What if Normal Therapy Doesn’t Work For You? Should You Try to Control Your Emotions? Conversation with Steven Hayes

 

A SHORT TRAILER:

 

 

This is an incredibly rich conversation, in which you will hear:

What you can do if conventional therapies like Cognitive Behavioral Therapy (CBT) don’t work for you;

Why panic is what you feel when you are trying not to feel anxious, and depression is what happens when you refuse to feel sad;

How you can gain ‘real control’ over your emotions; and

Why psychedelics help some people;

Finally, Steven leads us through a guided exercise that you can do right now.

I am sure you will enjoy Steven’s generosity and intelligence as much as I do.

 

ABOUT STEVEN

 

Steven C. Hayes, Ph.D., is the developer of “Acceptance and Commitment Therapy” (ACT), a popular evidence-based psychotherapy that uses mindfulness, acceptance, and values-based methods.

He is Nevada Foundation Professor at the Department of Psychology, University of Nevada. An author of 46 books and over 600 scientific articles, his popular book Get Out of Your Mind and Into Your Life was featured in Time Magazine.

Dr. Hayes has been the President of several scientific societies and has received many national awards, including the Lifetime Achievement Award from the Association for Behavioral and Cognitive Therapy.

In 1992 he was listed by the Institute for Scientific Information as the 30th “highest impact” psychologist in the world and Google Scholar lists him as among the most cited scholars in the world (www.webometrics.info/en/node/58). 

Check out Stephen’s TEDx talks: http://bit.ly/StevesFirstTED or  http://bit.ly/StevesSecondTED

Google Scholar high impact researcher: http://www.webometrics.info/en/node/58

Blogs: Psychology Today  http://www.psychologytoday.com/blog/get-out-your-mind

Twitter

Facebook

Trainings go to www.praxiscet.com

Stephen’s newest books (2015 or later):  

A Liberated Mind: http://bit.ly/ALiberatedMind  also see: stevenchayes.com/a-liberated-mind

Evolution and Contextual Behavioral Science: http://bit.ly/EvoSciandBehaviorSci

Process-based CBT: http://bit.ly/PBCBT

Learning ACT (2nd edition): http://bit.ly/LearningACT2

The Act in Context (my canonical papers): http://bit.ly/HayesCanonical

The Wiley Handbook of Contextual Behavioral Science: http://bit.ly/CBSHandbook

Mastering the Clinical Conversation http://bit.ly/MasteringCC

ACT for clergy and pastoral counselors: http://bit.ly/ACTforPastoral

 

 

EPISODE SUMMARY

 

HOW DID YOU COME TO DO WHAT YOU DO?

The therapy work I do and the research work I do come out of my own personal struggles. I’ve always been pretty upfront about that, but I haven’t really fully detailed that story until this new book I just finished called Liberated Mind. In the book, we’ll walk through it in some details of my own struggle with panic disorder, a bit about my own family history, the domestic violence that was going on at home and some pretty sad forms of addiction, depression, OCD. ACT is an attempt to answer in my own life a commitment I made to myself long ago to do something about the suffering I saw in my own home.

 

CAN WE GET RID OF OUR EMOTIONS?

When panic disorder gets going, it’s very hard to do the least little thing like give a lecture or prepare for your courses or just functioning. Panic is what you feel when you are feeling anxious when you’re trying not to.

You’re essentially trying to run away from yourself and your own emotions, your own memories, your bodily sensations, your own experiences. I realise that A, that didn’t work very well. B, you don’t have to do it.

It’s sensible but it’s not helpful.  If you get into a mindless pursuit of avoidance as it begins to take away more and more of your life. The metaphor I use is like finding a tiger in the kitchen and deciding that you’ll defeat him some big stakes to placate him. That’s fine for now, but tomorrow it’s worse and the next day it’s worse and the next day it’s worse.

We’re feeding the avoidance of emotions inside our culture massively. It’s inside our minds anyway because it’s a simple extension of this evolutionarily recent thing of problem-solving. By a thousand times, it’s more recent than the things that produce your emotional history. Every organism that evolved since the Cambrian period, which is 545 million years ago, will associate painful experiences that occurred earlier with things that are occurring now if there’s any form of similarity.  But what you and I are doing right now is thousand times more recent.

We cannot control everything. That’s for sure. And in fact, it’s a blessing that we can’t because if you were able to get away with fully controlling what your mind tells you should control in order to live a happy and successful life, we would essentially plug ourselves into The Matrix, that movie or become a smiley face button. I think we’re stupid enough that we would give away our capacity to feel.

Babies come into the world yearning how to feel. It’s one of the several things they yearn for; it’s the most natural thing for a baby to reach out and taste something, smell it, lick it, feel it, etc.  When we get a little older, we have more complex emotions. There isn’t an emotion that you can name that you don’t buy books, or movies, or songs, or art or something to produce that particular emotion. Yet what your mind does is that it says “Yeah, I know how you can do it. Here’s the way you’ll solve this problem of feeling. Just feel-good stuff.”

That takes you from how do I learn how to feel and learn from my emotions and turn it into “How do I not feel this long list of very useful emotions?” If you do a good job of eliminating them, you now essentially are like a person without a capacity to feel with their fingers. You’re not going to be more effective if you don’t have fingers you can feel. You’re not going to be able to do things that require feeling in the same way. It just doesn’t come packaged that way. What we have found in our research is that when people get committed and not feeling sad, anxious, or whatever, pretty soon they can’t feel joy, happiness, satisfaction.

We’ve got this cultural delusion that a powerful life is a numb life. We produce it with our medications. We try to produce it with our mindless pursuits of short distractions and so forth. Why? Happy numb is not happy!

WHAT WAS CHILDHOOD LIKE FOR YOU?

I was a sensitive kid. My parents were very loving and caring people but they also were pretty disturbed in a way. And at the time, it wasn’t like you had therapists to go to.  My dad was an alcoholic. My mom was OCD and depressed and they would fight in ways that sometimes were very destructive and frightening.  I told the story on a TED talk that I’ve given of hiding under my bed as my dad has come home drunk and then enter in a knock-down, drag-out fight in the other room. I was hearing these loud crashes and wondering ‘is there going to be blood when I go out there?’ ‘Is he hitting her?’

It easily leads you to be eight going on 38, and you become hyper responsible. You feel as though somehow you’re supposed to fix it. If you’re not taking care of yourself, you really might not survive.  What being hyper-independence does is that you don’t do a very good job of playing.  It probably has helped me with achievement. I worked really hard out of that same ‘I will just do it’ mentality, but it is hard on those around me.  I’m a work in progress about being able to be more present, and open, and vulnerable. Luckily I have people who love me, who see that I’m a work in progress. They see that I do get better.

WHAT IS ACCEPTANCE COMMITMENT THERAPY (ACT) ?

ACT is a collection of acceptance, mindfulness processes and behaviour change processes for the purpose of producing psychological flexibility. What psychological flexibility is, is being able to come into the present moment as a whole conscious human being, with your feelings and thoughts as they are; being able to feel them and think them without becoming entangled or with them or dictated by them, or running away from them. It is being able to allocate your attention, flexibly, fluidly and voluntarily to the opportunities in the present moment, and then to creating values-based action habits.   

ACT is psychotherapy but it’s not just psychotherapy, we call it Acceptance and Commitment Training when it’s being brought in to business and industry or sports, or dealing with prejudice or stigma or helping people with challenges of physical disease and so on.

ACT is a part of the evidence-based therapy movement. It’s loosely inside the cognitive and behavioural therapies, but it’s not really a very specific protocol. It’s not like this kind of therapy or that kind of therapy because of its breadth, it really is more a collection of evidence-based processes that are central it appears to human functioning.

HOW IS ACT DIFFERENT FROM COGNITIVE BEHAVIOURAL THERAPY (CBT) ? 

CBT is a family of therapies and it started in behaviour therapy and then it added cognitive methods. Some of the processes that are inside traditional CBT such as the focus on destructive or irrational cognitions that need to be detected and challenged and disputed and changed. It turns out those processes are not really that central to the outcomes from CBT.

While it’s a good thing to know what to do with cognition, it turns out that detect, challenge, dispute and change is arguably inert in terms of the outcomes. Some of the things that are focused on in cognition from a CBT point of view produce cognitive flexibility. That is being able to step back and notice your thoughts: ”Well, in addition to thinking this, you could also think that. Then you could also think that and you could think that.” Now, which of these things are most helpful to you?

What can be harmful is to get focused on trying not to think of certain things.

Most CBT therapists have patients come back and say, “I’ve been doing it but my thoughts haven’t changed. They’re coming back again. I keep doing it. I just keep coming back.” They’re involved in some sort of mental war, and that’s not helpful to people.

The more emotion-focused therapies/ relationship focus therapies make an important point. What has happened over the last 15 years is that the mindfulness work has come into the CBT, and ACT was one of the early ones with a pretty well-developed theory. Unlike some traditional forms of CBT, we had a basic science of cognition that we’re working on called relational frame theory, and that gave us some advantages that weren’t just relying on a clinical theory of cognition.

The cognitive behavioural traditions go all the way back to the animal learning tradition where you had highly refined basic behavioural principles, and they worked wonderfully until you get to what you and I are doing right now.

What’s different is instead of trying to change the form of what you think and feel, we should focus more on the relationship between ourselves and what we think and feel, and how to produce a relationship that’s more open and flexible, and that power us to come into the present moment and do what really matters.

Most of the new forms of CBT (Mindfulness-based Cognitive Therapy, Dialectical Behavioural Therapy, Acceptance Commitment Therapy) have made that same meta shift—  It’s the relationship that’s important.

SHOULD WE TRY TO ‘CONTROL’ OUR EMOTIONS?

We can easily get into the self-amplifying loops. In fact, when people experienced really intense emotion, of course, they think emotions are a problem. they think emotion is a problem. Why wouldn’t a panic disorder person think that anxiety is a problem?  But it turns out that panic is what you feel when you’re not willing to feel anxious. And the same thing with major bouts of depression. When you’re not willing to feel sad when you’re not willing to feel mad when you’re not willing to feel… we call it depression.

So when you have people who are struggling with really intense emotions what I think is — of course sometimes we’re in situations where that comes directly, but often that comes through a combination of pretty painful experiences that we’ve had in our life that hasn’t been fully handled plus, trying to handle those emotional responses in ways that have actually artificially amplified them into something that’s overwhelming. And so can we find a way to one step at a time expand out our capacity to feel in a way that allows us to both feel and to move forward? If you take something like the mindful approach where there’s a little sense of stepping back not in a defensive way but stepping back so that you can see it. In the same way that if you’re standing in front of a painting only an inch away, you wouldn’t be able to see it. You step back so that you can see it.

There’s a sense of stepping back and of opening up with an attitude of dispassionate curiosity; like really watching the rise and fall or where it comes, and when it goes. What does it actually feel like? Where in your body do you feel it? And you become curious about that. Well, when you feel emotions deliberately like when you reach out and feel the table in front of you you feel the little features of it. If you do the same thing with your own psychological emotions, you begin to gain confidence and feeling.

We need to learn how to feel. It’s a skill that we can train. It does not serve our interest to be mindlessly chasing the happy numb.

It is true in some limited sense, the word control. In ACT one of the things we teach is to let go of conscious, deliberate, purposeful control where it doesn’t belong. But what people then sometimes do, as we see it in our self-report measures, is they feel a meta control because they realize that ‘When I handle my emotions in this way that’s more open, there’s less of a desperate attempt to try to make it be a particular form. I don’t get overwhelmed. I can feel even really intense things and it’s not going to kill me, it’s actually going to help me in many ways.’ Space opened up inside us to accommodate things so we don’t have to be scared of whatever comes up from inside of us. That is control at another level. That is the kind of control I think people really want because that’s the one that determines whether or not you’re going to be able to live a life worth living. What people are afraid of with emotion is that you’re going to lose your ability to live a life worth living.

It’s like riding a bike, you don’t have to be very careful in every moment thinking of how to put place your legs. You just do it. It’s automatic. If you slow down somebody riding a bike, you would notice they’re constantly falling out of balance, and then they adjust. And if you adjust, you don’t put your face into the street. It isn’t the problem that you’re losing your balance; Riding a bike includes that, in the same way, emotions and thoughts will come up that’ll knock you a little bit off-balance. If you have those skills, those kinds of mindfulness and acceptance and awareness skills, as you notice them in a way that isn’t taking them to be literally what they say they are, running from them or getting all wrap around them, you naturally come into the moment again.

A GUIDED EXERCISE

Firstly, pick something where you have a sense that this is not so overwhelming that you’re going to run from it if you touch it. Spend a little bit of a time bringing the emotion directly into your life and taking time to feel it.

Here is a fun way to do it — I’ll give you just a few questions. If you have a little phone or something, you can record these questions and give yourself 20 seconds, 30 seconds between each one.

Sure. This is an example of a physicalizing exercise, a classic ACT method. First, so you focus in on an emotion that also involves maybe bodily sensations, some thoughts, some memories. It’s an amalgam. It’s very rare that we would just feel an emotion. It comes in a package with little snippets of memories and bodily sensations and thoughts and judgments, and sense of self and so forth. So pick something that your instinct is saying: This is something I want to do a better job of feeling, and it’s not going to overwhelm me. So you don’t leap into the deep end of the pool right away. Be kind to yourself.

Take a little time to get in touch with that.

I’m going to ask some odd questions.

If this were an object, how big would it be? And then allow your mind to answer that.

If this had a speed, how fast would it go?

If it had a colour, what colour would it be?

If it had a shape, what shape would it be?

If you could feel a surface texture, what would it feel like?

If you could reach inside it, what does it feel like inside?

If it could hold water how much would it hold?

If it had power, how powerful is it?

When you’ve asked those questions, I have a second question to ask of you, which is: How do you feel towards this thing and now? If you have recorded it on the iPhone and you’ve actually explored it this thing that is of that size and colour, and shape, and speed, and power, and texture, how do you feel about this?

If you’ve sensed any sense that it’s something you have to defend yourself against or protect yourself against, watch out for that or something where you’re judging or pushing, or wanting it to eliminate or go away.

If you did have that reaction, move this first one off to the side and now take your reaction (judging, pushing, etc..) and put it right out in front of you, and go through those same set of questions. If it had a size how big would it be? If it had a colour, what colour it would be? If it had a shape, what shape would it be? And so on.

When you’ve done all that, the question I want to ask of you is, is it okay for you to have that experience metaphorically of that size, and shape, and colour, and speed and all the rest?

Can you let go of any sense like ‘this has to change, that this has to go away?’

If you can get there, look over at the first one and see if it’s changed at all.

What often happens is as you open up to your reactions, judgements, et cetera, that first one metaphorically starts changing its colour, or its size, or its power, or its speed. It starts telling you in ways that you can sense that it’s okay to be felt.

THE POWER OF EXTERNALISING

When we look at things, we naturally don’t feel judged by that. If you look at a door and it’s a painted very in a very ugly way, you don’t feel like, “Oh my god, there’s something wrong with me.”  Whereas if it’s thought within, you do. By bringing it out and looking at it and objectifying it, just that alone it gives you a little space, but then by bringing also your judgments and feelings and worries about it in a second-order way, you can expand that space.

It’s an example of learning how to feel. We use these exercises not as a way of diminishing or regulating emotions. Regulation is okay as a word, but regulations sometimes sound like you’re doing a math problem or something. That’s not what emotions are for. You’re not a math problem, you’re more like a sunset. We look at what’s there with a sense of observing and describing and opening and noticing. We know how to do that if you look at a sunset tonight.  I’m not going to say, “Gee, it’s a little bit too pink.” It just won’t occur to you. You might say something like ‘wow’. And in that same way, if we can bring that ‘wow mode’ of mind to our own emotions and thoughts, our own history and bodily sensations, space opens up where it’s easier to be ourselves. And from there it’s easier to create a life.

SPIRITUALITY AND PSYCHEDELIICS

The very first thing I ever wrote about ACT in 1984 was called making sense of spirituality, and it was published in the journal of behaviourism. I’m not here as a spiritual leader or religious leader. I’m thinking just like a natural scientist. 98% of the human population says they’ve had spiritual experiences, so you need to address that, test that, and I think we’ve learned a lot about what those are.

If you take measures of experiential experiences; almost always they include a different kind of awareness that goes across time, place, and people. You feel more connected or universal or one with others. You feel expansive across time or place. This oceanic awareness and things of that kind might happen through all kinds of means. It can happen in meditation.

The psychedelics are back now. Hopefully, we’re not going to be as stupid as we were the first time. Indigenous people have been using those things forever to try to produce a spiritual experience and the data are good. It can be transformational. It’s very interesting about how it happens neurobiologically. Psychedelics diminishes the midline structures that are central in our narrative sense of self, which has terrible effects of dramatically filtering the sensory and sensory-motor information that doesn’t fit our conceptualization of ourselves.

With our narrative sense of self, we’re living inside a world that’s almost like a cartoon version of the world we live in where our own ego-based stories are so dominating. Spirituality is central in being able to achieve a sense of perspective and connection that is a place from which it’s possible to be more open, aware and actively engaged, to be more connected and loving and caring of others.

In the newer forms of psychedelic therapies, there are usually one or two sessions that are opening the door, but then you have to build it out in some way. This is not just done by a chemical.  ACT is actually used by quite a number of the new wave psychedelic therapist because it fits nicely with the change processes.

RESILIENCE

Resilience is being able to come into the situation with your whole history as it is and to be able to orient you towards what the situation affords such that at the end of this next set of moments, your life has expanded. You’re a little bigger.

I view it as a way of thinking about what does it take for a human being to grow psychologically. That means being able to bring your history into the present, being able to connect with what the possibilities are in the present, and then being able to care by choice. The things you do are intrinsically valuable because they reflect the kind of qualities that you want to put into your chosen moments.

Psychological flexibility is essentially a resilience model.   If in any the six areas — cognition, emotion, sense of self, attention, meaning, and behaviour— you’re inflexible, life has got to go in a negative direction. You’re going to be less resilient. But as you learn to be more cognitively and emotionally open or attentionally flexible, and to have a sense of perspective that connects you with others, to be able to care by choice and to build habits of values-based action, you create flexibility skills that are useful to in every area of life.

BOOKS THAT HAVE CHANGED YOUR LIFE

I got into psychology because of the writings of Abraham Maslow (Religions, Values, and Peak–Experiences); I was interested in peak experiences and I wanted to have a psychology that could aspire to that, but that it was scientific in some way.

The book that most changed my life might surprise you. There’s a utopian novel that BF Skinner wrote called Walden Two.

Walden Two became popular during the hippie-dippie days. It’s an idea of a behavioural communist essentially. I didn’t view it as an answer to what we should do to be able to apply psychology to create a way of being with each other.  I viewed it as an attempt to say, “This is a really good, good question.”  It was how do we create a psychology that could actually aspire to foster the best of what we want to be, and I’ve tried to live my life around that of trying to create a psychology that is more worthy of the challenge of the human condition.

A POEM THAT INSPIRES

I have a wonderful poem at the end of the Liberated Mind by Julia Fehrenbacher. If you buy Liberated Mind, there’s a link in the back. The poem is called Hold Out Your Hand.

Let’s forget the world for a while

fall back and back

into the hush and holy

of now

are you listening? This breath

invites you

to write the first word

of your new story

your new story begins with this:

You matter

you are needed—empty

and naked

willing to say yes

and yes and yes

Do you see

the sun shines, day after day

whether you have faith

or not

the sparrows continue

to sing their song

even when you forget to sing

yours

stop asking: Am I good enough?

Ask only

Am I showing up

with love?

Life is not a straight line

it’s a downpour of gifts, please—

hold out your hand

NEXT FOR STEVEN

I’m excited about A Liberated Mind because it’s the first attempt to put the entire story of psychological flexibility, the science story, my personal story into a book that you can give to anybody. It has self-help features to it, but it’s really more a think book, a book that is meant to just uplift people in whatever kind of lives they’re living.

Part of what I want to do is to bring together these worlds of spirituality and of yearning for these deeper human emotions and so forth on the one hand with Western science and psychotherapy on the other hand. I’ve been doing it inside a process-based approach. Can I dig down to the processes that liberate people and put them into systems? More recently I’ve been writing a lot and exploring the implications of an extended evolutionary synthesis, and I have a book that came out even after Liberated Mind. It’s only been out a little more than a month, but I already had another book coming out called Pros-ocial that links ACT and Lin Ostrom’s Nobel prize-winning design principles.

She won the Nobel in economics for showing that indigenous people can protect their forests and lakes and rivers and streams relevant to the climate crisis situation, and become more cooperative by building groups that reflect what we know about how evolutionary principles work. We’ve combined ACT plus her principles in this book called Prosocial.  What I want to do is I want to try to make some connections. As a high school student reading Maslow and then that’s a college student reading BF Skinner, I thought, “Man, I could square this circle of putting together this very geeky basic science types/ the animal learning people with the people who are aspiring to peak experiences.” I’ve been on that journey for most of my professional life and now I’m at a point where there are enough studies and enough things out there that you can actually make some connections. In Liberated Mind, I do it inside the ACT work and in the book Prosocial, extending that out to other people who are looking at social change processes that might produce more cooperation in small groups. I think that is going to need to happen in the world for us to step up to the political and economic, and environmental challenges we face.