act with love russ harris, act world con 2011

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ACT With LOVERuss Harris, ACT World Con 2011

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Are relationships easy?

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Fight-or-Flight

Ever had thoughts about leaving the person you love?

Ever had thoughts about hurting the person you love?

Popular Myths?

1. The perfect partner2. It should be easy3. Everlasting luurrve4. You complete me

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Exercise

Reactive partner versus ideal partnerWhat does this tell you about your values, as a

partner?

Mindfulness of the Hand

How did your relationship with your hand change?

How does this apply to your intimate relationships?

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DRAIN

How to DRAIN the vitality from a relationship: Disconnection Reactivity Avoidance of discomfort Inside-your-mind Neglecting values

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LOVE

How to increase the vitality in a relationship: Letting go Opening up Valuing Engaging

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Setting Up: Informed Consent

ACT: involves learning new skills to handle difficult thoughts and feelings more effectively

And clarifying your values, and using them to guide your behaviour, so you can:

1) Contribute to the relationship2) Influence your partner constructively

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Setting Up – Informed Consent

‘Guitar lessons’ metaphor: talking is not enough; you need to pick up the guitar and practice

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Setting Up - Workability

Explain ‘workability’Workability is the ultimate authorityClients, not therapist, are the experts on what

works for them

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Setting Up - Workability

Express your intention to highlight both workable and unworkable behaviour

Get permission to: a) interrupt unworkable behaviour, b) rehearse a workable behaviour instead

Practice in session is

Essential!

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A – Antecedents B – Behaviour C- Consequences

Situation Thoughts FeelingsBiological State

Short term

Long term

Situation: heated argument with wife about drinking habitsThoughts & Feelings: ‘I can’t stand this marriage’Anger & anxietyRighteousness: ‘Who is she to tell me what to do?’ Urge to drinkBio state: tired and sleep-deprived

Short term:Feeling of relief; painful thoughts, feelings, urges disappear

Long term:Drinking problem worsens; tension in marriage worsens

Drinks alcohol

Mindfulness Values & action

B & C = Workability

Something an organism does

Public or private

If consequences lead to an increase in behaviour over time = ‘reinforcement’If consequences lead to a decrease in behaviour over time = ‘punishment’

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Behaviour Change 101

How do we influence behaviour?

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Most effective way to influence behaviour, while maintaining a good relationship?

Positive reinforcement of desired behaviour NB: Shaping

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Least effective way to influence behaviour, if you want to maintain a good relationship?

Punishment of unwanted behaviour

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Ideal ratio of positive reinforcement to punishment?

5: 1 What is the ratio in your relationship?

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Behaviour Change 101 Therapist aims to: Reinforce workable behaviour when it

happens in the room. How? Undermine unworkable behaviour when it

happens in the room. How? Teach clients to do the same. How?

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Taking A History

We’ll get to the problems shortly, but first:What do you appreciate about your partner?What are their greatest strengths/qualities?What do you like to do together?What attracted you when you first met?

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Taking A History

Relationship history: how did you meet, what attracted you, wedding day etc.

What did you appreciate in your relationship & your partner back then?

What do you not want to change in your relationship?

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Taking A History

Can you tell me about a recent event that represents the main issue(s)?

What have you tried so far to fix this? How did it work?

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Taking A History What sort of workable and unworkable

behaviour might we observe as we ask these questions?

How could we reinforce the workable stuff?

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Taking A History

Model, instigate & reinforce factual description versus judgment & criticism

‘Differences versus defects’ (Jacobson, ICBT)Assess the behaviour, not the person

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Taking A History

Model, instigate & reinforce mindful attention

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Taking A History

Validate each partner’s painModel, instigate, reinforce compassion. How?What does it feel like for you when he/she

behaves like that?What does it feel like for you to hear that’s how

your behaviour affects him/her?

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Taking A History

Draw out values wherever possible. How?Continually ask clients to notice both values-

congruent and values-incongruent actions.

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Taking A History

Q: How would you like your relationship to improve? What would you like there to be more of - both from yourself and from your partner?

Watch out for ‘dead man’s’ goals

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Taking A History

Q: If I could wave a magic wand, so that your partner was suddenly perfect – then how would you behave differently?

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Taking A History

On a scale of 1-10, how much work are you willing to do to improve the relationship?

Therapist models accepting, non-judgmental stance (even if score is low) then moves on to the resilience formula

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The Resilience Formula

4 approaches to any problematic situation1. Leave 2. Stay & change what can be changed 3. Stay & accept what can’t be changed & live

by your values4. Stay & give up & do stuff that makes it worse

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Addressing Willingness

Q: So in terms of changing the situation, what do you have most control over?

Q: So let’s come back to workability: how will it affect your relationship if you are not willing to work on it?

If one partner is unwilling, we can still work with the willing one and get positive change

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Stay or leave?

If possible, see the client alone. BUT reserve the right that anything shared in

private can be raised in a duel session, if relevant

Assess pros & cons of each choice Q: Have you given it your best shot?

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Stay or leave?

Sitting on the fence metaphor Live by your values, whether you stay or

leave

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Stay or leave?

Until the day you actually leave, you’re staying – so what do you want to stand for?

Both options = anxiety, doubt, uncertainty Set a brief period each day to reflect on the

decision. Rest of the time, defuse. How?

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Taking A History

Family of origin/ psychodynamic?Brief therapy approachesMy preference: gather this information as you

go & link it to what is happening in the room

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Taking A History

E.g. How old is this story? When was the earliest you can remember it showing up?

E.g. How old is this behaviour? Did anyone model this for you, growing up? How did your family deal with issues like this?

E.g. Where does that rule come from? Who told you, or how did you learn it?

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Taking A History

E.g. Do you react that way in other relationships – parents, siblings etc?

Eg. Have you reacted that way in the past, in other relationships, parents, siblings etc?

E.g. Has anyone in the past elicited these reactions from you, parents, siblings etc?

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End of first session

What is one issue that you’d like to address first?

Do you both agree?If not, each choose one issue to work on.NB: sexual issues – almost always need to

improve the non-sexual aspects first

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End of first session

Notice what both you and your partner do that’s workable

Notice what you personally do that’s unworkable

Notice what thoughts and feelings show up before you start doing the unworkable stuff

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6 Things Each Partner Can Do

1.Stop acting in ways that make it worse2.Clarify and act on your values: be more like

the partner you ideally want to be3.Accept what is out of your control4.Notice & reward behavior you like5.Facilitate change via effective negotiation &

communication skills6.Create rituals to cultivate affection, warmth,

fun, sensuality, sexuality, intimacy etc.

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The best outcome is likely if both partners do these things.

Pre-empt: No two partners will do these things to the same extent.

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Many approaches focus heavily on 5 & 6 In ACT, we focus on all six - but first and

foremost on 1,2, 3 & 4 Why?

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1,2, 3 & 4 are more empowering; you don’t have to ask your partner to do anything!

The Paradox: If you live by your values, stop trying to control your partner, instead practice acceptance, and actively show appreciation… often your partner will make positive changes spontaneously!

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Acceptance & Change

Each partner typically starts from this: You need to change … …but accept me as I am!

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Acceptance & Change

Think of everything that’s wrong with your partner.

Write it down Do you like being judgmental and critical?

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Compassion for your partner

What is it like for you to be looked at as a problem?

Imagine your partner as a young child – and yourself as an adult, shouting all those negative judgments & criticisms

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Key Issues: Self-Compassion

Kristin Neff, 2002: Mindfulness Kindness Common humanity

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Values- Magic wand- Ideal vs reactive partner- 10th anniversary – partner gives a speech- Values worksheets- Sweet spot- Share values- Read out values in session

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3 Important Values

Connection Caring Contribution

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Key Issues: Acceptance

Love & Pain are intimate dance partners

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Key Issues: Acceptance

NAME the emotion Notice it Acknowledge it by name Make room Expand awareness

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Values to Goals

What’s a small step you can take?What’s a little thing you could do?

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Values to Goals

If your partner actually does that, what difference would it make to you?

How will you let them know that?

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Values to Goals

If client makes positive changes: What was that like for you? What happened to your relationship as a

result? What’s another little step you can take?

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Values to Goals

If client doesn’t make positive changes: What was that like for you? What happened to your relationship as a

result? What got in the way?

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The Barriers to change: F.E.A.R.

Fusion Excessive goalsAvoidance of discomfortRemoteness from values

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The Antidote to FEAR is DARE

DefusionAcceptance of discomfortRealistic goalsEmbrace values

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Key Issues: Willingness

Willingness to change, versus wanting to change

Facilitate willingness through values Distinguish values-driven change from:

resentful change/ guilt-induced change/ trying to ‘keep her happy’/ trying to ‘put up with him’

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Key Issues: Influencing

What’s in your control, and what’s not?Carrot versus stickShaping

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Key Issues: Conflict

Name your tactics! Name your ‘pet arguments’! Agree to call them out

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Stop arguments in session Do mindfulness then and there What’s your body doing? Breathe into it. What’s your mind saying? Name it.

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Always come back to workability: What sort of things do you say & do?

How does that work in the short term? Does it help your relationship in the long

term?

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What judgments does your mind make about him/her?

What happens if you buy those judgments? I’m making the judgment that .. Naming the story; putting it on a card

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Being right versus being loving I’m right; you’re wrong Superior/inferior stories

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Distinguish values from rules What are your rules? What are your partner’s rules? Where did these rules come from? What happens when you fuse with them?

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Defusion of Rigid rules: Expect them Notice them Name them

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Discuss inevitability Increase awareness of antecedents Increase acceptance

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Shark vs puppy dogDoormat or battering ram

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‘Needs’ versus values Values: how do I want to behave while I try to

get my ‘needs’ met? Values: how do I want to behave when I don’t

get my ‘needs’ met? Values: how do I want to behave when I DO

get my ‘needs’ met?

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Be wary of simple solutions ! For many issues there is no simple solution.

Examples? Can that be accepted? Learn to discuss difficult issues with

mindfulness and compassion

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Staying on track Two cards 1: values I want to live by while we discuss 2: the issue, and the desired outcome

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Therapist repeatedly comes back to: Workability Grounding/dropping anchor Acceptance/defusion Compassion to self and partner Values

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Key Issues: Solutions

Win-win options: Ideal: outcome meets both partners needs Exchange Take turns Willing sacrifice Relative importanceDraw: Compromise

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Lose-lose options: DRAIN In relationships, there is no ‘win-lose’ option A ‘win-lose’ for one person is a ‘lose-lose’ for

the relationship

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Win-win solutions are ideal, but not always possibleEg one partner wants a child, the other doesn’tShift from a specific goal/outcome to brainstorming multiple ways of meeting both partner’s needs on an ongoing basisRecommended reading: Getting To Yes

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You can’t always get what you wantValidate reality gap & facilitate compassionRecall: 4 approaches to the situationHow can I get my needs met, even though I can’t get the outcome I want?Acceptance & grieving

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Key Issues: Aggression

‘Anger Management’? Run through the ABCs

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A - Antecedents B - Behaviour C - ConsequencesSituation, thoughts, feelings, biological state

What you do short term & long term

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Key Issues: Repair attempts

What’s the tiniest step you could take that might repair some of the damage?

Acknowledge & accept repair attempts (John Gottman: 7 Principles of Making Marriage Work)

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Key Issues: Repair attempts

Conflict into compassion Vulnerability and openness Drop the story, reveal the emotion

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Reframing Problems

How can I grow from this? What can I learn from this? Imagine your partner is a personal trainer or

life coach that you have hired to help you grow: what skills can you learn, what strengths can you develop?

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Key Issues: High Expectations

The Perfect Partner Story Do they exist? Do you always act the way you expect

yourself to act?

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Key Issues: Communication 101

Ask clearly for what you want (& explain why) – video description, non-judgmental

Express clearly what you don’t want (& why) – video description, non-judgmental

Be clear about boundaries & consequences -– video description, non-judgmental

Speak in a way that works to build the relationship – body language/voice/ vocab

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Key Issues: Calming down

Drop anchor! If necessary leave the situation If you do leave the situation, practice

mindfulness (defuse from unhelpful stories, accept feelings, self-compassion)

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Key Issues: Calming down

Once grounded, ask yourself What sort of partner do I want to be? What

are my values here? If I could be that ideal partner, I would

respond by doing … Visualize/write/rehearse those responses

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Key Issues: Relapse

Discuss inevitability of ‘relapse’ When your partner screws up, how will you

respond? When you screw up, how will you respond?

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Key Issues: Refresher

Be present, open up & do what matters: Letting go Opening up Valued action Engaging fully

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Key Issues: Intimacy

Be present Share valued activities Practice connection Acceptance of vulnerability/anxiety

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Emotional, psychological and physical Sharing thoughts Showing feelings ‘Eyes on’ exercise Mindful touching (‘sensate focus’)

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Be present Share valued activities: create rituals Practice connection Acceptance of vulnerability/anxiety

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Key Issues: Affairs

Metaphor: it’s like taking drugs Motivation: avoid pain & seek pleasure Relationship problems don’t cause affairs Affair = a personal choice (like taking drugs)

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Affairs: Both Partners

Validate pain Full disclosure or not? Discuss pros and cons If yes, ensure it is ‘once off’, not lingering on

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Affairs: The Unfaithful Partner

Take responsibility Acknowledge personal choice Genuine apology Make amends

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Affairs: The Betrayed Partner

4 options What can your partner do to make amends? Normalise the desire to know ‘why’? No explanation is likely to be satisfying Can you accept an apology? How can you both rebuild?

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Key Issues: Forgiveness Give yourself what was there before Anger & resentment – costs of fusion Respond with mindfulness Not just about ‘letting go’; the aim is to let it

come, let it stay and let it go - as it chooses!

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Key Issues: Forgiveness

FORGIVENESS RITUALEach partner writes:-The thoughts, feelings/ memories I’ve been

holding on to are …How holding on has hurt me & our relationship:

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Key Issues: Forgiveness

FORGIVENESS RITUALCommitment to letting all this old stuff come and

go without holding on to itChoose a special place, read it out, do

something symbolic (eg burn it & scatter the ashes) then do something to connect lovingly

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Key Issues: Trust

Distinguish the action of trust from the ‘feeling’ of trust

No control over ‘feelings’ of trust – only over the actions.

Balance values around trust with values around self-protection

Mindful trust versus blind trust

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Key Issues: Trust Mindful trust: look for Sincerity Reliability Responsibility Competence

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Key Issues: Trust • What are small actions of trust you can

take? Mindfully assess what happens! • What will you need to do to honour your

values around self-protection? • What will your partner need to do to

demonstrate he/she is trustworthy?

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Key Issues: Trust Acceptance of time involved Acceptance of both partners emotional

reactions This will never be forgotten Commitment to working on the relationship

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Key Issues: What Is Unacceptable? Follow all legal obligations & be transparent

about it. After that, it is up to the client to decide. The extreme case: domestic violence.

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Key Issues: What Is Unacceptable? You can share your feelings, in a defused,

open, accepting, non-judgmental manner - but do not try to enforce your beliefs on the client.

Deal with your own stuff!

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Key Issues: What Is Unacceptable?

Focus on building the therapeutic relationship and making a safe space for the client.

Help clients increase their psychological flexibility.

Then let them choose for themselves.

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Other Common Issues

Chaser/distancer cycles Deep-seated fears Jealousy Anger/blaming cycles Parallel lives

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Parting Words

“For one human being to love another: that is perhaps the most difficult of our tasks; the ultimate, the last test and proof, the work for which all other work is but preparation.”

- Rainer Maria Rilke

act with love russ harris, act world con 2011

Documents

interrupt unworkable

good relationship

difficult thoughts

hand change

relief painful thoughts

ideal partnerwhat

habitsthoughts feelings

informed consentact