On the go? Listen to the audio version of the article here:
Like addiction, suicide is a form of escape. Given my suicide research background and my current focus on addiction, I thought it would be appropriate to share my perspective on their similarities.
Suicidal thoughts can lead to addiction, and addiction can increase the risk of suicidal thoughts. Beyond their co-occurrence in this downward spiral, both operate similarly as a form of escape.
Suicide is an escape from deep emotional pain, in addition to an escape from the self and the world. It often occurs when one feels hopelessly socially isolated or feels like a burden on others.
Let’s unpack what this means and how suicide and addiction operate in similar ways.
What Causes Suicide?
Before considering escapism and addiction, let’s summarize the major theories of suicide, in simple terms, from the individual to the social level.
Starting with the most individual level, Edwin Shneidman states suicide is the result of “Psychache.” He defines this as extreme emotional pain.
Roy Baumeister adds to this theory, stating that the emotional pain is produced by constant painful thoughts regarding one’s self. In his article, Suicide as Escape From Self, he shares how these thoughts often involve the sense of oneself as a failure, an impostor, or not living up to an imagined standard.
Thomas Joiner builds on both of these theories in his Interpersonal Theory of Suicide. He states that the pain and thoughts result from the lack of belonging, combined with feeling like a burden and hopelessness regarding the prospects of this ever changing.
These theories can be mapped onto the societal level, considering Émile Durkheim’s sociological theory of suicide. At this level, suicide is often the result of an unregulated, individualistic society where people lose a sense of purpose and no longer feel a sense of community.
The risk of suicide is produced on various levels. Each case’s details will vary, but these theories highlight a general way of thinking about suicide, beyond some of the myth about it.
Let’s now consider how suicide and addiction are a form of escape.
Escaping Emotional Pain
As I share in my article on the root causes of addiction, trauma, and the pain of unmet needs, often fuels addiction. Substances or addictive behaviors serve as a way to cope with these challenges in the short-term, leading to increased difficulties in the long-term.
Addictions and suicide are both ways to escape from emotional pain. They are both short-term solutions with long-term consequences, affecting many others beyond the individual.
Like Baumeister’s description in Suicide as Escape From Self, people often use substances or addictive behaviors to cope with aversive thoughts such as, “I am not enough, I don’t deserve any better, and I am a failure.”
Like Joiner’s Interpersonal Theory of Suicide, persons with an addiction often feel isolated, as described in my article on the impact of isolation on addiction. They also begin to feel increasingly burdensome, beginning to believe others may be better off without them.
These similarities can also be observed on a societal level, as highlighted by the sociological theory of suicide. Community degradation can lead to economic despair, family disintegration, and increased rates of addiction.
Although addiction and suicide frequently occur together, they both independently function through similar processes.
A War In Your Head
In the case of both addiction and suicide, the individual experiences an intense mental struggle. They want a better way forward while also wanting to escape the pain. This battle is characterized in my article highlighting Stephanie’s experience, here:
“It was the biggest mind war I ever went through. You know what you’re doing is hurting you but can’t stop. It’s like watching a bad movie you are the star of.”
Suicide works the same way. A person often stays in a state of uncertainty of whether they will follow through with it, right until it’s too late to turn back. Fortunately, Kevin Hines lived to share his experience. After surviving a jump from the Golden Gate Bridge, he shares:
“I thought it was too late, I said to myself, ‘What have I done, I don’t want to die ‘”
Although he got a second chance, many others likely had the same thoughts while suspended mid-air, who did not survive.
This tragic reality highlights how suicide, like addiction, is not the person’s preferred path. No one wakes up one day and decides they want to become addicted to heroin. It is a gradual process, fraught with internal battles and mixed desires.
As highlighted by Kevin, a person thinking about suicide does not want to die. They want to escape the pain. Addictions are ways to escape the problem temporarily, but result in more pain in the long-term.
The link between addiction and suicide can be best highlighted in opioid addiction, particularly among Fentanyl users. In my experience working in a residential withdrawal context, persons using Fentanyl are generally well aware of the overdose risk, likely knowing several others who have overdosed. Speaking to these individuals, I often gathered there was a constant state of suicidal contemplation. Although they didn’t want to die, part of them hoped for it so that the pain would go away.
Playing Russian roulette with Fentanyl seemed to be a way to dull the pain while remaining open to the potential for a fatal outcome. This tragic situation has been recently highlighted by professional commentary in the New England Journal of Medicine:
“…data suggest that the true proportion of suicides among opioid-overdose deaths is somewhere between 20% and 30%, but it could be even higher.”
With the absence of a note, opioid overdose suicides are challenging to study, since the motive cannot be known. Also, as highlighted by the Golden Gate Bridge example, a person’s motives are often highly ambiguous, changing moment to moment as the war in their head continues.
Conclusion
Both suicide and addiction function through similar processes. They are attempts to escape from emotional pain caused by underlying troubling thoughts, unmet needs, or a sense of being hopelessly isolated and a burden on others. This process operates on an emotional level, a cognitive level, an interpersonal level, and a societal level.
If you want to learn more about the subjective experiences of individuals thinking about suicide, I’ve written an in-depth article here: Inside the Mind of a Suicidal Person
If you or someone you know is struggling with thoughts of suicide, please reach out to someone you trust or seek help from a qualified professional.
If you are in crisis, you can call the National Suicide Prevention Lifeline (in the US) or seek out your local Crisis Centre and speak to someone who can help.
On the go? Listen to the audio version of the article here:
As an addiction counselor, I have been fascinated by the psychology of motivation. I’ve always wondered what motivates human behavior, spending a significant amount of time researching our underlying drives, and how motivation works.
With recent scientific advances into the science of how motivation works, we are still failing to apply these lessons in our daily lives. In this article, I translate the science into a practical guide to understanding motivation. So how does motivation work?
Motivation works though a dopaminergicneural process whereby our brains reward us when we carry out a task that meets our internal human need for a sense of autonomy, competence, relatedness, or basic survival needs such as food, safety, or relief from pain.
Let’s unpack what this means.
What is Motivation?
Motivation is the desire to engage in a particular behavior. This behavior may meet a specific psychological or physical need or avoid a specific harmful outcome.
Motivation is an adaptive mechanism, helping us survive. Without motivation, we would have no drive to eat, drink, procreate, or engage in any other kind of activity that would maintain our survival.
There are two general types of motivation: extrinsic motivation and intrinsic motivation.
Extrinsic Motivation
This is motivation based on an external reward. This type of motivation works through external rewards such as money, food, or possessions. For example, giving your child money for doing their homework is an extrinsic reward. If you take away the reward, the child no longer has the motivation to engage in the task. This is why this form of motivation is great for short-term tasks, but it does not maintain the long-term behavior.
Intrinsic Motivation
This type of motivation consists of behavior driven by one’s internal sense of reward for engaging in the task. A person may feel a sense of passion, engagement, and a sense of deep psychological satisfaction when engaging in the task, even without external reward. For example, a writer may have a passion for engaging in the task of writing, independent of praise or monetary gain.
At first, psychologists assumed extrinsic rewards could increase intrinsic motivation, but studies later confirmed this is not true. A 1971 study on The Effects of Externally Mediated Rewards on Intrinsic Motivation demonstrates that extrinsic rewards decrease intrinsic motivation.
For example, if your child enjoys practicing the piano and you introduce a monetary reward each time they practice, their internal motivation to practice decreases, making them less likely to practice when you take away the external reward. This is why getting paid for your passion can risk making the task begin to feel like work.
The Psychology of Motivation
Extrinsic motivation works through rewards and punishments. Rewards consist of pleasant external stimuli that evoke pleasure, like in laboratory models of operant conditioning. Early behavior modification techniques treated humans as if they were lab rats. This worked by reinforcing desired behaviors through rewards or extinguishing undesirable behaviors through punishment. Although this can work, it has it’s limitations, as stated above.
Intrinsic motivation works by meeting our fundamental human need for a sense of autonomy, competence, and relatedness. This is the basis of self-determination theory, an evidence-based model of intrinsic motivation. Autonomy is our need for a sense of independence and control over our lives. Competence is our need to feel like we are progressing in life. Lastly, relatedness is our need for a sense of social connection.
Although this is a highly simplified breakdown of the psychology of how extrinsic and intrinsic motivation works, it captures the aspects of motivation required for practical usage in everyday life.
How to Improve Motivation
Understanding the basics of how motivation works allows you to apply these lessons to yourself or others. Here are a few practical tips for improving motivation:
Focus on Small Wins
Gaining small wins over time works to enhance motivation by fostering an internal sense of competence. The sense of incremental progression over time builds motivational momentum. Like rolling a snowball, the power of small wins compounds over time.
Get Clear on Your Values
Getting clear on your values works to build motivation by giving you a sense of purpose and autonomy. This means we feel in control of our lives, deciding to act in alignment with our chosen values, rather than feeling constrained and controlled by external forces.
Be Accountable to Others
Being accountable to others works to build motivation by fostering a sense of relatedness. This means our need to connect with others is met through holding ourselves accountable to them. For example, many people use personal trainers for the sense of motivation built into the accountability provided by the relationship.
Recall these same lessons when helping others build motivation. When helping someone, it is tempting to take the lead, telling them exactly what to do. This violates the principle of autonomy, taking away their sense of control over the process, decreasing motivation. Instead, it is more effective to engage with empathy, evoking their reasons for making the change, and collaborating with them on a plan.
Conclusion
Motivation works on many levels, neurologically and psychologically. In simple terms, it works through external rewards and punishments or our internal need for autonomy, competence, and relatedness.
Focusing on intrinsic motivations rather than extrinsic motivations allows for sustained motivation that is not dependent on external rewards or punishments. It is also important to note that introducing external rewards to behaviors that are already intrinsically motivated can decrease intrinsic motivation. In other words, be careful when getting paid for your passions.
We can build our intrinsic motivation by focusing on small wins, getting clear on our values, and being accountable to others. When helping others develop their motivation, we can use these same lessons, taking a collaborative approach that keeps the other person feeling in control of the process.
If you are interested in learning more about helping others build their motivation, I wrote an in-depth article on Motivational Interviewing here. This is a powerful conversation style, designed to overcome resistance, helping someone develop their motivation for change.
When helping someone change, it can feel like we are trying to convince them of a better path forward. They may be stuck in self-destructive forms of avoidance, rationalization, or rigid thoughts, keeping them from being present and living in alignment with their values.
It is tempting to argue our way through, but the more we try, the more resistance we encounter. If you are a professional working in mental health and addiction, or a frustrated family member or friend, the creative hopelessness technique may help you move forward more effectively to provide support.
The concept of creative hopelessness is a technique in Acceptance and Commitment Therapy (ACT) designed to help persons give up on ineffective ways of being, helping them open up to a new values-based path forward. It avoids argumentation by posing a set of questions that allows the other person to be convinced by their own lived experiences.
Drawing on the work of Steven Hayes and the lessons presented in his course, Act in Practice, the approach can be summarised in the following steps:
Ask what they want.
Ask what they have been doing to get what they want.
Curiously ask how these things have been working.
Actively listen, then summarize their desires and actions.
Ask if they are willing to try a new approach.
Let’s delve into how it works and how you can use this powerful technique in your interactions.
How Creative Hopelessness Works
Creative hopelessness works by guiding a person toward convincing themselves to give up hope on ineffective approaches. The key is having them persuade themselves, based on their own experiences. Their lived experiences are the most powerful motivational tool at our disposal.
When we try to argue with someone, based on our own experiences, they can’t fully integrate the advice. They may say “you’re right,” showing signs they agree, generally followed by a, “yeah, but…” giving rationalizations on why it’s different for them.
As FBI hostage negotiator, Chris Voss shares, hearing “you’re right” is deceiving, since it feels good. We think we just won them over, not realizing it is a short-lived hollow victory. If you hear “you’re right,” it may be a red flag that you’re doing too much arguing and not enough listening and evoking.
Rather than hearing, “you’re right,” you want to hear, “that’s right.” This means you are demonstrating accurate empathy, and the person is actively engaged in a collaborative process, rather than being a passive recipient of well-intentioned advice.
Creative hopelessness requires guiding the person through the lessons of their own lived experiences. This is how one comes to terms with the ineffectiveness of one’s current approach. As Stephen Covey says:
“If we keep doing what we’re doing, we’re going to keep getting what we’re getting.”
Merely telling someone this has a very different effect compared to inquiring into what they have been doing and asking how it has been working.
When asking how their previous attempts have been working, it is also essential to maintain curiosity and neutrality rather than asking presumptively or sarcastically. Perhaps some aspects of their previous attempts are actually working.
The goal is to determine the aspects of their experience that have not worked, having them come to a state of hopelessness regarding those approaches, not a general state of hopeless.
From Hopelessness to Hope
This is where the creative aspect of creative hopelessness comes in. Guiding someone to a place of hopelessness regarding their current way of operating is only helpful if they are presented with a new sense of hope in moving toward a valued direction.
Asking if they are willing to try something different offers a way out of this state of hopelessness, so long as they are willing to take a courageous step into unfamiliar territory.
If they are still showing signs of hesitation, it may be useful to refocus on what they want and what they value. As stated by Victor Frankl:
“Those who have a ‘why’ to live, can bear with almost any ‘how’.”
Keeping the process focused on their ‘why’ increases motivation to move forward, despite the fear and uncertainty. It is vital to continually revisit this ‘why’ recalling what is important to them and what they value.
In Acceptance and Commitment Therapy (ACT), values are ways of being. This means you are generally able to turn it into an adverb. Here are a few examples: lovingly, creatively, genuinely, excellently. Values are qualities of being, not destinations in themselves; therefore, gaining clarity on one’s values allows for ongoing motivation. See the “Values” section in my comprehensive summary of ACT here.
Values-based goals can also be drawn on for motivational momentum. Goals involve a vision of a specific valued destination. When discussing goals, it is important to make sure the person describes what they want, rather than a description of what they don’t want.
For example, when asking what someone wants, they may say, “I want to stop feeling so anxious.” Although this may be true, it does not pave a valued path forward. Perhaps re-framing the question may be helpful. For example, “So let’s imagine your anxiety is gone… What would you do? (goals) What do you want your life to be about? (values).”
This is one way to gain a clearer answer to the first step of creative hopelessness, inquiring into what they want. Although it is the first question, it may be effective to continually come back to it, clarifying a values-based path forward. This ‘why’ provides a positive vision of the future, offering courage when letting go of old habits.
An Example of Creative Hopelessness
Here is a rough example of creative hopelessness, following the steps indicated in the introduction. I open the conversation with an ineffective approach, then transition into a collaborative creative hopelessness process.
Ineffective Approach
Person: “I’ve been struggling for years, feeling like I am stuck in my head. I’m always analyzing everything, thinking about what might go wrong.”
You: “You need to get out of your head and focus on the present… have you tried meditation?”
Person: “Yeah… it hasn’t really worked… I feel like if I stop worrying, everything will fall apart.”
You: “That’s not a realistic thought… things will likely be fine.”
Person: “You’re right… but I’ve been through a lot, and this is helping me survive.”
Effective Approach
You: “What do you want your life to be about?”
Person: “I want to be able to protect my kids and show them love.”
You: “And what have you been doing to protect your kids and show them love?”
Person: “I’ve been constantly thinking about what might go wrong and how I can give them the best life possible.”
You: *curiously inquires* “How has this been working for you?”
Person: “I guess I’ve kept them safe, but I don’t feel like I am able to be present and show them love, since I’m stuck in my head.”
You: “What else have you tried?”
*Continue inquiring into the effectiveness of past approaches.*
You: “So it looks like you value your family and want to be able to give them a great life, while being present and engaged.”
Person: “That’s right.”
You: “And this pattern of retreating into your had has kept you from lovingly connecting with them as often as you would like.”
Person: “That’s right… I want to be there for them.”
You: “And retreating into your head seems to be taking you away.”
Person: “Yeah… it is.”
You: “And when you keep doing what you’re doing, you keep getting what you’re getting… so I’m wondering if you would be willing to let go of this approach and be open to trying something different…”
Person: “Let’s do it.”
Conclusion
The end of the creative hopelessness technique is the beginning of the change process. It simply brings the person to a state of willingness to move forward. The process of change can be uncertain and uncomfortable, so fostering this sense of initial motivation and commitment can help an individual take the initial steps forward.
The initial steps depend on the person. In the example above, work may start by developing present moment awareness. If the person’s primary concern is related to emotional avoidance, work may begin by focusing on acceptance and emotional openness. If the person is unclear on their values, work can start with exercises focused on clarifying values.
For a comprehensive overview of Acceptance and Commitment Therapy (ACT), check out my article How to Improve Psychological Flexibility. In that article, I break down each of the six ACT processes, offering metaphors and practical exercises.
Although this article is focused on ACT, I also drew on my background in Motivational Interviewing (MI). The creative hopelessness technique can significantly benefit from integrating MI since it is focused on working with resistance and increasing motivation for change. For a comprehensive overview of MI with examples of how it works, check out my article, How to Do Motivational Interviewing.
Since this article is focused on techniques used in mental health and addiction treatment, many aspects may not be relevant if you are using this outside of a clinical setting.
If you are helping a child or family member, some aspects of this approach may be helpful, but it is important to maintain personal boundaries since over-involvement can be counterproductive. For more on this topic, see my article on the difference between helping and enabling. If you are helping a child or family member, my article here may be helpful.
On the go? Listen to the audio version of the article here:
Here is a recording of a live training I conducted on Motivational Interviewing. If you or your organization are interested in setting up a private workshop or one-on-one coaching, you can contact me here.
Motivational interviewing is a powerful counseling style, focused on helping someone gain motivation toward a valued direction in their life. The technique was first developed in the addiction field and is now being used broadly within healthcare settings.
As an addiction counselor, I have attended several workshops on motivational interviewing and noticed a wide range in the quality of instruction. I’ve witnessed persons leaving these workshops with a shallow understanding of the approach, feeling confused, or deciding to give up on the approach altogether.
Since I am passionate about motivational interviewing and love sharing complex ideas in accessible language, I was inspired to create a practical in-depth summary of this powerful approach.
These are the four processes of Motivational Interviewing (MI), a scientifically validated approach to helping someone change:
Engage them through reflective listening
Focus on the main issue they are facing
Evoke their reasons for change
Collaborate on a plan for change
In this article, I delve into each of these four motivational interviewing processes, translating the most practical elements into simple language. Whether you work in mental health, addictions, other areas of healthcare, or are just trying to help a friend or family member, I hope this powerful approach can help.
What is motivational interviewing?
According to Dr. William Miller, the founder of Motivational interviewing:
“Motivational interviewing is a collaborative conversation style for strengthening a person’s own motivation and commitment to change.”
Rather than merely a set of techniques, it is fundamentally a way of being with people. It is tempting to simply try to give people the psychological tools as if simply explaining it to them clear enough will make them change. This is an antiquated learning model, based on the idea that persons are empty receptacles, needing to be filled with knowledge.
As a university course instructor, I quickly learned that merely lecturing people is a highly ineffective way to facilitate meaningful learning. This lesson was reinforced in my work doing problem gambling prevention. Although some people are naturally curious and want to learn more, most people shut down as soon as they feel like someone is giving them advice.
“People don’t resist change. They resist being changed.”
Resistance to change is not personal. Persons are coping with underlying pain, the best way they currently know how. Attempts to change someone are met with resistance since they take away someone’s need for control.
Deep down, people who seem to have no motivation do want to change. Getting to that kernel of desire is the goal of motivational interviewing, and this starts with considering our way of being with them. This entails actually being there with them.
How to be with a person
This is also referred to as the “spirit of motivational interviewing”. It is a way of being that entails partnership, acceptance, compassion, and evocation, forming the acronym, PACE. Keeping PACE with others means meeting them where they are at.
Let’s start by delving into acceptance since it has several aspects.
Acceptance
Accepting another person as they are, while also supporting their growth, is foundational. Although acceptance sounds like a simple word, there are four aspects of acceptance: absolute worth, empathy, autonomy, and affirmation.
Absolute Worth
This means maintaining a nonjudgmental attitude toward people who are presenting difficulties.
When we hear anger or frustration, it is useful to consider what pain might be causing the person to react the way they do. Slow down and see their humanity, despite the challenges on the surface.
This aspect of acceptance from Carl Rogers’ concept of “unconditional positive regard.” It requires setting aside one’s judgments about another individual, empathizing with them, and genuinely wanting the best of them.
When someone irritates us, it can be challenging to have unconditional positive regard, but when we start with empathy, we can understand the context of their behaviors, not taking it personally, and not blaming them for being ‘bad’, ‘lazy’, or ‘stupid’. We can see them as an imperfect individual, like ourselves, striving to live a ‘good’ life. When we have unconditional positive regard, we empower individuals to see the best in themselves, inspiring them to act accordingly.
Empathy
This means actively attempting to understand the other person’s point of view.
We can start by becoming curious about the other person’s inner world. This curiosity allows us to take a step back from our own biases and assumptions, facilitating mutual understanding and respect.
Autonomy
This entails facilitating the other person’s sense of control and independence.
We can’t make people change. We can only help spark their own desire to change. Supporting their autonomy means knowing when to slow down and simply hold space.
Affirmation
This means acknowledging the other person’s strengths and efforts.
We are often quick to latch on to the negative traits a person displays, overlooking their unique strengths, abilities, or efforts. Recognizing someone’s strengths helps us maintain respect for them as an individual.
Compassion
Compassion requires us to actively promote a person’s welfare based on their own needs.
We often feel compelled to judge what will be best for another person. This causes us to direct the focus, assuming we know what they need to prioritize. As we take the reins, we disempower the other person, putting them into a passive role in the process.
This aspect of motivational interviewing was added when the founders, Rollnick and Miller, noticed that their method was being advertised by an “influence coach” selling his book on “How to Get Anyone to Do Anything — Fast!”.
Getting “anyone to do anything” does not require compassion since it does not consider their best interests first. Rollnick and Miller wanted to be clear that their technique is intended to be used with and for the other person, not simply for the interviewer’s personal benefit.
Evocation
Evocation requires us to actively elicit the person’s own reasons for change.
We often feel compelled to make arguments for why someone needs to change. Usually, the arguments for and against change already reside within the other person. It is our job to evoke their ownarguments for change, thereby increasing their intrinsic motivation.
This is the opposite of those all too common “should” statements. Has anyone ever said you should do something? How do you feel after someone tells you this? Evocation elicits the person’s own arguments for change, bypassing this resistance.
Partnership
Partnership requires us to collaborate with the other person to form a plan.
We may feel compelled to dictate what we may consider a strong action-plan, pacifying the other person, leaving them feeling like they have “homework” rather than having a collaboratively constructed plan of action. Partnering with the other person inspires intrinsic motivation to change becuse they feel in control of the process.
This is the foundation of motivational interviewing. Without being with people in this open, accepting, compassionate way, the technical skill will generally be ineffective.
Now that the foundation has been laid, let’s consider the four processes listed in the intro:
Engaging
Focusing
Evoking
Planning
These may occur in the order listed, or the conversation may go back and forth, depending on the situation’s requirements. Let’s take a closer look at each of these processes and how they work.
Engage them through reflective listening
This means establishing a trusting and mutually respectful relationship. In practical terms, it’s how we help people feel like we are someone they can trust and with whom they can share their personal experiences. Engagement can happen instantly, or it can take a while.
The best way to develop engagement is through reflective listening. Reflections consist of responding with a summary of what the person is sharing with you. Our natural tendency when listening is to ask questions continually. Reflective listening is different since it means limiting the number of questions you need to ask.
Reflections are more engaging than questions, helping facilitate empathy and a sense of understanding. To be optimally effective, try to use at least three reflections per open-ended question. For example:
Person: “Yeah… I was doing so well… I hate when this happens!”
You: “And you want to gain more control over your drinking.” (reflection 2).
Person: “Yeah… I’ve been trying a few different things but I don’t know if I should go to treatment.”
You: “And you are still not sure if treatment is a good fit for you.” (reflection 3).
Person: “That’s right… I feel like I have a lot of support.”
You: What do you feel you need right now? (open-ended question).
Notice how reflective listening builds rapport while delving into the person’s underlying needs. Asking too many questions risks maintaining a surface-level conversation. Reflective listening delves into the other person’s experience while using infrequent open-ended questions to guide the conversation gently.
Since there are several different types of reflections, here is a brief definition and example for each:
Simple Reflection
This consists of reflecting the exact words or phrases used by the individual.
Example:
Person: “I feel guilty about my drinking because I often drink too much.”
You: “You feel guilty…”
When using a simple reflection, be careful not to sound like you are simply parroting the other person’s words. If done without a spirit of empathy, it can appear cold and mechanical.
FBI hostage negotiator, Chris Voss, shares he often used this kind of reflective listening by merely repeating the last two words the person said. Although I don’t personally recommend this when helping others, it can be a simple, fun exercise to practice reflection in everyday conversation.
Complex reflection
This consists of finishing the other person’s sentences or paragraphs by guessing what they mean. It is also one of the most powerful forms of reflection. The key to this technique is that the dialogue should flow as if it were a single person speaking.
Example:
Person: “When I comes to drinking, I find it difficult to control myself.”
You: “…and you’re looking to gain back some control.”
Person: “yeah… I miss the way things were before I started drinking.”
You: “… spending quality time with the ones that matter.”
Note that you need to sometimes go out on a limb and take a guess at what phrase may accurately represent the other person’s experience. If you are not on the mark, the other person will correct you. If they correct you, adjust your reflection to fit their experience, maintaining a spirit of empathetic concern or curiosity.
Summarizing
Summaries are reflections that consist of paraphrasing two or more items someone has shared.
Example:
Person: “I tried going to a therapist to deal with my gambling because my partner was frustrated with my spending and told me I had to go, but I don’t think it helped because I keep wanting to gamble, but I also don’t want to upset my partner. I just feel lost and overwhelmed because my relationship is very important to me.
You: “So you’re feeling lost and overwhelmed because you enjoy gambling, but your partner thinks you are spending too much and wants you to get help. You value your relationship so you sought help, but you feel that it was not helpful for you.”
Summaries are most useful at the end of conversations or immediately after someone shared many concerns.
In summary, reflection builds connection and increases motivation by encouraging the other person to continue talking about their reasons for change. Rather than simply listening, asking questions, and offering feedback, incorporating a large dose of reflection into your conversations will help you better connect with others, in addition to increasing their likelihood of making a change.
Focus on the main issue
This consists of seeking and maintaining direction in the conversation. In practical terms, it’s how we help people share their most important concern.
Rather than making assumptions about what they need, focusing is a collaborative process, revealing what is best for them.
Focusing is tricky because we could take the conversation in so many places. How do you focus on one particular aspect of a person’s complex experience and list of challenges?
Open-ended questions are the most useful tools for this process. Some examples might include questions like “What is the most important issue for you right now?” and “What issue is your main priority right now?”
The key to focusing is to never make assumptions. The problem may seem “obvious” in the beginning, but this may or may not be the real issue. Guiding the focus of the conversation through open-ended questions ensures you are focusing on the most relevant aspects of their situation.
So how do you know when you’ve focused enough? Here are some quick tips:
Not yet Focused
The person jumps around between ideas and topics
The person reverts to small talk after disclosing an area of potential focus
The person is still sharing important background information
Focused
Person has directly identified a top area of priority
You have confirmed the focus with the other person.
Evoke their reasons for change
This consists of increasing motivation by evoking the other person’s own arguments for change.
In simple terms, it’s how we help people increase motivation and maintain their commitment to change.
The best map is useless if they’re not ready to take the voyage.
Talking about our why is the fastest way to build motivational momentum. Clinical studies on this technique demonstrate that getting the other person to talk about their own reasons for change correlates with increased successful outcomes. Miller and Rollnick call this “change talk.”
Studies looking at this technique’s effectiveness show change talk is one of the significant predictors of change.
So how do you get the individual to state their own reasons for change? Listen carefully for a reason, and then reflect that reason back to them in your own words, encouraging them to continue talking about it.
Here is a simple example:
Person: “I guess if I stop coming to the casino so often, I could take better care of my elderly mother.”
You: “It looks like your mother means a lot to you…”
Person: “Yeah… she was always there for me, so I really want to be there for her.”
Whatever you reflect, you will hear more. Therefore, reflecting change talk gets you more change talk. Note that this also works in reverse. If you are not selective in your reflections, you may be encouraging more counter-change talk, keeping the person entrenched in past behaviors.
To unlock motivation, keep your ears on alert for change talk, focus your reflections, and encourage the other person to continue talking about their own reasons for change.
The purpose of evoking change talk is to increase intrinsic motivation, reducing ambivalence.
Those seeking change look toward a huge mountain ahead, ambivalent to whether they should make the trek. They want to get to the top, but also have reasons not to take the risk. Torn between these two competing desires, they are stuck.
When someone comes to us for help, it is tempting to start planning for change immediately. Before doing so, we need to take a step back, inquiring into the other person’s reasons for change. Evoking change-talk helps the other person build intrinsic motivation, a key indicator of successful long-term growth.
Special Evoking Technique: The Readiness Ruler
Simply ask the person about their readiness to change on a scale from one to ten.
Ask what made them choose that number instead of a one or two.
Ask what it would take to get them to a number or two higher than the one they chose.
The readiness ruler is not a measurement tool. Rather, it is a technique designed to evoke change talk. Each step is designed for this purpose. It does not necessarily matter what number they say. What matters is how you engage the person relative to the number they chose.
Step number two might seem counter-intuitive. Why would you ask someone about their reasons for not being less motivated?
When asked about their reasons for not being less motivated (a 1-2 on the scale), they will need to respond with reasons why they are motivated. The question necessarily frames them as having some motivation, guiding them to elaborate on it. This elaboration is the essence of change talk. Using continued reflective listening is crucial to this step.
Question number two is focused on evoking, while question number three starts the initial planning phase. Strong change talk goes beyond vague desires, delving into someone’s reasons and deep internal need to change. Turning this desire into commitment and action involves collaborating on a plan.
Collaborate on a plan for change
Collaboration is like a dance. We give and take, meeting the person where they are, guiding the flow of the dance while remaining in harmony with one another. The goal is to guide them toward action, not force them into submission.
To use another metaphor, we must be like travel agents of change. We may be experts on the matter, but we can never really know what kind of trip will be best for the individual until we collaborate with them. Even when the plans are set, and the trip is booked, it is not our job to go on the trip with them. If things get rocky on the trip, they can call us for support, but it is not our responsibility to fly out and rescue them.
People need space to feel empowered when making changes. When we become confrontational experts, we disempower people, making them feel incompetent. When we collaborate with them, guiding the change-process, we empower them to take responsibility for changing, giving them the ability to see small rewards accumulate by their own volition. As these rewards start to accumulate, motivational momentum snowballs into committed action.
Collaboration solves underlying motivational issues by encouraging an active mindset rather than spurring temporary action driven by the desire to avoid criticism.
When helping people change, we are often tempted to take the lead. We want to direct them on making the change, telling them what they need to do, and perhaps even begin doing some of it for them. We may find ourselves working harder than the other person, wondering why they won’t take control over their life. If we find ourselves in this situation, it may feel like we are helping, but we have actually become part of the problem.
Special Planning Technique: Elicit-Provide-Elicit
Our contributions to a plan are better received when delivered in an elicit-provide-elicit sandwich.
This requires asking what they know about an area, providing relevant information (with permission), then asking their thoughts on the information. This technique helps bypass resistance when planning, allowing you to offer feedback without sacrificing collaboration:
You: “What do you think about counselling?” (elicit)
Person: “I think it would help me out a lot right now.”
You: “Can I tell you more about local services? (asking permission to provide)
Person: “Sure!”
You: “X is a great local resource…” (provide)
You: “What are your thoughts?” (elicit)
Common traps and roadblocks
Sometimes our interactions are smooth sailing. Other times, they feel heavy and difficult. You may be getting yes or no answers, “yeah buts…”, no eye contact, or the person may have difficulty opening up. Here are some common ways you might be caught in a communication trap.
The Expert Trap
This occurs when you present yourself as an expert on how the other person should be living. Being too directive creates a power-dynamic where the other person loses a sense of control over the process, decreasing motivation.
The expert trap might be tempting since it is easy to believe we know what’s best for someone. We may feel like we have access to all of the right tools and techniques, knowing exactly what the person needs to do.
The issue with jumping to solutions is that it does not work. How many people follow their family doctor’s expert advice, after being told they need to eat healthier and exercise more often?
Being an expert and presenting yourself as an expert are two different things. The founders of motivational interviewing, Rollnick and Miller, state that a true expert is invisible to the untrained eye.
Rather than creating a power dynamic where you are the expert, and the other person is a passive recipient of knowledge, it is more effective to see both of you as different types of experts. You may have expertise in psychological processes and coping skills, but the other person is an expert on the details of their own lives. As stated in the research here:
“The alliance between you and your client is a collaborative partnership to which you each bring important expertise.”
The Assessment Trap
Similar to the expert trap, putting too much emphasis on assessment places the other person in a passive role, similar to the doctor-patient dynamic. This can be a useful dynamic in many areas of physical health, but it can be a barrier to connection when helping someone with mental health and addiction issues.
Asking too many questions can intimidate and bombards the other person. Rather, it is more effective to evoke their experience through reflective listening. Luckily, process-based approaches such as Acceptance and Commitment Therapy (ACT) have moved away from diagnostic assessments, preferring a functional analysis of the thoughts, emotions, and behaviors, instead. You can learn more about ACT in my article here.
The premature focus trap
This entails trying to immediately solve the person’s problem, jumping to the solution rather than simply listening to build engagement and trust.
There may be times when you want to steer the conversation in a particular direction prematurely. Although we may feel like we have the answer, it is most effective to focus on areas that are right for the other person.
Ask yourself: Whose need am I meeting right now? Am I trying to meet my own need to provide information? Am I trying to gain a sense of importance by fixing the other person? Am I engaging with a spirit of compassion?
The Chat Trap
Although small talk can be engaging, the chat trap prolongs shallow conversation, neglecting focus and direction.
The chat trap lingers between engaging and focusing. The person may be engaged, but you may find yourself in a conversational tailspin, focusing on surface-level content.
This is perhaps most relevant when it comes to conversations with individuals we are highly familiar with. They are successfully engaged and comfortable chatting, so stepping out of this comfort zone takes a bit of courage from both yourself and the other person.
Summary
Motivational Interviewing is a powerful approach to helping people change. It starts by engaging the person through reflective listening, then focusing the conversation. It then consists of evoking their reasons for change and collaboratively planning for the change.
The acronym RULE can summarize motivational interviewing:
Resist the righting-reflex: Avoid trying to correct them or convince them. Understand their motivation: Seek to understand their values, needs, and abilities. Listen with empathy: Listen to their motives and potential barriers. Empower them: Collaborate with them to build a realistic plan.
Reflective listening is a major aspect of motivational interviewing, so gaining comfort with this skill is one of the best things you can do to help sharpen your abilities. Below, you will find a list of resources focused on helping you delve deeper into the practice of motivational interviewing.
Resources
If you are curious about the psychological processes behind motivational interviewing, check out my article, “How Does Motivational Interviewing Work?” where I break down the various aspects of intrinsic motivation in plain language.
For free video demonstrations on how to do Motivational Interviewing, check out these great online modules by the British Medical Journal, here. I highly recommend it!
On the go? Listen to the audio version of the article here:
Psychological Flexibility is quickly becoming one of the key indicators of psychological health and well-being. Improving one’s psychological flexibility promotes mental health and helps a person take action toward valued directions in life. Improving psychological flexibility is the goal of Acceptance and Commitment Therapy (ACT), supported by over 330 clinical trials.
When learning ACT, it is easy to feel overwhelmed by the unique concepts. As an ACT practitioner myself, it took a while to feel comfortable with the language and unique process-based approach.
In this article, I summarize the six pillars of ACT in plain language, to hopefully benefit you or your clients. So how do you improve psychological flexibility?
Be Willing to Feel Difficult Emotions
Step Back From Your Thoughts
Focus on the Present
Focus on Connection, Not Comparison
Live by Your Own Values
Build Habits Based on Your Values
These six processes can be divided into three major areas: openness, awareness, and engagement. Let’s take a closer look at the meaning of these processes and how you can use them to improve psychological flexibility.
Flexible Openness
These processes consist of a sense of openness to painful emotions and difficult thoughts.
Be Willing to Feel Difficult Emotions
Explanation
This is the ACT process of acceptance vs. avoidance. It is rooted in our yearning to feel and experience life. When we tell ourselves we need to avoid painful feelings, we begin to avoid more and more situations that could potentially lead to a painful outcome.
Rather than merely avoiding pain, one may begin to avoid positive situations as well, out of the fear that they can potentially result in pain. For example, a person may avoid feelings of love and intimacy out of a deeper avoidance of the potential pain if the relationship does not work out.
Acceptance opens a person up to a sense of willingness to experience emotions. This means one can flexibly open up to painful emotions and learn from them. Rather than viewing emotions as good vs. bad, a flexible approach views emotions as information.
Opening up to emotions does not imply being consumed by them. Rather, it means opening up to the lessons they are sharing with us.
Being willing to experience painful emotions also allows one to begin opening up to experiencing more pleasurable feelings as well. This leads to being able to savor life and fulfill our deep human yearning for feeling.
Metaphor
This metaphor for acceptance is called “ball in a pool,” cited from the ACBS website, here:
“Imagine what you’re doing with these (thoughts/distressing memories/feelings) is like fighting with a ball in a pool. You don’t like them, you don’t want them, and you want them out of your life. So you try and push this ball under water and out of your consciousness. However, the ball keeps floating back to the surface, so you have to keep pushing it down or holding it under the water. This struggling with the ball keeps it close to you and is tiring and futile. If you were to let go the ball, it would pop up, float on the surface near you and you probably wouldn’t like it. But if you let it float there for a while, with your hands off, it would eventually drift away and out of your life. And even if it didn’t, at least you’d be better able to enjoy your swim rather than spending your time fighting!”
Exercise
Name the particular emotion you are feeling, curiously observing it like a scientist. What shape is this emotion? Allowing it to be there, breathe it in. What feelings come up in your body? Continue observing it curiously. You can even adapt this to fit with the metaphor of the ball in the pool. What color is the ball? Are there any designs on it? If you had to rate the ball on a scale of 1 to 10, what would you give it?
Why it Works
These techniques are designed to facilitate a process whereby a person stays in contact with difficult thoughts or emotions. The willingness to observe it in this way facilitates a degree of openness that changes one’s relationship to these emotions or thoughts.
Rather than being something one must fight, suppress, or avoid, flexibly making space for the pain also allows one to open up to pleasurable experiences, fulfilling the yearning to feel.
Step Back From Your Thoughts
Explanation
This is the ACT process of cognitive defusion vs. cognitive fusion. This is a fancy way of saying, having some distance from your thoughts vs. being constantly identified with everything your mind tells you.
Throughout one’s day, the mind may make commentary regarding how things should be: “I should have done that better… he should do things a different way… The government should fix this.”
Although these thoughts could potentially be useful in helping us improve ourselves, others, and society, they are often intrusive and rigid, causing us to react rather than step back and act mindfully and effectively.
This temptation to be rigidly identified with our thoughts comes from the yearning for a sense of coherence and understanding. We want the world around us to make sense and we want a sense of understanding of how things work.
When one’s mind becomes too rigid, we try to impose a false sense of order on the world, treating life as a problem to be solved. Living more and more in your head, one may develop defense mechanisms such as rationalization and intellectualization.
You may feel like you need to be right, constantly debating, and looking for opportunities to argue your perspective. Learning to step back from your thoughts allows for increased cognitive flexibility, allowing you to mindfully engage in dialogue more openly with yourself and others.
Learning to talk to yourself more flexibly is the foundation of this process.
Metaphor
This popular ACT metaphor is called “Leaves on a stream” and can also be incorporated into a visualization during a meditation session.
Imagine you are sitting beside a gentle stream in the Fall. Leaves from nearby trees occasionally fall into the stream and are gently carried away.
As you watch the imaginary stream, bring your attention to your breath, noticing the sensations. As you keep the focus on your breath, you may have thoughts pop into your mind. Simply place that thought on a leaf and watch it float by. It may get stuck for a moment, but simply let go, gently bringing the attention back to the breath.
You can find a version of this metaphor as a guided meditation on YouTube here.
This exercise is designed to depict how you are not your thoughts. Rather you can be aware of your thoughts, choosing where you want to focus your attention.
This is the difference between saying, “I’m stupid,” and “I’m having the thought that I’m stupid.” Listening to the way someone phrases these kinds of statements gives you insight into their level of cognitive flexibility at that moment.
Exercise
Pick a particular intrusive thought. Now imagine that thought is written on your hand. If you had to place that thought at any distance from your face, how close is that thought right now? How close is that thought when you’re in a particularly challenging situation?
If your hand is covering your eyes, notice how difficult it would be to engage in daily life with this thought so close. Now, move your hand away and slightly to the side.
Now you can see the thought clearly, in addition to the rest of the world around you. The thought will not go away, but this distance allows you to move forward effectively.
You can watch Russ Harris perform a version of this exercise here.
Next time this particular thought comes up, perhaps you can even give it a name. Some people use a name inspired by a suitable television character. When the voice in your head begins to take over, greet it like an old friend, thanking it for trying to help. If it is not useful right now, leave it alone and focus your attention on what matters most.
Why it Works
This is designed to facilitate a process whereby a person can flexibly relate to their thoughts rather than being dominated by them. When the mind becomes a dictator, we lose control of our focus, being pulled into rigid ways of being.
Getting some distance from our thoughts allows for a more functional way of being, engaging with issues pragmatically as they arise, rather than trying to impose a false sense of order onto the world. Gaining distance from the dictator within allows for greater wisdom and peace of mind.
Flexible Awareness
These processes are focused on developing a sense of presence and awareness.
Focus on the Present
Explanation
This is the ACT process of present moment awareness. This means flexible attention to the present moment as opposed to being caught up in thoughts about the past or future.
Although it is useful to consider the past and the future, getting caught up in thoughts about the past or future takes away from one’s ability to effectively engage in the world, potentially even affecting one’s relationships.
This process is often compared to mindfulness or meditation practice, but it does not require any kind of belief or spiritual tradition. As Daniel J Siegel states:
“Mental presence is a state of being wide awake and receptive to what is happening, as it is happening in the moment, within us and between the world and us. Presence cultivates happiness.”
Although it sounds simple, this can be a challenge in practice. Throughout daily life, we may drift into worries of the future or ruminations on past situations. These thoughts generally start with, “what if..” or “I should have…” and derail our focus on what can be done here and now to most effectively move forward.
Metaphor
Here is an ACT metaphor on present moment awareness adapted from “the mind as a GPS” description by Philippe Vuille here:
Imagine your thoughts about the future are like a GPS voice, telling you what is coming up next. You then become too fixated on the GPS, fiddling with the controls, adding stops, checking your arrival time, and adjusting the volume.
Becoming so focused on the GPS, you lose focus of the road, missing an exit, nearly rear-ending a car, and perhaps even making a wrong turn into a lake. Although a GPS can be helpful, we need to listen to its feedback from the present moment, engaged in the task at hand, and mindful of our surroundings.
Exercise
Here is a simple guided meditation that can help develop present moment awareness:
As you sit with your feet on the floor, notice the sensation of your body in the chair. Now bring your attention to your breath, noticing the rise and fall of your chest. Now notice the sensation of your feet on the floor.
Notice any tension in your legs, arms, hands, shoulders, and face, letting it go. Bring the attention back to the breath for a moment.
Now expand your awareness to any sounds around you. Perhaps you may not have been aware of small sounds like a fan, the hum of electricity, people talking, or nature. Simply notice the sounds.
Keep the attention on the sounds while also noticing the breath.
You can now continue in this way for however long without the guidance.
If a thought pops up, you can use the previously described leaves on a stream metaphor to refocus your attention.
Why it Works
Getting pulled into the past and the future comes from our yearning for a sense of orientation. We want to make sense of our place in time, often ruminating or worrying. This mindless disconnection pulls us away from being able to flexibly engage in the present.
When we are engaged in noticing the present, we can act more effectively. As Mary Schmich states:
“Don’t worry about the future. Or worry, but know that worrying is as effective as trying to solve an algebra equation by chewing bubble gum.”
Being here and now allows for a more flexible, fluid, and voluntary approach to life. Through this mindful awareness, we can better meet our need for orientation without getting caught up in our thoughts, missing the metaphorical off-ramp.
Focus on Connection, Not Comparison
Explanation
This is the ACT process of the observer self vs. the conceptualized self. This means the difference between perspective-taking and being trapped in an egoic sense of self.
This comes from the core yearning for a sense of belonging. When we feel like our sense of belonging is threatened, we may try to compensate by fostering a sense of specialness. Rather than having a genuine connection, we focus on how we compare to others.
Perhaps this is an attempt to gain a sense of security by carving out our place on top of a hierarchy. Social media has been a popular median for this type of social comparison. I discuss this further in my article, Is Social Media Making Us Less Social?
This attempt to fill one’s need for connection through ego inflation leaves us feeling even more alone. Rather than stuffing the ego full of status symbols and identities, developing the observer self allows for true connection.
Metaphor
The following description is adapted from the “torch in the dark” metaphor, illustrated by Russ Harris here.
Imagine you are in a dark room shining a flashlight on various objects that are around you. The light comes from the same source, and what you see depends on where you point the light.
Like the flashlight, you bring your attention to various things. Sometimes this awareness goes inward while other times it becomes aware of external objects. You are not the objects you illuminate. Instead, like the flashlight, you are the awareness noticing these objects.
The conceptualized self fixates on the objects, clinging to them for a sense of identification. It forgets that you are not these things. Rather, you are the awareness of these things.
Exercise
Here is an ACT exercise by Russ Harris, shared here. It builds on mindfulness practice to develop a sense of oneself as awareness rather than identification with the contents of awareness.
“Notice how you’re sitting (5 secs) Notice what you can see (5 secs) Notice what you can smell and taste (5 secs) Notice what you can hear (5 secs) Notice what you’re thinking (5 secs) Notice what you’re feeling (5 secs) Notice what you’re doing (5 secs) There’s a part of you in there that notices everything you see, hear, touch, taste, smell, think, feel, or do… is it good, bad, or ‘just there’?”
Why it Works
Developing a sense of oneself as awareness instead of being rigidly ego identified allows for greater flexibility in one’s interpersonal relations. Rather than trying to fill the need for belonging through a false sense of specialness based on social comparison, this process lets go of these attachments, allowing space for genuine connection.
Letting go of the conceptualized self allows for greater behavioral flexibility since the constant need to defend one’s ego falls away. Rather than being on high alert for any threat to one’s sense of self, one can focus on the present, more aware and engaged, better fueling a sense of connection and community.
Flexible Engagement
These processes consist of knowing what you want and committing to taking action.
Live by Your Own Values
This is the ACT process of values-orientation. This means having a sense of the things you value rather than merely following orders or operating based on external social ideals.
This is based on our need for a sense of meaning and self-directed purpose. In the absence of a self-directed purpose, one may fill this need by turning to external standards of what one is told one “should” want. In our world of social media and rampant consumerism, this often manifests as a drive to acquire consumer products.
This need for purpose may also manifest as compliance or simply going through the motions of doing what one is supposed to do.
Both of these routes ultimately lead to this need not being met, resulting in a sense of emptiness or boredom. Developing a clear sense of one’s own values provides a sense of self-directed purpose.
Imagine playing your favorite sport. Throughout the game, the score goes back and forth, and there are several exciting moments. During the final seconds, your team pulls ahead. You look at the scoreboard and notice the number, indicating you’ve won.
Now, what if the scorekeeper were to come along at the beginning of the game and offer to put that same score on the board, without having to play the game? Would you take up that offer? If not, why wouldn’t you?
This is the difference between values and goals. Values are about the process of how the game is played, and goals are about the outcome. Although the goal is to win, the value is what keeps us engaged in the game.
Some values at play in this metaphor may include fairness, resilience, excellence, and teamwork. Goals without values seem empty, like putting the final score up without having to play the game.
Exercise
Values can be found in three major areas of life: moments of sweetness, moments of pain, and role-models. These values exercises are adapted from The Big Book of ACT Metaphors:
When clarifying one’s values by looking at moments of sweetness, think back to a moment where you felt alive and engaged. Notice the details of this moment. What were you doing? Who was with you? What did you feel?
Slow down and see if you can emotionally connect to what you value about this moment. This same exercise can be applied to painful moments, pulling out values by noticing what was missing in those moments.
Values can also be found by looking at one’s role models. Pick a person you admire. What qualities of theirs do you admire?
Slow it down, emotionally connecting with the aspects of this person you admire. Now consider what values come from these qualities. Some examples might be compassion, creativity, genuineness, and selflessness.
Now how might you be able to live by these values yourself?
Why It Works
Connecting with one’s values leads to more psychological flexibility by offering a ‘why’ to fuel the ‘how’ and the ‘what’. We often prioritize knowing what result we want and how we will get that result, neglecting why we want it.
“Those who have a ‘why’ to live, can bear with almost any ‘how’.”
Living in alignment with our values provides motivation in addition to psychological flexibility when obstacles arise. Like the game being more fundamental than the final score, values are more fundamental than the end goal. You do not have control over the end goal. You only have control over the way you engage in the task.
Victor Frankl goes on to highlight this fundamental ability to choose one’s valued way of being:
“The last of the human freedoms: to choose one’s attitude in any given set of circumstances, to choose one’s own way.”
Choosing one’s own way of being fulfills our human yearning for a sense of purpose and direction.
Build Habits Based on Your Values
Explanation
This is the ACT process of Committed Action. This is based on our core yearning for a sense of competence. When we do not have this need met, we may react by seeking external achievements, status, and engaging in addictive approaches to work.
Others may fall into the opposite trap, becoming paralyzed by perfectionism. To maintain a false sense of competence, a person may self-sabotage by failing to take action or complete a project to maintain one’s false sense of competence, fearing possible criticism.
Both of these approaches are disconnected from one’s values, relying on external validation and fear of judgment. Connecting to our values allows for a more flexible approach to taking action since the criteria for success is based on how one operates (values), not the end result (goal).
This process is focused on integrating increasingly larger habits of values-based actions into one’s daily life. There can be a degree of appropriate goal-setting in this process, so long as a commitment to values is the foundation.
Metaphor
This metaphor for committed action is called “waiting for the wrong train,” adapted from The Big Book of ACT Metaphors:
Imagine you are waiting for a train to go somewhere special. There are two trains indicating they are going to your destination. The first train looks odd, dirty, and uncomfortable, while the second one looks clean, comfortable, and luxurious.
You excitedly choose the second train, anticipating the trip ahead as you wait to board. The first train then leaves, and another odd-looking one going to your destination pulls up.
You keep waiting for the comfortable train all afternoon while the other trains come and go. Will the comfortable train ever leave the station?
This metaphor highlights how leaving your comfort zone is often required when stepping out on your life’s journey. Also, if you keep doing what you’ve been doing, you will keep getting what you’ve been getting.
Ask yourself, what do you want in life? After you have a picture of what you want, ask yourself, what have you been doing to get that thing? For each thing you have been doing, ask yourself, how has that been working? The key here is to remain curious rather than critical. If what you have been doing up until now has not been working, ask yourself, are you waiting for the metaphorical luxury train? If so, would you be willing to try something new? If you are committed to acting on this new path, what small thing might you do tomorrow to get the train moving?
How It Works
Building out patterns of committed action over time builds behavioral flexibility by moving toward a greater sense of genuine competence, based in one’s values, rather than being stuck in external validation-seeking.
The process of building out these behaviors in incremental habits allows for a greater level of practicality and a sense of long-term sustained progress.
Summary
Improving psychological flexibility is the core purpose of Acceptance and Commitment Therapy (ACT). This approach is supported by over 330 clinical trials. Improving psychological flexibility leads to better mental health outcomes, helping people meet core needs and take action toward a values-oriented life.
Here is a summary of the information presented in this article:
Openness
Be Willing to Feel Difficult Emotions
ACT Process: Acceptance Explanation: Meeting one’s need to feel by being open to experiencing both painful and pleasant experiences rather than avoiding them Metaphor: Fighting with a ball in a pool Exercise: Name and describe an emotion
Step Back From Your Thoughts
ACT Process: Cognitive Defusion Explanation: Meeting one’s need for coherence by gaining distance from one’s thoughts rather than imposing false rigid order Metaphor: Leaves on a stream visualization Exercise: Thoughts as your hand in front of your face
Awareness
Focus on the Present
ACT Process: Present moment awareness Explanation: Meeting one’s need for orientation by living in the present rather than ruminating on past experiences or worries of the future Metaphor: Mind as a GPS Exercise: Mindfulness meditation/ leaves on a stream
Focus on Connection, Not Comparison
ACT Process: Observer self/ transcendent self/ self-as-context Explanation: Meeting one’s need for connection by taking a broader perspective rather than narrowly identifying with rigid conceptualized self-identities to seek specialness Metaphor: Torch in the dark Exercise: Noticing various senses
Engagement
Live by Your Own Values
ACT Process: Values orientation Explanation: Meeting one’s need for purpose and direction through core values rather than empty conformity to external standards Metaphor: The scoreboard Exercise: Moments of sweetness, moments of pain, and role-models
Build Habits Based on Your Values
ACT Process: Committed action Explanation: Meeting one’s need for competence through habits of values-oriented actions rather than seeking validation through overwork or perfectionistic procrastination Metaphor: Waiting for the wrong train Exercise: Creative hopelessness adapted to the train metaphor
Resources
The explanations, metaphors, and exercises presented here are some of my personal favorites, but there are many more. Here are some helpful ACT resources:
If you are interested in taking a deep dive into ACT, I highly recommend the online ACT Immersion course by Dr. Steven Heyes, the founder of ACT. This course has been an invaluable resource for me personally and has informed many of the explanations provided in this article. If you are serious about learning ACT, this is the course for you. Check it out here for more information.
The Big Book of ACT Metaphors is another great resource I would recommend. As you may have noticed, I cited it several times throughout this article. It is a highly practical book full of explanations, metaphors, exercises, and ACT worksheets, ready to use in your everyday practice.
ACT Made Simple by Dr. Russ Harris is another excellent resource, offering an easy-to-read summary of ACT. This book has recently been updated to include an ACT understanding of self-compassion and trauma, translating complex ideas into simple language.
If you would like to connect with a specialized ACT therapist, view the directory on the official ACBS website here.
