Psychology: Acceptance and Commitment Therapy

Psychology 498

Module 2: Open Up

Practice Booklet

Acceptance and Commitment Therapy Seminar PSYC 498

Open up: Titchener’s repetition

Try Titchener’s repetition, which you can follow along with in the lecture video in Module 1.

After completing Titchener’s repetition

Reflection: Consider taking some notes on the following:

· Were you able to imagine freshly baked cookies? How powerful would you say the image was to you?

· As you said “cookies” rapidly over 40 seconds, what happened to that image that you had of cookies? Did your feelings or thoughts about cookies change at all?

Open Up: Acceptance

Try a meditation for working with difficulties, which you can follow along with in the lecture video in Module 1.

Consider the following question: When focusing on psychological pain, what are the things we ought to accept vs. the things we do not need to accept?

After engaging in the Meditation for Working with Difficulties

Reflection: Please take some notes on the following:

· How willing did you feel as you considered difficulties during the exercise?

· How much do you think that willingness to have a difficulty (a difficult thought or a difficult emotion) is tied to living a vital, values-based life?

ACT question (ACBS, 2019)

1. (Self-as-context) Given a distinction between you and the stuff you are struggling with and trying to change…

2. (Acceptance) are you willing to have that stuff, fully and without defense…

3. (Defusion) as it is, and not as what it says it is,…

4. (Committed action) AND do what takes you in the direction…

5. (Values) of your chosen values…

6. (Contact with the present moment) at this time, in this situation?

If the answer is “yes,” that is what builds psychological flexibility.

Reflection: Open Up

Consider taking some notes on the following (this may help you gather information you can use for the participation discussion post and/or the reflection assignment in Canvas):

· How easy and/or difficult was it for you to engage in the exercises (e.g., the mindful breathing exercise) in this “Open Up” section of the seminar?

· On a scale from 1 (not at all important) to 10 (extremely important), how important do you think it is to “Open Up” to the unwanted parts of life (e.g., feeling stressed) that come along with living a value-driven life? Why did you give that number?

· Can you come up with some examples of when “opening up” to unwanted parts of a value-driven life might not really be helpful?

Acceptance and Commitment Therapy Anxiety Case Studies link: (link uploaded)

Optional Practice Materials: Opening Up:

1. Please note: this document builds on important content discussed in chapter 12 of 2nd edition of ACT Made Simple.

TITCHENER’S REPETITION: LEMONS, LEMONS, LEMONS

This exercise (Titchener, 1916) involves three steps:

1. Pick a simple noun, such as “lemon.” Say it out loud once or twice, and notice what shows up psychologically—what thoughts, images, smells, tastes, or memories come to mind.

2. Now repeat the word over and over out loud as fast as possible for thirty seconds. Please try this now with the word “lemon,” before reading on. You must do it out loud for it to be effective.

3.Now run through the exercise again with an evocative judgmental word—a word that you tend to use when you judge yourself harshly, for example, “bad,” “fat,” “idiot,” “selfish,” “loser,” “incompetent,”—or a two-word phrase such as “bad mother.”

Please try this now and notice what happens. (You need to do it aloud to get the benefit). Most people find the word or phrase becomes just a meaningless sound within about thirty seconds. At that point, we see it for what it truly is: an odd sound, a vibration, a movement of the mouth and tongue. (But when that very same word pops into our head and we fuse with it, it has a lot of impact on us.)

Note: If doing this exercise with a client, first pick a non-distressing word (e.g. lemon, chocolate, milk) and then repeat the exercise with a word that typically elicits a painful reaction in the client. For example, if the client often fuses with “I’m an idiot”, you could repeat the exercise with the word “idiot”. Single words usually work better than whole phrases.

2. Leaves on a Stream-Cognitive-Defusion-Exercise

Cognitive Defusion Exercise

Harris (2009) provides an excellent cognitive defusion exercise used in Acceptance & Commitment Therapy:

“Leaves on a Stream” Exercise

(1) Sit in a comfortable position and either close your eyes or rest them gently on a fixed spot in the room.

(2) Visualize yourself sitting beside a gently flowing stream with leaves floating along the surface of the water. Pause 10 seconds.

(3) For the next few minutes, take each thought that enters your mind and place it on a leaf… let it float by. Do this with each thought – pleasurable, painful, or neutral. Even if you have joyous or enthusiastic thoughts, place them on a leaf and let them float by.

(4) If your thoughts momentarily stop, continue to watch the stream. Sooner or later, your thoughts will start up again. Pause 20 seconds.

(5) Allow the stream to flow at its own pace. Don’t try to speed it up and rush your thoughts along. You’re not trying to rush the leaves along or “get rid” of your thoughts. You are allowing them to come and go at their own pace.

(6) If your mind says “This is dumb,” “I’m bored,” or “I’m not doing this right” place those thoughts on leaves, too, and let them pass. Pause 20 seconds.

(7) If a leaf gets stuck, allow it to hang around until it’s ready to float by. If the thought comes up again, watch it float by another time. Pause 20 seconds.

(8) If a difficult or painful feeling arises, simply acknowledge it. Say to yourself, “I notice myself having a feeling of boredom/impatience/frustration.” Place those thoughts on leaves and allow them float along.

(9) From time to time, your thoughts may hook you and distract you from being fully present in this exercise. This is normal. As soon as you realize that you have become sidetracked, gently bring your attention back to the visualization exercise.

3. UCLA-Semel-Meditation For Working With Difficulties_Transcript

Meditation for Working with Difficulties (6:55)

You can use this practice to work with difficult emotions or body sensations

Find a posture that's comfortable to you

And then check inside your body and try to locate a part of your body that feels good to you right now

Pleasant, safe, at ease,

Or at the very least, neutral

You can check out your hands or feet or legs

But let your attention go to this pleasant part of your body

Hands or feet or wherever you've chosen

And let your attention rest there

Feel it

Sense it

Notice what those sensations are

Let your mind relax a bit

Feeling that part of the body

And now if there's something difficult that's happening for you

A difficult emotion, or a physical sensation that's hard

Let your attention go to that

So, it may be an aching in your shoulder or back

Or a headache

Or it could be a sense of sadness

Or anxiety

Or anger

Where do you feel that sensation in your body

Where do you feel that emotion in your body

Notice it

Just notice it for one moment

Tap into it

Feel it

Make sure to breathe

And now return your attention back down to that area that feels at ease

Your hands or feet or legs

And just let yourself stay there for a moment

Feeling it sensing it

Relaxing. maintaining the mindfulness

Yet giving yourself a break from what could be potentially overwhelming to feel

And now once again return your attention to that part of the body that feels unpleasant

The body ache or pain

Or the emotion the sensations of the emotion in your body

The vibrations in your chest

Or the clenching in your belly

Or the tightness in your jaw

Just notice

And breathe

And let it be there

Let whatever is there, be there

And then bring your attention again back down to this pleasant or neutral part of the body

Hands, feet, so forth

Relaxing

Staying present and alert

Feeling the safety

The connection in that place

Now let yourself stay connected to this place

But see if you can cast what we might call a sidelong glance at the difficult area in your body

Is it possible to still feel connected to your body in the area that feels good

And yet know there's something going on that feels unpleasant

And just let it be there

Keeping maybe 75% of your attention on the part that feels peaceful and at ease

Still breathing

Casting the side long glance at this difficult area

Noticing what happens to it, is it growing or shrinking

Is it changing, shifting into something else

Becoming aware of whatever it is it's doing

Relaxing, breathing

And now see if you can bring some loving kindness

Just some kindness to yourself for whatever you're feeling right now

Physical pain, emotional pain

Hold yourself with kindness

You're not the only one

So, may we all be free from our pain and our suffering

May we all have happiness

[bell rings]

4. Struggling versus opening up worksheet-R. Harris

Struggling vs. Opening Up Worksheet

Fill in this worksheet once a day to help keep track of what happens when you struggle with your emotions and what happens when you open up and make room for them.

Struggling vs. Opening Up Worksheet
Day/Date/Time Feelings/Sensations What events triggered this?	How much did you struggle with these feelings? 0 = no struggle, 10 = maximum struggle. What did you actually do during the struggle?	Did you open up and make room for these feelings, allowing them to be there even though they were unpleasant? If so, how did you do that?	What was the long-term effect of the way you responded to your feelings? Did it enhance life or worsens it?

5. HARD Barriers Worksheet - Russ Harris

What's Holding You Back? Identify Your HARD Barriers.

The aim of this worksheet is to clarify your own internal barriers, holding you back from stepping out of your comfort zone, or trying new things, or facing your fears, or tackling your big challenges, etc. There are two ways to fill out this worksheet. One option is to do it for a specific domain of life - e.g. work, education, friends, partner, parenting, spirituality, hobbies, health etc. The other option is to do it as a broad overview of life in general.

H = HOOKED What reasons does your mind come up with for why you can’t, shouldn’t, or shouldn’t even have to take action? What bad things does it tell you will happen if you do take action? Please write them below.

The antidote: If you get hooked by these thoughts, then you probably won’t take action. So use your unhooking skills. You can’t stop your mind from saying these things, but you can unhook from them.

A = AVOIDING DISCOMFORT Personal growth and meaningful change means stepping out of your comfort zone. This inevitably brings up discomfort. And if you aren’t willing to make room for that discomfort, you won’t do the things that really matter to you. Please write below all the difficult thoughts, feelings, sensations, emotions, memories, and urges you are unwilling to have.

The antidote: Use your “expansion” skills; practice opening up and making room for your discomfort. Before you set out to do the challenging things that matter to you, think ahead: What sort of discomfort is likely, and are you willing to make room for it?

R = REMOTENESS FROM VALUES What values are you ignoring, neglecting, forgetting, leaving behind, or failing to act on when you opt out of doing these important things?

The antidote: Connect with your values. Why bother to do this challenging stuff if it’s not important? If it is important, then connect with what makes it meaningful. What values will you be living with every step you take?

D = DOUBTFUL GOALS On a scale of 0–10, how realistic do your goals seem to you? (10 = totally realistic, I’ll definitely do it, no matter what. 0 = completely unrealistic, I’ll never do it.) If your goals seem less than a 7, it’s doubtful you will follow through. Are your goals excessive? Are you trying to do too much? Trying to do it too quickly? Trying to do it perfectly? Are you trying to do things for which you lack the resources (such as time, money, energy, health, social support, or necessary skills)?

The antidote: Set more realistic goals. Make them smaller, simpler, easier, matched to your resources, until you can score at least a 7 in terms of how realistic they are.

Please write down your goals below and scale each one 0–10 in terms of how realistic they seem. If any score less than 7, you need to make them smaller, simpler, easier - or change them completely - until you can score 7: