Here's What Acceptance and Commitment Therapy Looks Like | MedCircle

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- Let me ask you when you think these thoughts or beliefs first emerged? Do you remember the first time you started thinking, "somehow I feel less than"? When did you first recognize that? - When my mom died when I was 16. My first 13 years of my life, it was me and my mom. So when I lost her, I lost the number one person in my life. Number one, I mean, number one by... I don't want to cry on this thing. Number one by a long shot. Hi, Dr. Judy. Thanks for seeing me today. - Hey Kyle, nice to see you. What's going on? - Well, I recently have been- when I say recently, not recently. So much of my life, I have felt that I am lesser than, and I'm putting that in air quotes, that certain members of my family. I feel very loved by my family, very accepted by my family. But, for example, my brother and father have a very strong bond. They work together. They're interested in sports. They travel together. They do lots of stuff together. And I have great relationships with both of them, but I don't have as close of a relationship with my dad as my brother does, for example. And when I really start to think about that, well, it makes me sad. It makes me... Yeah, it makes me sad. And it makes me also feel like, why am I not? What do I need to do? Who do I need to be in order to have those types of bonds that I see other members in my family have? And it's kind of embarrassing to say all this at 35 years old 'cause I feel like a little kid who's like, "I want attention from my family!" But it's kind of true; I want attention from my family, you know. And it was always manageable and it still is manageable, but it's harder to manage now because I just moved back home. So I see it all. It's closer to me. I'm less removed from it. I'm in the middle of it and I get to see everybody more, but I also get to see those relationships that they're having with each other more. Did that make sense? - Yeah, it does. Let me ask you, when you think these thoughts or beliefs first emerged? Do you remember the first time you started thinking, "Well, maybe they're closer," or somehow, "I feel less than." When did you first recognize that? - I know, I know exactly what it was. It was when my mom died, when I was 16, my brother was 13. And at that, my first 13 years of my life, it was me and my mom. Oh my gosh. I mean everywhere, everything, me and my mom. I recognize my dad and brother are part of the family, but in my head it was, it was me and my mom. And so when I lost her, I understand my dad lost his wife and my brother also lost his mother, but I lost the number one person in my life. Number one, I mean, number one by, I don't want to cry on this thing. Number one by a long, like a long shot. And naturally, as my brother and father also were grieving this, they probably bonded together. I very quickly went off to college anyway, so I was separated. So I think it was a combination of, I think it was a combination of my mom going, me moving off to college and being by myself, and then I also just think there are natural differences with me being gay and my father and brother being straight. We live in two different worlds, not completely, but in certain areas, you know? My experience in this world is very different from theirs specifically because I'm gay. And so that, you know, it takes a little more effort on both of our ends in order to kind of build that bridge. - Thank you so much for sharing that. And it makes so much sense that in this huge developmental phase of your life, where you lost your mother so tragically at that age, that your primary attachment figure was gone. So it makes you feel a bit less secure about your bearings. You've essentially lost your safe haven. Or when we talk about attachment, your secure base. The person who you could always come back to if you made a mistake or you, you know, had a setback. She's always going to be the person who protects you and cheer leads you. - And a person who I felt like I didn't ever have to explain myself to. It was an immediate, "You get it." Like to her, to me... Even though I was only 13- no, I was 16 when she died- she was certainly a mother. I don't want to paint the picture that we were friends, but we had a friendship as well. I mean, there's no point. And if she was alive today, I really believe we would be very, very close best friends. - [Judy] Right. - I also lost the only person who I felt like saw me. Because being closeted and 16 and felt removed from my family unit in some ways, I was like, "No one sees me anymore." And, you know what, Dr. Judy? Sometimes I think because I felt that way, that's why I have pursued a career in front of the camera instead of behind it. I mean, there's a reason I'm here and not where Bridget is, you know, behind the camera producing. Because sometimes I feel like I'm trying to be seen to get validated for what I lost when I was a teenager. - Right, right. That because of your mom not being with us anymore, you need more of that frequent, more frequent anyway, validation. We all need validation as human beings, but maybe you need a little bit more than the average person since she passed, because she was always the person who validated you, even if you didn't have to say anything about it. It was just there, right? And whereas maybe you feel a little bit more like, you'd have to explain yourself more to your dad and your brother, and that you'd have to prove yourself a bit more to them. And that can certainly explain the dynamic that you're describing. So tell me about some of the specific thoughts that you have, especially now that you're observing your dad and your brother's interactions more, that come up? That cause you to kind of think back on this idea of, "Maybe I'm not good enough"? Or, you know, maybe even- - Well, I'll answer that. And I want to preface that this answer with: I, at my core, believe that these thoughts are not true. And I'm only saying that in case my family watches that. [Laughter] 'Cause I really do. What I'm about to say is not my core belief, but they are thoughts that I have, I guess, if that's one way to put it. My thoughts are that my brother and dad like each other more than me, so therefore don't want to, or don't necessarily need to see me or hear from me as much as they would somebody else. Sometimes I have the thought that my place in the family is a place I have to continually earn, while other people's place in the family, They get it without it. It is unconditional. You have it, you know? Just because. Does that make sense? - Yeah, it does make sense. So let's take one of those thoughts and it sounds like it's not necessarily something that's always rooted in reality, per se. And that, you know, they've never said, "Well, don't come around here. We kind of like our two person dynamic." - No. - It's not like that at all. It just comes up all the time. - Oh my god, my dad and I, I really do, I feel like I need to defend them only because this is a semi-public thing we're doing. I mean, even today, my brother has texted me multiple times, encouraging me on this little project. And I sent him this gospel song that I like because him and I both like gospel music randomly. And that's all happened today, you know? It's not as though my family in no way is like, "Boo Kyle." It is just me. It's me. Sometimes I feel that way, even though I couldn't blame them, really, for it. - Right. Yeah, absolutely. So this is a really helpful example for me, and I want to introduce a couple of techniques that I like to use using the theoretical paradigm of acceptance and commitment therapy to try to see if we can get some movement on this. So let's go back to identifying that specific thought that you have. So whether or not you're actually watching an interaction, or it kind of just can pop up in your head. Which, we know, is how thoughts work. You know, it's not like you have to be triggered by seeing them, you know, hanging out on the couch together, watching your show. Sometimes it just comes up. It can just come up whenever. Tell me what that thought is once more, in as specific terms as possible as it comes up to you. - Oh wow. Okay. I am not worthy enough to be in this family. - Right. - Does that work? - That does. And "I'm not worthy enough to be in this family," as you can think about that thought right now, how does that feel if that actually represented what was truly going on? I mean, how does that feel to you emotionally and viscerally right now in this moment? - Overwhelmingly devastating. I mean, even saying it out loud feels so violent, it feels like a knife going into my stomach. It feels like somebody I cared about insulted me when I say what I just said out loud. I mean, it feels devastating. Devastating is the best word I can come up with. - Absolutely. It goes to your core beliefs about who you are. And if you feel that you are not worthy to be within your own family, well, it's kind of a common idea that our families should be the most accepting. And so if you're not worthy enough to be part of your family, then who are you, essentially, worthy to be a part of in terms of the rest of the world? And that, of course, is devastating. So I really appreciate you sharing that. But of course, as we've talked about, thoughts are not necessarily facts, but they feel so real when you say it like that. And you can see the emotional devastation one can feel when they really lock into that thought and entertain it for any period of time. So what I would like us to do is really a couple of challenges that will help us to loosen this thought. Because sometimes, we become so fixated on the thought, we fuse with our thought. An in acceptance and commitment therapy, we talk about fusion. Like you fuse your identity and who you are with the thoughts that you're having as if they're one and the same. So somebody could have a thought, "I'm a loser." It's a thought. It's a mental event. But if you fuse with that idea, well, what's going to happen? You're going to have all kinds of negative. self-defeating thoughts that cascade from that, along with negative emotional reactions, and also self-sabotaging actions where, "Well, if I'm a loser, then why even bother applying for this job? I'm not going to get it." Right? So you preclude yourself from the opportunities of having better outcomes. You don't even essentially test out those hypotheses anymore. - And you know what that happened to me in May of this year. I was in a really bad spot, and part of my rumination was where I fit in with my family. And I even had conversations with some friends when I was really at a low point where I go, "I don't even want to reach out to them anymore. I don't want to have to go over there. I'm going to remove myself." And it was, it's exactly what you just said is what I was doing. Yeah. - Yeah, and it's really hard to separate yourself from a thought once you're fused with it. - Yes. - And in acceptance and commitment therapy, we talk about these techniques called diffusion, where essentially you are actively trying to diffuse the bomb, in a way, diffuse the bomb. Because thoughts can be very devastating, as we talked about. Very destructive. But also, un-fuse yourself from the thought. Separating yourself from the thought. Knowing that you are a separate entity and that the thought is just a mental event that you, as a person of agency, is having. - [Kyle] Yes. - And that can be very empowering and can also help, so that there aren't this cascade of negative thoughts that follow, along with the emotional reactions and the self-sabotaging, self-defeating actions that you actually just gave a good example of. So my favorite way of working on one of my diffusion techniques is to have you actually write out the thought that you just spoke to me. So if you have a piece of paper handy, go ahead and write it down on the paper. - Oh, write down the thought itself? - Yes. Write down the thought itself. So, "I'm not worthy to be a part of my family." - All right. Done. - So how does it feel seeing the thought on the page? - Well, it's a mixture of the devastation, but also a little bit of like, "Get over at Kyle." - Right, which is of force a judgment, is a judgment of your thought, like, "Wow, what's wrong with me?" - Yeah, I am. You're complaining about your loving, giving, supportive family. Like, who do you think you are? Honestly, it's a mixture of those two thoughts. - And actually you just gave a great example of how these secondary waves of emotion can be created. Because then you judge yourself for having the thought, "Well, who are you to say this? Do you know how many people are so much more unfortunate in their lives? And they don't even have loving families. like they don't even have people to complain about. They don't even have..." You know, you can see how quickly it can cascade. But let's do an exercise. So most of the times when we see these negative thoughts, we try to push them away to some degree. I don't know if you've had that experience when maybe you try to like, "Oh, get over it.' I mean, that's one way, right? - All day, Dr. Judy. That's what I do. - Right. Or you try to cover it or you try to reinterpret it in some way. In many ways, when we do that with the thought, we're struggling with it actively. So imagine the thought. You have the paper in front of you. You imagine the struggle. So the struggle usually, I mean, I try to visualize it with with my clients by saying, you know, you're kind of wrestling with it. So it's almost like you have to take the paper in your hand and you're essentially wrestling with it. Both of your hands are occupied. You're holding the paper in your hands. So go ahead and do that. Just hold it up. Right. You're kind of wrestling with it. You can see that both of your hands are there. And maybe in some points, you're just like, "Oh my god, get away from me." So you're pushing it out. So go ahead and just like push it out As far as you can. Now, how does that feel, even in your arms? Is there a lot of tension? You're like, "Ahhh." - Yeah, I'm squeezing this paper way harder than I need to be. - Right. So you got all this tension in your arms, and by the way, now your hands are not free to do other things, right? You can't text somebody. You can't look up something on the internet. You can't write an email. You can't work out. Your hands are occupied. But what if, instead of struggling with it, we just put the piece of paper in your lap. So actually, right now, if it's in your lap, it's closer to your body, than when you were pushing it away, which caused a lot of strain and caused you limitations and other things you could do. But now it's in your lap and your hands are free, right? So let me see your hands. Yeah. They're free. So they're free to do whatever you want to do. They're free to cuddle your wonderful dog. They're free to write an email. But yet the, the thought itself is actually closer to your body, but you're not struggling with it. - Dang! I see where this is going, I think. - Yeah. So that's one of the analogies that we use and ACT, by the way, uses lots of analogies to try to bring forward these ideas in a more vivid fashion. And it's this idea of, "Hey, when you're struggling with something, it actually precludes you from doing things that are meaningful to you." And yet, somehow, when the thought is closer to you, so they could actually harm you more, because there it is in your lap. It's like, "Ahhh!" But at the same time, your hands are free. You can do whatever you want to do, especially things that mean something to you, that matter to you. And this is essentially one of the ways that we start to work on this concept of diffusion. So from here, there's two ways to work on this exercise. One is just to continue on this route. And essentially, now you've written down this thought and you can place it in your pocket, put it on your desk, you know? Somewhere close to you where you're going to recognize that it's there. And understanding that when it comes back up, you can tell yourself, "Well, yeah, I have this thought from time to time. It's actually right here in my pocket." - Yeah. - But it's written down. It's there. I've acknowledged it. It's also a separate entity from me. Obviously, it's a paper. So it's not me; it's a paper. And I'm freely choosing to put it in my pocket. And I'm choosing to acknowledge that I have the thoughts sometimes and still move forward with whatever I need to do today. What's on my to-do list. The things that are important. So that's one way that we can work on that. And it's called "card carrying." But I actually want to work on another extension of this exercise, which is to take the paper. And I want you to write, let me see how you wrote the thoughts, so I can see where it's laid out on the paper. Okay, perfect. So now I want you to write it. I want you to write, I guess right now we write underneath it. - Okay. - And we would write, "I'm having the thought that-" And now if you link those two concepts together... Go ahead and read that out to me, starting with, "I'm having the thought that-" - I'm having the thought that I'm not worthy to be a part of this family. I can tell you as soon as I wrote, "I'm having the thought that-" What it actually did for me just now, is it actually opened up more of my brain to really think about what I'm thinking about, what I'm feeling about. Because before, when you said, give me that specific thought, I was really in a place of self-judgment and ridicule, because I was fused with it. And I almost like this technique as a way to explore my real thoughts. - MM-hmm. - Like, what other thoughts am I having? Because I'm not so close to them anymore. It's easier for me to identify them and say them. Does that make sense? - Absolutely. And that's exactly the kind of reaction many people have when they are able to identify, "The thought is just the thought that I'm having." So first of all, "I'm having" makes you feel like you're the agent again, "I'm having the thought." "I'm having the thought. The thought is not having me." Right? "I'm having the thought that-" and then you filled in the rest. "I'm not worthy enough to be part of this family." But now I would like you to add another clause below that, which is, "I noticed that-" So now read the entire sequence together, starting with, "I noticed that-" - "I noticed that I'm having the thought that I'm not worthy to be a part of this family." Wow. - Okay. So what do you think that has added for you? That last clause of, "I noticed that-" - Well, two things. One, space between me and the thought and the fact that my brain is a observer of thoughts. Kyle is observing thoughts. And so I can sit here, and me, myself, and observe the thought. It's like an extra step between thinking it without being mindful. And then, "I'm having the thought that-" Well, that's still you, and now you're the observer of your thoughts, so it's one more removed. It feels like you're getting a 30,000 foot view of what's going on in here. - Yes. I'm so glad that you said that. And this exercise is really important because it also establishes another concept in acceptance and commitment therapy, which is self-as-context. So we talk about these different versions of self and self-concept. And oftentimes we talk about the identified self, which actually, in acceptance and commitment therapy, they call self-as-content. So this is, "I am Kyle. I'm smart. I'm no good." It's these identifications that we put on ourselves in terms of our content, you know, who we are, personality traits, things that are likely to happen to us, et cetera. But self-as-context is this really revolutionary idea where essentially, the self-as-context is yourself, the perfect version of yourself that hasn't been through damaging experiences, that doesn't have all of these broken hopes and dreams or negative ideals about yourself, but rather is the observer to everything that's happened in your life and is a pure version of yourself that is resilient and a senior-self through all the ups and downs of your life. A couple of other analogies to explain self-as-context is it's like, you're the chess board and the chess pieces in each individual game is kind of the outcomes of different problems you might have in your life. Sometimes the white chess pieces win, sometimes the black chess pieces win. The chess board sees all of these games, thousands of games in its life, but it's not particularly attached to any single game. Yet it's experienced all of them from an observer level. Another analogy is as if you were watching a movie or a play. You're the audience member. You do care about the storyline on stage, but you're not so personally invested in it that it might cause you to do something that could be self-defeating. And so it's this idea of understanding that there's the self-as-context for all of us. That all of us can have this 360 degree view and no matter what is happening right now, we don't have to be attached to the content as much as we're likely to do because this is just the way that the human brain works. Another extension of this exercise is to look at the paper that you wrote down this thought. And of course, below that, now you've written, "I'm having the thought that-" and below that again, you wrote, "I noticed that-" And even looking at the physical placement of the words. You, Kyle, are farther away physically from that original damaging thought, and it's farther away from you physically, also. So there's that idea of physical distancing from the thought. - Mm-hmm, mm-hmm. - And that can also be a powerful imagery for some people. Where they can say, "Yeah, before the thought was like, right here, it was like crippling me and now, wow. There's barriers in between. There's like two layers of protection, in some ways, between me and this thought now that we've added these two clauses." - Yeah. Really fabulous. Dr. Judy. I don't know why I would expect anything else, but that was fabulous. Thank you for that. That was a real, I brought you real stuff and you gave me real applications. That was great. Thank you. - Thanks, Kyle. - Thanks for watching. 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Channel: MedCircle
Views: 85,423
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Keywords: acceptance and commitment therapy, therapy, act, medcircle, kyle kittleson, mental health, depression, anxiety, ptsd, psychotherapy, psychology, thoughts, mindfulness, therapist, feelings, memories, ceu, client, values, educational, acceptance, cognitive behavioral therapy, addiction, act therapy videos, youtube, video, interview, discussion, treatment, help
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Length: 25min 14sec (1514 seconds)
Published: Tue Oct 05 2021
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