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ACT Book Summary: Pages 249 - 254

Primary barriers to committed action:

When a client resists committed action, often the client is struggling with how the action will alter his (or her) personal history; how the client has created in his own mind his place in his world. The client may also be grappling with the impact this history has had on his conceptualized self. The client has constructed a self perception of who he is. If he has been subjected to an abusive or otherwise harmful environment, his self perception embraces how he has been victimized by others.

Not surprisingly, the client is threatened with the possibility of positive change. This threat challenges both the client's self perception and the hope that an abuser may someday validate the client's self perception and make amends. For example, a client was physically abused as a child. He now perceives himself as a victim of physical abuse; the perception is intertwined with his identity. If he makes positive change, he may no longer appear as a victim to himself or his abuser. He loses his self perceived identity (as a victim).

Clients with history of painful events (especially in childhood) may have learned that life can be unpredictable and punitive. By limiting their exposure to painful thoughts, they mistakenly believe they can curb their sense of trauma. The opposite is often true. Psychological pain hurts but does not damage; whereas psychological trauma is pain without the willingness to experience the pain. This unwilling causes damage; the effect of the pain persist.

An exercise to teach the difference between psychological pain and trauma:

  1. Ask the client to describe past painful and traumatic events in detail. 

      - distinguish between the original pain and, 

      - the client's reaction to the events.

2.  Inventory the area of responses (i.e. physical reactions, emotional reactions, memories, thoughts, etc.)

3.  Note the sense of trauma

4.  As the client becomes aware of the reaction, ask the client to let go of the struggle with the reaction.

The client's willingness will shift the context of the events; this change will often reduce the client's tension related to the event. As a consequence, the client will be begin to distinguish between trauma and pain. The pain will remain; the trauma will disappear; positive change may occur. A client's reluctance and resistance can be expected. If so, the clinician should:

  1. point out to the client the burdened caused by resisting the avoided content
  2. have the client notice physical, emotional and cognitive responses that attach to the unwillingness
  3. prompt the client to let go of the struggle with unwillingness and be willing to be unwilling
  4. if the client is able to do this, ask the client to notice the difference between struggle and letting go
  5. encourage the client to continue the process of letting go and bringing up avoided material.

Things to remember:

  • The therapist must identify the functional connection between failing to be "right" about being a victim and remaining a victim who demands redress.
  • If the client believes he must remain "broken" in order to prove someone else wrong, the client is stuck, not broken.
  • Intervention is delicate.
  • The events in question are not being disputed.
  • What is being disputed is the necessity of living in a self defeating life in the service of waiting for the recognition and redress that seldom, if ever, comes.

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