ACT Book Summary: Pages 98 - 105

Confronting the System: Creative Hopelessness (this is a little long, but wanted to make sure I covered everthing adequately)

• Begins by noting that engendering creative hopelessness is the first ACT intervention (following thorough assessment of the client's 'presenting problem', change agenda, and strategies that have been tried to resolve it.
• Also notes (or warns) that doing this inevitably involves the use of human language, which is part of the trap the client is in anyway - the conundrum of attempting to side- step the trap of language, but needing to use language to deliver interventions. The therapist is thus just as susceptible as the client to the trap of literal language, and must be careful about too strongly believing or becoming fixed on the logic of words.
• This highlights the equality of therapist and client, with the therapist's only advantage that of having an outside perspective (the client would also have this advantage were the therapist's problems the topic of discussion).
• The therapist confronts the system by working outside it, using language only to meet certain ends, not to change beliefs or model more "rational" beliefs and thoughts. If those ends are not met, then the words are not true, no matter how logical. So this takes us from the typical reliance on logic to relying on workability - this become our metric. The question for both clients and therapists is "does that work for you?".

Workability and Creative Hopelessness

• In the beginning of this section, the authors provide a caveat that it is written with severely affected clients in mind (although the tools are still useful in less severe circumstances).
• The work starts with confrontation, although of a different sort than typically thought. The confrontation is between the client's change agenda and the client's experience of the workability of that system. The message of the therapist and client being in the same boat as far as confronting this system (i.e. the therapist is not some expert who has all the answers) can be powerfully conveyed by the therapist sitting next to the client, with the system imagined as out in front, being confronted by both people together.
• The therapist is armed at this point with information related to strategies the client has tried in the past that haven't worked.
• Unworkability is gently suggested - the therapist highlights how hard the client has been thinking and working at the change agenda, and that consulting a therapist is another attempt to find a solution. Another powerful intervention here is to highlight that usually when we work this hard, things get accomplished, but that this situation seems different. All this effort has not resolved the issue.(this is a subtle way to highlight the role of the client's experience)
• This moves into a discussion of the notion that perhaps looking for solutions is part of the problem. That the client is stuck, and it's not because they are not clever enough to figure it out or are not trying. Perhaps it is because it can't work. The authors suggest that a way to make this more tangible to the client is to suggest that the client doesn't actually believe there is a solution - that anything offered by the therapist would likely just be refuted by the client based on the client' s experience that it would not work. So here, the idea that experience and mind tell the client different things, and that experience is more accurate is brought to the discussion.
• The authors break from the therapeutic dialogue here to discuss the importance of framing creative hopelessness as a positive thing. Being careful not to suggest that the client is hopeless or to engender hopeless feelings. But rather to introduce this idea as a starting point for giving up unworkable strategies and opening up for new possibilities to emerge.
• Several metaphors are provided, including the Man in the Hole metaphor, p. 101, to side-step the trap of language. This metaphor is flexible and can be used to address many issues a client might raise, such as:
  • giving up
  • belief in the need to delve into the past
  • responsibility
  • blame
  • continuing to look for solutions - this one actually seems really important and I think best highlights the goals of this part of therapy. The therapist really seems to stay away from promising solutions, but takes on a role of saying "I don't know". The goal at this point is batter down the tendency toward sense-making and to stay with the importance of the client giving up unworkable strategies, even without any promise of what will come next. This is a leap of faith and should be noted as such, since clients (like the rest of us) are definitely not used to not trying to make sense of things when there are problems in our lives.
  • illustrating the opportunity suffering presents for us to learn to disentangle ourselves from our own minds.
  The goal of this dialogue and the highlighting of what experience tells us, then, is to break apart the control-private-events-to-control-life-quality believe system. It is also to make contact with the client's knowledge of how the world works (rather than systems of logical language and rules that govern behavior). The authors highlight the importance of being mindful of this goal through this discussion.