Some clients are reluctant to defuse from their thoughts because their self- concept is about their thinking (for example, “I am very intelligent”). They can be so wedded with their thoughts that they simply can’t or won’t conceive of a distinction between themselves and their thoughts. One way to approach it is to ask clients to consider what life was like before they developed language. The idea that there is more going on with them than the language- based ticker tape of cognitions running constantly in their heads can be a really foreign idea and can pave the way for cognitive defusion. Again, I’ve found that using a third- person example can help these clients see what is hard to see when they are fused with their own thought processes.
Me (continuing a discussion about the role of language): “I remember having mixed feelings about my daughter, Chloe, learning language. I mean, obviously I wanted her to learn to
communicate, but because of this work I’ve become very aware of what gets lost as well. For example, I remember holding her up before a mirror when she was, oh, six months old or so, and she would gaze at herself with pure delight. She was simply fascinated by what she was seeing. She wasn’t looking at herself and thinking, ‘Geez, shouldn’t I have more hair by now?’ She had no word for ‘hair’— for ‘I,’ even. She certainly hadn’t learned what ‘should’ or ‘shouldn’t’ meant, what ‘more’ or ‘less’ meant. She had no concept of ‘not as much as’ or ‘not enough,’ or ‘something’s wrong with my head.’ And yet she existed. She was living, breathing, experiencing, observing. Just as there was an activity of observing going on before the cognition ticker tape in your head got going with all its language- given thoughts. In this moment you are living, breathing, experiencing right along with
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all those thoughts going on. In fact, we can’t begin to capture all the various processes going on with you right now. Your brain is picking up and sending out signals right and left, your heart is pumping, hormones are being released, blood and oxygen cells are running around, the hair follicles in your ear are waving around picking up sound waves…but it’s the thought process that has your attention. The thoughts on that ticker tape are so compelling, so seductive, it’s as though we fall into them. We don’t see that we both produce and experience that ticker tape; we think we are that ticker tape.”In this example, the role of language development in our experience and concept of ourselves is highlighted. An exercise such as the Continuous You exercise would be a nice way to extend self- as- context at this point.
Given that we must use language to tackle language processes, it can be particu- larly useful to draw upon experiential exercises. Note, though, that the “experiential exercises” used in ACT are not purely experiential. That is, we must use language as a means to change the client’s awareness. We use language as a tool for the experiential work. I also like the “tell me how to walk” exercise, as it not only demonstrates the limitations of language but does so in an experiential fashion. That is, using verbal instruction alone, the client is asked to tell the therapist how to walk, as though the therapist has never done so. The client is quickly confronted by the limitations of his mind as this task is shown to be fundamentally impossible (as we didn’t learn how to send a signal to our leg to move forward because someone told us how), and this real- ization pokes a hole in the idea that languaging is the only game in town. A common example that is also used to make this point is that of driving: When we are driving a car we are managing to do so without ongoing input from the cognitive mind. We are not giving ourselves internal instructions such as “Now I need to turn my head and look left while pressing on the brake pedal.” Both of these examples, and similar exercises and metaphors, highlight how even very complex and important behaviors are not verbally dependent— again undermining the idea that the only reality going on is the one offered by our minds.
SUMMARY
I began this chapter by commenting on the importance in ACT of which words we use in therapy. This is logical, given that the model is based upon what we’ve learned about language acquisition. I also shared my observation that many of the ACT therapists I have worked with essentially avoid working explicitly on the role of language with their clients. I have argued that including this piece can significantly enhance the therapy, particularly work on cognitive defusion and self- as- context. I have also suggested that excluding it due to therapist discomfort or lack of clarity shorts the client, and that
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Advanced ACTskimming the surface or otherwise mishandling the topic can contradict some of the points we are hoping to bring home in ACT.
Although I have been pretty direct about making these points, I do so with com- passion and understanding. I personally found this aspect of the therapy surprisingly difficult to translate into clinical practice, and it was only after many clumsy attempts and simply wrestling with it for a while that I learned ways to make it work for me and my clients. I also revisited the ACT literature and found both old and new gems that deepened my understanding and directly translated into increased skill in the therapy room. In chapter 12 I will share these and other ways to continue to advance in ACT. My hope is that by pointing out some of the trickiness in this area, I will enable others to circumvent common missteps, or at least move through them quickly. By offering examples of how language might be brought into the work effectively, I am hoping that therapists who have not been capitalizing on this aspect of ACT will be encouraged to start pulling it in, and that in doing so they will discover it was well worth the effort.