Lynette is a former student and client. I’ve changed her name and a couple of other characteristics to maintain her confidentiality but retained all of the key aspects of her case to illustrate how I used ACT to help her.
A high achiever, Lynette recently returned to college full-time at age thirty-five to finish her bachelor’s degree in business with a focus on management. She sees this as a stepping-stone to earning her MBA and attaining a high-level management position in a
large corporate travel agency. She earned an associate’s degree in travel agency management fifteen years ago and has already had a successful ten-year career as an agent and owner of her own small travel agency. Besides attending college full-time, Lynette still manages her agency while being a mother, a wife, and a homemaker. Lynette is an intelligent, energetic, highly organized, and hardworking woman.
On paper it looks as if she is successfully juggling her various roles, but in person, she’s a train wreck waiting to happen, because she’s stuck in her troubling thoughts and painful emotions about being a “superwoman.” Lynette has a personal script and mental image of herself as being able to not only manage all of these roles but do them all perfectly. She still clings to the same standards she set for each of these roles individually, even though now she’s involved in all of these roles simultaneously. Her mind’s standards for perfection might have worked for her in the past, when she was involved in only one or two of these roles at a time (for example, being a worker and a single person maintaining an apartment), but expecting to be able to meet the same standards of perfection while engaging in all her roles simultaneously is not only unrealistic but stressful. Lynette is threatened by her inability to be perfect in all her roles and feels unable to cope with being less than perfect.
Lynette is not mentally ill; that is, she does not have a disorder that falls within the parameters of any of the DSM-IV diagnostic criteria. However, she is exhausted, unhappy, anxious, and worried, and she can’t fall asleep without sleeping pills. She feels stuck because she has created a personal script and mental image of a perfect life for herself but sees it as falling apart and doesn’t know how to reorganize her goals and priorities to continue moving forward.
I tell her I won’t spend a lot of time discussing her past but will talk a little about how her past experiences factor into how she views the present and thinks about the future.
Specifically, I explain an ACT view of how her mind works when it’s stuck and how it takes unhelpful information from her past and projects it into the future. I also explain that, rather than try to control, avoid, or eliminate these unhelpful thoughts and feelings about the past, present, and future, I will teach her how to accept these things and move forward in her life. I briefly explain how ACT research shows that ruminating over trou-bling thoughts and painful emotions actually makes them worse (see chapter 2 for a clear explanation of this).
The next thing I do is help Lynette examine and clarify her values, which helps her examine her goal of earning her bachelor’s degree in light of what she truly values most in life, which she identifies as education, family, and career-growth opportunities. We rank her values and find that having a perfect house and workplace are the least important things
to her. We also discuss how her goal of earning her degree represents a broad, long-term outcome and how she needs to set short-term, measurable objectives that can help her track her progress toward her goal. She decides that being a college student facilitates setting up quarterly goals, since school revolves around the quarter system. The last things we discuss related to her goals are the criteria she establishes for success, specifically, trying to do everything perfectly. She agrees that she can no longer do everything perfectly, because she simply does not have the time. She even admits that she can accept some things as being less than perfect (the cleanliness of her house, for one). Lynette understands that her mind sends her outdated visual images and personal scripts (collections of thoughts) about her standards for perfection and that she’s stuck trying to adhere to them, when in fact they are no longer helpful to her in meeting her goals.
I explain to Lynette that she must be vigilant in paying attention to what her mind tells her about her goals, objectives, and standards for perfection. I explain that to do this, she needs to become more mindful, and I teach her how to practice mindfulness, both as a formal meditative experience and as part of her everyday practices, like eating, cleaning, and caring for her dog.
Since Lynette is not afraid to commit to doing the work, the commitment part of ACT is simple. The hardest thing for her to understand is the notion of committing to act despite the presence of troubling thoughts and painful emotions. Once she understands how trying to control, avoid, or eliminate such thoughts and emotions actually makes them worse, she accepts that she can move forward while carrying her troublesome thoughts and painful feelings along for the ride.
We spend the rest of the time talking about specific relaxation strategies and lifestyle changes related to managing her stress. She really likes diaphragmatic breathing and visu-alization, and she even goes so far as to write and record her own visualization script that revolves around a relaxing day floating on a raft in a mountain lake. She also starts to take control of her time more efficiently by using a cleaning service to care for her house; she manages to negotiate a good deal with the same service that cleans her office. Rather than try to micromanage her travel agency, she decides to hire an office manager to essentially run the place on the days she’s in school. Little by little, she begins to take control of her time and spend it more on the things she really values than on activities that are a source of stress.
Lynette earns her undergraduate degree and enrolls in an online MBA program that affords her the greatest flexibility while providing a high-quality academic experience. When I last speak with her, she feels better and enjoys her life while steadily progressing toward
her newest goal of earning her MBA. She explains that the work we have done together has helped her move forward and meet her goals while staying true to her values. She feels that she has learned how to accept her unhelpful thoughts about work, cleaning, and being a “superwoman.” She also is willing to live with the guilt she sometimes feels about paying someone to clean her house and about delegating some of her work-related tasks to others, because she realizes she values her time with her family more than cleaning and minor work tasks.