and a box of matches. He lights the first candle from a match. Then he lights the second candle from the first candle. Then he blows out the first candle. He asks the question: Is it the same flame, or a different flame?

This is where dualistic thinking breaks down. Reality is more complicated that we would like for it to be.

As you say, I am not the same as I was when I was a child. No part of my physical content is the same. You would say that my self-as-perspective has remained unchanged. I would disagree. Certainly, in the sense of the two candles, there is a connection. But my ways of observing my thoughts, the things I look at, the things I think about are very, very different than when I was a child. They are different than when I was a cocaine addict. It is not just the thoughts that are different - it is the way I perceive them.

My self-as-perspective changes as it interacts with the environment. It is not the same as it was when it started. But I agree that it is also not completely different.

As with the candle analogy, the best word I can use is "continuation." My self-as-perspective is a continuation of the self-as-perspective that was when I was born. But it is not the same.

If this self-as-perspective could not change, what would we be trying to do in therapy? I believe that a constantly changing locus of observation is the hope for the world - that which makes us human, and that which makes us able, at any level, to understand each other at all.

Not same. Not different. A living, interactive part of this glorious organism we call the universe.

How about "contextual self"?

Self as context=contextual self

I enjoy your point, I just look at it more from a Buddhist perspective of the unchanging self in the changing environment. The self itself (pardon the language faux pa) may change over time to fit the necessary perspective, or context that the individual is living in, but it is unaltered by events that surround it, and can PERCEIVE those events rather than indwell the event characteristics as qualities of the self. Your flame example made me think, and I would say yes, it is the same flame, and it has been moved to a new candle yet has maintained its integrity as a flame. The changing of the candle has not changed the flame, the flame has actually changed the candle, thereby it has not bent to its environment it has actually bent its environment to meet its needs. If you blow it out, and only smoke remains, you have in essence "killed" the flame, eliminating its effect on the environment, thus eliminating its perception (I know this is quite metaphorical but bear with me) and only smoke would remain, thus only a lingering memory of the fire, but the environment, the candle, would still be changed by the flame. To be honest I just think that self as context is required in ACT as a prerequisite for cognitive de-fusion because without an unchanging idea of self it would be difficult to view thought as thought because we would be allowing the thought to define us. But I do definitely agree that our existential self changes as a part of universal dynamic, it is just a goal of ACT to have the self and self concept VIEW thoughts and events mindfully and with awareness rather than BE thoughts and events with judgment or avoidance.

Let me make sure I misunderstand you

But my ways of observing my thoughts, the things I look at, the things I think about are very, very different than when I was a child. They are different than when I was a cocaine addict. It is not just the thoughts that are different - it is the way I perceive them.

Can I test my (mis)understanding here?

"The way you perceive your thoughts" is itself a thought or thoughts. Thus it can't function as part of an unchanging "self as perspective" in a non-verbal sense, if that had been intended.

Likewise "self as perspective" as commonly discussed in RFT (or in ACT) is also a thought ... a thought about the history of a certain aspect of non-verbal experience. This aspect is experienced as unchanging when recalling it afterwards.

Is it possible that if "the way you perceive your thoughts" seems to change as you grow older, it may involve a different frame (more story attached) than the simpler/smaller frame of "unchanging self as perspective" as the memory of a non-verbal continuity?

Also, what do you think of the whole I-HERE-NOW vs. YOU-THERE-THEN framework? Does that work for you?

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Randy Burgess
Writer, editor, book doctor
www.raburgess.com
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Usefulness

I find it more useful to think of even that last vestige of perspective as changeable.

I notice different things at different times in different locations.
I am not a "perfect" (unchanging) perceiver. My very awareness is modified by: what I have noticed historically, my emotions, etc.

We can propose the existence of a perfect awareness, one not affected by context - but that's not my experience. Is it yours? And how does that help me, to think that I have a consistent, perfect awareness of what is happening in the universe?

What then, shall we do with this unalterable, unchanging awareness that does not respond to changes in contextual variables?

What aspect of it is "experienced as unchanging"? Location? Time?

I-HERE-NOW is a lot different than I-SAME PLACE-ALWAYS is it not?

Greg R

I don't want to get all mystical, but ...

You are way, way more Buddhist than I am. So I will probably come a cropper here. But every aspect of what you just described fits the descriptions of spiritual transcendence that I have read about in Zen, Tibetan, and Theravadan literature.

Unchanging (albeit always changing), unalterable (except alteration is no longer even a question or a need), perfect, encompassing the entire universe (which is no longer separate from 'me').

Is I-HERE-NOW different than I-SAME PLACE-ALWAYS?

No. At least not in the place without words. Or so they say who say they have been there.

More to the point, ACT posits a "safe place" in which we can allow our content to be without having to be our content. Here we can let go of "I am ________" without fearing complete destruction.

If this place is itself changeable, subject to changes in context, then it doesn't sound especially safe anymore. The usefulness would be in the difference between this place and every other place in our experience. Or, if you like, the sameness between this place and every other place in our experience.

We are not enlightened

I was going to say that this unchanging awareness sounds like God or an extremely enlightened being.(Steve makes this comparison in the paper he references, positing God as the "extension of experiencing ourselves as context or pure perspective.) I would reserve this "pure perspective" for God (if there is one)or for an extremely enlightened being (not me or anybody I've met).

I don't feel that enough of us get close enough to that ideal for that to be useful.

I think you put your finger on it. Pema Chodron and many of the others discuss the idea that we are constantly wanting some "solid ground" to cling to. (Fuse with?) A safe place, so to speak. In my personal view, this is avoidance. It's not safe. But it's still ok. You know why it's ok that it's not safe? Because it is not about some grandiose, unchanging, nearly Godlike ME that has been elevated to a position of centrality in the universe by my flawed PERSPECTIVE.

As a small player in the game, I don't have to worry so much about this part (me) because, in my view, I am not the most important thing going on.

But the main point of Steve's article, and of this idea of "self-as-context" seems to me to be the ability to realize the existence of an awareness that is separate from the thoughts. This is extremely important, and is not altered by the fact that the awareness evolves over time. I am not depressed. I am an awareness that is affected by depressed thoughts sometimes, but not defined by them.

Changing Nothing

I'm curious why this seems to upset.

I've run into this before and it has always puzzled me. My guess is that it is because it seemingly conflicts with Buddhist thought (everything is changing; there is no self). I say seemingly, because I don't think it does conflict (and so far I've not met a Buddhist master who think it does, though I confess only one has looked at it truly seriously), though if it did or not is not hugely important to me personally because I'm not trying to maintain adherence to Buddhist thought or anykind of thought.

I am not talking about the fixed nature of the content of consciousness. And I'm not speaking ontologically. I'm talking about a psychological process that is based on a useful way of speaking about language, and its creation of a void -- a psychological no-thing -- at the center of consciousness simply because contacting the limits of this process is not possible for the person engaging in it. And I have seen directly that supporting folks in opening up to nothing -- to "that without distinction" -- is transformative. If it isn't, bag the whole thing.

These messages have so many attributes. Grandiose. Godlike. Centrality in the universe. Fixed. The most important thing going on. Etc. But all of these terms have features and evaluative connotations. How did nothing get so many attributes?

I'm not arguing that "it" is unchanging as opposed to changing. My question comes before that. It is pretty simple: What changes when nothing changes?

We are at the edge of what can be said. But we are not at the edge of what can be experienced. Go into the terror. Do it relentlessly and you will find ...

Nothing

- S

Steven C. Hayes, University of Nevada

'what changes when nothing changes?'

 

Time? Without time passing 'nothing changing' couldn't be perceived.

Or, if nothing were changing then nothing could be perceived, if the passage of time is dependent on change, rather than it being an independent thing-in-itself.

I feel like my head is going to explode. In a good way..

or London

If you go truly relentlessly into the terror you find London. Which I've heard can be a bit intimidating, but will be ok since to some extent we bring our own context (and guitars I hear?) with us.

Which reminds me. Why aren't all of the pre-conference ACT Trainings full?

Square

Doesn't have the same ring to it, though, does it?

But I'm all for simplicity. "Acceptance" causes some problems with people interpreting it as "give up" but I'm not sure that "Being Present" all by itself contains "willingness" which is a key concept. Willingness to "have" thoughts and feelings we didn't think we wanted. But that is a lot like being willing to be fully present. Ok, I'll go with "willing to be fully present to my thoughts, emotions and experiences."

Now what was the other one? Oh, how could I forget! You can keep "self-as-context" as defusion covers it, and this term seems to imply "permanence" over "impermanence" as well as seeming to imply that I exist in my own little context, without want or need of input from the outside world. I do understand the concept, which has to do with "that which is aware" of thoughts and feelings, but I think all we need to know is that we are not the same as our thoughts and feelings.

Square -O- Flex? Just doesn't ring a bell. Maybe we're stuck with Hexoflex. But this has been an entertaining and informative exercise (no hard feelings anybody?).

But I'm all for simplicity.

But I'm all for simplicity. "Acceptance" causes some problems with people interpreting it as "give up" but I'm not sure that "Being Present" all by itself contains "willingness" which is a key concept.

But what is it about willingness which is not contained within being fully present for you? You can't be fully present if you fruitlessly edit experience (avoid), and/or fruitlessly analyze experience (fuse); what's left when you don't do these is willingness. Being fully present--in functional terms--is being willing.

We could scrap Being Present and just use Acceptance instead, if you'd like. It's hard to imagine how you could be Letting Go, accepting and embracing if you weren't in the here and now. Or I could perhaps see a distinction between being Fully Present (internally) and being Fully Present (externally); or distinguishing between "letting go verbally" (defusion) and "letting go with the body" (acceptance). But the current distinction seems really muddy to me.

Right on the self as context, which is why Fusion is enough. It is in fact the paradigm case of fusion to think you are yourself rather than just the holder of those aspects. There is no real difference between the side effects of fusing with self versus fusing with any other verbal construct: it's perspectivalism is hidden and one thus remains trapped inflexibly in its grasp. I am a bit more tolerant of keeping Self as context because, though it's nothing more than fusion, some unique "processes" come out like certain meditation exercises. But, really, most of the fusion exercises work for the self or external concepts, and many work on both points of the hexagon at once.

One

I used to say that all 12 of the 12 steps were exactly the same, once you were done working any one of them. Because in order to work one step completely, you had to do the processes of all of them. So every time we "move on" to another step, we are really just starting over, trying again to admit that we don't have all the answers, that we make mistakes, that we get caught up in stuff that doesn't matter, that we act in self-centered ways, based on fear, instead of based on love. We pretend that we can do it all alone, instead of admitting that we can only truly exist when we are truly connected to others.
12 steps. Three Dharma Seals. Four Foundations of Mindfulness. The Four Noble Truths. Five Skhandas/Aggregates. Six sides to the Hexagon. The Eight-fold path.

All fingers pointing to the moon. We have the opportunity to live all of them, and none of them, just by showing up and living honestly moment by moment. Breathing in, I know I am breathing in. Breathing out, I smile.

Flow of the six parts of the hexaflex

Hi all,

I thought I reactivate this thread for further discussion.

As a very new player and learner in the ACT model, I feel it does help to have a supported structure and approach to learn ACT.

For example throwing people into Committed Action without examining values may not be helpful?

Also the structure for learning ACT could then guide early attempts at therapy as well.

Regards,
Peter