Getting in on the Act

Tue, Jun 7, 2011, 01:00

More people are coping with the stresses in their lives by turning to Acceptance and Commitment Therapy, writes MICHELLE McDONAGH

THE SELF-HELP sections of our bookshops are packed with books telling us how we can beat depression, stress, anxiety, addiction and many other problems. Every day, we are bombarded with advice from various “experts” on TV and radio about how to improve our lives and yet, humans do not seem to be getting happier. The opposite appears to be the case, if levels of depression, anxiety, drug and alcohol addiction are anything to go by.

The majority of self-help programmes tell us that we will find happiness by banishing all negative thoughts and images from our minds. However, the creators of a new model for changing human behaviour that is growing in popularity claim that being able to control what you think and feel is one of the many myths actually preventing people from finding happiness.

Acceptance and Commitment Therapy (Act) claims a firm basis in scientific research and has been found to be successful in helping people with a wide range of problems from depression and anxiety to chronic pain and drug addiction.

Developed in the US by psychologist Steven Hayes and his colleagues, Kelly Wilson and Kirk Strosahl, Act teaches us to use the time and energy that we spend struggling against unwanted or negative thoughts to help us move towards what really matters to us in our lives – our values.

The reality, they point out, is that life involves pain – we all at some time have to deal with sickness, death, grief, disappointment and failure. The good news is that although we can’t avoid such pain, we can learn to handle it better and reduce its impact on our lives.

Creator of Act and professor at the Department of Psychology at the University of Nevada, Steven Hayes, explains that the therapy takes a different approach from other interventions by being more open and flexible with thoughts and feelings, by learning from them, but also shifting attention to the values we want to be reflected in our actions.

“Act is part of a family of acceptance- and mindfulness-based therapies that take this position, and the data in support of them is growing every day. They are not a panacea – but they are moving human lives forward toward greater peace of mind and values.”

Author of The Happiness Trap, Dr Russ Harris says Act is an innovative approach to developing mindfulness skills in a short space of time. Mindfulness is a mental state of awareness, openness and focus which has been part of Eastern philosophy for thousands of years.

A GP from the UK, Harris retrained as a psychotherapist and Act therapist after becoming disillusioned with simply handing out prescriptions for antidepressants all the time.

“What makes Act different is that it’s realistic. It starts from the premise that negative thinking is normal, that positive thinking often doesn’t work, that life involves plenty of pain for everybody, and placing too much importance on ‘feeling good’ often creates problems,” he says.

“Act assumes the things that make life rich, full and meaningful don’t just give you good feelings, they give you plenty of painful ones too. For example, think of long-term intimate relationships, or having children, or any big important project you undertake.”

Psychologist and director of Act Now Ireland, Aisling Curtin, was introduced to the therapy while studying psychology at NUI Maynooth and went on to learn from its creators in the US and also from Russ Harris in Melbourne who has become a mentor to her.

As well as seeing how Act has benefited her patients at St Edmundsbury Hospital in Lucan (part of St Patrick’s University Hospital), Curtin has found the therapy really helped in her own life.

“I lost my brother tragically in a car accident less than a mile from our home when he was 11 and I was 14. I was in the car as well. In that day, everything that I knew went up into smoke and it just made me so aware of how everything can change in an instant,” she says.

“My parents brought us all to see a counselling psychologist, which was really important in helping us come to terms with what had happened.

“I realised then that I would like to be able to help other people to find some meaning and make some positive changes from even the most horrendous things that happen to us in our lives.”

She points out that the creators of Act have all struggled in their own lives and have brought the lessons learned from their own personal experiences to their work. Steven Hayes was affected by panic disorder, Kelly Wilson lost a brother to suicide and battled with depression and addiction, while Kirk Strosahl had major depression.

As well as holding public workshops, Curtin has been using Act with great success with both inpatients and day-patients at St Edmundsbury Hospital over the past year.

“What I love about the Act approach is that it works really well for people who have serious major depression or serious problems with anxiety and who have really been quite debilitated for a long time. But it also works well for people who just feel a bit stuck in life or feel that something is not quite right.”

Curtin asks people to look at all of the wide and varied means they have tried in the past to get rid of unwanted emotions such as sadness, anger, fear, guilt and shame. From reaching for the tub of ice cream or that glass of wine to avoiding social situations, she says the list is endless. In one residential workshop, the group came up with 108 different ways they had tried to get rid of negative thoughts – not one of which worked on a long-term basis.

“If there was one way that permanently got rid of unwanted thoughts, emotions and bodily sensations and helped us to move towards the person we want to be, we would have figured it out by now and there would be nobody like me in business. Until then, I have found that Act works really well.

“So instead of putting all our time and energy into trying to get rid of things we don’t want in our lives, we start to put the same time and energy into the things that really matter to most to us, like our family, health and wellbeing.”

Through Act, Curtin teaches people the skills to “defuse” or gently unhook from recurring unwanted thoughts and to live more in the present rather than focusing, as we all do so often, on the past and the future. She provides many of these exercises as MP3s available free on the Act Now website, actnowireland.com.

“People in my groups keep saying to me, if they had learned these skills earlier in life, they wouldn’t need to be there or have ended up in hospital in the first place,” she says.

Dr Kelly Wilson will be giving a two-day workshop for health professionals at the Ashling Hotel, Parkgate Street, Dublin on Saturday and Sunday. A free Act workshop is also being held for the public tomorrow at 6.30pm in the Maldron Hotel, Smithfield. To register, e-mail aisling@actnowireland.com or tel: 086-3331225.

THERAPEUTIC: ‘IT HELPS ME STAY IN THE PRESENT AND TO RELAX’

Rita, a 66-year-old Dublin grandmother, had been suffering from depression when her doctor suggested she try the Act programme at St Edmundsbury Hospital. She has found the therapy so helpful that she sets aside 30 minutes every day to do her exercises.

“I have found Act helps me to stay in the present and to relax. I have not had a recurrence of my depression since I started Act. Although I don’t know if that’s the only reason, I do think it keeps me well,” she says.

“Everybody is stressed these days, including parents of my age who have children struggling with mortgages and have lost money ourselves in shares and pensions. I think Act is a terrific tool to help cope with different stresses in life.

Brendan (53) found he was struggling to cope with life after he broke up with his wife. The farmer from Co Westmeath attended a weekend residential Act workshop which, he says, helped him to “see the wood from the trees” and has enabled him to focus on the moment.

I slowly began to realise there was more to life than ‘I have to be somewhere by such a time’ or ‘so and so is horrible to me’. I have always had a love for the land and animals, but I have more of an appreciation now of the nature that is all around me.

“Instead of getting caught up in myself and getting so upset and worried about things, if something does not work out, I ask myself: what can I learn from this and what can I do to bring me towards my values?

Whenever you notice yourself getting hooked by an unhelpful thought, such as “I can’t cope” or “I’m just not good enough”, stop for a moment, Then say to yourself, “I notice I’m having the thought that I’m not good enough AGAIN”.

An alternative Act approach is to close your eyes and imagine your favourite cartoon character saying your unhelpful thought out loud with all their usual mannerisms. Notice if this changes your relationship to the thought in any way.

When you are feeling stressed or overwhelmed, try placing one hand on your chest and the other on your belly and take notice of yourself breathing in and out.

Think about how your life might look differently if you had 100 per cent confidence and no longer struggled with unwanted thoughts and emotions. Think about how this might affect the four main areas of your life – relationships, health and wellbeing, recreation/leisure and work/education? This will give you some indication of what truly matters to you.

It is generally best to concentrate on one area of your life to start working on first. If we look at the entire journey, it can appear overwhelming. However, with one step at a time, even great difficulties become manageable.

ACT ADVICE: TIPS FOR WELLBEING

Whenever you notice yourself getting hooked by an unhelpful thought, such as “I can’t cope” or “I’m just not good enough”, stop for a moment, Then say to yourself, “I notice I’m having the thought that I’m not good enough AGAIN”.

An alternative Act approach is to close your eyes and imagine your favourite cartoon character saying your unhelpful thought out loud with all their usual mannerisms. Notice if this changes your relationship to the thought in any way.

When you are feeling stressed or overwhelmed, try placing one hand on your chest and the other on your belly and take notice of yourself breathing in and out.

Think about how your life might look differently if you had 100 per cent confidence and no longer struggled with unwanted thoughts and emotions. Think about how this might affect the four main areas of your life – relationships, health and wellbeing, recreation/leisure and work/education? This will give you some indication of what truly matters to you.

It is generally best to concentrate on one area of your life to start working on first. If we look at the entire journey, it can appear overwhelming. However, with one step at a time, even great difficulties becomemanageable.