ACT Book Summary: Pages 244 - 249

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The section titled "Committed Action Invites Obstacles" begins with the idea that once we have a value-guided game plan, it is time to act. The Eye Contact Exercise is a live demonstration of action and a way to begin to behaviorally confront a common avoidance behavior. This exercise may elicit the reactions described. My experience has been also that many of the client's friends, relatives and acquaintances may perceive a change in the client as eye contact improves. Sometimes it gives them "the creeps". An action oriented, surprisingly powerful intervention.

The FEAR and ACT algorithms are introduced as help aids in identifying barriers to willingness(Fusion with thoughts, Evaluation of experiences, Avoidance of experiences, and Reason giving for behavior) and maintaining focus on the game plan(Accept your reactions and be present, Choose a valued direction, and Take action). These can be printed on cards and carried. Live confrontational exercises in the therapy hour are suggested and the "Looking for Mr. Discomfort Exercise" is described on page 247. There's the business of renegotiating the clients relationship with "Mr. Discomfort" and possible use of earlier references to the Passengers on the Bus Metaphor. "Culprits" or likely suspects in failure to complete committed action sited in the book are actions not connected to client's valued ends(direction?) with possible influence by wishes of others, being hooked on literality bolstered by destructive reason giving, or taking a step that is too large or with insufficient preparation. There is also the tip in exposure exercises of identifying component experiences(bodily sensations, memories, emotions, thoughts) and being willing to have them rather than what it says it is or may become. There is also the technical tip of reminding awareness of external environment while encountering negative private experiences. This is helpful when the client "can't stand it" and resorts to devaluing the valued end(direction?). The authors' use of "valued end" in this section bothers me as it seems to raise the specter of goals rather than the previously emphasized compass direction.

The Swamp Metaphor on page 248 helps illustrate the idea of walking "through pain the service of taking a valued direction". The Expanding Balloon Metaphor considers the edge of the balloon as a growth zone where the question is asked: "Are you big enough to have this?" You may respond to each issue with a yes or no. Yes, you get bigger. No, you get smaller. No matter how big you get, there's always more "big" to get. It does not get easier (very important) as each issue may seem relatively as difficult. It may become habitual, however, which begins to provide a source of strength and confidence in the process. Figure 9.1 illustrates how avoided issues cause one to distort life around the issue until it is faced.

The Take Your Keys with You Metaphor additionally helps deal with the relationship between avoidance and action. The keys represent difficult emotions, thoughts, reactions, sensations, etc. The client may pick up and carry the keys without them preventing the action and the keys may open doors(an illusion to insight?) The metaphor is given on page 250 and its use creates a tangible for the client to use in his outside therapy life.

I'm surprised at how few comments there are on the summaries. These metaphors can restructure a persons' cognitive experience of life and facilitate behavior change. Is it a form of insight? Is that an important question? Is anyone else bothered by the "valued end" versus "valued direction" thing? Is it important? Why or why not? The idea that willingness never gets easier and can't be done piecemeal strikes me as important. I take an exercise class that seems to have this characteristic. It involves recurrent unpleasant private experiences, but doesn't seem to harm or traumatize me. The instructor reminds us, "If this was easy, everyone would be in here doing this." Is this an example of acceptance in service of health as a valued direction? I can tell you, it never gets easier. Do the FEAR and ACT algorithms que rule directed behavior? Could they have a down side?