Defusion techniques are most useful when the client is engaged with thinking in a number of potentially problematic ways. Examples include when the client is holding the literal meaning of a word to be true, when the client is trying to control thinking, when the client is generating reasons to justify behaviors, or when the client is insisting on being right, even at personal expense. The defusion techniques used in ACT include paradox, meditative exercises, experiential exercises, metaphor, and language conventions.
Clients are encouraged to focus on effective action, given the current situation once defusion has been established.
The following hypothetical situation illustrates how this might be helpful. John’s alarm does not go off, and he wakes up late. He immediately thinks of his wife, and the thought appears: “She set the alarm wrong.” Now, if he does not catch that this is a thought, he may begin to look at the situation as structured by that thought. He does not need to be aware of this process in order for it to occur. If he were, in that moment, aware of the process of thinking and of the fact that he just had a thought, he might not say the next thing he says, which is “You forgot to set the clock again. Now I’m late.” His wife now feels blamed. An argument ensues. If John had been able to observe the thought, he might have caught that it was just that—a thought—and been able to respond more flexibly. He might have noticed the thought, and then focused on what would probably be more effective in this situation, and following his values to be open and loving, he might have said, “Honey, do you know what happened with the alarm? Did I forget to set it?” Being able to simply catch the process of thinking in flight and watch it as an observer can begin to create an opening wherein one might be able to step out of habitual patterns and engage in more effective and values-based actions.
Therapists learning ACT can struggle with defusion because there is something inherently difficult in using the main tool at our disposal—language—to weaken language. The situation is similar to how oil well fires are often extinguished. An explosion (itself fire) is created at the source of the oil well fire that momentarily uses up all the available oxygen. The remaining oil is left without oxygen, and thus the fire ceases. Similarly, ACT uses language, and loopholes in its functioning, to extinguish its effects in certain areas of our lives. It’s not that language itself is eliminated, but some of its less useful func- tions are weakened in some contexts, so more flexible ways of knowing can have greater influence over behavior.
It would be nice if fusion could be weakened by simply explaining the dilemma, much as we have done in this chapter so far. Unfortunately this explanation depends entirely upon literal meaning for its impact, and in order to defuse, we must step outside literal meaning. To do this, ACT uses language in nonliteral ways, such as the way a coach might speak to a player, for example, by saying, “See if you can hold that thought like you might hold a butterfly that has landed on your finger.”
WHAT SHOULD TRIGGER THIS PROCESS?
Focusing on this process is most appropriate whenever the therapist finds the client believing, “buying,” “holding onto,” or clinging to a particular thought or word, and these same actions are limiting or prevent- ing healthy movement in the client’s life. This usually shows up when a client seems to be heavily saddled or “trapped” by a thought or feeling and finds himself or herself unable to take valued action based on the same thought or feeling. For instance, a client might say, “I will never be able to find a partner, I am just worthless. Who would want me?” Here, we can see that the client is trapped by the word “worthless.” Held to be literally true, it seems that finding a partner would be impossible: who would want a worthless human being as a partner? However, if the client can come to see that “worthless” is a word that is said under certain conditions and given a particular history, and that it is not something he or she literally is, then “I can’t find a partner because I am worthless” has less control over behavior. This does not mean the client has to stop thinking he or she is worthless or start thinking he or she is worthy; rather, if the client can see the thought as a thought, then its power to control actions is lost, even if that thought continues to occur. The following transcript demonstrates the triggering of use of defusion in session (approximately five sessions into therapy).
Therapist: You seem pretty blue today. What’s happening for you?
Client: It’s just always the same story … I try to do something to make things better and it fails … It always fails. It’s always like that.
Therapist: So there’s this place where you get stuck when this same story, “I try and nothing works,”
shows up.
Client: [hangs head and speaks softly] Let’s face it, I’m doom and gloom.
Therapist: You’ve mentioned that several times now. You’ve told me you are doom and gloom. Client: I am doom and gloom.
Therapist: I want to recognize the pain of this thought and the struggle that is built around it, but I’m
wondering if you might be willing to be a little playful with me for a moment?
Client: Sure … might as well.
Therapist: This might sound a little silly, but would you sing the words “I am doom and gloom” for me? Client: [chuckles] What?
Therapist: Let’s just work with this for a minute. Give it a try.
Client: [sings the words “I am doom and gloom”; unbeknownst to the therapist, he has quite a good voice and sings solemnly and with heartfelt pain]
Therapist: Great … Could you sing it again? Only this time, sing it with great enthusiasm, as if you are
in a Broadway play.
Client: [chuckles again] Okay. [sings the words, but from the new perspective]
The client was then asked to sing the words from several other perspectives: as a woman, as a small child, as Mickey Mouse. With each new rendition, the therapist could see the client beginning to defuse from the words.
Client: The words just seem kind of funny to me now.
Therapist: Interesting how that works, isn’t it? When you are really trapped in those words, it seems that
they paralyze you. But now that we have loosened the trap a little, what do you notice?
Client: They don’t seem to have the same power. They’re kind of funny now.
Therapist: From this place, being loosened from those words, I wonder if we can start to work on where
you are headed?
This is just one example of the many ways defusion can be brought into session. It is important to note that these exercises are designed to take the meaning out of (deliteralize) the words, not to change the number of times the client thinks them, nor to change them into positive words (e.g., “I am great and good”). Also, defusion should be done with a compassionate nature, which can be playful or serious. It should never be done from a position of one-upmanship or from a position that makes the client feel silly or humiliated for having the thoughts.
WHAT IS THE METHOD?
Already, scores of defusion techniques have been developed for a wide variety of clinical presentations. For example, a negative thought can be observed dispassionately by having the client watch the thought as if watching an uninteresting, nonprovocative television commercial. The thought can be treated as an externally observed event by the client, who gives it a shape, size, color, speed, or form. The client can thank his or her mind for such an interesting thought; label the process of thinking (e.g., “I’m having the thought that I am no good”); or mindfully observe the thoughts, feelings, and memories that occur in con- sciousness. Such procedures attempt to reduce the literal quality of the thought, weakening the tendency to treat the thought as what it refers to (e.g., the experience “I am no good”) rather than what it is directly experienced to be (e.g., the thought “I am no good”). The result of defusion is usually a decrease in the believability of or attachment to private events, rather than an immediate change in their frequency or their form.