Steve Hayes ACT for OCD

hello all right greetings I do know yeah I'm doing all right how are ya good good I just had such a moment where I was planning to string this to YouTube and then after all this planning YouTube just decided to you know just not be able to do that and I magically switched everything over to Facebook live so we'll be streaming on that and it's pretty exciting and then I had to tell the people from YouTube to go to Facebook live and all the while I was just trying to you know just see how active would apply for this situation you know what my mind was telling me how like I'll be like the laughingstock you know I had my license revoked right so that dictator within definitely had plenty to say about that situation and I'm so glad that you made the time to join us today sure and yes so this is part of the my OCD care lecture series where you know we have different people speaking about different ideas I'm about OCD about anxiety CBT in general all the various waves and you know we want to just get more information out there new ideas within the field so I'm really glad that you're able to join us I'll just read a brief intro from your website dr. Steven Hayes is Nevada foundation professor in the behavioral analysis program at the Department of Psychology at the University of Nevada I'm an author of 44 books and one that just came out which was which is truly amazing i liberate in mine we'll talk about that a little bit more and nearly 600 scientific articles his career and has focused on an analysis of the nature of human language and cognition and the application this understanding alleviation of human suffering and I guess just briefly like my first foray into therapy was actually in an act lab with that with dr. Joseph's car to pain I mean you know he was my first mentor in the shadow' to him that she's watching hello so so basically I came to grad school to you know has a psychologist like make people feel better and I got to this lab where they were talking about something very different and there was this thing called act where you know we're not trying to make people who are sad feel happy or anxious you know fields don't come but it's something very different and I wanted to know um I guess to start if you could just give a brief introduction to what act kids and yeah well sure yeah well thanks for having me on the program you might be able to tell I you're if you haven't yet you will I have a bit of a cold but hope I won't Koff at that folks too much but act has been developed over nearly four years and so it has quite a long history but it's been come more known in the last 20 years and there's a large community around the world which is helping to develop and including people like Joe who I've known for many years and what act is is if you just talk about it in terms of what it looks like or what other procedures used that's kind of part of CBT but it has a different set of assumptions than traditional cognitive behavioral approaches and it mixes acceptance and mindfulness processes and commitment and behavior change processes for the purpose of producing what we call psychological flexibility what psychological flexibility is is a kind of an immediate target that makes a difference in long-term outcomes if you mismanage it it predicts all kinds of bad outcomes and if you manage it well it predicts the life that's gonna unfold in a powerful way and it's a collection of six things that has to do with emotional openness being able to sort of notice you're thinking without becoming entangled with it to do this from this kind of awareness a point of view not the ego based or the face that you put on for others but this kind of deeper sense of self this more spiritual sense of self you might say and then being able to come into the present moment inside and out in a way that is flexible fluid and voluntary and then focus your attention on what brings meaning and purpose into your actions and build habits around that so those are there's six things in there joy it down I can pull them out and name them they fit together they go together they support each other it turns out that no one of them can kind of stand alone you can't really do any one of them to the nines without sort of moving towards all of them if you could simplify the six I would say it's a matter of being psychologically open aware conscious and in the moment and engaged in what brings meaning and purpose into your life so open aware and engaged will give you most of the model and there's nuances in those three well it turns out if you use acceptance of mindfulness processes commitment and behavior change processes to to focus on that it gives you kind of an immediate target and you can know that you're changing it and then over time what that does is things like anxiety depression substance abuse relationships being able to manage health issues step up to the challenges of physical disease when that comes down the pike or you're looking at an old dude what happens when aging starts showing up and people start falling away or you know ability to use to have you no longer have or other things like being able to manage a business or to you know deal with your own biases in a way that's fits your values you know what do you do with parts of you that are prejudiced or stigmatizing towards others all of those things turns out as an a fact sitting on top of now a mountain of evidence are fostered or helped are supported by psychological flexibility so that's the game we're playing and it gives us a new way forward inside the evidence-based therapies strongly evidence-based there's more than 300 randomised trials in almost everything you can name from sports to depression to anxiety to being able to go through a exercise program and on on and on it goes yeah and acts commitment to really rigorous science has has always been something that really attracted to me so I like trust me or this feels so good or it feels so right it's it's about data and I really like that it's very data-driven in its approach um so as far as its application to the treatment of OCD what kind of research is there behind using it for OCD what might be in the works yeah well there's quite a bit you know the in terms of randomized trials and so forth you're probably looking at a least a dozen if you look at the underlying core processes a much larger number and some major people in OCD are focused on it you know people who like to folks who run the OCD foundation or you know things that are important to people who suffer with OCD and it it seems to give a new way forward in part because of its unusual way that it handles issues of language and cognition and so especially in areas like you know more purely obsessive kinds of things and so forth it adds to the exposure based methods that we have the emotional openness piece adds to it by helping you to put exposure in a larger context and the values work helps by you know giving you another motivation beyond you know a secret desire to have the anxiety you go to what go away you know anxiety goes up and down anxiety may go away but it turns out there's a little loopy paradox there which is if it's really really really important for you not to be anxious than anxious anxiety something to be anxious about and so there's a self amplifying loop that comes basically from this more evolutionarily recent adaptation that you and I are doing right now we're not doing with the bird outside the windows doing they're doing the same thing they were doing you know twenty thousand years ago but we're doing stuff that are pretty new on the planet and language and cognition can mash up against things that are ancient let me give you an example if you had something difficult happen when you're a kid let's say and then something similar occurs and you begin to feel anxious that process is almost half a billion years old every single organism that evolved since the Cambrian which is five hundred forty-five million years ago does that all of them snakes and horses and dogs and cats all do-nothing jellyfish don't sponges don't but you're not a jellyfish but what you and I are doing right now is not that you know maybe it's a couple hundred thousand years ago maybe it's a couple million years ago guessing as to what the hominids did but it's not what the rest of the animal kingdom is doing and we've taken the time you you gave us a little shout out for being evidence-based where evidence-based in another way an even older way that's inside the behavior therapy tradition from which the CBT tradition came which is dig down to these basic principles and in the carry case of language and cognition we did that hard slog and we don't think we have the ultimate answer or final answer but we think we don't have a darn good answer as to what is really going on and what you and I are doing right now and that why does it make anxiety depression and so forth so hard for us and what can we do about it so so there's quite a bit and I if I could just say you know I really have heart for this part of the work a I've struggled with it a little bit be my mother was clinically OCD I'm you know the way downs of bleeding hands things of that kind yeah I think I found out things about her history only in the last few years she's dead now mo died five years ago at the age of 93 she'd be 98 as of two weeks ago if she was still living a very sweet wonderful lady but suffered enormous lis with both depression and OCD and so I've seen what it can do I've watched it's kind of how it works inside me and it's a wonderful window into the problem we all face which is how can we create a context in which we get to be here conscious and whole and free and still have this analytic judgmental whirring produces rumination focused problem-solving mind that as you said earlier dictates to us that's a challenge and OCD opens the door to some really interesting and I think useful ideas about how to be : free despite the vagueness you got this problem solving Oregon between your ears yeah and I definitely find that Act has made its way into the way pretty much everyone treats OCD you know I find like there is almost some influence in the way whether it's just focusing more on values lower or diffusion techniques so there are a lot of therapists who will describe themselves as you know there are a few therapists of their act inform those who are like using a doctor to expand yule and what are you thoughts on you know you know act informed or using some extra principles with you know exposure or response prevention classic hi I think it works fine I I really don't have a problem with that I'm not kind of an act to burr all this guy you'd think that I would be but you know in the grand scheme of things if we bring processes and into our work that a door for people you know the name and the details of stuff doesn't matter over time now there are some places that you can get contradictions so I would be cautious about on the one hand saying really what you need to do is detect challenged dispute and change your irrational thoughts versus really what you need to do is take a step back and notice your thoughts and letting your thoughts be thoughts and then bring your attention to what's of importance in this situation and using skills you use the word diffusion we call it that it's a neologism we made it up you won't find it in the dictionary I had a role making it up because I couldn't say the name that I first used which was deed literalization has been say it fasting at ten times she can't do it but the fusion defusing diffusing you can do it so we made it up it's not diffuse and it's de and the word fusion and you know in OCD there's long men and understanding that there's a kind of a fusion between a thought that occurs and what it refers to it seems as though just to think it is to have it has to experience it is even to do it I mean it's right inside some of the you know the kind of undoing rituals that people may have or things of that kind is that very strong I would say almost fear or connection that language is what it says it is and you know in children go through a phase like that you know don't step on a crack or break your grandmother's back or you know thinking he'll or somebody never mind children I mean I'm doing it talks about this I say okay you think you're so free of all this I'll tell you what once you think of somebody you love stand up and say loud really loud I hope they die tomorrow people won't do it well what do you think the words are magic you think like sound is that but they won't do it so that's how strong even in all of us you know words have this magical quality that thinking is doing and it is a kind of doing but it's not what your mind says so back to point I would be a cautious about working with a therapist thing would give you this challenge both fight to get rid of the irrational thought and change it and step back and notice it dispassionately with an attitude of curiosity I mean how do you do both those things at the same time I don't have it but if you just take away that part you know I'm okay with act informed work and I think exposure is so important because the you know the bottom line is that life is gonna happen and it's gonna ask you are you willing to experience this you know whatever the particular thing is and if that's not true well then why is the thing even disruptive in your life you know you know we could create a situation that might look superficially like OCD but if it never occurred you know if you never actually face that's the situation never happened to you you're afraid of something let's say that never occurs well you know if you're an obsessive spin around it then it is occurring it's coming right now but so you know we're not the brain police we don't have to sort of clean up everybody's thought process or something but if you're in a situation where things are difficult for you then yeah I want to bring what the science suggests is most helpful and I know I'm going on excuse me for that but one little point yeah that's very one little point is there's something cool about diffusion because you don't nominate certain people as winners and losers we are all getting hooked all the time and it's as important to unhook yourself a little bit from positive thoughts as negative funds if you're thinking I'm great I'm grande there's no one better than me man I don't care if that looks positive hang around with people who are living inside that story and you kind of don't want to be around yeah it has a cost so just because it's positive doesn't mean it doesn't have the forum doesn't decide it it's the function that decides it and because of that there's a real kind of leveling of the playing field and yeah you see something with clinical OCD that you might not see in the absence of that but in terms of the really basic processes man this is shared people are not alone they're not you know the you know the ones who are weird and other people are nor something it sounded like that this is just a process that we all touch getting a hold of a human being in such a way that's creating some real problems but in small ways it's creating problems for all of us so we can be more kind of more level and more fair and you know I think that's true not just with OCD but a lot of the disorders I mean that I want to put them at scare quotes because the real processes involved in these quote-unquote disorders are human processes that are shared almost everybody yeah and I want to discuss a little bit about illumination um you know compulsive rumination particular and you know you mentioned earlier like pure pure oh and very often like their compulsions are are very much mental and there'll experience like continuous ruminations um what what is the act understanding of compulsive rumination in OCD and the most effective way to address it yeah there's several flexibility and in flexibility processes that bear on it for one thing our attentional processes going back to the past and trying to figure out you know why this happened or what the sequence is it's very close to problem-solving it's even necessary in problem-solving if suddenly in the middle of this little podcast you found yourself in the grocery store the very first thing you'd come to mind is how the heck did I get here and so you want to be oriented you got here why because it may help you for example get back in front of the mics is you can finish this Facebook livestream yeah so there's this little piece that's the piece of orientation and the the verbal part of figuring it out understanding at putting in a system being able to predict that's central to problem solving too if you had your car breakdown you're gonna figure out why did it break down what do I need to do to break it and you're gonna read you're gonna reason and you're gonna think it through there's an emotional punch that comes with it too I mean part of what activates it is this feeling of doom or unease or somethin Bad's about to happen or maybe I'm bad or you know if I don't something really Bad's gonna happen there's that kind of pull to the past in order to control the future but there's an emotional punch to it and that includes bodily sensations memories and emotions well you know we want to be able to feel all of us want to be able to feel but the mind tells you yeah okay you can do that but only if you feel good stuff and it doesn't feel good you know in those spaces where you compulsively ruminate if you're just slow it down and watch where your body feels like where your emotions are what memories show up you'll notice there's a lot of stuff happening there that is very unpleasant yeah so those are the three kind of examples but there's others you know sometimes the what your ruminating about spills over even into how you think about yourself who would I be if I or if this doesn't get handled what does it show that I'm you know it has a larger spread it sort of fits for the story you know like maybe I'm perverted maybe I mean maybe I'm insane maybe I'm can't be trusted maybe I'm the devil maybe I'm in on and on or whatever it is you know I mean things show up that are more like self-concept things right and you know that is sticky I think it's a sticky in part because we fear that if we don't have the right persona and really I'm saying it in the way the Greeks would you know meant the claim asked that the theater performers war and Greek theater that persona was a fixed expression and if I have the wrong person I'm not gonna be wanted I'm not gonna be welcome I'm not gonna be brought in nobody's gonna want to be with me I'm not gonna be part of the group and the fear sometimes inside ruminative processes is a you know I don't somehow change this or fix this or eliminate this I'm gonna be cast out you know I'm gonna be the one who's rejected who's alone you know what the kind of monkey we are that's life and death you know we we are biologically prepared to really care about others I mean babies if you get in front of them I mean neonates are only a few hours old and you look them in the eyes they dump natural opiates in the brain they go like woohoo I'm being seen you know so we come and it needs to be because we need to be able to orient these other creatures around us in order just to survive infancy you know it's there for a reason we're dependent on others and those little coos and smiles and all that you do as an infant is life death for an infant if the other monkey's called humans didn't like babies you know you you're not gonna survive that era so there's lots of reasons for why it's impactful but what act gives you is some counterintuitive ways forward with it and if the three I've just mentioned but there's others that are haven't gotten to yet but three I just mentioned would be would it be possible baby oriented in now and to respectfully decline your mind's invitation to get oriented in the grand arc of the past in the future I mean just notice that you're here you're here now you're in this situation and this thing you're ruining about ruminating about may not even be relevant in the here now and part of us in the air now is are these thoughts you can notice that too but without entering into them and disappearing into the conceptualized past so that's one could we find a place in which we can belong by birthright and not belong by having the right mask that we put on so the punch of that fear that you're going to be cast out is eliminated and instead but we're connecting with is the the gratitude and power of being connected with others as we are you know including these things that we worry that are unacceptable the thoughts that we have or the history that you have or the feelings we have or the urges that we have could we be more open to our own emotions instead of having this agenda we only get to feel-good emotions which means we basically can't feel safe and feeling any emotions because even the good ones go away and you don't know how to subtract emotions anyway and could we instead focus on how to feel in ways that are more open and free and then with thoughts could we respectfully decline the Minds invitation to take the thoughts literally and instead take what's useful and and leave the rest so when the mind's telling you you have to and that voice gets real loud you have to go back did you actually do this did you do it to number of times what happened you know whatever the particular content is you know do you maybe you really do have a disease maybe you would contaminate that person whatever the particular thing is could instead you notice that thought as a thought and allow it to be followed or not based on your actual experience of what works for you a very gentle not heavily mind II not figure it out it just be guided by your experience and I think most people when they start with OCD they know full well that another run around that mulberry bush not gonna do anything helpful but it's so powerful and if we can find the ways to sort of take the thoughts that are really up close and put them out a little bit so you can still see him but in that gap you have a little bit of choice that you can notice them without necessarily having to do what they say or erase them so those are examples the kinds of things that you do in an act approach that would augment and facilitate the exposure work that you do and almost all the evidence based the therapies in dealing with OCD sorry for going on so yeah yeah thank you so much for that and so I try to listen and at the same time think of my next question so that time I was trying to mindfully listen and now I'm gonna come back to mine okay RFC writes a relation relational frame theory sometimes I find like that differentiates those who are actions formed and those who are axed practitioners perceived so so I'm part of a OCD specialist group on Facebook it's a really great great group shout out if anyone's watching from them and the have you heard of Association splitting or or that a concept where I am and I'm interested in it give me a half speed get me up to speed run oh yeah so I'm definitely not the one who could get you up to speed on it as I've only recently heard it but basically like we have you know in our minds kind of you know individuals with the OCD often instead of just you know for example in contamination OCD won't you know see instead of seeing like drawer knob opening the door doorknob access doorknob you know moving forward they'll see like though instead associated or knob germs door doorknob HIV so associations splitting I recently learned as a technique where you practice like realigning the original associations not in the heat not like when you're in a really challenging moment not when you're in like a panic moment it's like specifically like training train yourself to like broaden your associations with that feared stimulus stimulus so in the group they brought up really how this very much sounds like rft yeah right in the and how yes I was wondering if you could speak a little bit to rft and OCD as well as you know your based on my quick synopsis of the rotation splitting yeah yeah I think it would fit and maybe you could even use rft to expand out the meth a little bit with show having just heard it I'm on a riff but I'll get to in a second you know the difference between rft and other approaches to language is that it's one of the few real evidence-based ones in psychology that is based on the concept of relationship and not simply on the concept of Association Association is one kind of relationship and there's but it's it's not the only kind and the real when you when you realize that a language is relational it lands in two ways one is that you're less certain that you can use traditional eliminative methods with language and have good outcomes and number Tuesday you realize there's many avenues towards the same point let me give you an example of what I mean by the difference between associations relation I'll do it with a metaphor and I'll do it actually with a contamination issue but it's just because it's an easy one but it's I'm not deliberately trying to walk it over in the OCD area it's just an interesting one if you're in a large group like let's say in a movie theater and somebody walked in and shook somebody's hand and then that intermission left and then let's say before the movie let's outs the CDC shows up and says there's a person who walked in and shook someone's hand and then laughed and they have a terrible disease and we needed to figure out everybody who either shook his hand or talked to anybody who did during the intermission well that would be like an associative model Association is kind of like if there's chalk on your hand and you shook somebody else's hand they'll be chalk on there it'd be like you know propagating disease of germs by touch that's association and in psychology you know Association works because things come together in time and place or they look similar that's it they either directly touched each other and time and space or quite close like in classical conditioning you know Bell food Bell food Bell food pretty soon the Bell makes you salivate or it looks similar you know like the red light comes on and then shock happens and then the purple light comes on and it's not as strong a response but more than if a yellow light came on because it looks more like a red light all right what if we think about so so imagine that movie theater if you think about that way and if these were thoughts instead you might be able to say well you know maybe I could really do something a limit if I could just find the few thoughts to touch this thought and somehow change or get rid of them that seems possible but now let me give you another metaphor suppose it's not like that suppose the mind is like a movie theater same movie fear full of people except here's the deal they're all related we say our relations meaning our family so maybe this is one ginormous family that had its you know annual gathering you know like the the relatives of Thomas Jefferson you ever seen how big that is I mean hundreds and hundreds of people show up better somehow related Thomas Jefferson and now we know some of them are african-americans so it's kind of cool it's mixed audience shows up and they're all related right suppose I knew how everybody was related in this big movie theater and a person walks in and shakes somebody's hand except I don't know who that person is and then they sit down and then intermission and they leave and then before the end person comes in and says you know that person who came in and sat back there and shook somebody's hands that's Susie over there's sister of her sister see Susie over there okay stand up Susie yeah that's her sister Jones kid okay if everybody was related and you knew everybody's knew that you could relate everybody to everybody in that movie theater it would take you like ten years to list them all I mean you do the math on and it's just incredible when you have a big crowd I mean just the number of zeros to express how many relationships but here's my point how many new relationships now are possible by knowing who the person is who came in the door it's an enormous enormous what's the minds like that and by the way it is it is everything relates to everything in every possible way I use the example of family relationships but let me give you an exercise that shows this and what it will show two people are struggling with OCD number one why eliminating thoughts is never gonna work number two what else could you do with things like you're talking about with association splitting so so here's the exercise let's come up with two nouns and a relationship so I'm gonna do it for you and I'm gonna do it by looking at what's on my desk and over here objective yes okay it's over here I see a small glass that's right there and right over here I see a little lip okay and I'm gonna pick a weird relationship but I'll use one like when I just use let's call it is the father of so here's the thing we have to do hello is a small glass the father of lip gloss we have to come up with an answer or something bad will really happen so let's just see we can do it so I'm tagging you with this problem Ellie can you come up with huh all right so how is a small glass the father of lip gloss the first lip gloss was actually came from you know a small glass was the original receptacle until it involves more of the plastics awesome so maybe like they put in the wax they mixed it up they might have actually put it in a glass that's actually quite possible right yeah before they made those little sticks that you buy when you're working on the formula I bet you they had some sort of fun okay now here's the point either that was just an accident or every because you noticed when you came up with the answer it seems like it's really in the object right there's an arbitrary it really could be this this all glasses the father of lipgloss okay we'll do it the other way around how's the lip gloss - father of small glass well the original when the small glass was being designed it was done actually with the lip gloss and awesome somebody actually lost their pen and they use lip gloss yeah plan on paper it could have actually happened goodness yeah okay now notice it looks as though it's actually in the objects now it's not arbitrary but I have done this exercise a hundred and thirty forty hundred two hundred times with just ridiculous because usually I say somebody in the audience think of an ounce I mean I'm just think of a noun and I'll give them some relationships to pick from and they pick one I make it more arbitrary there's actually a little in the rft book the original one there's a table where you can do it by numbers you just pick three numbers and then you look on the table and they'll give you a sentence like that you know like how is it you know better than a piece of chalk you know it's just well it's always answerable and when you finish and it's apt and it must always feels like wow it's actually right there in the object it's not arbitrary that has to be an illusion either everything is related everything else in all possible ways or this is an illusion of mind we can relate anything to anything in any possible way exactly well now here's the problem you're gonna clean that up you're gonna subtract something from the hat are you kidding me as soon as you go in and say oh man I don't want the lipgloss to remind me of of the glass okay the lipgloss has nothing to do with a glass nothing to do nothing to do okay I'll get rid of it it's terrible it's terrible to think that he drew his lip gloss I hate that thought though it gives me the creeps for whatever reason right okay but wait a minute now that you've finished and the lip gloss has absolutely nothing to do with the glass I'm gonna ask you a question and I'm gonna do a little pair of linguistic cues say what comes to mind hot Sun okay do it listen my peril and go secours good morning okay I'm gonna give you a couple seeds then hot cold just like an inn playing password I was relying on your heart and I'm gonna do good and the answers bad you got that okay all right so now why what okay great big SMO okay lip gloss glass you see the problem yeah if you succeeded in making it nada or different from or even opposite to the problem is it's still related because the mind doesn't do just equals it will do not equals it would do different little opposite who completely and you know you can remind people of white with the word black right so how is it eliminating this scary thing to be going oh if the plus doesn't mean do the glass or you know the door tonight so back to your association splitting you know what I think you want to do is maybe practice the relational connections between a doorknob for example an opening moving through etc but be very very careful about practicing nada with regard to germs nada because germs not a doorknob or doorknob not a germ well actually paradoxically build the relationship between germs and doorknobs in the new form of nada opposite of or whatever so I bet you in the associative splitting they're practicing creating positive and not positive meaningful associations I bet you they're cautious about not doing what I think many of us would do that which is to practice eliminating and subtracting associations because when you practice that you're building them because any relation is a relation and it's why you know I I can tell you this is a panic disordered person in recovery even though I have struggled with OCD I've told that I won't old some stories about that in the liberated mind but there's a phenomena and panic disorder called relaxation induced panic right and it goes like this boy these tapes are really working I'm feeling so relaxed that's so great that's so awesome it's a lot better than it was last week when it was really awful and nervous but now I'm feeling more relaxed and I really like this better a lot better than that that oh that nerve a lot did my heart just skip a beat there yeah because I'm but how far away is the door I'm feeling a lot I'm not feeling so good and boom you can have a panic attack by noticing that you're relaxed and somebody listening to this is probably gonna think of a glass when they hear about lip gloss so it's a wild horse I you know you these things are happening when you're asleep do you know if your head dreams and you wake up and then do for like hours you feel differently and something's a little off or or something sweet sometimes I'll be controlling that but it's literally making connections it's like a spider weaving a web or like a fractal you know just running the formula even when you're not watching so rft cautions be careful about subtraction and then it gives you a lot of cool ways of playing with amplifying and using networks but then the final thing it says is it only makes a difference in behavior when you give it a function and there's a lot of things you can do that diminish functions so we've learned we've created hundreds of diffusion methods I'll give you an example take a thought that normally was really punchy that you know cause you to wince to look away to want to change things you know to undo something like that okay my kid falling in the playground okay that's the thought that comes in okay now take that same thought and sing it to the tune of happy birthday okay yeah this is a great I've done this one a lot yeah if you did the same thing in the voice of your least favorite politician do the same thing and the voice of Donald Duck you know just say it very very slowly or say it in a different accent or you know the point is not to eliminate the point is to notice that it's a thought I'm having a thought that lipgloss goes with small glasses or is different from fine thank you very much you know like I suggest that people give their their dictator within a name I've - called George so George tells me things and it tells me to worry about things and I usually thank George for his effort to run my life and sometimes when I'm doing my taxes are trying to remember whether or not you know I've made the dentist appointment or something it's helpful a lot of times it's not helpful so could we use what's useful and respectfully decline the rest you don't have to go to war with it treat it more like you would if you had a kid following you talking constantly some of what said might be useful a lot of it want yeah and this I guess how it all comes down to flexibility right exactly and so these diffusion skills that we teach and act are not to explode meaning we need meaning when you're doing your taxes or fixing your car or reasoning out for problem solving but put it on a leash because if you're not careful that same dictator will say I'm you and you have to do this or else or you will never be able to function if you don't do this and this this the next thing you know you've lost control of your life in the attempt to get control over your thoughts and feelings by following what the dictator says which doesn't give you a control over him anyway plus meanwhile the costs happen you know if you're counting putting on your socks a hundred times you know you're missing the the bus or you're not there for the meeting or you you know it's human but it's not it's not what you want to turn your life over to yeah thank you thanks so much for that um as far as I wanted to ask a little bit about OCD and GA D if you get sure you got another administer oh sure I'm sorry yeah you just let me know when you got to get a run yeah so I'm curious and then we'll spend a little time talking about of the book of lubricants which I'm very excited about I was rated mine I'm like there are some you know individuals who are more of the second way of CDT influence and you know they will recognize that in OCD like we're not going to use any of our cognitive restructuring tools you know but when it comes to JD related concerns which are more let's say more you know just constant regular everyday worries that just don't turn off like they may then use more cognitive restructuring sure I'm curious about your understanding about that distinction between GA D you know worried thoughts and OCD intrusive thoughts kind of how act would potentially either see them the same or different and kind of whether the approach would change based on you know that you know diagnosis well it wouldn't be so much the diagnosis as it would be the person specific details like for example there are times when dealing with worries just in a purely logical way makes perfect sense like if somebody truly is not informed about something you know if somebody really thinks for example if you get you know anxious you're gonna have a heart attack and die it's not gonna hurt to say well you know actually the data on that is it's really really really really rare for people to get anxious and then of our heart attack and die and it does not very likely because of these physiological reasons but you know very often if you ask the questions people will tell you right back what you're about to tell them in other words they've done the reading they've gone on the web they've read the books they know well then why you telling them because you're so smart I mean who nominated you I mean what are you to do and you have worries that are hard to deal with I mean very often some of the same folks I mean you look at the actual data on you know our people more or less likely to have divorces and all I got I don't like therapists are not so smart let's just be honest about so I think that somewhere is the data are a lot worse than they are with your therapist oh so if it really is a matter of information for example I'm cool with it but I want to do in a person specific way and not simply by a syndrome or category in part because there's so much overlap in these syndrome categories there's so much variability within the same one that I think we're really getting awfully tired of it I mean even then I am age does not fund it anymore yes I just saw a recent study where they took 3,000 people who had major depression and they listed all the signs and symptoms and how many different patterns did they find in the 3,000 people more than 1000 patterns so you like what is this ridiculous thing then come on you know like you do the math on PTSD there's almost 700,000 different variants of PTSD these combinations of symptoms that are allowed allowed by a diagnostic category but so there's that but rant over coming back to when you wouldn't when you wouldn't I think the core of reappraisal is often not the new information that occurs or just now you'll be convinced to only think about it this way because you're gonna think about a lots of ways back to the same reason that a lipgloss can produce a glass what is really going on in our reappraisal methods when they work and there's good data on this is they work by cognitive flexibility so sometimes by essentially saying you know in addition to thinking about it like that you could think about like this and you can think about it like that you can think about it like that now we show those do you think would be like helpful to you in this situation that's perfectly reasonable to me I want to be able to think creatively flexibly broadly you know and there's good data on that in another way you know just being able to generate possible alternatives boom boom boom boom boom in a fast way predicts loss of positive outcomes if you have enough freedom to then pick the ones that are useful to you and leave the rest you could turn that into a compulsion by the way but let's say the flexibility of thinking is a healthy thing so what diffusion does is it doesn't blow your mind it isn't like you just suddenly become irrational it just softens the attachment to a particular formulation so that you can more openly have a variety of formulations and then among those what are the ones that right now seem to be most useful based on your history and your parsing of the situation and just based on your gut not just your mind D filter but also your sort of gut experiencial filter you know like if you hear the thing I often ask when I'm dealing with OCD as I say it's something like and is that a really new thought have you ever had a file like that before they say yeah how'd it how did it work in the past when you've done what you're saying you need to do now oh well I felt better yeah okay immediately nimeth and then it got worse okay well do you want to do something that will quote make you feel better and then make you worse yeah doesn't sound too late you know so could we do something else so we do something that's really different then if we're gonna do something different you know if you keep doing what you've been doing you'll get what you've been getting let's see if we can do something that's really more fundamentally different and then a lot of the acts stuff is more fundamentally different because they change the rules it comes out all that feel that's on a completely different playing field if you're singing your thoughts or you know noticing what shape they have or what they know or you know saying I'm slowly and so forth there's a lot of playful things you can do with thoughts so I'm fine with persons specific choices about how to manage cognition and my biggest focus would be cognitive flexibility and workability you know being able to think in a way that's flexible and free and to do what works and that will help you whether it's your you know in a school system or a working at work or managing your relationships or your spouse or that's gonna be helpful to you and some of the things that are called restructuring or reappraisal at times are really helpful but they tend to be more the flexibility forms of it in the studies of cognitive reappraisal for example when they are subtracted out of the flexibility effects they can have most of what's left is not helpful doesn't predict positive outcomes because you sometimes are really close to things that are you know what's the right thing and I did I think about the right way oh no I'm not thinking about the right way you know if you ever met somebody who's trying to do CBT really right and then gets obsessive about how wrongly they're doing CBT and then it's a whole another variant of the same you know kind of entanglement I've met a lot of people like that so because you could put perfectionism inside CBT you've got rumination inside CBT you know not it's not that CBT means to do that it's just what humans sometimes do with cognitive change strategies so why don't we put it as a kind of flexibility strategy it's safer and then you can combine second wave in the third wave and in a way that's more seamless and then and then fit it to the different needs and I think you're all right that in this broad category there are some folks are gonna you know actually need and you have a useful for new information sometimes that's really helpful right yeah I think that was very helpful speaking about workability I wanted to talk about about your new book and I liberated mind and I guess what I you know I'm halfway through so no spoilers no but I will say it it kind of made me fall in love with act all over again you know that I think that you know you did really an exceptional job with it not that my compliments is gonna know any other thing but yeah so I want to talk a little bit about the concept of pivoting yeah like which wasn't you know you know naturally part of what many people have you know we learned about the hexa flex and the different things I'm curious about just the concept of pivoting and if you could speak about the pub in general it's a single thing that's most knew about the book if you know anything about act you know what this book is an attempt to try to write a book that is a personal story a science story and helpful and man it's a kind of a think book meets a self-help book and so what I'm wanting it to be is a statement of the 40 year history of psychological flexibility the research on it in a way that doesn't feel heavy in sciency and finger waggy and geeky but is personal and direct and useful and engaging and and you begin to see kind of like you know how we got in this situation you know the human beings come by suffering very easily because we're trying to do something that's really hard of taking symbolic thinking and sitting at a top these processes that are a thousand times more ancient and that's really hard because for one thing give an example that you're gonna have feelings that this new part of human functioning says oh I don't like that well dogs and cats don't have to do that I mean they have the feelings they have they'll avoid situations that are harmful but they're gonna struggle with their own feelings they don't know how to do that they're not gonna struggle with her own thoughts and memory I don't know how to do that we do and so everywhere you go your pain follows you your history follows you your memories follow you if you've done something shameful or if something bad has happened to you that's really sad if you've been abused if you've been raped if you've had tragedies happen there's no place else for those things to go you know you're there's no delete button in the nervous system they're gonna go with you through your life and how do you manage that and so what I what I discovered I think maybe is the right way to say it but what I came to realize in the work that I was doing in act more recently and what I put in a liberated mind this book took 11 years to write but 40 years to produce what's inside it as I began to see that there was a need or a yearning or a motivation that's inside human suffering and what and it's exactly what's inside the flexability processes and what that told me was you know where it's not a problem that we're doing the things that are unhelpful or destructive we're trying to do the right thing we're trying to meet a real need the problem is is this my knee recent part of us is not delivering the goods its luring us into the kind of a fish trap where you know the way a fish trap works is it has a broad funnel on the outside but then it narrows down and narrows down and narrows down and narrows down by the time the fish realizes that's really in it it can't turn around anymore and it's happily not on the happily swims into the net or what's like that so let me give you an example I mentioned this earlier there we come into the world yearning to belong why because we're social primates for by far the most social and cooperative primate and our development requires others for us to survive and even when we become adults if you're the cast out monkey you're very likely the dead monkey you know that you have to be part of the tribe part of the group well that's true and when you're young and a little bit still true even as you throw so how do we get to belong well I think this yearning for a belong gets channeled in to justifying why you should be in the group either because you're especially good or especially needy you tell a story of Who I am and what I bring to the group that you think will either lead you to come in because you're so sad you're so disabled you're so needy that's surely any kind of person would let you in or because you're so special you're so smart you're so able you're so loving you're so trustworthy or so something positive that you'll be let in but take one of these I'll give you an example I'm a good kind person okay are you kind all the time to everyone have you been kind your whole life in all the situations you big fat liar you know that's not true so you have to put on a clown suit you have to pretend and you have to hope that people don't notice meanwhile you're feeling half guilty that you're lying B if you fool people and just see I'm so kind I'm so sweet and you're dampening down these places you can go where you're angry and you're unkind and you cut people off and you secretly think thoughts that are really critical in them and all that kind of stuff by the way some of the very things that sometimes hook people in OCD right I mean what are we really afraid of there's some monster within or we reveal right what if I'm a bad person if I'm gonna add person what if I'm evil I've got germs I'm gonna kill every baby you know you're not gonna want me I mean it but it's right inside what it's right inside a yearning to belong and what we find actually the data on this when you go inside the story itself the ego-self the the conceptualize self when you start in a way lying to others and then believing I take instance of lying about one out of four of your interaction with people that are extended you know more than 10-15 minutes long include errors of omission or Commission that you know about in other words there's little lies in there if you do it and if you look at why it's not instrumental it's not because you're gonna get something from it and yeah people say because otherwise I'd hurt their feelings if I told them they really know I don't like your blouse I think it sucks or whatever the thing is yeah of course but really what's in there is because otherwise I may not be included I may be pushed out like if I were to say something offensive or friends really say what's going on for me but now here's the sad thing so about one out of four you creates some sort of little white line with those conversations you now are significantly less interested in the person and less willing to engage in another conversation with you sense that there's something wrong there's an inconsistency and even if you're saying is so flowery and wonderful you know are avoiding the person so here you did this thing so you could be included so that you could belong and the effect is is that you have to stay away from people plus if you did it knowing that knowing it you did it now you've kind of fooled them into loving you caring about you thinking well of you their opinions of you go down because who can believe them feelings of fools you don't feel lifted up by the feelings of fools so this is my narcissus aren't lifted up at all when people applaud and say they're wonderful they just feel more empty and so and it happens on the negative side we're telling the sad stories but here's my point what I realized within all of the inflexibility processes is that there's a deep underlying yearning you could call it a need or a motivation if you wanted and that it's what we're really trying to satisfy so the reason we go into the conceptualized self the reason we tell the stories is so that we belong and so that will be included but it actually doesn't give us that it gives us a sense of specialness and disconnection we now are actually less not more engaged with others and so it it's Lucy's football you know it's kick it and the you know it's gonna go right through well you're gonna miss it again but what do we do we just tell the we enter into the clown suit again you know so what act as in the flexibility processes is instead of giving you the smaller sooner or reward that costs you the larger later reward it puts you on a path where you get the larger later ones how could you actually experience belonging for example well one way to do it is to slow down to show up and your eyes and to come out and enter into the world of the eyes of the person you're interacting with to take their perspective to see how they're feeling to be genuinely interested in what's going on inside their lives to share what's going on inside yours in other words there's going to be this metaphorically kind of eye to eye connection we even do this in act workshop so as you know Elliott right we actually do this exercise but in other words belonging will be produced by conscious interconnection does that make sense but to do that you have to let go of the story right you have to take more seriously the possibility that your awareness consciousness and presence period end of story not the form nothing with this and the nice flowers on your lapel or the perfume you're wearing or the whether or not you have wrinkles on your face or said the smart thing no just by being there and you know you think about people who lifted you up peaked about the people who love and move you and I bet you you can find moments when you looked at them and you felt deeply seen and cared for and then you could see their consciousness behind their eyes they were there with you connected with you yeah and so instead of wearing a clown suit could we take the time and I think our mindfulness methods or our spiritual traditions I think act and its deepest sense tries to strip self down to this place that's interconnected with a consciousness of others and that's a real experience of belonging and yet so instead of an ID it's not gonna give you the cheap thrill two-minute version of belonging it gives you the longer arc of belonging like being able to enter into a genuine conversation where you share what's going on with you and you're really genuinely interested in what's going on to the other person it'll support that so I've given you one example of going from the yearning to belong letting go the attachment to the clown suit of the conceptualized self good better and different it doesn't matter its form let all that fall away come into this more spiritual side of you this sort of beyond categorization pure awareness part of you and now extend that out into interconnection with others that really satisfies belonging you feel as though you belong because you are in a relationship with others that is supportive and loving and caring and connected that's true with each one of the pivots and so it's again I held off fourth I'm sorry for that but I'd gone these rants but I wanted to explain what's new and in each of the areas now and liberated in mind I dig down to what did you really want is a simple way to say what I'm saying I can cut through all the blah blah blah let's focus on what you really wanted and you're gonna find inside your own misery this precious jewel this sweet strand of a human being yearning for something that's not your enemy yeah that way of doing it isn't gonna work great let's learn from it but now let's take the energy in that and redirect it in a brand new direction that will give you gradually but then increasingly over time what you really want and there's six yearnings inside the six pivots and I think there's pretty good evidence I go through some of it in the book that these are yearnings that people deep we have and that they can deeply accomplish if they can get the mind out of the way the problem-solving mind out of the way and be able to bring the whole of us and satisfying those underlying earnings yeah that was and I you know just give that detail that just was off I think it was really cool and about that index like I found that index really interesting because it was almost like a conversation it's like if you need if you need a citation for that like you should really just keep read it there something like that yeah so reading it was really you know excellent so far that I'm really excited to continue this conversation has been really awesome I really appreciate your time in the most honest way possible and the link to the book is gonna be on my website at my OCD care calm forward slash learn as well as this conversation and is there anything you'd like to add about the book or anything else before I just say it well if people want to get on my newsletter list and all that I don't spam people just go to Steven C haze comm there's a little 7 lesson mini course on act that you can get on and I you know I do let people know about the workshops I'm doing and I send out my blogs because I try to blog with some regularity and I put it out so those things happen and then the yeah I'll see let me know what you think of a liberated mind I have kind of written this in a way that I hope this is the act book that you can give to people without feeling as though you're either suggesting they need a shrink or should be one you know we all need help and psychological flexibility is just useful to people and I wrote the book in hopes that people would be able to bring it into the cultural conversation and the family conversations that we have and you know I do want to say this one little thing to the people who are listening because my presumption is le a lot of folks are listening because they've struggled they've suffered they know something about pain and that man this is good sound reassuring or even patronizing I I hope you know and if you read a liberated mind you'll see because I walk through my own panic disorder history and some of the details of my own family and the domestic violence in my home and things like that you'll see that I'm not saying this with a any sense of patronizing but I think people who suffered are the lucky ones if you can find that place in which it can move you towards being more fully human whole and free because what you just stepped into is something that the person next to you knows something about no they may maybe they don't have OCD but you know maybe they've got an addiction problem or maybe you know they're on you know a journey that is led to multiple failed relationships or you know maybe they don't know how to face the challenges of physical disease they have and on and on it goes this is a human situation and so what's in a liberated mind is kind of like a a manual for why it's hard to be human and guide for how to be more fully human and when when inside that you realize that your sufferings not your enemy it's more like you know the the faith's needing though you know softening you up and I hope that doesn't sound patronizing but it it I do truly believe it the people who are suffering in a way are the lucky ones because you have a chance you've been given a chance to change the system inside you and then in the culture and you can't fail but turn on the television screen without realizing that it's need we got to figure out how to be human beings and still live in the kind of modern world we're living in where that computer in your pocket can expose you to horror and judgment in comparison so I kind of view people struggle with anxiety to soldiers as the lucky ones and see all our fellow travelers if you struggle with anxiety Ben they're still there and there's something really important inside an anxiety struggle that can lift up a human life all right thank you so much for that thank you so much for taking the time and I hope to you know continue and I hope you all by the book that liberate in mind and have a great night thank you so much thank you Eliot and thanks to all those who we're listening or viewing on Facebook I appreciate the opportunity all right

Channel: My OCD Care

Views: 27,355

Keywords: ACT, therapy, OCD, anxiety, CBT

Id: mk5AJP41QB0

Length: 74min 27sec (4467 seconds)

Published: Fri Oct 18 2019