Acceptance & Commitment Therapy (ACT) – Odyssey Health Services

22/Mar/2018

price-of-admission

“Discomfort is the price of admission to a meaningful life.” – Susan David

Dr. Susan David is a Psychologist at Harvard Medical School and is a founder and co-director of the Institute of Coaching at McLean Hospital of Harvard Medical School. In her Ted Talk about emotional agility, which you can find here, she discusses the concept of emotional agility, how society has made a push towards positivity, and inadvertently, how this may have led to additional suffering.

There is a push in our media, in our society, and in our homes to be positive; think positive, look on the bright side, or simply, smile! Dr. David posits that this push towards positivity often leads to denial of the truth and denial of our emotions. We can end up feeling bad about ourselves for experiencing negative emotions and negative thoughts because we’re supposed to be happy and positive all of the time.

The truth is, life isn’t always happy and positive. Certainly there are times in our lives when we are happy and things are going well and we feel good, but there are also times when things do not go our way and we just feel bad. Dr. David suggests that instead of trying to be positive during these times, and pushing those negative thoughts away, we need to embrace them, to learn to deal with and cope with them rather than trying to run away from them. Dr. David’s Ted Talk mirrors much of what is discussed in Acceptance and Commitment Therapy and, in particular, the idea that we must accept, rather than try to push away, negative thoughts and feelings. These things are a way of life and like a rollercoaster, sometimes we have to just wait it out.

I like to use grief as an example in my practice with clients. Our society treats grief as something that is normal – we are expected to be sad or to cry when someone close to us passes away. We also know that people we love may pass away, and as much as we do not like that thought, we have no choice but to accept it. We treat grief with a lot of respect, in most cases, and allow it to come and go naturally. I believe that we need to learn to treat the rest of our emotions with the same type of respect that we treat grief. When we are feeling anxious or sad, rather than beating ourselves up for these feelings we should be accepting that this is how it is right now, and allowing those feelings to come and go. Often, the more we try to control these feelings, the worse off we become. Either we actually end up enhancing the feelings that we started with, or we add additional distress, such as shame or frustration when we do not succeed in getting rid of the feelings.

I would like to challenge you to you try accepting your negative thoughts and feelings, and treating them with the same respect that you would grief. Listen to Dr. David’s Ted Talk, and reflect back on your own experiences of trying to get rid of your negativity. Try something new, and see what happens.

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Source: Click

Jenny Thomson

20/Oct/2017

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To Begin I’d like you to watch THIS VIDEO.

What thoughts came up for you as you watched this video? Were you able to relate to what the individuals were saying? Did you understand why they answered the way they did? I’d like you to take a moment to reflect on a time when you made a mistake, and some of the things that you said to yourself. What sort of words did you use? How did those words affect you? Now think of the last time a loved one came to you and told you about a mistake. How did those words differ from the ones you told yourself? I’m willing to bet that there is a big difference in how you speak to yourself versus how you speak to others.

Why Self Compassion?

I’m sure you’ve heard the term self-compassion before. Maybe you wondered why it was important, or why people even bother talking about it. Maybe you thought you didn’t need to be self-compassionate, or that it simply wasn’t something that would impact your life. Kristin Neff (2012) suggests that self-compassion is more than looking on the bright side or attempting to avoid negative feelings. Self-compassionate people are able to recognize when they are suffering, but act kindly towards themselves. Neff (2012) further explains that studies have indicated that individuals with higher levels of self-compassion experience less anxiety and self-consciousness when asked about their weaknesses, display more wisdom and emotional intelligence, and often experience higher levels of social connectedness and overall life satisfaction.

If we can learn to be kinder to ourselves, we can learn to let go of our mistakes and shortcomings, and move forward from them. This doesn’t necessarily mean ignoring them, but rather not allowing them to hook us into a pattern of self-depreciation and dislike. Instead, we can accept our mistakes/shortfalls/situations for what they are, learn from them, and move forward.

So how do I be Kinder to Myself?

Being compassionate towards oneself is similar to the way that we express compassion for others. As in the video above, it is clear that many of us are better able to be compassionate towards our loved ones than we are to ourselves. Learning how to be self-compassionate will not happen overnight; it may take time, practice, and trial and error.

Neff (2012) posits that there are three main components to having compassion for oneself:

Self-kindness
A sense of common humanity
Mindfulness

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In short, these three aspects of self-compassion involve being understanding towards ourselves and our downfalls; recognizing that we are not alone and that other people struggle as well; and practicing living in the moment and accepting some of our thoughts, feelings, and emotions. What self-compassion is not, is self-pity, self-indulgence, or self-esteem (Neff, 2012). To learn more about how you can be more self-compassionate, click here to read Kristin Neff’s chapter on The Science of Self-Compassion.

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Source: Neff, K. D. (2012). The science of self-compassion. In C. Germer & R. Siegel (Eds.), Compassion and Wisdom in Psychotherapy (pp. 79-92). New York: Guilford Press.

Kayleen Willemsen

12/Oct/2017

Every day, we are faced with difficult thoughts and feelings that are uncomfortable. Whether it’s sadness, fear, shame, guilt, or anxiety, these feelings can take on a life of their own and feel overpowering. Soon enough, we may start to have other unpleasant feelings as a result of our struggle with the initial feeling. For example, we may feel frustration over the fact we are anxious, or guilt over the fact we are sad. That’s the problem with many of our feelings – the more that we struggle with having the feeling, the more the feeling takes hold of us.

What if there was an alternative? What if there’s a chance that these feelings are here because there is something that is meaningful, something that is so important we hurt because of it?

If struggling with the feelings isn’t working, the only other alternative we have is to create space to allow them to be present. Give this a try:

Take a few breaths. Notice how it feels when you breathe, and how the air feels as it flows in through your nose when you inhale, and how it feels when it exits when you exhale. Notice the speed of your breath, and how your rib cage moves slightly up as you inhale, and falls again when you exhale. Now see if you can locate the difficult feeling. Is it in your stomach? In your chest? In your heart? Your head? Notice where you feel it. Notice how big it feels – does it feel large and heavy, like it’s weighing you down? Does it feel small? Notice if it feels like it has any movement – is it pulsing, or vibrating? Is it still? If it had a colour, what colour would it be? What kind of texture would it have – would it be smooth, or spikey? See if you can create a picture of a creature for this feeling using these qualities.

You don’t have to like the creature or want it there, but see if you can allow it to just hang out. As ugly or undesirable as this creature may be, it is telling you that something is important. We hurt where we care, and this creature’s presence is a sign that something is very important to you. In other words, struggling with the creature is only struggling with an essential part of yourself. What’s more, struggling with the creature ties up energy and resources that you could be using to do things that bring you closer to the life you want.

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So, next time you see the creature, see if you can hold it lightly. See if you can soften a little around it, and provide yourself with self-compassion like what you would feel for a friend experiencing the same thing. Notice that you are always larger than the creature. And maybe, it is okay to have this little creature along for the ride with you after all.

Kathryn Camacho

23/Aug/2017

I’m sure we have all had those moments of craving something sweet or salty or savoury. It feels like nothing would pleasure us more than satisfying that urge to indulge in what we may be craving in that moment. Whether it’s a reward, a treat for ourselves, or a way of coping when we may be feeling stressed or down, it’s often quite a powerful sensation and urge that may at times be difficult to simply ignore.

The problem with cravings is if we buy into them too often, they can take over our daily diet. The more we engage in those cravings, the more likely you are to find that you start to gain weight, realize you aren’t eating the nutritious diet you should be, and then secondary problems with mood, like guilt or shame, may arise.

Due to mindfulness’ popularity and our curiosity about the benefits it can provide, it did not surprise me to find that research has been undertaken to see the advantages it can provide to many areas of our life, including eating. Through my own research I have found information relating to the benefits of mindfulness in not only effectively reducing food cravings, but also helping to lose weight and find space from troublesome thoughts.

“The results showed that participants in the experimental group reported significantly lower cravings for food after the intervention compared to the control group. The findings are discussed in terms of possible mechanisms like prevention of goal frustration, disengagement of obsessive thinking and reduction of automatic relations between urge and reaction” (Alberts et al., 2010).

Check out this full article, to see all the details about what researchers have to say about using mindfulness to decrease food cravings.

Because of our expertise in Mindfulness and Acceptance and Commitment Therapy (ACT), as you may have noticed from previous posts, we have created an ACT for Mindful Eating course to help you work through eating related challenges, including cravings! For more information about our ACT for Mindful Eating course that starts this September, please contact Michelle Urbanc at 905-317-8890 or by email at info@ohs-jma.com today!

Alberts, H. et al. (2010, March 23). Coping with food cravings. Investigating the potential of a mindfulness-based intervention. Appetite, 2010 (199). DOI: 10.1016/j.appet.2010.05.044

Jessica Rickus

15/Aug/2017

Acceptance and Commitment Therapy (ACT) is a form of Cognitive Behavioural Therapy (CBT) that uses a combination of strategies to foster psychological flexibility including, mindfulness, acceptance, commitment, and behaviour change. Rather than the focus being on ridding oneself of ‘negative’ internal or external content (i.e. thoughts, feelings, emotions, pain), ACT focuses on inviting individuals to be open to experiencing all that life has to offer us, whether pleasant or unpleasant, and to learn how to move towards the people and things that are meaningful to us, particularly in the presence of challenges.

The way we see ACT is not only as a type of therapy used in a wide variety of clinical settings for a wide range of clinical diagnoses, but also as a way of life, that each of us at OHS have adopted. Our work at OHS is broad and so using a type of therapy that is also very broad is quite fitting. We have been able to incorporate components of ACT into each and every one of our services, and have seen plenty of success in doing so.

In September 2017, we will be launching our ACT for Mindful Eating course which uses components of ACT to address the challenges and barriers that typically come into play in other weight loss initiatives (i.e. dieting, counting calories, restricting). In preparation for the launch of our course we have been exploring what researchers studying ACT’s role on weight control and eating behaviour have discovered. We came across research that revealed that ACT has shown favourable outcomes for long-term weight control outcomes.

“At 3-month follow-up, ACT participants had lost an additional 1.6% of their body weight, whereas the control group gained .3% and overall a significantly higher proportion of the ACT participants had maintained or lost weight. The ACT group also showed significant improvements in quality of life and reductions in psychological distress and self-stigma” (Lillis et al., 2009).

Check out this full article, to see what these researchers have to say about using ACT independently or in combination with Standard Behavioural Treatment for weight control: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4238039/

For more information about our ACT for Mindful Eating course please contact Michelle Urbanc at 905-317-8890 or by email at info@ohs-jma.com.

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Lillis, J. and Kendra, K. (2014). Acceptance and Commitment Therapy for weight control: Model, evidence, and future directions. Journal of Contextual Behavioral Science, 3(1), 1–7

Jenny Thomson

27/Jul/2017

eating

I’m willing to bet that you’re here reading this because you are, or have at some time, tried to lose weight. I’m also willing to bet that you’re well aware of information about which foods are “healthy”, that you should probably exercise more, and that you may need to eat less. Weight loss, diets, and information on how to be “healthy” are all around us, but with so much information out there, what are we to believe? We have all of this information flooding our computer screens and cell phones constantly, so why can’t we lose weight? According to Acceptance and Commitment Therapy (ACT), the answer to this question lies in our behaviour as well as the way that we think about food and our emotions.

Dr. JoAnne Dahl, Ph.D., hosts an Acceptance and Commitment Therapy (ACT) podcast, ACT: Taking Hurt to Hope, in which she delves into many different topics and difficulties that individuals face in their lives, and talks about how we can understand these difficulties from an ACT perspective. In particular, Dr. Dahl explores the mechanisms underlying why we do what we do, and attempts to help us understand how we can alter our behaviour and our thinking in order to change that.

Dr. Dahl has four podcast episodes that cover the topic of eating behaviour and weight loss:

Hope for weight strugglers: In this episode, Dr. Dahl speaks with Dr. Jason Lillis, a psychologist at Brown University, about the role of self-compassion in your journey to lose weight.
Struggling with Emotional Eating: Feeding [or starving] your Feelings: Dahl teams up with Dr. Emmett Bishop from an eating disorder clinic in Colorado to discuss the mechanisms behind why we eat ‘junk’ food even when we know it will cause us to gain weight, and why people who suffer from eating disorders have such a difficult time changing their behaviour.
Struggling with Choices: Eating Problems: Dahl, along with Dr. Joseph Ciarrochi of the University of Western Sydney in Australia, discuss the effects of unhealthy weight control behaviours, advertising, and more on the obesity rates of today’s children.
New ACT book The Diet Trap: Dahl speaks about her book, The Diet Trap, and why this book is different from most books related to dieting and weight loss. The Diet Trap focuses on the emotional aspects of eating and why we turn to food for comfort, as well as how to change this.

To listen to any of the above episodes, simply click on the episode title and listen for FREE. I would also strongly recommend listening to other episodes of the podcast, as the concepts in ACT that are introduced in the context of eating and weight issues can also be applied to other aspects of our lives. Click here to access the main page and browse Dr. Dahl’s many podcast episodes.

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Kayleen Willemsen

21/Jul/2017

You’re at home in the evening, and all of a sudden a wave of sadness creeps in. You find out you didn’t get the promotion you worked so hard towards, and you feel shame, wondering how you’ll tell your family. You arrive at an event, notice you’re significantly under-dressed for the occasion, and instantly feel embarrassed, wishing you could just disappear. We experience a multitude of emotions each and every day, and yet we dread and try and avoid this experience as best as we can. But why?

Were you ever told as a child, “Big boys/girls don’t cry”, “Snap out of it”, or “Don’t worry about it”? From a very young age, many of us were taught to do our best to avoid emotions, to not think about them, or to use distraction techniques. We learned that some emotions were “good”, and some were “bad”, and that we will only be happy in life if we avoid the “bad” or “negative” emotions. As such, we start to become masters at avoiding emotions, whether it be holding them in, harshly judging ourselves for experiencing them, or trying to dampen our emotions with substances or other avoidance techniques. Although this can sometimes be effective in the short term, there are many long-term implications for treating our emotions as enemies, such as anxiety, depression, and substance abuse.

In Acceptance and Commitment Therapy (ACT), our emotions are viewed as a part of our experience that are neither good nor bad. Instead, ACT takes a radical stance that we must learn to universally accept all emotions, no matter how they make us feel. Acceptance does not necessarily mean that we want the emotions or like them, but rather that we are choosing to allow space for them to be a part of our experience. When we allow space for our emotions, we are fostering self-compassion by allowing ourselves to be here, as we are, right now. Dr. Joan Rosenberg, a psychologist based in Los Angeles, argues that emotions actually help us to feel more comfortable in our own skin. In her TEDx Talk, she discusses how we must embrace our emotions, as they are the path back to being more fully you. In other words, to deny our emotions is to deny a part of ourselves and perhaps the very thing that makes us human.

So how can we end this battle with our emotions? Next time you experience a strong emotion, pause. Notice where you feel the emotion, and any thoughts that show up with it. Notice if any rules or judgements about your emotions appear. Notice if you experience the urge to run away and escape this uncomfortable feeling. Then, instead of doing the escaping – just let it be. Open up and allow space for the emotion, granting it permission to be there. Physically, emotions hurt, but they cannot harm us. We are always bigger than any emotion we may experience. We hurt where we care, and experiencing an emotion is a sign that there is something we care deeply about. What is it? How can we honour this part of ourselves? Can we thank ourselves for caring so deeply and passionately about something? It is through this last step of gratitude that we can slow down, connect, and centre ourselves in what’s really important.

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You can view Dr. Joan Rosenberg’s TEDx talk by visiting https://www.youtube.com/watch?v=EKy19WzkPxE

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Kathryn Camacho

1/Jun/2017

I am sure I am not alone in ever wishing away the next few tough days at work or getting an unpleasant appointment or test over with, dreaming of the weekend. I LOVE WEEKENDS, I get to go where I want, take my time doing so, and enjoy ample time with my loved ones.

But, as my use of mindfulness and other aspects of Acceptance and Commitment Therapy has increased over recent years, I have also found myself reflecting on the importance of soaking up each day or rather each moment, instead of trying to rush through week days to arrive at my very short lasting weekend.

Incorporating fulfilling and important tasks into your daily life is so important– including on week days! Seeing as though 5 out of 7 days of the week (that’s 71% of our time) are week days I’d say using those days to do things that are important to you and bring you closer to the life you want is crucial. Otherwise, we can all end up spending the majority of our time rushing through life and missing out on a full life.

For example, this week I have made it my mission to do something that aligns with what is important to me every single day. Here is my schedule:

Monday: Call my Mom and plan a dinner date for next week

Tuesday: Go to the park with my Husband and dog in the evening

Wednesday: Go out to lunch with a group from work

Thursday: Write in my journal on my break at work

Friday: Go to the gym in the morning

So my challenge to you is to try to not just live for the weekend. Yes, weekends are a great break for many of us, but I encourage you to make the best of your time during the week too. Not only spending time at work but with the other hours you have to spend with your loved ones, taking your time and doing things that bring fulfillment to your life.

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Kayleen Willemsen

5/May/2017

“My happiness grows in direct proportion to my acceptance, and in inverse proportion to my expectations” –Michael J. Fox

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Although acceptance is the namesake and one of the main premises of Acceptance and Commitment Therapy (ACT), it can be a difficult concept to understand and an even more challenging one to put into practice.

There are many misconceptions about acceptance. When we speak of acceptance, we do not mean liking or wanting something that we are struggling with. It also does not mean resigning or giving up on trying to improve a situation. Rather, acceptance means taking a stance that is fully open to experiencing thoughts, feelings, and sensations, whether pleasant or unpleasant.

Our minds do not seem to come innately wired for acceptance. More often than not, we find ourselves struggling with difficult thoughts, feelings, and sensations. Almost all of us have some version of a “not good enough” story. We may compare ourselves to others in terms of wealth, attractiveness, status, or achievements and wonder why we do not stack up. This can then lead to struggle, and attempting to cope with the struggle by doing things that do not bring us closer to achieving these ideals.

For example, one may have the thought “I wish I was as attractive as them” which then leads to feelings of shame, guilt, frustration, or sadness. The individual may struggle more with those feelings, and then try to alleviate some of the pain through distraction techniques such as television or overeating. Unfortunately, these strategies are unlikely to rid the individual of the feeling forever, and they are likely to produce further feelings of frustration, sadness, and shame. This can lead to further distraction techniques, which then becomes a cycle of struggle.

Acceptance offers us an alternative to feeling caught in a battle with our own mind. When we choose to accept a thought, feeling, or sensation, we are acknowledging that sensation and allowing its presence – even if it is unpleasant for us to do so. It is greeting the feeling with open arms; even if it is not something we want, with the knowledge that it is normal and natural to have this feeling. It is meeting the feeling with compassion, noticing that we hurt where we care, and this is a feeling that is telling us something is important to us.

So how do we do this? The first step is to notice the thoughts, feelings, or sensations you may be struggling with. What is it? Notice where you feel this struggle – how does it show up as a sensation in your body? Do you feel a tightening in your chest? A knot in your stomach? A lump in your throat? Notice what your urge to do is when this sensation shows up. Do you have the urge to run, and not confront it? The urge to watch television, or have a snack? The urge to yell, or tell somebody off? Notice if these urges bring you closer to the person you would like to be, or take you away from them. Finally, you may ask yourself: Is it possible to sit with these sensations and allow them to be there while refraining from acting on the urges?

We may find that acceptance is easier with some thoughts or sensations, and more difficult with others. There may be times when acceptance comes easy to us, and we welcome thoughts and feelings with open arms. Then there may be other times when we notice we are in a struggle, but cannot seem to find the will to accept. Accept this. The more we accept, the more we can notice thoughts that hook us and the urges that come from the thoughts, without acting on those urges. The more we utilize acceptance, the more we may have compassion for ourselves and for others who are struggling.

Kathryn Camacho

24/Mar/2017

Through my work with Acceptance and Commitment Therapy (ACT), I have always found having the discussion regarding primary pain versus secondary suffering not only useful, but usually eye opening for many clients (as it also was for me when I was first introduced to the concept).

As symptoms and uncomfortable thoughts and feelings arise, it is almost second nature for us to try and palliate or rid ourselves of these symptoms as soon as possible! A problem usually arises, though, if there isn’t a simple and easy fix to our unpleasant situation.

When someone has been dealing with symptoms on a chronic basis and they find they feel stuck in their suffering or that their suffering is getting worse, it can be important to begin to decipher the difference between their primary pain and their secondary suffering. So let’s start with that:

Primary Pain: This is the root of the problem. These are the actual unpleasant feelings you would experience inside your body, whether it be feelings of chronic pain, depression, anxiety, etc.

Secondary Suffering: This can be looked at as the havoc/problems the primary pain can cause in your life. This is the additional pain that arises when you resist and react to your primary pain. For example, if your primary pain is anxiety and you cope by avoidance (i.e. not spending time with friends, avoiding your regular gym class, avoiding family events), your secondary suffering would be the loss you experience by not spending time doing these things that bring fulfillment to your life.

Because we live in a quick-fix culture, and things like chronic pain, depression and anxiety may not always be helped by a quick fix, ACT’s approach is to help to reduce and eliminate the secondary suffering. One may not be able to quickly or efficiently reduce their primary pain, but many have found that by reducing secondary suffering by working on completing daily behaviours that bring them closer to the life they want (i.e. still going to spend quality time with friends or attend your favourite group gym class), the volume of the primary pain may eventually turn down, and the even bigger bonus is that doing so guarantees a decrease in their secondary suffering!

This may sound easier than it looks – and that is true – it takes an individual’s commitment and acceptance every day to make choices that bring them closer to the life they want. Strategies like mindfulness can help keep you grounded and accepting of each moment. Continued reflection of your daily choices and committed actions will also help with keeping you on track. Use patience and perseverance to work through making committed actions daily because the reduction in secondary suffering will definitely be worth it!

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