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Monday, November 23, 2009
they're not thoughts, they're facts!

:: 9 Comments :: Article Rating :: ACT Made Simple
 

Last week, we considered how clients may object to the word ‘mind’. They may also object to the term ‘thoughts’. Typically this happens when the client insists that their thoughts are true.

Therapist: "So what happens when you get all caught up in those thoughts about how lazy your husband is?"
Client: "They’re not thoughts. They’re facts. He really is lazy. He never lifts a finger around the house. He’s a slob."
Therapist: "Okay, so there’s a real issue here, isn’t there? Your husband does not do anything like the amount of housework you want."
Client: "He does nothing. He’s a lazy slob."
Therapist: "Okay. I can see this is a really important issue for you. This obviously really pushes your buttons. So we’ll go a bit deeper into it in just a moment, but first I think we need to reach an agreement on the words we use in session. A moment ago when I used the word ‘thoughts’ you objected; you said they’re not thoughts they’re facts."
Client: "That’s right. They’re facts. He’s a lazy slob. That’s a fact."
Therapist: "So here’s the thing – there are many different types of thoughts. Thoughts that state the truth we call 'facts'. But “facts” are only one type of thought. Do you know any other types of thought?"
Client: "Errmm. I’m not sure."
Therapist: ‘Well, here are a few other types of thought: plans, comparisons, judgments, criticisms, values, memories, predictions, opinions, attitudes, desires and so on. So 'facts' make up a very small percentage of the thoughts that we have each day. So I wonder, is it okay if we use the word 'thoughts' in these sessions, to mean all of your thoughts, not just the ones that are 'facts'? And if not, is there some other word – for example, if you prefer, we could use the technical term for thoughts – 'cognitions'?"

At this point most clients agree to the word ‘thoughts’; a tiny number prefer ‘cognitions’. From time to time, these clients may still object. For example:
Client: "Okay. We can call them thoughts."
Therapist: "So when you get caught up in all these thoughts about how lazy your husband is, what kind of things do you say and do?"
Client: "But they’re not thoughts. He really is a slob."
Therapist: "I can see you’re still having trouble with my use of the word 'thoughts'. The term doesn’t imply that these things are false or unreal or made up. As I said before, there are many types of thoughts, some of which are clearly true – usually called 'facts' – some of which are false, and most of which are neither true nor false, such as opinions and attitudes. If I can’t use the word 'thoughts' with you, we need to come up with an alternative. 'Cognitions' is the most common alternative; would you prefer that term?"
Client: "Yes."
Therapist: "Okay, so when you get all caught up in these cognitions about how lazy your partner is, what kind of things do you say and do?"

It’s very important to address this issue at the onset, otherwise you can easily get pulled into debates about whether thoughts are true or false. Remember, in ACT, we are rarely concerned about whether a thought is true or false. What we’re interested in is the function of the thought, rather than the validity: When I get hooked by this thought, what happens? If I hold this thought tightly, does it help me to behave the way I truly want to?

Posted By newharb / 12:00 AM / Monday, November 23, 2009
Comments
comment By Allison @ Wednesday, November 18, 2009 6:04 PM
I'm excited about this blog! The first two entries are very clear. I have done some reading, and attended one (excellent) workshop but am still stuggling to pull things together. I think this will help me.

comment By Dominique @ Wednesday, November 18, 2009 8:50 PM
Great blog keep them coming. Thanks Russ.

comment By Jim Brandel @ Wednesday, November 18, 2009 10:09 PM
I've been in psychotherapy, self help groups, 12 step groups, Recovery Inc. and a couple hundred self help books, for 60 years. I have a diagnosis of Bipolar, PTSD, Anxiety Disorder etc. I have been on most of the psychotrophic Medications at different times, and am in the process of weaning myself off them now.

I became aware of Mindfulness Meditation from Jon Kabat-Zinn, about 3 yrs ago - and have practiced it as sitting and breathing meditatiion. I went on to MBCT for Depression. Then ACT by Steve . Then the Happiness Trap, and now the best of all - ACT made simple.

Russ Harris has done wonders for me, by reading his books and practicing selfhelp on my own. My psychiatrist cannot figure out how I've made all the positive changes, that I have, so I've given him Russ's 2 Books. Everything I've tried in the past was designed to get rid of the "Symptoms", rather than accepting them and getting on with my life. I am spreading the WORD, about Russ and ACT to people, I think will use it. I'm sure this is the next step in Humans evolving from the Fight/Flight, Pain/Pleasure reactions, to greater and kinder understandings of each other. Anyone wishing to contact me personally can use my email address: jimbran77@msn.com - and I will be happy to discuss any aspect of my painful journey out of Hell.

comment By lucy @ Wednesday, November 18, 2009 11:54 PM
That's great Jim. Keep up the good work. ACT is fascinating, but I'm still a little conflicted about using CBT or ACT with certain clients I work with, or whether to incorporate CBT with ACT in some way, or not to use CBT at all. It's a process of learning to reflect on my work. I have been using ACT, and it's great. I do like to have an eclectic approach with clients but now I'm confused as to whether to be eclectic or to incorporate ACT with all my clients. What do others think?

comment By Kerrie Matthews @ Thursday, November 19, 2009 4:50 AM
Hi Lucy,
I think healing is a spiritual practice, as well as a psychological practice. Depending upon where a patient is in their healing, probably helps to determine their acceptance of ACT. Our society generally does not realise that we can move forward without thinking and critically analysing every thought, attitude and emotion. Sometimes, people want to stay in the pain they are suffering, as there is a deep unconscious pay off to them. I think CBT is more effective with these people until they are ready to "hear" about ACT -acceptance. a lot of times when suffering, people want to blame, shift their anxiety and not accept the responsibility for themselves. If they are defensive when ACT strategies are introduced, they are not ready. Use CBT until a strong respect and rapport is established. As the client trusts you, then they will be more open to hear you and trust in ACT.

comment By Robyn @ Thursday, November 19, 2009 5:28 AM
Hi Kerrie,
I resonated with your comments. Had a session yesterday that required me to regroup and pull back and respect that my client wasn't ready to go where I was wanting to take her with an ACT intervention. From her previous therapy experiences she has a pretty concretized view of her 'problem' and i realized I had jumped ahead in my excitement. I needed to step back in order to join her again before it made sense to explore other possibilities. She definitely wasn't ready to let go of her current explanations, regardless of whether or not they were working. So ACT is also giving me lots of practice with patience.
Regards, Robyn

comment By Larry @ Thursday, November 19, 2009 9:06 AM
Because I have had a sitting practice (Vipassana) for over 30y I have been attracted to MBCT as well as ACT. I find enormous value in ACT theory. The language of ACT, such as experiential avoidance, valued action, and other ACT terms and theory are a major contribution to the world of psychotherapy. However, as valuable as ACT theory and the exercises are, I find that the lack of inclusion of mindfulness meditation such as the form offered in MBCT is a possible short-coming for many clients. I believe this possibly is an area where ACT could be expanded and improved upon. I'd love to hear others' comments on the value of including insight meditation into ACT.
Larry

comment By Kerrie @ Tuesday, November 24, 2009 5:10 AM
Hi Robyn,
My therapist often suggested at things that were six months ahead of where I was emotionally. I still heard everything he said, pondered about it and as I grew, his words would resonate with me and support me. Value from a session is not only while you are there - but what you take away from it. Sometimes I would want to avoid the next appointment, feeling like a naughty little schoolgirl who had not acted upon his suggestions. On speaking to this, he clearly let me know that he trusted me to know what was right for me, and when I was ready. His trust in me was encouraging, supportive and empowering for me in developing in the areas I needed to progress and allowed me to progress in my own time, when I was ready. It has been an amazing journey! Trust your instincts.

comment By Jo @ Thursday, November 26, 2009 4:14 PM
This is a great - to hear others experiences, journeys and confusions with understanding how to incorporate ACT into their own lives and therapeutic work rather than only trying to figure it out from the books (and one ACT training to date). I'm wondering if anyone has used either ACT or mindfulness practices with teenagers or children and if so what was your experiences. Also wondering what your experiences might be using ACT with individuals of below average cognitive ability and those who have less verbal abilities. Thanks for your thoughts - Jo

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