The Time Magazine story (2006)

The Time Magazine story (2006)

There are a number of popular stories on ACT / RFT that have appeared. You can find the ACT ones in "About ACT / Communicating about ACT / Popular Media" but given the prominence of Time Magazine this one is listed here. The article in Time (Cloud, 2006) came out in the February 13, 2006 issue. It was pretty long -- 6 pages -- and dealt with ACT in some depth. It sent Get Out of Your Mind and Into Your Life into the top 25 books (and number 1 self-help book) on Amazon for nearly a month and is still reverberating in the form of stories in the popular media in various other outlets.

Some of the issues raised by the Time story are discussed in the child pages attached to this page.

Happiness Isn't Normal
by John Cloud
February 13, 2006

Before he was an accomplished psychologist, Steven Hayes was a mental patient. His first panic attack came on suddenly, in 1978, as he sat in a psychology-department meeting at the University of North Carolina at Greensboro, where he was an assistant professor. The meeting had turned into one of those icy personal and philosophical debates common on campuses, but when Hayes tried to make a point, he couldn't speak. As everyone turned to him, his mouth could only open and close wordlessly, as though it were a broken toy. His heart raced, and he thought he might be having a heart attack. He was 29....


Steven Hayes

Is ACT a Cult? Is ACT Just a Fad?

Is ACT a Cult? Is ACT Just a Fad?

These thoughts are in bullet point form from a power point presentation by James Herbert at Drexel University.

He gave this talk at the ACT Summer Institute at La Salle University in summer of 2005.
I've (SCH) tweaked it to make it more readable and understandable in this form.


Is ACT Just a Fad or a Cult? Addressing the Critics
James D. Herbert, Ph.D.
Drexel University

 As ACT has moved into the mainstream, a variety of criticisms have emerged from within the academic community.

  • As ACT becomes more popular, we can anticipate even more criticism from even more voices. The common theme is that
  • ACT is merely the latest therapeutic fad to litter the mental health landscape.

The purpose of these points is to outline the criticisms so far, examine them critically and honestly, and explore how we as a community may respond.

There are a number of complaints about ACT. These include the following: 

  • Overly-hyped claims
  • “Getting ahead of the data”
  • Excessive enthusiasm among those interested
  • ACT is a cult
  • ACT has excessive and grandiose visions
  • Proselytizing
  • ACT as a “way of life"
  • Promotes “undue influence” by seeking to identify principles and technologies that could be used to impact behavior without their explicit consent
  • Experiential exercises in ACT training are coercive and manipulative
  • There’s “nothing really new” here
  • Premature dissemination to the public via self-help books
  • Both ACT and especially RFT are plagued by obscurantist jargon

Let’s look at each of these in turn.

Getting Ahead of the Data

In order to evaluate this we must examine the evidential warrant of specific claims

Some critics have tried to say that the ACT community is making excessive claims based on the ratio of theoretical to empirical papers. But this means that mere interest would indicate excess. That is not fair. The ratio isn’t a proxy. Nor are dreams/visions

Some critics are clearly unaware of the data that exist (e.g., see Hayes, Luoma, Bond, Masuda, & Lillis, 2006); those who are correctly note that it’s limited, but don’t generally compare specific claims with evidence, or consider the research strategy being pursued.

In fact it seems that ACT proponents have in fact been appropriately cautious in claims

Our response: Continue to be clear about specific claims and back claims with evidence

Excessive Enthusiasm

This seems to be largely based on reactions to the listserv, and to reactions of some professors to their students returning inspired from workshops. But enthusiasm per se is only a problem if it interferes with critical thinking. Is there any evidence of this? If so, let's look at it, but so far the concerns do not seem to be linked to such interference.

Our response: Make sure not to be blinded by enthusiasm.

The “C” word: Is ACT a Cult?

“Cult” label usually evoked by:

  • A closed system
  • A charismatic leader, or if there is more than one, a very small group of such leaders hand picked by the main leader
  • A strong profit motive
  • Financial and/or sexual exploitation of vulnerable populations
  • A hierarchy of secretive levels to pass through in order to gain special knowledge or status
  • Intolerance of dissent

Such groups also:

  • Challenge the status quo
  • Offer a grand vision
  • Engender high levels of enthusiasm

So is ACT a Cult?

The first set of features don’t apply. This website is an example; the list serve is an example. Anyone can participate and argue and have their say. But the second set of features clearly do apply. However, these latter features are poor discriminators of science vs. pseudoscience or cults.

Our response: This is silly; ignore it -- but also make sure that we maintain an open, horizontal, self-critical, empirical culture.

Grandiose Visions

Rightly or wrongly, ACT does indeed aspire to great things. Helps to understand history of behavioral analysis to appreciate the historical context. Behavior analysis always had a utopian vision (e.g., Walden II). It is critical to distinguish specific claims from distal goals and dreams; the former are subject to direct examination via evidential warrant; the latter are not.

Problem is that mainstream psychotherapies are cautious about big claims, whereas many dubious ones are not. So unless people look carefully, ACT can look too expansive.

Our response: Clarify explicitly the distinction between specific claims and distal visions.

Proselytizing ACT as a “Way of Life”

There are two variations of this: Clinicians must adopt an ACT perspective to their own life, and the focus of the client’s presenting problem is inappropriately shifted to ACT-consistent goals. Although ACT does suggest that clinicians try out some principles on themselves, it doesn’t require them to adopt any particular belief system.

Regarding clients, this is not unique to ACT, as all psychotherapies attempt to socialize the client to their model. The key in all cases is informed consent.

Our response: We could probably be clearer on these points, and we need to be cautious about things an individual clinical may do in applying ACT to her or her life and things that are said to be "necessary" in the absence of data. Individuals are free to explore -- claims can only be made based of scientific criteria.

ACT Seeks “Undue Influence” Over Others

This is a very familiar criticism to radical behaviorists. There are ethical issues surrounding parameters of informed consent that are an important cultural values. Like all values, must be decided independent of science per se. An extreme Libertarian stance rules out all public health interventions (e.g., programs promoting smoking cessation, safe sex to prevent STDs, routine diagnostic procedures like mammograms and prostate exams, childhood vaccinations). The fact that a technology could possibly be misused is no reason to stifle science.

Our response: Participate in the broader public ethical dialogue.

ACT Offers “Nothing New”

This is generally argued by those with minimal familiarity with ACT. Ironically, traditional CBT folks sometimes who make this argument have themselves been on the receiving end of this allegation from psychoanalysts and others. Many (though not all) techniques and strategies are indeed openly borrowed, and so aren’t new. What is new is the organizing model, and especially the close link with theory, a basic research program, and philosophy.

Our response: Point this out when challenged. Help others learn RFT, behavior analysis, and functional contextualism, and to see how this informs treatment development.

Experiential Exercises in Training Are Coercive and Manipulative

Experiential exercises are used in ACT to highlight consciously self-reflective nature of ACT. But we must remember the audience, and be very careful to avoid coercion, even implicitly. Degree of focus on experiential exercises remains an unresolved issue empirically.

Our response: Examine this issue openly within the community, ethically and empirically. Until this is worked out, be mindful of the issues, open to the concerns, and cautious.

Self-Help Books

There is a legitimate debate over appropriate threshold for direct dissemination via popular literature. On the one extreme some say you must have strongly supportive data, not only of general approach, but its effectiveness in the self-help format and for the specific problem in question. A growing number of ACT self-help books are being studied in randomized and open trials for effectiveness (as of 2011, we know of trials assessing Get Out of Your Mind, The Mindfulness and Acceptance Workbook for Anxiety, and Living Beyond Your Pain). Even outside of ACT, only a tiny number of books have that. At the other extreme: Anything goes. Reasonable people can disagree about this, but it is in no way unique to ACT.

Our response: Encourage authors to be appropriately cautious, while participating in the broader dialogue - and continuing assessing self-help book efficacy.

Obscurantist Jargon

Some critics see too many new terms in ACT and RFT, and reject them before learning these terms. The problem is that one person’s obscurantist jargon is another’s technical vocabulary. All other areas of natural science have technical languages. To evaluate jargon, must look at things like theoretical coherence, precision, scope, and connectivity. The ACT / RFT community has largely done this so far.

Our response: Develop the language as necessary, but be mindful of Occam’s razor. Distinguish scientific talk from clinical talk. Be prepared to defend the use of a technical term by showing that no existing term would do.

The Bottom Line

These criticisms fall into four camps. Those base on: Ignorance; style; a challenge to the status quo; and substantive issues. It is critical to distinguish these, as each calls for different responses.

Criticisms Based on Ignorance

Educate (e.g., journals, workshops, books, presentations), with a sensitivity to the audience

Criticisms Based on Style

Attempt to understand the reaction, and decide how to respond. We are not obligated to address every stylistic criticism. But we should be mindful of our audience and our purpose. Remind others that this tradition is not about individuals but a scientific model. If person X has the wrong style, focus on the message, not the messenger and evaluate the evidence.

Criticisms Based on Challenges to the Status Quo

Continue to do good science, including modifying theories and technologies based on data. Science is inherently self-correcting, so if ACT lives up to its promise it will eventually win hearts and minds. But be wary of striking the pose of Galileo; it isn’t enough to be novel – we must also be “right” in the sense of useful as considered against the goals of "prediction and influence with precision, scope, and depth"

Substantive Criticisms

Carefully consider substantive criticisms, especially those challenging the evidential warrant of specific claims and specific theoretical issues. Then, offer a thoughtful response, and remain open to change when appropriate based on arguments and data.

Steven Hayes

Steve's reactions to the Time article

Steve's reactions to the Time article

The author did a terrific job, in my view. He starts out with a sentence that has me as a mental patient and finishes with a paragraph that says for ACT to go mainstream it will have to shed "its icky zealotry and grandiose predictions" but in between is a pretty serious effort to understand and explain.

I want to acknowledge John Cloud publicly. If every reporter treats this work as carefully and fairly we will be blessed. He is an honorable guy who worked really hard over several months to get it right.

The first thing John said was "I'm doing the RFT tutorial. I'm half way through it." I paused and replied "OK. If you are doing that, I'm there. If you are that serious I will answer every question and spend every ounce of energy needed to help you do your work." And I did. I was an open book (as you can see!). Some of what is in that story my mother did not know. But he earned that.

Of course, he is a writer, and writers need angles. The angle he chose was almost mythological: wild eyed rebel vs. the establishment. Even the photos fit that theme (me in a motorcycle jacket; in a tree fort; etc). So some of the basic science, the grants etc were deemphasized and things like bad clothes or weird rings were emphasized.

But, hey, in the grand scheme of things ACT is more outside than inside, so it was not a functional distortion to omit some things like that.

I apologize for the focus on me. That was not of my doing: John came to ABCT, interviewed Tim Beck, David Barlow, Judith Beck and many others. He went and saw talks by Kelly, Kirk, and many others. He then wrote the story as he chose. I suppose he felt that he needed to get people to care about the issue enough to read a very long story ... and he did that by putting my own struggles at center stage.

Mostly all other names in the ACT / RFT universe are not in the story. I did try repeatedly to push the names of researchers or co-authors (as John will attest!) but reporters just make their own calls on such things. And I wish he'd mentioned behavior analysis at least once (I begged!). But RFT is there by name; and some of the science is there. He does mention in a general way the students and the researchers and clinicians around the world. And the World Conference is mentioned! Woo Hoo. And the website is there ... which may be why you are reading this.

I am so thankful that there were no "anti" quotes from the ACT side about anyone. The story shows us (well, at least me) as a bit goofy, but not negative toward others. We took a few shots ... but that is to be expected I suppose.

Is this story premature? Maybe, but the culture decides on such things, and through accident and interest, here we are.

On the issue of grandiosity

No predictions are in there that are grandiose. What is in there is the willingness to see that the culture needs so much more from behavioral science than it is providing. I did say "Our survival really is at stake." That is so. Can anyone looking at the "war on terrorism" not realize that soldiers alone cannot do it? But that does not mean I think we can solve the problem. I did not say that and that is not in the quote. I just think we have to try. We have to try to solve the problem of hatred. We have to find a way to help people learn to love themselves and others, and to act in accord with their deepest values. And I do think we may have a possible path forward inside this work -- let's see. Together, let's see. That is a grand vision maybe ... but I'm not the only one dreaming. Who knows about outcome ... can we begin the process?

On the cult deal ... look for the other page and James Herbert's great talk on that given at the ACT Summer Institute.

My bottom line

In the long run what will matter is the substance: the science and the human value of the work we do. We will need every ounce of community and shared values and purpose we've gathered to do our work together as it becomes more visible and as the resulting centrifugal forces gather. The reason this work is being noticed is because of a community that cares. It is not a cult. There is no forced agreement. Look at this site! Anyone can post anything; and to be a member you just join. How much more open can a group be? I know of no other scientific group that is developing as an open community like this. How can a shared, open, self-critical community be a cult! It is just a fear word.

To the critics who say it, I say, join the group and post your views. You will find reason, support, and compassion here, not hierarchy.

So let's keep our eye on the horizon and remember why we got into this work in the first place. It was not about attention in magazines, nice though that might be. Unlike the fear expressed from by others outside of this community, it does not run on artificial agreement or hierarchy -- we need each of us to bring ourselves forward and to create something of value together. As individuals. Together.

Despite the worries, it seems clear we are entering into the conversation in a new way. That is an opportunity. It is also a burden. It will cut in multiple ways.

Could I also say on a personal level that I appreciate the support I've received in this process from many of you who have known it was going on. The letters and emails I am now getting from people who are suffering are enough to make me weep ... as my students have seen. Let's remember them. This work is about them.

Steven Hayes

Reacciones de Steve sobre la entrevista en la revista Time (traducción al español)

Reacciones de Steve sobre la entrevista en la revista Time (traducción al español)

El autor hizo un trabajo excelente, en mi opinión. Comienza con una oración acerca de mí como paciente y termina con un párrafo que dice que para que ACT se haga popular tendrá que sacudirse su “fanatismo y predicciones grandiosas”, pero entre esas dos afirmaciones hay un serio esfuerzo por entender y explicar.

Quiero reconocer a John Cloud públicamente. Si cada reportero tratase su trabajo tan cuidadosamente y equitativamente podríamos sentirnos afortunados. Es una persona honorable y ha trabajado realmente duro durante varios meses para entenderlo bien.
La primera cosa que John dijo fue “estoy haciendo el tutorial de RFT. Voy por la mitad”. Yo me detuve y contesté “Ok, si estás haciendo eso, estoy aquí. Si estás tan comprometido voy a contestar cada pregunta y dedicar cada gramo de energía que sea necesario para ayudarte a hacer tu trabajo”. Y lo hice. Fui un libro abierto (como se puede ver!). Algo de lo que apareció en esa historia no lo sabía ni mi madre. Pero él se lo ganó.

Por supuesto, es un escritor, y los escritores necesitan ángulos. El ángulo que él eligio fue casi mitológico: rebeldes vs el orden establecido. Incluso las fotos encajan en ese tema (yo con una campera de motociclista, en un casa en un árbol). De manera que las partes de ciencia básica, las becas de investigación fueron minimizadas y cosas tales como la vestimenta o los anillos raros fueron enfatizadas.

Pero, ey, en el panorama general de las cosas ACT está más afuera que adentro, de manera que no fue una distorsión funcional el omitir esas cosas.

Me disculpo por el foco en mí. No fue obra mía: John fue a la ABCT, entrevistó a Tim Beck, David Barlow, Judith Beck y muchos otros. Y luego fue a ver charlas de Kelly [Wilson ], Kirk [Strosahl], y muchos otros. Y luego escribió la historia en la manera en que quiso. Supongo qu esintió que necesitaba que la gente se interesara en el tema lo suficiente como para leer una historia muy larga… e hizo eso poniendo mis propias luchas en primer plano.

La mayoría de los otros nombres en el universo ACT/RFT no están en la historia. Repetidamente intenté introducir los nombres de investigadores y coautores (y John puede dar fe de eso!), pero los periodistas toman sus propias decisiones al respecto. Y desearía que hubiese mencionado el análisis conductual al menos una vez (se lo rogué!). Pero RFT está mencionado; y parte de la ciencia está ahí. Menciona de manera general a los estudiantes, investigadores y clínicos que están por todo el mundo. Y se mencionan las Conferencias Mundiales! Woo hoo! Y el sitio web está ahí… lo que quizá sea el motivo de que estés leyendo esto ahora.

Estoy muy agradecido de que no hubiera citas “anti-“ del lado de ACT acerca de nadie. La historia nos muestra (bueno, me muestra a mí), como un poco torpes, pero no negativos hacia los otros. Recibimos algunos golpes…pero eso es esperable, supongo.

La historia fue prematura? Quizá, pero la cultura decide sobre esas cosas, y a través de accidentes e intereses, aquí estamos.

Acerca del tema de la grandiosidad.

No hay ninguna predicción nuestra que sea grandiosa. Lo que hay allí es la disposición a ver que la cultura necesita mucho más de la ciencia conductual que lo que se está proporcionando. Dije “nuestra supervivencia está en juego”. Esto es así. Puede alguien que esté viendo la “guerra contra el terrorismo” no darse cuenta que los soldados en sí no bastan? Pero esto no significa que crea que podemos resolver el problema. No dije eso y no está en la cita. Sólo creo que debemos intentarlo. Tenemos que intentar resolver el problema del odio. Tenemos que encontrar una manera de ayudar a que las personas aprendan a amarse a sí mismas y a los otros, y actuar de acuerdo con sus valores más profundos. Y creo que quizá tengamos un camino posible dentro de este trabajo –veamos si es así. Juntos, veamos si es así. Es quizá una gran visión… pero no soy el único que sueña. Quién sabe cuál será el resultado?... pero podemos empezar el proceso?
Respecto a lo del culto… busquen la otra página del sitio web y la charla de James Herbert en el ACT Summer Institute.

Mi línea final.

A largo plazo lo que importará es la sustancia: la ciencia y el valor humano del trabajo que hacemos. Necesitamos cada gramo de la comunidad, los valores compartidos y el propósito que hemos reunido para hacer nuestro trabajo juntos a medida que se vuelve más visible y como resultado de las fuerzas centrífugas que se van generando. La razón por la cual este trabajo está siendo notado es porque hay una comunidad que se interesa. No es un culto. No hay un acuerdo forzado. Vean el sitio web! Cualquiera puede postear cualquier cosa, y para ser un miembro sólo debes unirte. Cuánto más abierto puede ser un grupo? No conozco ningún otro grupo científico que se haya desarrollado como una comunidad abierta, tal como este. Como puede ser un culto una comunidad compartida, abierta y autocrítica? Sólo es una palabra temida.

A los críticos que dicen eso, les digo: unanse al grupo y publiquen sus opiniones. Encontrarán razón, apoyo y compasión allí, no jerarquías.

De manera que mantengamos nuestros ojos en el horizonte y recordemos por qué empezamos con esto. No fue para obtener la atención de las revistas, halagador como pueda ser eso. A diferencia del temor que albergan algunos fuera de la comunidad, ésta no se rige por acuerdos artificiales o jerarquías –necesitamos a cada uno de nosotros para avanzar y crear algo que valoremos entre todos. Como individuos. Juntos.

A pesar de las preocupaciones, parece claro que estamos entrando en la conversación de una nueva manera. Esto es una oportunidad. También es una carga. Repercutirá de múltiples maneras.

Podría agregar a título personal que aprecio el apoyo que he recibido en este proceso de parte de muchos de ustedes que sabían lo que estaba pasando. Las cartas y los emails que estoy recibiendo de personas que sufren son suficientes para hacerme sollozar… como han visto mis estudiantes.

Recordémoslos. Este trabajo es para ellos.

Fabian Maero

The Epilepsy study

The Epilepsy study
The epilepsy study mentioned in the article is this one: Evaluation of Acceptance and Commitment Therapy (ACT) for refractory epilepsy: A randomized control trial in South Africa The positive effects of psychological methods have long been known, but the research has hardly made an impact on the treatment of epilepsy. The purpose of this study was to develop and evaluate a psychological treatment program consisting of Acceptance and Commitment Therapy (ACT-said as one word) together with some behavioural seizure control technology shown to be successful in earlier research. The method consisted of a RCT group design with repeated measures (N= 27). All participants had an EEG verified epilepsy diagnosis with drug refractory seizures. Participants were randomized into one of two conditions; ACT or attention control (AC). Therapeutic effects were measured by examining changes in quality of life (SWLS and WHOQOL) and total seizure time per month. Both treatment conditions consisted of only 9 hours of professional therapy distributed in two individual and two group sessions during a five-week period. The results showed significant effects over all of the dependent variables for the ACT group as compared to the control group at the 12-month follow ups. Seizures were reduced more than 90% at the one year follow up. The results from this study suggest that a short term psychotherapy program combined with anticonvulsant drugs may help to prevent the long-term disability that occurs from drug refractory seizures. Key words: Epilepsy, Acceptance and Commitment Therapy, Seizure control techniques, South Africa Tobias Lundgren, Cellphone +46 70 612 4555, JoAnne Dahl, Cellphone +46 70 66 34 345 Lennart Melin, Department of Psychology, Uppsala University, Sweden Bryan Kies Department of Neurology, University of Cape Town, South Africa
Steven Hayes