ACT Book Summary: Pages 198 - 203

Here is my attempt at the next couple of section called "Therapeutic Do's and Don'ts", "Progress To The Next Phase", "Personal Work For The Clinician: Is Your Self Getting In The Way?", and "Clinical Vignette". In the fist section "Therapeutic Do's and Don'ts", the authors caution clinicians about a couple of things. First "Reinforcing the Problem", in this section we a cautioned about joining in with the client's language, which will show "itself in the development of an excessive amount of logical, rational talk about why the client can't trust his or her thoughts, the lack of self-confidence, and so on." I usually see this rearing it ugly head when I realize that I am talking way to much, and at times trying to convince the client of something. At these moments the authors suggest we return the focus to "experiential exercises and metaphorical talk." We should also "Reaffirm for clients that there is no secret formula that delivers happiness in any consistent way." Because, inevitably we want to take our new found tools for living and turn them into shovels and start digging new holes. Next "Spirituality As An Experience, Not A Religion", warns of the dangers of seeing ACT as a religion. This is a pitfall that we have seen since the beginning of AA, where they warned of being swept up in a religious zeal. These new ways of living daily can bring with it a new found spiritual awakening, and as the book says "that is gravy." As therapist, we need to "emphasize the concept of workability for the client, not a belief system." Next "The Multiproblem Client And Self-Obliteration", in this section the authors deal briefly with the topic of more seriously dysfunctional individuals. I see this section as boiling down to two sentences from the section. One, "The destructive effects of trauma lie less in the event per se than in the escape and avoidance maneuvers used to compensate for the event.", and Two, "ACT strongly promotes the use of experiential and metaphorical exercises that undermine the need for avoidance with such clients." And isn't that the lesson to learn? This reminds me of a poem I once wrote; "Lost and Found I lost what I was looking for Because I was looking for what I hadn't found. I hope I find what I'm Looking for Before I've lost what I find that I found." Next "Progress To The Next Phase", how do we know when it is time to move on to the next stage? When clients start to speak of "looking at, rather than being caught up in, private experiences." The authors also state "Another critical sign at this stage is the ability to laugh at oneself in earnest." In my own life it shows when I spontaneously think of how I "dig my holes" and can laugh to myself as I say "Mark, step awayyyyyy from the shovel." Next "Personal Work For The Clinician: Is Your Self Getting In The Way?", this is where you break out your pad and pen, and get a chance to play along at home. In this section we are suppose to look at the "monsters" we have been avoiding in our own lives. This is not for the squeamish, but it can be truly freeing. I will share one of my "Monsters", but I suggest you use your own. "Remember to save your work." (My "Monster" is the internal circus that happens every time I am called Doctor.) 1. What emotion does this problem present that is most difficult for you to deal with? (When this happens, fear rushes through me, and I think someone is going to expect me to be something.) 2. What thought(s) does this problem present that is most difficult for you to deal with? (That I am unworthy, and inadequate) 3. What memory or personal history does this problem present that is difficult? (I have many memories of being told in High School that I wasn't college material, and that the best I could hope for was maybe getting in the military.) 4. Is there anything in these private experiences that, considered on their own terms, you cannot have and still live a vital life? If you can't have them or a part of them, just notice you are not having that part. (I don't think this issue for me rises to this level, however, there are times that it gets in the way of me making my opinion known.) 5. Are you willing to get into contact with these emotions, thoughts, memories right now? If so, practice having them in a new context. For example, if there is a horrible thought, say the thought out loud 50 times as fast as you can. If it's painful feeling, hold the feeling in your mind and mentally describe its shape, color, texture, temperature, or smell. Try to see it as a feeling and see yourself feeling it. If it's a painful memory, consider holding it in mind and separating out the physical sensations first, then put them "out there," then move on to the emotions and put them out there, then the images and put them out there. (I have found that when separating out the sensations, emotions, and images that I can move in to the present without the negative effects of these past experiences.) 6. As you consider each of these content areas, notice also that a conscious person is considering them. Review items 1 to 5, but this time see whether you can also be aware of the person "behind the eyes" who is aware of what you are aware of. (Wow, that was a trip. You may need to be in a quiet place to try this, but it seemed as if I was invading my own body.) Finally "Clinical Vignette", here you are asked to "conceptualize the client's dilemma from an ACT viewpoint." This is a good exercise that folks can check out in the book starting on page 202.