When behavior is inflexible and influenced more by verbal networks than by experienced environmental consequences, we can say that the person is engaging in cog- nitive fusion. Hayes et al. (1999) use an interesting turn of phrase when discussing cognitive fusion; they say that verbal symbols and environmental events are “poured together,” as if two separate things become one compound. Think about two different things being fused together as when soldering or welding metals together. Two discon- nected items become one solid, rigid entity.
From an RFT point of view, cognitive fusion is defined by “the domination of behav- ior regulatory functions by relational networks, based in particular on the failure to dis- tinguish the process and products of relational responding” (Hayes, 2006b). Technically speaking, cognitive fusion is demonstrated when a relational context dominantly governs behavior relative to the context of function. In other words, verbally related anteced- ents and consequences such as thoughts, feelings, and judgments have relatively greater influence over responding than directly contacted nonarbitrary contingencies. Simpler still, fusion is when people are guided by the literal content of their thoughts rather than by their direct experience with the world. Responding to fused content is like respond- ing to descriptions rather than to the event described. We will continue to use the word “fusion” when referring to “cognitive fusion,” as there is no appreciable difference in the terminology.
Fusion can play a large role in human suffering when the relational context of lit- erality reigns over behavior. Let’s see how this operates in the life of one man. When a private event arises, such as the thought “I am bad,” and he is entangled in that evalu- ation as if it corresponded to a literal truth, he is relating his experience to his own self (the “I”) as if it was coordinated with direct aversive properties (“bad”). When “bad” (an arbitrary stimulus) has a history of being related to things to be avoided—things that are malformed or behaviors that are socially punished—and the man has now coordinated “bad” with himself, he now shares some of the same stimulus functions as “bad.” That relation can elicit and evoke reactions—such as shame, depression, and guilt, and some- thing to be avoided—that are classically and operantly conditioned to “badness.” Fusing with the statement “I am bad” can elicit mood states (such as sadness or dejection) that make valued action less probable. The mood state, as a motivational operation (MO), might narrow this man’s behavioral repertoire by reducing the effectiveness of certain reinforcers and reducing the evocative effects of certain antecedent stimuli. In simpler terms, when he frequently tells himself, “I am a bad person,” and believes or buys that
thought (is fused to that thought), he is more likely to be in a bad mood, thereby not seeing opportunities for living a more vital life. He may also discount the positive things that happen to him.
In contrast, a man who can defuse from the thought “I am bad” might simply notice the thought, recognize it as a piece of his history brought to bear on the present situa- tion, and go on with his current activity. Suppose the man who can readily defuse from his evaluative thoughts is playing soccer and misses a shot at the goal, or asks someone on a date and is turned down. He might have the thought “I’m bad” and recognize it as a thought that shows up when he performs in a manner he negatively evaluates. He does not buy the thought and quit the game (whether soccer or dating) or become very distracted; he notices the thought and goes on playing.
Additionally, and perhaps more importantly to ACT case conceptualization, when the man is fused with his thoughts, he may attempt to avoid the unwanted thought and/or situations that evoke that thought. If fused with the thought “I am bad,” the thought can have aversive properties, and the experience of thinking “I am bad” itself becomes something to be avoided. An experiential avoidance agenda is set up, and the losing game begins, because any plans to avoid private content are likely to be followed by relatively unhelpful and inflexible behaviors characteristic of an experiential avoid- ance agenda. Suppose the man usually has thoughts of his “badness” when he goes to his house of worship or visits his parents. He may then choose to avoid practicing his spirituality or gathering with his family in the service of avoiding these thoughts, even when these aspects of his life are important to him.
Here are a few things to do—and not do—regarding cognitive fusion during assess- ment and conceptualization of your client’s behavior:
Look for instances where responding is guided by concretized evaluations
and inflexible rules.
Note the client’s verbal responses and the effect they have on his behav-
ioral rigidity in the Inflexahex Case-Conceptualization Worksheet. This part of building a case conceptualization could look like many other therapy worksheets, self-help forms, and thought logs where the clinician or client jots down “irrational beliefs” or “distorted thoughts.” The simi- larity to ACT is only in form.
Jot down the assessment data and use it to assess and then address the
function of verbal events.
Do not use these data in order to dispute the verbal events.
Record the client’s statements in order to individualize defusion and
mindfulness interventions, note what private events the client avoids, and help elucidate what valued action should be encouraged.
Conceptualizing Functionally 99
As the end goal of ACT is to foster psychological flexibility, this area of case conceptualization investigates what verbal events the client is unhelpfully and rigidly following. We will further discuss assessment and treatment of fusion and defusion in chapter 13.