Developing contact with self as context facilitates the development of a sense of choice by the client. Choice becomes important because it is the behavior that allows clients to select actions consistent with their stated values. Often, clients who are stuck report they are in that state because they don’t have a choice. Some thought or feeling is interfering with their ability to move forward. Often, reasons and stories are offered to explain why they remain stuck. These reasons can range in nature from traumatic childhoods to anger to unforgivingness to feelings of worthlessness. The therapist’s job is to help the client defuse from these stories and recognize that choice is still possible.
If the client can operate from self as context, it is easier to notice thoughts and feelings without avoidance or fusion. For instance, the client can have the thought “I can’t do this,” and then do it. The key is to observe the thought and then take action with respect to what is there to be done. The therapist can help clients build this repertoire in a number of ways. Helping them connect with their experiential sense of knowing is one way, as shown in the following transcript.
Therapist: Have you ever said to yourself that you can’t stand it for another moment? Client: Yes.
Therapist: What happened? Client: Well … [chuckles]
Therapist: Another moment passed, didn’t it? Client: Yes.
Therapist: And then another and another. Those moments just kept on coming, and here you are now.
You stood it, even though your mind told you that you couldn’t.
Client: Yes, but it still felt very bad.
Therapist: Agreed. I do believe it felt bad. But imagine for just a moment that your thoughts actually
controlled all your behavior, that every thought you had caused you to do something. What if thoughts actually caused everyone’s behavior? What would the world look like?
Client: It would be a mess. It would be obliterated.
Therapist: Yeah, things would really be bad. Thank goodness our thoughts don’t cause our behavior.
Our reasons, our stories, don’t force us to do things. But they do like to look big and scary sometimes, as if they could force us to do things. But all they can do is look big and scary. Your mind tells you, “I can’t stand this another moment,” and then your experience tells you that you can. My question is: who is aware of all these thoughts in the first place?
Client: I am.
Therapist: And is that sense of awareness dependent on only certain thoughts being there? Can you
Client: Sure.
Therapist: It is from that place that choice is possible. Whose life is this, anyway? Your thoughts? Can
you make choices while observing your thoughts? While being with your thoughts, while noticing them, can you take actions that fit with the life you want to live?
The therapist can give a number of homework assignments that are specific to the client and that help the client practice making choices with his or her thoughts and emotions rather than for those thoughts and emotions, while being fully aware as a conscious person. This effectively links self as context to the other ACT processes of contact with the present moment, defusion, and valued living, for example.
CORE COMPETENCY PRACTICE
The rest of this chapter focuses primarily on the core competencies of a therapist working on helping clients distinguish self as context from the content of self that is conceptualized. Four ACT core com- petencies are involved in distinguishing self as context. Each core competency is described, followed by sample transcripts and practice opportunities.
CORE COMPETENCY EXERCISES
COMPETENCY 1:
The therapist uses metaphors to help the client distinguish between the content and products of consciousness, and consciousness itself.EXERCISE 5.1
A sixty-one-year-old client presents to therapy following a divorce from her husband. She has never been in therapy and has often used avoidance strategies to deal with difficult emotions. She would like to discover how to live her new life, given that she has not been alone in more than forty years. She is fearful about trying new things and wants the fear to go away. She has tried multiple types of avoidance to escape the fear, including isolating at home, drinking alcohol while alone, and avoiding new situations and activities.
Client: [directly following the chessboard metaphor] But isn’t there any way to win this war? I would
really like this fear to go away. Can’t I just push the pieces over on the board? Write here what your response would be (remember you are using competency 1):
COMPETENCY 2:
The therapist utilizes exercises to help the client make contact with self as context and distinguish this from the self as conceptualized.EXERCISE 5.2
Transcript continues with the same client as in competency 1, but in a later session.
Therapist: It seems you have been in this relationship for so long that you have come to see yourself as
“the housewife.”
Client: It’s the way I’ve always been. I’m the one who does the dishes, cleans the house, stays at
home, takes care of other people. I just can’t do anything else. Write here what your response would be (using competency 2):
What are your thoughts in saying this? What are you responding to and what are you hoping to accomplish?
COMPETENCY 3:
The therapist utilizes behavioral tasks to help the client notice the work- ings of the mind and the experience of emotion while also contacting a self who chooses and behaves with these experiences, rather than for the experiences.EXERCISE 5.3
The client is a twenty-eight-year-old female who is having difficulty with colleagues at work. She feels intimi- dated and wants to quit her job, but feels she can’t due to financial pressures. She wishes her feelings would not get hurt by these interactions. She reports keeping a “stiff upper lip,” but struggles silently at work and cries at home about the work interactions. She is angry at herself for feeling this way.
Therapist: [toward the end of session] How is this stiff upper lip thing working?
Client: Not very well. I’m really trying, but it’s getting harder and harder. I feel like I’m going to break
down in tears all the time, but I’ve been able to fight them off so far.
Therapist: What kinds of things do you say to yourself about breaking down in tears?
Client: That I’m weak and that I shouldn’t let these petty things bother me.
Write here what your response would be (using competency 3):
COMPETENCY 4:
The therapist helps the client recognize the distinction between the self who evaluates and the evaluation itself.EXERCISE 5.4
Transcript continues with the same client as in competency 3, but in the next session.
Client: These interactions make me feel so awful. I feel like I’m worthless to them and I’m starting to
believe that I am worthless, that something is wrong with me or it wouldn’t be this way.
Write here what your response would be (using competency 4):
What are your thoughts in saying this? What are you responding to and what are you hoping to accomplish?
Core Competency Model Responses
COMPETENCY 1
Sample 5.1a
Therapist: Notice that you’ve been in this war and you’ve been trying to win it. Your battle has included
staying at home to eliminate the fear piece, and drinking alcohol to try and squash the fear piece. The result is you’ve limited your life in this battle, this war, to try to push the fear piece down. Meanwhile, let me just ask you this: Are you still “you”? Are you still aware of all of this? In what sense do you have a huge stake in this war if you’ve been you through all this struggle?
Explanation: The therapist is helping the client connect to experience, then points to the distinction
between the content of struggle and the conscious context of this struggle.
Sample 5.1b
Therapist: Let’s suppose you engage the battle to win the war and you’re able to push the pieces all over
the board. Remember, you can’t push them off because this board stretches in all directions. [takes chessboard and pushes piece over] Here’s my problem with that. You went from who you are to who you aren’t, and now large aspects of “you” are your own enemy. Of what threat to the board are all of these pieces?
Therapist: Right. But of what threat to the pieces are the other pieces? It’s huge, right? So how can you
possibly stop fighting? You can’t. You won’t. So, my question is just this: if you make that move, when could the suffering possibly end?
Explanation: Here the therapist highlights some of the costs of attachment to particular forms of self as
content (e.g., large parts of yourself and your history become your enemy) and then points to contact with a transcendent sense of self (i.e., self as context) as a possible way out of the war.
COMPETENCY 2
Sample 5.2a
Therapist: So, it really seems as if no other sense of “you” exists; there’s only the housewife you. But
you also told me you have a sister and you’ve been a daughter. You let me know that you volunteered at one point. So we could describe each of these senses of you, too, and they would look different from the housewife you, I would guess.
Client: [thinks] Yes.
Therapist: But also notice there is a “you” who’s aware that you were a housewife, that you are a sister,
and that you were a volunteer. And you’re here right now. Who’s aware of all of these aspects?
Explanation: The therapist is, again, helping the client connect with the board-level sense of self—self as
context—by pointing to all of the conceptualized selves about which the client has talked or could formu- late, and is helping her notice that she’s aware of these and more than these. It is from this place that the client can be encouraged to take actions that are not about continuing to cling to the conceptualized self as a housewife.
Sample 5.2b
Therapist: I’m wondering if you’d be willing to do a little exercise with me? Client: Sure.
Therapist: [adapted from Walser & Westrup, 2007] I’d like you to close your eyes and imagine yourself
in your home as the housewife. When you have that image in your head, raise your right finger.
Client: [raises finger]
Therapist: Okay, now silently to yourself describe her appearance. What does she look like? [pause] Now
notice how she feels. What emotions does this self—self as housewife—experience? [pause] What does this housewife say about the world and the way it operates? [pause] How does she define herself? [pause] Now, as you have the full image of this you in your mind, with all of her thoughts and feelings and ways of being, what would it mean if you had to let her go? [pause] What emotion shows up for you as you think about letting go of her? [pause] And if you find any resistance there, see if you can notice that she is not you anyway. She is just a role you play. Now imagine you could hold her lightly, like you might hold a butterfly in the palm of your hand, and choose to live those values you would like to bring to life.
Explanation: The therapist engages an experiential exercise to help the client disentangle from the con-
ceptualized self. This provides a small window through which the client may be able to free herself from the housewife role and make alternate choices about how she will live her future.
COMPETENCY 3
Sample 5.3a
Therapist: I’m wondering if you’d be willing to have the thoughts that you are weak and that petty
things shouldn’t bother you and to let yourself cry. Let yourself have this experience.
Client: I’m afraid I’d fall apart.
Therapist: Okay, then that one, too. Would you be willing to have the thought that you’re weak and
you’d fall apart, and let yourself contact that emotion? Is it possible to sit and open yourself up to this emotion, even to cry?
Client: I could give it a try.
Therapist: Okay, here is what I think might be helpful. Go home, and tonight go through the observer
exercise we did using this tape. And when you’re finished and are more deeply in contact with this transcendent self of “you,” spend at least fifteen minutes deliberately remembering some of those painful experiences. Cry if that comes up. But all the while, see if you can also hold those experiences lightly, as a whole conscious person, not as a person defined by your emotions.
Explanation: The therapist is encouraging the client to actively turn toward her avoided emotion, while
also experiencing the thoughts that she is weak and may fall apart, but to do so from the stance of the observer self. If the client is able to do this, her experience will tell her that she may cry, but that she will not literally fall apart and that she is far more than her emotions.
Sample 5.3b
Therapist: I wonder if you’d be able to do something at work that is consistent with your values, while
holding and observing these thoughts and emotions? What value would you like to bring to life at work? [explores with the client a work-related value and assigns a specific task that is consistent with that value (e.g., saying hello when she doesn’t feel like it); asks the client to complete the homework between sessions]
Explanation: The goal is to help the client contact the self that can observe thought and emotion, while
also choosing to do things on a regular basis that bring personal values to life. She may not get what she expects (i.e., others saying hello back), but she is still choosing to live her value.
COMPETENCY 4
Sample 5.4a
Therapist: It makes sense to me that you’d feel sad about what’s happening. I’m curious, though, about
your reaction to your own experience. I wonder if there’s a more compassionate stance you could take with respect to these feelings. If you were to observe someone feeling awful, would you believe that person was worthless?
Client: No, I’d try to comfort the person.
Therapist: So I wonder if there’s a way to take this stance toward yourself? Is there a way to have a
comforting, compassionate stance in this moment of experiencing the thought that you are worthless?
Client: Well, I could work on “seeing” the thought.
Therapist: Yeah, we’re not talking about convincing yourself otherwise or talking yourself out of it—just
standing with yourself, being present as you observe this thought… And you could take actions in your life that are consistent with compassion and comfort for the self; for instance, not isolating or hiding, but talking with others. What other things can you think of?
Explanation: The therapist is working with the client not to eliminate or debate the thoughts she has,
but instead to simply observe them nonjudgmentally. A deictic relation is used to contact a transcendent sense of self by shifting from “I” to “you” and then recontacting the difficult content from this perspective. This is a far more compassionate and loving stance than buying and believing something is wrong with her because she experiences these emotions. Notice that no effort is made on the part of the therapist to make the thoughts be different; the focus is on viewing the thoughts as content being experienced, rather than content she literally is.
Sample 5.4b
Therapist: Look at me, right in the eyes. [pause] Suppose I am you. Look right in these eyes and notice
“you,” now from the outside looking back. I want you to see a person is here who is having these evaluations and being aware of them. What would you say to “you” if you wanted to speak to this more conscious part and not just with the part all entangled in evaluations?
Explanation: This statement by the therapist uses deictic frames to appeal to a sense of empathy grounded
in a contextual self.
Sample 5.4c
Therapist: Notice that you’re evaluating your experience. You say you feel awful, and then you evaluate
it as something bad or wrong. But notice that this thought—“something is wrong with me”—is another piece on your board. It’s an experience you’re having in this moment. I’d like to help you connect to the place in which you are larger than the experience. One quick and easy way to do this is to say things such as, “I’m having the thought that something is wrong with me” instead of saying, “Something is wrong with me.” And as you do that, see if you can notice this: who is noticing the thought?
Explanation: This response points directly to the self that is having an experience categorized as an
evaluation. Pointing to this distinction is helpful when clients are buying their evaluations, when they see themselves as the chess pieces instead of as holding the chess pieces.