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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Behaviour Change 101
Most effective way to influence behaviour, while maintaining a good relationship?
Positive reinforcement of desired behaviour NB: Shaping
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Behaviour Change 101
Least effective way to influence behaviour, if you want to maintain a good relationship?
Punishment of unwanted behaviour
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Behaviour Change 101
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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6 Things Each Partner Can Do
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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6 Things Each Partner Can Do
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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6 Things Each Partner Can Do
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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Key Issues: Conflict
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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Key Issues: Conflict
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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Key Issues: Conflict
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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Key Issues: Conflict
Being right versus being loving I’m right; you’re wrong Superior/inferior stories
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Key Issues: Conflict
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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Key Issues: Conflict
Defusion of Rigid rules: Expect them Notice them Name them
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Key Issues: Conflict
Discuss inevitability Increase awareness of antecedents Increase acceptance
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Key Issues: Conflict
Shark vs puppy dogDoormat or battering ram
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Key Issues: Conflict
‘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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Key Issues: Conflict
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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Key Issues: Conflict
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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Key Issues: Conflict
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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Key Issues: Solutions
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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Key Issues: Solutions
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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Key Issues: Solutions
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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Key Issues: Intimacy
Emotional, psychological and physical Sharing thoughts Showing feelings ‘Eyes on’ exercise Mindful touching (‘sensate focus’)
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Key Issues: Intimacy
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
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