Baggage Check Mental Health Advice with Guest Dr. Steven C. Hayes

Jan 28, 2020

Licensed clinical psychologist Dr. Andrea Bonior was online to take your questions about relationships, family, mental health, motivation, work-life balance, well-being, and more. Read past Baggage Check columns here.

Get mental health tips and an early glimpse at Dr. Andrea's next book "Detox Your Thoughts" by following Dr. Andrea on Facebook or Instagram.

Important disclaimer: this chat should not be considered a substitute for one-on-one psychotherapy, and is for general informational purposes only. (Dr. Andrea's advice on 80s song lyrics and snacking, however, is completely official.)

Hello, all!

I am so glad you are here. It's a very special day today, as Dr. Steven C. Hayes-- the originator of Acceptance and Commitment Therapy, whose techniques I am extolling frequently in this chat and in my own therapy practice-- will be joining us to take your questions at 1:30pm.

It's also a bit of a poor techno karma day for me, as I am having layers of connectivity problems. And the first coffee shop I decamped to must have just closed in the past few days! So forgive me if I am a little behind; I didn't have much prep time at all today. But I see you in the queue, so let's get started! 

I've recently been in conversations with parents of grown children who expressed remorse over how they raised/treated their kids. One of them has a 40-something son with substance abuse and underemployment problems who now says that he handled things badly when his son was younger. And the other lost his daughter when she was in her mid-40s to a heart problem and, in addition to the grief of losing her, feels guilty about how he handled some serious issues in her life and how he treated her. My question is, what's the best way to respond to that? In both cases it's possible that their behavior might have made the problems worse, but it's hard to tell about any lasting impact their behavior might have had or whether there is any blame to place. How should I respond? How can I be reassuring without lying ("oh, you were just fine") or not knowing the full story?

Well, I don't think you need to be the arbiter about whether their worries have some validity to them. After all, you're not an assessing psychiatrist, or someone with a crystal ball toward a parallel universe that would have let you see how their children's paths would have turned out differently with different types of parenting. Nor are you their spiritual advisor looking to absolve them of something. 

I think what your friends need from you in that moment is just some empathy. An ear. To not be alone, to not feel like they are speaking into a void, or that they are the only ones struggling in life. 

Sometimes, there is no "right" thing to say-- it is just being there. "I'm so sorry you're struggling with this. It sounds painful on top of the loss." "The second-guessing must be so difficult. I wish I could make it go away for you." "Grief can be so complicated. My heart is with you."

How do those sound? 

I get frequent requests to watch, like, comment on and subscribe to a relative’s YouTube channel. The parents are looking to monetize their kids (5&7). Not my cynical take, that’s actually what they wrote. I love the kids and communicate with them regularly, but I don’t want to be forced to be one of their fans. I don’t like the way the kids - or their parents - behave when a camera is pointing their way and they are under pressure to do something cute. I know that my opinion would be unwelcome, so I haven’t said anything. My relative is under pressure from the spouse to get more likes and subscribers and my name is obviously missing so what can I possibly say if asked directly that will not be insulting to them?

Oh, wow.

What kind of relationship do you have with this relative in general? 

If you want to keep things totally superficial in the "Thanks but no thanks" kind of way and not have a deeper conversation about what this might be doing to their kids, then I think you keep it short and sweet.

"Sorry, I'm not a youtuber."

or

"Apologies, but I like to keep my relationship with your kids in the real-life realm."

But I also do wonder if in your haste to not be insulting to them (an understandable and kind instinct), you run the risk-- over time-- of keeping quiet about behavior that may indeed be deserving of being brought up. Especially if it gets worse over time.

Chatters? 

Hello Dr Bonior, Can you recommend a way to let someone know, gently and kindly, that while you want to be there for them and be supportive through a health crisis, that five or six months of bulldozing over any conversation not focused on their health issues may be taking a toll on a friendship? I have a friend who's had some terrible side effects from chemotherapy. A group of us has gotten together to do everything from go to doctor's appointments and take notes to drive her to infusions to come over and clean her house. We all check in every day or two. We very much want to be there for her. Unfortunately over the past several months, it's become harder and harder to just... have a conversation. I've spent over 45 minutes on a call without even hearing 'hey, how are you?' Obviously in a situation this serious we know our friend needs to vent, but I'm burning out on being talked over in every situation, full time, even if I've tried to say something along the lines of 'that sounds so hard,' or ask what I can do. I miss the friend I used to talk to about current events and books. I miss laughing together. I miss feeling as though I'm a friend and not just support staff. Then I feel terrible for having those feelings when my friend is enduring so much. Is there a compassionate or fair way to bring up a topic this difficult? I don't want to get to the point where I start screening calls when I don't have 90 minutes to endure an nonstop monologue, and there are now times when I think about it. I've tried to accept this as just where we are and where she needs to focus right now, so maybe I just need to find a better way to reframe my thinking. But... I just miss the friend who had all of us so grateful for the chance to be there.

I am sure you miss her-- and I am sure she misses her, too!

I don't say that at all to be unkind or unsympathetic to your plight. But I am saying that yes, her life has been turned upside-down in ways that are orders of magnitude bigger than the ripple effects you're suffering-- and so altered expectations should be the reality here. This is the part of friendship where the reward comes from knowing how much you're helping, even if you're not getting any of the usual positive reinforcement of being in the friendship.

That said, caregiving is no joke from an emotional and burnout-potential standpoint, and caregivers need and deserve support, whether they are friends, family, or anything in between. (You'd be amazed how many exes are caregivers to each other!) First, I'd urge you to make sure you are finding support in your own right-- outside of conversations with your friend. Do you and any of the other friends get together to blow off some steam? Have you thought about searching around for some caregiving support online?

But no, it doesn't have to be verboten to bring this up in a gentle way, as talking about books or things other than your friend's illness may eventually be helpful to her too (though if it's not, it's not, and that should be accepted.) Go extremely heavy on the empathy and the flexibility.

"Hey, I read XYZ that made me think of you the other day/heard something that made me smile/etc. Do you mind if I tell you about it for a few minutes? Maybe we both could use the laugh."

See how that goes, and then proceed from there.

My feeling is that if these parents are so obsessed, they'll just get angry and dismiss any attempt to get them to see reason.

Could be. But if multiple people plant the seeds gently over time, it could give them something more to think about. 

Why can't you just subscribe anyway? It doesn't mean you have to watch them. And if asked, say "I don't spend time on YouTube, sorry".

But it seems like OP doesn't want to buy in to this system. To be part of filling the monetizing appetite that may grow and grow and grow and perhaps become toxic or severely dysfunctional. 

I get it! 

The parents have to think that it's THEIR idea.

Maybe!

Goodness knows there are plenty of think pieces they could read to start planting the seeds themselves. 

Hello I have brain fog, from an autoimmune disease. Sometimes I remember words, I know how to add or subtract and how to complete day to day simple tasks. Other days I can’t complete simple tasks. Recently while flying across the country I sat next to an interesting woman and was enjoying talking with her. But in the middle of our conversation, I could not remember simple everyday things. I was talking about an art exhibit but couldn’t remember the word “burgundy”. Then I could not remember how to explain a simple recipe that I make all the time. After experiencing brain fog a few times I explained why I was forgetting words. I felt I had to say, I am not stupid, slow or uneducated but it’s a medical issue. The issue of when to explain ... at a party when I am meeting acquaintances I may or never see again if I am experiencing brain fog at what point do I explain? If someone says “Go to the left at the end of the hall” and I am panicking because I don’t know which way is left. Or I can’t remember words should I just explain? It’s easy with friends they know my situation- recently at a restaurant with a friend I was adding the tip and the food total. I could not figure out how to add 9 and 4. Since I was with a good friend I could ask her “What’s 9+4?” I don’t want pity. I am not dying or suffering with too much pain. If I explain I have brain fog, often you have to explain it, no it’s not from menopause or dementia or Alzheimer’s. I look forward to to your answer and to the comments in the comments section.

I think there are two important truths here: one is that it is 100 percent your right and your decision to decide when to disclose, how to disclose, and what to disclose.

But the second is that you can't control- or even always predict-- other people's behavior.

There will be those who surprise you with how they take it, whether that be by letting it not be a Big Stinking Pitying Deal or just by being kind. And there may be other people from whom you expect better who disappoint you by their social cluelessness.

But it is you who gets to figure it out. Let's start here: if there were no "right" or "wrong" at all, what would you have them know? And how would you want to phrase it? That can be a guiding principle in any given situation.

Or, you could also come up with some sort of euphemism that feels comfortable to you, if that's what you wanted. When it's about directions, calling it a spatial issue. When it's about math, calling it a calculation issue. Or being more general about both.

Has anyone else been through this? 

My SIL’s mother is officially on hospice care, doing ok but she probably doesn’t have more than a few months left to live. My SIL helped with both my parents when they were failing and even though I have a brother (her husband) and 2 sisters the one to show up consistently was my SIL. I HAVE NEVER FORGOTTEN THAT! Now it’s 15 years later and SIL is an only child and as a result her mother’s only caretaker. She does pay people to stay with her mom so she can sleep, pay bills, take care of her animals but the majority of time my SIL is with her mother. I don’t know what, if anything, my brother does. She needs a break! I would like to offer to go up and help, as she did for me but here’s the crux of the matter. They are evangelical Baptist, devoted to Christ and their church. They also support political beliefs I disagree with. Neither issue would be a deal breaker for me, I’m an adult and am willing to participate in some (polite but limited) discussion. except they try to HAMMER me into submission. They live in a red state that just past some horrific laws against LGBTQ in the guise of “Religious Freedom”, and I really do have a problem with that! I’m pretty sure if I go up to help my SIL with her mom my brother will try to pull out all the stops in effort to “save me” (he announced at xmas dinner that I was going to hell (to my sister, I wasn’t there) but that’s not the first time I’ve heard him talk about me like that. In case you’re interested I am not going to Hell! Since it’s in the Bible that wives must submit to their husbands I don’t get much support from my SIL, ultimately she would like me to be “saved” too, she’s just not as aggressive about it as my brother. I could make the trip short but that wouldn’t help my SIL by much. I’ll feel crappy as all heck if I don’t go up and give her a hand but I really don’t want to deal with being “Hammered” every time I look like I got a free minute or to be “witnessed” to by strangers my brother will inevitably bring into the house in effort to “Save” me. Should I stay or should I go?

It does seem that a shorter trip is the answer. There's a bit of all-or-none thinking in the "wouldn't help my SIL by much." Okay, but it presumably would help her more than zero-- which would also help assuage your guilt compared to not going. 

I also know it might be seen as an inopportune time to bring up given what your brother and SIL are going through, but I can't help but wonder-- since this behavior sounds so intense-- whether this situation could benefit from some gentle pushback. "Bro, I am here to help with your wife's Mom. It's making me uncomfortable that you are trying to make this about my going to Hell. I'd like to help in the here and now; I love you very much and am here to support your wife. When you do this to me, it makes it very difficult for me to do that, and ultimately hurts her. Can we please try to do things differently?"

And if you do cut your visit pretty short, then that helps the message be received as well. 

Hi! So I have been dating a man for 1yr and 1day! I am on a path of self-discovery and healing, so I was thrilled to meet someone who appeared to be on the same path. However, at my age 44 and his age 50, I am wondering if some of his rhetoric is making me feel crazy. First off - he is married. Not married in the traditional sense, but separated for over 10 years. He has strong beliefs about marriage, ironically, so he remains steadfast that neither divorce or marriage is in the cards for him. I have been married twice and a couple of years ago did not envision getting married again.. and now I have been thinking differently. Maybe I do want to get married again! My man is vehemently against the "institution" of it.... and based on my flip-flop on the subject, I am not quite sure this could be considered a deal-breaker. However, other topics such as using the word Love or talking about the Future result in comments like, "what is the future, really?" (which I totally subscribe to - The Present Moment, but in this situation I am rattled) and he believes the word Love is used incorrectly, so it does not get expressed often in our relationship. He tells me that the energy and words he expresses to me during the day far exceed the misuse of the word Love. He is very successful (after living a life of meager means for many years after his wife left him to take care of their 2 children) - which comes at a price of limited time with him. I do see him at least 2 times a week - and he is very present and generous in those moments... almost too generous... when I politely try to refuse gifts such as a $7,000 oven, he tells me to please let him share his generosity because it brings him joy. I would prefer more time with my partner opposed to gifts TBH. Also, he plays golf so sometimes I do feel like a golf widow. Whenever I express to him that I feel that we may be mismatched, he encourages me to look at all the wonderful time we spend together and just live in the present and enjoy what we have together. When I express that I'm giving up my relationship values and goals to remain with him, he says he hears me yet he doesn't believe ending our relationship is the answer. I do believe in some of these concepts, but there is a part of me that feels like he's just saying things in this way to keep me engaged (ironic) and confused. He also tells me that I can just "stop" my painful thoughts and "choose" to live in peace. I GET THIS, but I feel like I am just not "there" quite yet. Is this some sort of masterful manipulation? I am aware of my own codependent tendencies based on past relationships, and am aware that may be the reason I haven't walked away.

Okay, he's so against the institution of marriage that he refuses to end his own.

Wait, wut? 

This is one of the longer ones that I've been able to post-- no producer here so I apologize if I can't be as careful as I'd like with my reading/editing-- but what I am hearing here on a very basic level is him getting to have everything on his own terms, and anything you are unhappy with, you're told to calm down and find peace.

Interesting that he doesn't have to find peace with ENDING A MARRIAGE THAT HE CLAIMS TO NOT AGREE WITH IN THE FIRST PLACE, SO THAT HE CAN NO LONGER BE COMMITTING ADULTERY BY BEING WITH YOU.

The fact that you mention that you have had past "codependent" tendencies makes me even more concerned. I am not saying that he is actively choosing to manipulate you, but rather the situation that you are in has been designed to meet his needs.... not yours. And of course he is happy with that.

You wrote to me, though, so it seems that you are not. And I'd argue very passionately that you shouldn't be. 

Is there a way you can help in other ways - paying for another caregiver, caretaking packages, etc.? One thing that occurs to me is that these encounters with your brother may be upsetting for your SIL as well, though she would never say so, so helping in other ways might be better for her as well -

Great points. Thanks. 

Thank you for the Detox Your Thoughts columns! It truly helped me calm down an impending anxiety episode. My husband was later getting home from a long road trip than I expected, and I suddenly had thoughts of him being in a car accident. I was able to sit down, tell myself that the thought wasn't rational, and I was able to breathe through the panic. Thank you for your words of wisdom - they do get through!

Music to my ears. Thank you so much for letting me know this-- it is exactly what I hope to hear, and why I felt so strongly about writing it.

And the much-expanded book version is getting close close close! May 5th (yes, Cinco de Mayo!) it will be released. We're about to put some pre-order incentives into place, too. Yeah, I know those things are often gimmicky, but the deal is you'll get a free printable workbook that offers some additional nudges and space to put the techniques into practice. That will all be happening over the next couple of weeks at www.drandreabonior.com. 

Dr. Steven C. Hayes is here! I know a lot of us have been looking so forward to this. I see some great questions in here for him already. Keep 'em coming!

Hi everybody. Steve Hayes here. It is just great to be with you today!

I’m looking forward to what we might be able to explore together. Acceptance and Commitment Therapy (ACT … it is pronounced as a word, by the way, not initials) is one of the most researched new methods of life change over the last two decades and its underlying model of psychological flexibility goes, as I often say, “anywhere that a human mind goes.” There are over 3,000 studies on the model and about 350 randomized trials on ACT itself and the breadth of application is stunning … from mental health to diet and exercise; from business to sports; from addiction to chronic pain.

One cool implication is that when you learn psychological flexibility skills you have tools that you can apply to many areas of life. We say we’ve cracked the code and psychological flexibility is the 20% that does the 80%. A chat like this tests that idea, which is one reason I’m so excited to be doing this.

Let's go!

Can it work with kids? My anxious child could really use the help. Any chance some of your books are for kids?

Psychological flexibility works in pretty much the same way in kids as in adults.  Regardless of age, inflexible psychological patterns are harmful …. whether that is running from feelings, getting entangled in difficult thoughts, buying into rigid and often negative stories of who we are and who others are, losing flexible attention to the present moment, failing to see what really matters, or an inability to build values-based habits.

 

There are great ACT resources for children (I’ll mention a couple below), but learning how to be more psychologically flexible needs to start with parents.

 

For one thing, kids imitate us. If they see us being inflexible, they do the same. There are now several large trials showing that when difficult things happen to children, you can predict how those things will land by measuring the parents’ psychological flexibility.  So start there.

 

Don’t hear me saying “it’s your fault” – that kind of entangling judgment is exactly what we need to learn to rein in. Self-kindness and self-compassion is what is needed and that is what acceptance, mindfulness, and values brings to our lives. It is hard being a parent and you are not a horse to be whipped into shape. Your needs and health matters; your balance, values, and sense of wholeness is a gift to yourself, yes, but also your kids.

 

So consider starting with A Liberated Mind or Get Out of Your Mind and Into Your Life

 

And then learn how to apply flexibility skills to parenting

 

Lisa Coyne and Amy Murrell’s “The Joy of Parenting” does a great job.  So does

Chris McCurry’s “Parenting Your Anxious Child with Mindfulness and Acceptance”

And Ciarrochi, Hayes, and Bailey’s “Get Out of Your Mind and Into Your Life for Teens”

 

No. This is not something you are SUPPOSED TO GET. He's brushing off ALL your concerns and telling you that you have to change. Don't fall for this manipulation.

Agreed.

It's so interesting how OP is the only one who is supposed to "adjust" here. 

Well of course he doesn't. This way he gets to have his cake and eat it, too. It doesn't sound like he has made the least effort to meet you even halfway, and thinks that extravagant gifts will placate you (will he expect you to return that stove if you break up?). Don't be gaslighted like this, please.

Another data point! And a good one. Thanks. 

I struggle with obsessive thoughts, constantly. I don’t really know that I have OCD because I don’t tend to have any habits or compulsive behaviors. But I find the same thoughts repeating to me over and over and over again. Regrets about the past and worries about the future. I know that it keeps me from fully participating in the moment, and it absolutely sucks. Any tips for me?

You’d be shocked at how common this is. ACT defusion skills are really helpful.  Go to bit.ly/StevesSecondTED for some methods to try.

And learn to bring your attention to the present moment. Rumination and worry can go on in the background ... you get to chose if they are in the foreground .. but if you try to push them out, there they are in the foreground again so really you need to learn a skill your mind does not know how to do. It's not the first time. You learned to walk by trial and error after all. The mind screams you can't do it, but there is more to your than your mind. 

I think the main ACT self help books are also a good place to begin. Russ Harris is a very good writer so if you want to expand your options beyond A Liberated Mind or Get Out of Your Mind and Into Your Life, try his books. And consider ACT therapists. The head of the OCD Foundation is a major ACT person and you can explore their website; a good social media person who is very ACT focused is Mark Freeman and his OCD stories website

 

My father has done this with us. Nothing specific, just "We made so many mistakes with you kids." I don't know how to answer. I don't want to reassure him ("no you didn't") because they did do harmful things - not intentionally, but because they didn't know better. But I also don't want to get into a discussion of just what was wrong and what was ok. Any deflections?

It's definitely more complicated when it's your own parent! 

I think it may be helpful to figure out what you might want in these situations. Would you most just want to deflect and move on to a different topic? Or is there a part of you that wants him to hear that yes, mistakes were made (as they say?) In the former, deflections are simple enough. "Parenting is hard, I know. How about that new season of Curb Your Enthusiasm?" "No parent is perfect. So, would you rather have pasta or chicken?" 

But if there's a part of you that would like the validation of his hearing something more, then you do open the doors to a little bit of conversation. "None of us emerge unscathed from childhood. We all have our struggles." And if it's something that he and you want to go further on (though I'm getting you that you don't), then you could at that point. 

I just got A Liberated Mind and am looking forward to reading it. I know that what I have the most trouble with in terms of how I relate to my mind is flexibility. It has always been a problem in a lot of areas of my life. I know that mental flexibility is a big part of mental health, and I know it’s been a big part of what you try to teach as well. Is there anything I can do as a first step to target mental flexibility?

Thanks for picking up A Liberated Mind … I hope it will open doors to ways of being more open, present, and engaged in what you deeply care about – to be more fully you. 

There are six major flexibility skills and you can start with any one of them. They are:

The Transcendent Self: Catching the observing or “just noticing” or pure awareness sense of self – the more spiritual part of you that hold objects in awareness much as the table in front of you holds a glass – and allowing yourself to be operate from that part of you, rather that to defend your storied ego and all of its comparison, shame, fear, and narcissism.

Acceptance: Taking more time to feel and experience fully while letting go of needless defense.

Defusion: Learning to watch your mind, to notice its products, and to use what’s useful and leave the rest as it is … without mindlessly disappearing into you mind and becoming entangled in a vast cognitive network you host but cannot fully control.

The Now: Coming into the present moment and allocating your attention flexible, fluidly, and voluntarily … not being jerked about like a poorly treated dog on a chain.

Values: Choosing and owning up to the intrinsic qualities of being and doing that you most yearn to put into your actions and life moments, and 

Committed Action: Building larger and larger habits of values-based actions.

If any one really grab you, start there but if you are not sure start with some defusion exercises. I give 12 examples in my second TEDx talk. This link will take you there:  bit.ly/StevesSecondTED  And if you would like to hear about my personal story of recovery from panic disorder (that is why there is an “ACT”!) and hear a quick review of all six flexibility processes check out this link: bit.ly/StevesFirstTED  

 

If you want a quick one to try: take a thought that punches you hard and tends to entangle you. Get clear on the thought and distill it down to a single sentence or phrase. Now sing it out loud to the tune of happy birthday. I’m serious! Do it and see what happens.   If you think I’m asking you to sort of ridicule your mind, I’m not. Please look at bit.ly/StevesSecondTED   and by the end you will know it is not that. 

 

You are not ridiculous. You are human. And your mind is a tool … its part of you, not all of you.

You need to read the book, "Why Does He Do That? Inside the Minds of Angry and Controlling Men" by Lundy Bancroft. I did not realize I was married to a narcissist for seventeen years until I read that book, and I had a master's degree in social work! After I read that book, I could predict what he would do--I understood him so well. And, yes, I ended the relationship, because orbiting him was not the life for me. Read the book and then see how much better you understand the dynamic he controls in your life.

Thanks! I have heard of the book, though I can't speak directly to it.

I am so glad it was helpful for you. 

The person with the friend consumed with health issues may want to take a look at "Ring Theory" It sounds like OP is experiencing caregiver stress, and grief missing the friendship and might benefit from expressing that... but since the sick friend is at the center of the crisis, OP should find a way to dump their issues away from the friend "Comfort in, dump out" https://www.psychologytoday.com/us/blog/promoting-hope-preventing-suicide/201705/ring-theory-helps-us-bring-comfort-in

Yes! That concept can be really helpful in these situations. Thanks!

I try to just confront these times myself head on with humor but not invitingly explanations by saying such as “I’m sorry, I seem to be temporarily acetecholine deprived at the moment, ... which way is left/ what is 7 x 9 ?” The most difficult part for me was not the having of these “blonde moments” ( I am blonde), it was being reminded myself that I wasn’t the person I used to be. Not too many ever asked me what acetecholine was, but usually they responded to my self deprecating humor, and the situations resolved. If asked for more info or explanation, I just deflect. It’s not their business, most of the time. It is hard to be kind to yourself, when you function so differently from before, especially when you can’t figure out which highway entrance you want because you’ve temporarily lost the understanding of East vs. west. My husband calls these my muffin-head moments, and I’ve learned to forgive my occasional idiocy fully accepting more now that these glitches are not a reflection of my intelligence or worth.

There is so much warmth and wisdom in this answer....I am so grateful. 

I am also so gratified to hear that you have found a way to handle this that works for you, and to show yourself some compassion in the process. I have no doubt that that will be helpful to OP! Thanks so much for writing in. 

If you know the people well, then you might consider whether you can say "You did your best. It's all you can do." We are none of us perfect. My father's standard for me in school was "Did you do your best?"

This could be comforting, and it's a kind sentiment. Thanks for the suggestion.

In some cases I have seen people to take this as a referendum that they didn't do enough, or made a mistake and indeed should have pushed themselves to try harder/do better. But I think if it's said in the right tone within the right relationship, it can be a lovely show of compassion. 

Yes! Yes, he is manipulating you! SOunds like a svengali to me. His entire approach to a relationship with you is horse puckey! Get out and find a person who wants to be with you. I guarantee you his wife is not as gone as he wants you to believe she is. Do you have any relationship with his kids? If not he's hiding his family from you, and you from his family.

Yeah, it's so interesting that the whole "technically still married and may be deceptive about how involved he still is with his ex" aspect is almost on the back burner here, but you raise a legitimate point. Thanks.

I have heard suggestions from friends in the field that therapy generally works because of the placebo effect and that different types of therapy don’t differ that much from each other. Do you agree with this assessment?

Not really.  It is true that a good relationship is most important but we have data showing that is because good therapists naturally model acceptance, non-judgment, being present, being connected consciously, caring about your values and trying to improve your life ... it is only when you internalize that (that are all the psychological flexibility skills) that your life really moves ahead. Where evidence-based therapies have there biggest advantage is a) know that process like that are the key, and b) know how to fit behavior change efforts to your life. You'd be shocked at how many therapists working with anxiety never do any exposure for example. I think the data are clear that BOTH the relationship AND fitting life change methods to what yo really need is important. There are several good forms of evidence-based therapy. ACT is one but I predict over time they will come together under a scientific understanding that includes "the relationship"   

Sorry, OP, is there any chance you are dating a cult leader? He seems to have a gauzy philosophical non-answer for everything that concerns you and the only effort he seems to be putting into the relationship involves doing/saying things to manipulate your opinions/emotions so that you remain 'with' him and go along with whatever pleases him. Maybe take some time to write down the facts of your relationship... not his platitudes/reassurances or the tally of the gifts he's given. But things like "I am a woman of xx age. I might want to get married some day. I am dating a man of xx age. He is married to someone else. He states he will never divorce. He states he will never marry me. We see each other for x hours every week. When I raise a concern he _________ (responds with empathy? tries to understand my perspective? dismisses my concerns? tries to convince me I'm wrong?) That make me feel ___________(loved? cornered? appreciated?) And then sit with that information for a while. Then pay attention to what your brain and your gut tell you.

Thank you. 

I do think, OP, that in your gut you are aware of how problematic this is, or you wouldn't have written in. 

I have a lot of hope for you in finding a path out of this into a better situation, and how rewarding that will be. 

Please do keep us posted! 

I agree with an earlier poster that he is not as "separated" as he claims to be. I'll bet he's is still married and involved with his wife.

Could very well be.

"But I hate marriage!" being a convenient excuse for him to negate not only the fact that he is still married but the fact that he doesn't want to get remarried. 

Many people find mantras helpful in these situations, too. "I am moving forward into new opportunities." "I bring a lot of experience they will want." "My skills match well with this organization." These are great - but they're generally considered affirmations. Mantras are to aid concentration - say in meditation or - as i'm doing now - in repetitive Kundalini yoga postures.

Yes indeed. This is from last week-- and proof positive that I am too loosey-goosey with the word "mantra." Apologies for the oversight-- and thank you! 

What’s the best way to find an ACT therapist?


There are about 5,000 listed on the main website for the professional society developing ACT. It is called the Association for Contextual Behavioral Science. There are nearly 9,000 members in 27 chapters worldwide. You can get to the website here: www.contextualscience.org (you can join too! They take public members and it lets you see the vast resources there on the website. Cheap). There is a “find a therapist” button on that front page, or just use this link:  bit.ly/FindanACTtherapist    Put in your location and when options show up click on “view” and find out more about them and their training, focus, or background

 

The LW mentions that she expects these hell fire attacks when s/he is in "the house". So, don't be in the house. Stay in a hotel and go to and from hospice. If they ask why you won't come over or stay with them, use a variation of the "bro" statement above "I'm here to help with mom, not be preached to".

Ooh, good catch! Nice possibility here. Thanks. 

Would you like to explicate the differences among Acceptance and Frame Therapy, Relational Frame Therapy, Cognitive Behavioral Therapy, etc.? And whatever happened to Gestalt Therapy? There was a time when that was the hot ticket. Perhaps you could take a common issue and describe your different ways of approaching it.

I love Gestalt as all old hippies did back in the day ... but there is another reason. ACT is a branch off that same tree. Gestalt was not developed just by  Fritz Perls ... in was developed also by a guy name Ralph Hefferline who was a function contextual behavior person (like me).  CBT same thing. I'm out of that tradition ... but I was there when it was just "behavior therapy" and all of the best stuff in behavior therapy is still in CBT, just like all of the best stuff in CBT is in ACT. ACT is usually said to be part of the "third wave" of CBT. So we gradually get better. CBT today is vastly different than CBT 10 years ago ... and ACT was part of that change. What is the difference? Well CBT thought you have to change thoughts to change emotions to change behavior. Third wave CBT like ACT discovered you needed to change your relationship to thoughts and emotions to change your life. So if you worry, for example, traditional CBT would have you test the logic and truth of the worry. ACT will teach you to watch it like watching a cloud. The change in that core idea opened up CBT to many other ideas (mindfulness etc). Now RFT is different. That is my baby and when I'm dead and gone I predict will be more important than ACT. Its a theory of how the mind works that is doing wonderfully well in areas like help kids learn to speak, raising intelligence, ... and yes changing therapy methods. I go thru the basics of RFT in A Liberated Mind. Think of it like physics and construction. Therapists are building the house; RFT shows why it stands up and where it needs a bigger beam. Geeky stuff ... but very powerful. If you want to explore it for you kids IQ there is a great website: RaiseyourIQ.com  

It's interesting that the LW describes him as having no plan when he does have a clear plan. It's just not the plan the LW wants. His plan is to keep his side chick booty call available. Sorry, LW....

Your last point may be a little much but your first point is well taken. Thank you.

Thanks for all of the comments. A few clarifications: I abjectly apologized at the time of the divorce and owned my behavior with my kids. And I have apologized again here and there in some halting discussions with them. I also go to a therapist for guidance. I don't hold money over them at all. On my re-marriage, I let my ex know that I planned to remarry "within the year" of when I did so and told my kids that the relationship was "headed toward marriage" but we actually just quietly eloped without engagement or participants, so they were not spectators nor were they "consulted." I will always show up for them but I guess I want them to see me as a person, not just their dad or their mom's ex-husband. I want to share my new happy self with them. And I want to share them with my new wife because I love them and am proud of them.

From last week. 

Thank you for this follow-up. Of course you want them to see you as a person, independent of the past baggage.... but that's a tall order. (It's also a bit of a strange order for them to not see you as their "Dad." You don't want to give up that role, do you?) I still think you run the risk of putting blinders on to how much this affected them. Yes, you'd like to excise it completely from their view of you, but their view of you is based on the fact that you were their father and things went a certain way. 

I really do think there's hope, I do. But I think you need to give them time. It is arguably just as unfair (if not more so) for you to except them to put their own feelings aside and view things completely newly and objectively going forward as it is for them to have feelings about this in the first place that may unduly follow you for a while. 

Please do keep us posted. 

My husband has major depression and anxiety which of course includes intrusive thoughts. We are not in the DC area. How can we find a therapist that uses ACT as part of their methods?

Look at the answer above and go to bit.ly/FindanACTtherapist    Help is out there. Don't lose hope

He absolutely has a plan. Lots of wisdom from the chatters. Save this chat and re-read it tomorrow. It's time to take back your power.

Yes! You chatters-- and the ways that you help each other-- are by far the best part of this whole shebang! 

Beware of trying to be your children's "friend" instead of their parent.

Valid point! Even when they are adults! 

What do YOU want? It doesn't seem like you're allowed to want anything, but rather you're supposed to conform your wants to what suits him. You're allowed to want things he doesn't want to give you. Grownups negotiate a compromise - they don't tell the other side they're wanting the wrong things.

Bingo! 

First, thank you both for making so much information and advice available. It helps. I have recently read A Liberated Mind, after reading Russ Harris's Reality Slap, Confidence Gap, and Happiness Trap (he likes the rhyme scheme?), as well as most of Steven Hayes's Get Out of Your Mind, plus misc. ACT material on the web. I regularly read both your wonderful blogs on Psychology Today. I also am seeing a psychologist who I got interested in ACT as part of his continuing education (although I can't say he's employed much of it in session yet). By now I have a pretty fair understanding of ACT and find many of its ideas and techniques helpful, such as defusion, acceptance, and the excellent set of metaphors and meditations. Yet I also see a lot of unconscious bias and assumptions around economics and class status, for example. As I read these books, I argued with them. So here's my main question: In all of them, there's an assumption that once a person has defined her values, then it's a simple matter to commit and put them into action, and that's that. It's a "Just Do It" approach. It's not so easy to just do it, and I find that part of ACT kinda breezy. One example, it's not simple to structure one's livelihood to align with one's highest values when there's no market for those values, rent to pay now, and real-life options are limited. Dr. Hayes considered some of that in part three of Liberated Mind, but surely there's more. Can you address that gap? When a person is forever struggling with survival matters (the bottom layers of Maslow's pyramid), how to pivot from ideals to action? Where do you find the mental/physical energy, for starters?

Great point and true I think. I have a new book called "Prosocial" exploring what else we need to put into people's life to help them move toward their values when issues of basic resources are at issue. A new ACT trial just out from the World Health Organization in Lancet Global Health showed that ACT could help South Sudanese refugees in Uganda who are dirt poor and have nothing and we applied ACT plus Prosocial in Sierra Leone to deal with the ebola crisis. So lets learn how to come together in small groups to support change even if it is hard. If refugees can do it, we can. There is a great "ACT for the Public" group on groups.io that is extremely supportive and has been going for a decade. Free. Join it. 


Thanks for the great questions. If you want to explore ACT I will send you an 7-item mini course if you go to stevenchayes.com and click on “yes, please send it to me.” No worries: I do not spam people or share these emails, and there is always a one-click opt out. If you want to read about my new book, A Liberated Mind: How to Pivot Toward What Matters  go to stevenchayes.com/a-liberated-mind. It is available everywhere and I think is the best way to get oriented toward what ACT can bring into your life and the lives of others.

 

My team and I would just love to know your thoughts on the overlaps of ACT processes (on self) in relation to Feedback informed treatment. Can those two together assist with clinicians mental wellness while also simultaneously improving outcomes for clients?

I think Feedback informed treatment is great and I would absolutely combine it with ACT. It help make ACT a more personal journey and that is the spirt of ACT in the first place. You can fit flexibility processes to your individual needs ... I teach how to do that (for therapists and clients alike) in A Liberated Mind.

Thanks so much for being here today. The hour always goes even faster-- which I'd barely think was possible-- when we have a guest. 
And what a guest we had today! The biggest of thanks go to Dr. Hayes, for his wonderfully thorough and thoughtful answers to your questions. Please do check out his work further at http://www.stevenchayes.com, and-- best of all, his new book, A Liberated Mind. Such an honor to have had him today!
In the meantime, take good care-- and I will look forward to seeing you next week. And you can always find me on Facebook and Instagram, and in my Psychology Today writings. 

In This Chat
Dr. Andrea Bonior
Dr. Andrea Bonior is a licensed clinical psychologist and the voice behind Baggage Check since its start in 2005. She serves on the faculty of Georgetown University, and is the author of two books in addition to the upcoming "Detox Your Thoughts: Quit Negative Self-Talk for Good and Discover The Life You've Always Wanted."
Dr. Steven C. Hayes
Steven C. Hayes, Ph.D., is a professor of psychology at the University of Nevada, Reno. The author of forty-three books and more than six hundred scientific articles, he has served as president of the Association for Behavioral and Cognitive Therapy and the Association for Contextual Behavioral Science, and is one of the most cited psychologists in the world. Dr. Hayes initiated the development of Acceptance and Commitment Therapy (ACT) and of Relational Frame Theory (RFT), the approach to cognition on which ACT is based. His research has been cited widely by major media, including: Time magazine, The New Yorker, The New York Times, Men's Health, Self, The Wall Street Journal, Psychology Today, O, The Oprah Magazine, and Salon.com. His most recent book is A Liberated Mind: How to Pivot Toward What Matters.
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