ACT

Overall structure

Mindfulness
Review homework/previous week
Psychoed
Skills
Review
Homework assignment
Week 1: Introduction

Mindfulness/Check-in

What is ACT?
o Acceptance and commitment therapy
Accept your feelings /thoughts and be present
Choose action that is in line with your values
Take action
o Evidence based
o Initially developed for chronic physical pain and realized it could be used for
emotional pain as well
o Like DBT it has mindfulness at its core; additional therapy that can give you
additional skills

Clipboard metaphor
o I want you to imagine that this clipboard represents all the difficult thoughts and
feelings and memories that you have been struggling with for so long. And Id
like you to take hold of it and grip it as tightly as you can so that I cant pull it
away from you. (Client grips it tightly.) Now Id like you to hold it up in front of
your face so you cant see me anymoreand bring it up so close to your face
that its almost touching your nose. Now whats it like trying to have a
conversation with me while youre all caught up in your thoughts and feelings?
Do you feel connected with me, engaged with me? Are you able to read the
expressions on my face? If I were doing a song-and-dance routine now, would
you be able to see it?
o And whats your view of the room like, while youre all caught up in this stuff? So
while youre completely absorbed in all this stuff, youre missing out on a lot.
Youre disconnected from the world around you, and youre disconnected from
me. Notice, too, that while youre holding on tightly to this stuff, you cant do
the things that make your life work. Check it outgrip the clipboard as tightly as
you possibly can. (The client tightens her grip.) Now if I asked you to cuddle a
baby, or hug the person you love, or drive a car, or cook dinner, or type on a
computer while youre holding on tightly to this, could you do it? So while youre
all caught up in this stuff, not only do you lose contact with the world around
you and disconnect from your relationships, but also you become incapable of
doing the things that make your life work.
 o What Id like you to do is place both your hands flat on one side of the clipboard
here, and Im going to put my hands on the other side, and Id like you to push
the clipboard away from you. Push firmly, but dont push so hard you knock me
over. (As the client tries to push the clipboard away, the therapist pushes back.
The harder the client pushes, the more the therapist leans into it.) And just keep
pushing. You hate this stuff, right? You hate these thoughts and feelings. So push
as hard as you cantry to make them go away. (The therapist maintains the
struggle so that the client keeps pushing while the therapist pushes back.) So
here you are, trying very hard to push away all these painful thoughts and
feelings. Youve been doing this for years, and are they going anywhere? Sure,
youre keeping them at arms length, but whats the cost to you? How does it
feel in your shoulders?
o (still pushing the clipboard back and forth with the client) And if I asked you now
to type on a computer, or drive a car, or cuddle a baby, or hug somebody you
love while youre doing this, could you do it? And whats it like trying to have a
conversation with me while youre doing this?: Do you feel a bit closed in or cut
off?
o Okay, now lets try something else. Is it okay if I just place the clipboard on your
lap, and we just let it sit there? (Client nods. The therapist places the clipboard
on the clients lap.) Now isnt that a lot less effort? How are your shoulders now?
Notice that you are now free to invest your energy in doing something
constructive. If I asked you now to cook a meal, or play the piano, or cuddle a
baby, or hug somebody you lovenow you could do it, right?: And whats it like
to have a conversation with me now as opposed to doing this
o Its still there. And of course you dont want it; who would all these painful
thoughts and feelings? But notice, now this stuff is having much less impact on
you. Now Im sure in the ideal world youd like to do this. (Therapist mimes
throwing the clipboard on the floor.) But heres the thing: youve been trying to
do that for years. Some of these things you do make this stuff go away for a
short while, but it soon comes back again, doesnt it? And isnt it the case that
this is now bigger and heavier than it was all those years ago when you first
started struggling with this stuff? There are more painful feelings, thoughts, and
memories here than there were five years ago, right?
o Were going to learn some skills that will enable you to handle painful thoughts
and feelings far more effectivelyin such a way that they have much less impact
and influence over you. How does that sound?

Hexaflex:
 o The goal of ACT is increased psychological flexibility. Its about increasing your
options for dealing with distress
o Overview of skills we are going to use in ACT

Passengers on the Bus

o It is as if you are the driver of a bus. On this bus weve got a bunch of passengers.
The passengers are thoughts, feelings, sensations, memories and other aspects
of experience.
o Some of them are scary. What happens is, youre driving along and the
passengers start threatening you, telling you what you have to do, where you
have to go. Turn left Turn right. The threat they have is that if you dont do
what they say theyre going to come up from the back of the bus. Its as if youve
made a deal with them- so long they sit in the back, scrunch down so you dont
see them very often, you will do what they say.
o In order to get them off you have to stop and go to the back to deal with the
mean-looking passengers. You had to stop. Youre not driving anywhere.
o You give up and go back to driving. The more that you experience this with the
passengers, it becomes second nature- you know where and when to turn in
order to avoid them coming up to the front.
o The power they have over you is that if you dont do what they say, they will
come up and make you look at them. Thats it. They could come up and do a
whole lot more, they look like they could but thats not the deal. So by trying to
get control, you have actually given up control. They could make a threat but
that has never happened. They passengers cant make you do something against
your will.

o Who are your passengers?

o Mine: I think I should know everything/ I never know everything/Im a failure,
discouraged to even try, etc
o What are the loudest? The oldest? The scariest?
o How do they impact your life?
o Do these passengers ever get off and stay off the bus?

Homework: Reflecting on your passengers

o The natural temptation is to listen to these passengers and then perhaps argue
with them, or try to get rid of them before driving on. However, if you can think
of at least one to three ask yourself:
 Whats happening to the direction and speed of the bus if we are focused
on fighting with the passengers?
Does engaging with the passengers make them more or less important in
our lives?
Week 2: The Struggle and Acceptance

Mindfulness/Check-in

Homework review:
o Did the passengers on the bus interfere with your driving?
o Today we are going to talk more about strategies for reducing their influence

Tug o War with a monster

o Imagine youre in a tug of war with some huge anxiety monster. Youve got one
end of the rope and the monster has the other end. And in between you, theres
a huge bottomless pit. And youre pulling backward as hard as you can and the
monster keeps on pulling ever closer to the pit. Struggle

Struggle
o Struggle can refer to:
The struggle with unwanted thoughts, feelings and psychotic sx
The struggle with oneself- negative self judgment, low self-esteem, self
loathing, etc
The struggle with life, others and the world
The struggle to remain psychologically present
The struggle with whatever is happening right here, right now, in this
moment.

Suffering
o ACT holds that psychological suffering is due to:
Cognitive fusion (getting caught up and entangled in your thoughts)
Experiential avoidance (trying to avoid or get rid of unwanted private
experiences, such as thoughts, feelings symptoms, memories, etc.)
o If you fuse with what your mind is saying, you will get caught up in a struggle
with whatever your mind has judged as bad or wrong
We will get to fusion in the future. We are going to address acceptance
now
o Suffering = pain + non-acceptance (In line with ideas of radical acceptance)

Avoidance strategies
o Control is the problem. Looking at if avoidance strategies have worked
 o Complete worksheet: ATTEMPTED SOLUTIONS AND THEIR LONG TERM EFFECTS-
ACT Made simple, pg 87 (draw concentric circles on board)
MOST COMMON CONTROL STRATEGIES:
D- How have you tried to distract yourself from these thoughts
and feelings?
O- WE often opt out (quite, avoid, procrastinate or withdraw)
people, places, activities and situations when we dont like the
thoughts and feelings they bring up for us. What are some things
that you opt out of?
T- Thinking- how have you tried to think your way out of it?
(blaming, worrying, rehashing, fantasizing, problem solving, self-
criticism, etc.)
S- Substances, Self harm, other strategies. What have you tried?
Does these get rid of your painful thoughts and feelings in the
long run so that they never came back?
o The power of avoided events derives more from our unwillingness to have them
than from the features they have. By engaging in tug of war with the monster
you are giving the monster power. Is there another option?
By letting go the rope, we are accepting the monster will be there and
will not go down the deep pit

Strategies for decreasing suffering

o Looking at workability- you can do a lot of things in response to distress, some
workable, some unworkable
Workability: how well something words towards creating a rich, full and
meaningful life (The aim of ACT is valued living: creating rich, full and
meaningful life through values-guided action.)
Something is workable if it enriches your life and enhances your vitality
We may take workable and non-workable actins towards a valued life
Does ___ work in the service of a vital, meaningful life?
Does listening to the thought, Im a loser, work in the services of
a vital, meaningful life?
Does avoiding going to parties or procrastination on my computer
work in the service of a vital, meaningful life?
o The things that help us avoid dealing with pain generally lead to more suffering
o Using a coping card to remind us to consider, Is this workable? can help
o Using acceptance strategies such as expansion or opening up can help
 Quicksand metaphor
o Lets say you were in quicksand and had no way to get out (alone, without rope,
etc). Most people (who dont know much about quicksand) will do what most
people do when they are stuck in something they fear: struggle to get out. This is
not how you get out of quicksand. Once one foot is lifted, all your weight rest on
only half of the surface area it formerly occupied. This means the downward
pressure instantly doubles. In addition, the suction of the quicksand around the
foot being lifted provides more downward pressure on the other foot. Then the
person will sink deeper. If you understand how quicksand works, you would
know to lie flat, spread-eagled, to maximize contact with the surface of the pool.
This may allow you to log roll to safety.
o Often we try to avoid unwanted thoughts, feelings and experiences. And for
most people, in spite of all their efforts, these problems persist and maybe cause
more suffering. ACT treats these unwanted thoughts, feelings and experiences as
you would treat quicksand. ACT asks you to accept that these unwanted
thoughts, feelings and experiences are present.
o It is a natural response to want to avoid suffering however, it us unlikely to
succeed in eliminating difficult feelings. This is because all it takes is an arbitrary
cue that evokes the right verbal relations.

Acceptance Strategies
o Encourage acceptance under two circumstances:
When control of your thoughts and feelings is limited or impossible
When control of thoughts and feelings is possible but the methods used
reduce the quality of your life
o Even though some control strategies are workable, there are times when nothing
seems to work
Acceptance strategies are mindfulness-based approaches to increasing
long-term vitality, for the times when our passengers wont get off the
bus, wont shut up AND when we want to keep driving away.
PASS OUT LIST OF COMMON ACCEPTANCE TECHNOQIES FOR DEAL WITH
FEELINGS
Start with noticing, breathing, expansion and compassion; Then
scientist or physicalizing, healing hand and struggle switch
Acceptance is a way of solving the problem that you might not
know was there
 If we dont accept what the problem is were not going to find the
right solution. What are the kinds of things that are hard for them
to accept? How do they think acceptance might be help with it?

HOMEWORK
o Struggling vs. Opening Up in ACT Made Simple- Russ Harris WS (pg 155)
Week 3: Values
Mindfulness/Check-in

Homework Review
o What did you notice about your struggle?
o What happened if you were able to open up and make room for them?

Intro to Values
o Values dictate where the bus is going. We want to move in the direction of our
goals even with our passengers telling us differently
o Clarifying values can be grounding and give us direction when the passengers on
the bus are really loud
o Can give us a sense of identity, a sense of who we are, how were the same and
different from other people
o Can be a source of motivation

Speeches
o This is an exercise thats about getting a sense for what you want to be about in
your life. Its a way of exploring what you would like to treat as important and
how you want to be with yourself or with others. If youre willing to give it a try,
well both close our eyes and Ill guide us through noticing different aspects of
our experience. Ill ask you some questions. You dont need to answer out loud.
Just notice what comes up for you. There are no right or wrong answers in this
exercise its all about noticing what comes up. Are you willing?
o OK, lets start by closing our eyes. Take a moment to get centered by noticing
your breath and noticing how your body feels. (Pause). If you find yourself
getting distracted or notice your mind wandering, thats OK. Just notice that and
gently bring your attention back to this exercise. (Pause). Now, imagine moving
forward through time. Imagine yourself aging and growing older as you move
through life. Imagine now that you are turning 80 years old, and your friends,
family, and coworkers have gathered to celebrate your 80th birthday.
o Imagine what you will look like on your 80th birthday. And, I invite you to
imagine not who you think would likely be there, but imagine who you would
most want to be at your 80th birthday party even if that means they would be
very old. There could even be people you havent met yet. (Pause). Try to really
picture who would be there. (Pause). Now the time has come in the party where
people are starting to give speeches. They are taking turns standing up and
speaking about what you have meant to them. They are speaking about what
you have stood for as a person, and the impact you have had. (Pause). Again, Im
not asking you to imagine what they would likely say. Im inviting you to imagine,
if you were to be bold in this moment, what you would most want them to say.
Deep down in your heart, imagine what you would most want others to say
about what youve meant. (Pause).
 o Imagine the first person standing up to speak. Imagine its someone very close to
you. Take a moment now and imagine what you would most want them to say
about the impact youve had. Try to really hear them saying that. (Pause).
o Now, imagine the next person standing up to speak. This could be someone from
a different part of your life perhaps a coworker or neighbor. And for them too,
imagine what you would most want for them to say about what you have stood
for in your life. (Pause).
o Now thank your mind for this experience, and gently bring your attention back to
the present moment. (Pause). Take a moment to get centered here, noticing
your breath and how your body feels. And when youre ready, you can open your
eyes.
o Questions:
What came up for you?
Who did you imagine speaking?
What did you most want them to say about you?
What other thoughts/feelings did you notice?
o Ideas to explore:
Values as a choice (in contrast to shoulds)
Values as an on-going direction or agenda in life (in contrast to specific
goals)
Values as a quality of action (in contrast to an emotion or object)
To care about something is to be vulnerable to it (pain and values are
connected)

Getting specific about values

o Lets talk more about values so we can take some of the ideas from the speeches
exercise and build on them and refine them so that eventually we have a list of
values across several areas of life
o What you do already know about values? (Put on board)
o Why is it important to clarify values?
o Some facts
Our values are our values, even if no one knew they were
Values are here and now; goals are in the future
Values never need to be justified
Values are best held lightly
Values are freely chosen
Values are ongoing. They dont have an endpoint. That doesnt mean
they dont change over time- they do, and the priority changes over time
Just because were not living in line with something at the moment
doesnt mean its not a value. Values are just what seem important to us,
even if its not currently being expressed.
For example: I value spending leisure time with friends that I can
be silly and adventurous with. Because I also value having a
challenging and personally rewarding career, and because that is
 the priority in this stage of my life and career, silly time with
friends isnt being expressed as much as I would like
It helps to be specific. We all value time with friends- what is it about the
quality of those relationships that matter most to you.
Right now, I really value a sense of humor and adventure. At other
times in my life, I may have valued open-mindedness and
intellectual curios most, or expressing dependability and honest in
my friendships
These are ways for YOU TO BE in relationships, not for OTHERS to be with
you. You want to formulate these things as ways of being in YOUR life,
not how you want others to be.
o Any questions?

Values worksheet
o Pass out values words- can mark words that jump out at you, and so you dont
end up with a really long list, underline words that are moderate values and
circle words that are strong values
o Then rank your values.

Homework
o Reflect on values worksheet

Other values activities (See Clarifying Values):

o Eulogy
When people die, what is left behind is what they stood for. Imagine that
a family member or friend is at your funeral and has been asked to stand
up and say a few words about what you stood for I your life, about what
you cared about, about the path you took.
First write down what you are afraid might be said if the struggle
you are currently engaged in continues to dominate your life, or
even grows
Then, write down what you would want to hear in your eulogy
about how you lived your life. This is not a prediction. Let these
words reflect the meaning you would most like to create, the
purposes you would most like to reveal about the time you spent
on this planet.
o Epitaph
 When people are buried an epitaph is often written. They say things like,
Here lies Sue. She loved her family, with all her heart. What inscription
would you like to see on yours How would you most like your life to be
characterized? Again, this is neither a description nor a prediction, its an
hope, an aspiration, a wish. What would you like your life to stand for?
Week 4: Action
Mindfulness/Check-in

Homework Review
o Review values and reflections
Committed Action
o Definition: taking larger and larger patterns of effective action and motivated by
values
It also means flexible action- readily adapting to the challenges of the
situation and either persisting with or changing behavior as required;
doing what it takes to live by our values
o The aim is a ongoing, evolving pattern of action. To establish the pattern of
repeatedly returning to our values, no matter how many times we lose touch
with them
o Metaphor:
Its like you were on a journey called Living well and you ran into a
swamp that stretched as far as the eye could see. Swamps are no fun.
Theyre smelly, theyre icky, theyre scary and yet swamps are part of the
journey. Life asks, Will you wade into the swamp or will you abandon
your journey? In order to choose to act on our values, willingness to
experience difficult events is necessary
The action of willingness has the quality of a leap of faith
o Step by Step
Choose a domain of life that is high priority for change
Choose the values to pursue in this domain
Develop goals, guided by those values
Take action mindfully
Activities
o SMART Goals
SMART
Specific
Measurable (or Meaningful)
Attainable (Adaptive)
Realistic
Time-bound
GOAL SETTING WORKSHEET
Practice setting SMART Goals for different time ranges
o The Willingness and Action Plan- Addressing internal barriers
Pass out
Pick one of previously created SMART Goals
Narrow to one domain based on importance, high life deviation or
feasibility
o Overcoming F.E.A.R
 If you havent taken action on a goal
F. E. A. R. covers most of the common barriers
F- Fusion
E- excessive goals
A- avoidance of discomfort
R- Remoteness from values
Opposite of F. E. A. R. is D. A. R. E.
Defusion strategies: name the story, thank your mind,
acknowledge Heres reason-giving or Heres judging, name the
demon/monster/passenger, recognize this is radio Doom and
Gloom broadcasting, or simply let the thoughts come and go like
passing cars
Acceptance strategies: name the feeling, observe it like a curious
scientist, rate it on a scale of 1 to 10, commit to allowing it,
breathe into it, make room for it, give it shape and color
Realistic goal-setting: If you lack skills, set goals around learning
them; if your goal is too big, break it down into small chunks; if
you lack resources, brainstorm how you can get them; if the goal
is truly impossible, e.g. due to health or financial issues or
external barriers over which you have no direct influence, then
set a different one
Embracing Values: connect with what matters to you about this
goal. Is it truly meaningful? It is aligned with your values? Is it
truly important? Is it moving your life forward in the direction you
wish to go?
o Alternate Activity
Bulls Eye
Clients may not identify with all the categories or some may be
missing fill in and fill out only what is applicable
*it is about how you want to be, not how you want others to be
Complete activity
Discuss
o Any passengers weigh in?
o Validate that it can be hard and that sometimes it takes
people longer than others
o Identification is the first step in driving the bus towards
your value
Week 5: Fusion/Defusion part 1
Mindfulness/Check-in

Homework Review

Cognitive Defusion: Your thoughts are not what they say they are
o What do we mean by thoughts?
Anything your mind creates: words, images, sounds, meaning, etc

o Fusion
Allowing thoughts to have excessive influence over our behavior
Looking from our thoughts rather than at our thoughts
Synonyms: absorbed, wrapped up, entangled, hooked

o Thoughts that may hook us:

Rules
I shouldnt be feeling this way, If I cant do it perfect, theres no
point in trying.
Reasons
Im too tired/busy/anxious/depressed, Ive always been like
this, Im damaged
Judgments
Im weak, Im no good at this, Im lazy.
The past
Old hurts, failures, mistakes, missed opportunities, the good old
days
The future
What you have to do later, fantasizing about a better life,
worrying about catastrophic possibilities
Self
Im not that kind of person, I am depressed person, I have a
disorder. I tell it like it is.
o WHAT THOUGHTS GET YOU HOOKED?

In a state of fusion:
o Thoughts are reality; its as if what were thinking is happening right here and
now even though its about the past or future
o Thoughts are the truth; we literally believe them
o Thoughts are important; we take them seriously and give them our full attention
o Thoughts are orders; we automatically obey them
o Thoughts are wise; we assume they know best and we follow their advice
o Thoughts may be threats: we need to get rid of them as fast as possible
 With defusion we can
o Let thoughts come and go, rather than holding onto them
o Simply notice thoughts, allowing us to act in the service of what matters to us
o Allow thoughts to have less influence over our behavior

Because in a state of defusion

o Thoughts are merely sounds, words, stories, bits of language, passing through
out heads
o Thoughts may or may not be true. We dont automatically believe them
o Thoughts may or may not be important. We pay attention only if theyre helpful
o Thoughts are not orders. We dont have to obey them
o Thoughts may or may not be wise. We dont automatically follow their advice
o Thoughts are never threats: no matter how unpleasant they are, we need not
get rid of them

Defusion is not about true or false but rather:

o Workable or unworkable
o In the service of dealing with things effectively, doing what you care about,
having a rich, full and meaningful life

Exercise:
o On the board:
o I am a failure vs Im having a thought that I am a failure
o I am pissed off vs I am having the feeling of anger
o ASK: What do you notice about them? What are their differences?

Discuss:
o Thoughts (Summary of Defusion Techniques from ACT Made Simple- pg 124)
Do a silly voice, singing, very slowly try with Milk

HOMEWORK:
o Getting Hooked Worksheet from ACT Made Simple, pg 133
o Pick 2-3 techniques and practice them. See if you are able to become more
present and if it decreases the influence of thoughts (did Diffusion occur?).
Week 6: Defusion
Mindfulness/Check-in

Homework Review
o Review concept of fusion: when a single aspect of your experience dominates
without choice
o When to use Defusion:
When your thoughts feel, old, familiar and suffocating
When you feel submerged in difficult thoughts and lose sight of the
external world
When your mind feels judgmental or has a heavy right and wrong feel
When your mind is overly busy or confusing

Activity: Take your mind for a walk

o One person plays themselves and the other plays their mind
o The person playing you mind is going to tell you all different thoughts, like minds
do
Plans: I have to organize my binder later, but first Im going to call my
mom, then check Facebook.
Observations: Its the end of the day and I havent thought about ___ all
day. Well until just now.
Telling you where to walk: Just sit down. This exercise is boring. People
are looking at you. Better yet, go to the bathroom.
o Your job is to continue walking, first and foremost, as well as to use some
defusion strategies
Identify 1 or 2 defusion techniques ahead of time
o If you are playing your mind, walk behind your partner, chattering like minds do,
telling the person what to do, what to think, where to go, while your partner
choses where to walk
o When you guys get started, check in with your partner about how hard they can
be on you
o The exercise will last 2-3 minutes each
Have them pair up
After 3 minutes, have them switch
o DEBREIF:
What was it like to be the mind?
What was it like to be you listening to your mind?
Emphasize: You had this distracting mind and you kept walking. Our
minds try to stop us in our tracks. When this happened were you able to
start walking again

Next activity: Feeling Good Exercise

o Complete and Discuss
 HOMEWORK
o Practicing Defusion
o Complete Defusion Practice form (3 times)

ALTERNATE ACTIVITY: Wear your thoughts

o Write down a judgment or thought you are ready to defuse from. Pick one
judgment- one word, a couple of words. This does not have to start with your
absolute worst judgment (Im stupid Im weak Im a bad wife). Out it on a
name tag or flashcard and wear it.
o Notice how it feels to have it out there
o This activity is about your ability to carry your history without losing your ability
to control your life- It makes it seem farther away and less important
o It doesnt take long for the power to decrease
o By doing this and confronting that fear, you take the power away. Avoid avoiding
things
o REMEMBER DO NOT RESCUE EACH OTHER. If you have the urge you can share
that you have the urge but dont engage in the behavior
o PROCESS:
What was it like to wear the signs?
What did you notice?
Its about not avoiding the thought and not struggling with it. It helps to
give the thought less power.
Week 7: Self-as context

Mindfulness/Check-in

Homework Review
o Review Defusion Practice Form

Discussion: Self as context vs. self as content (or observer self vs conceptualized self)
o Definitions:
The conceptualized self: all the beliefs, thoughts, ideas, facts, images,
judgments, memories and so on that form my self-concept, that describe
who I am as a person: my self-description. Fusion with these thoughts
leads to a sense of self-as-description: I am my thoughts!
Self-as-awareness: the ongoing process of noticing our experience,
contacting the present moment
Self-as- context: the locus/space from where noticing happens; the
perspective/viewpoint from which noticing happens; the I that notices
whatever is being noticed in any moment
Self-as context is not a thought or a feeling but a viewpoint
from which we can observe thoughts and feelings and a space in
which those thoughts and feelings can move. We get here but
noticing what we are noticing or becoming conscious of our own
consciousness. It is a place from which we can observe our
experience without being caught up in it.
o Metaphor:
Sky vs. Weather: Your observing self is the sky. Thoughts and feelings are
like the weather. The weather changes continually but no matter how
bad it gets, it cannot harm the sky in any way. The mightiest
thunderstorm, the most turbulent hurricane, the most severe winter
blizzard- these cannot hurt or harm the sky. And no matter how bad the
weather, the sky always has room for it- and sooner or later the weather
always changes. Now sometimes we forget the sky is there, but its still
there. And sometimes we cant see the sky- its obscured by clouds. But if
we rise high enough about those clouds- even the thickest, darkest,
thunderclouds- sooner or later well reach clear sky, stretching in all
directions, boundless and pure. More and more, you can learn to access
this part of you: a safe space inside from which to observe and make
room for difficult thoughts and feelings.
o This is important because:
The ability to shift into an observer practice can be source of strength
and stability
May be a place of being wiser and less attached to thoughts and feelings
May find it easier to let difficult things go
May find it easier to not be bullied by out feelings and thoughts
 May offer an answer to the question, well if Im fused with my
thoughts and feelings, what else is there?
o *Observing ourselves does not mean that we are passive. It does not mean we
cannot take committed action in line with our values

Activity:
o Tracking your Thoughts in Time (Get out of your mind, page 100)
It is likely that your thoughts will move around throughout time
The point is to simply notice the thoughts and where they occur from
2nd round:
do the exercise with the (gentle, defused) intention to stay more
present
If you are having a thought about the future or past, notice that
you are now having a thought
When you do that you are now back in the present and your
finger will be able to drift back towards the middle

HOMEWORK:
o Promoting self-as context worksheet
Will help us more quickly identify our labels
o OR continue with current mindfulness practice and every so often notice who is
noticing

ALTERNATE ACTIVITY:
o Track you thoughts on a continuum of good to bad, strong to weak (Get out of
your mind, page 103)
o Write your story from conceptualized self, rewrite it from observer self
Week 8: Willingness

Mindfulness/Check-in

Homework Review
o Review Good and Bad Labels
o Check in around noticing who is noticing

Discussion: Acceptance and Willingness

o Why would we want to accept thoughts and feelings?
We may want to stop thinking a distressing thought
One technique is thought suppression:
o Many psychologists have studied this technique. They
found that the frequency of the thought that you try to
think may go down for a short while, but it soon appears
more often than ever
o The thought becomes even more central to our thinking,
and it is even more likely to evoke a response. Thought
suppression increases our long-term discomfort

Activity:
o Lead activity:
Get a clear picture in your mind of a bright yellow Jeep. How many times
during the last few days have you thought of a bright yellow jeep? Write
down your answer in the blank next to number 1
Now for the next few minutes, try as hard as you can not to think even
one single thought of a bright yellow Jeep. Really try hard. Starting now
Now write down how many times you had a thought about a bright
yellow Jeep, however fleetings, during the last few minutes while you
were trying so hard not to think of it (next to number 2)
Now spend the next few minutes allowing yourself to think whatever
thoughts come to your mind
Write down how many times you had a thought about a bright yellow
Jeep, however fleetingly, during the last few minutes while you were
allowing yourself to think of anything (number 3)
o Process:
For most people, the number of times you thought about a bright yellow
Jeep went up over time
You might have been able to keep the thought of a yellow Jeep out of
your mind while directly suppressing it, but sometimes even that breaks
down, and the number of times such thoughts occur soars
Even if you were able to suppress the thought for a short period of time,
at some point, you will not longer be able to do so. When this happens,
the occurrence of the thought tends to go up dramatically.
 When we try not to think of something, we do that by creating a verbal
rule for ourselves: Dont think of X That rule contain X, so we will tend
to bring it up.
When we suppress our thoughts, we not only just think of something
else, we have to hold ourselves back from thinking about why we are
doing that. If we check to see whether our efforts are working, we will
remember what we are trying not to think and we will think about it. The
worrisome thought then tends to grow.

Discuss
o What is true for thoughts is also true for emotions
If we try not to feel a bad feeling, such as pain, not only do we tend to
feel it more intensely, but previously neutral events also become
irritating
Anyone who has or had a roommate knows this: if your
roommate is irritating you by making too much noise and your are
trying to ignore it, the noise just becomes more and more
irritating and, eventually, even little annoyances can cause you to
explode
o Outside the body, the rule appears to be: If you dont like it, figure out how to
get rid of it and then get rid of it
Examples: dirt on the floor? Sweep it. Split ends? Cut them. Headache?
Take ibuprofen
o Inside the body, the rule appears to be: If you arent willing to have it, you will.
Or, that which you resist persists.
o In addition to potentially increasing the frequency or duration of negative
emotions, suppression costs us because we miss out on the information that the
emotion may have to offer
In other words, if we chronically avoid what we feel, eventually we do not
know what we are feeling at all
Ex: you may begin a bad relationship by missing the signs your
own feelings would give you that your new love interest is very
similar to past partners who didnt work out for you. Or, you may
take a job that is overly stressful or overwhelming due to not
detecting feelings of reservation
o That being said: as DBT tells us Feelings are not facts.
Just because we sense danger doesnt always mean there
is danger; the emotion is the cue that tells us something
MAY be dangerous and we need to check the facts and
make a wise-mind assessment
o Acceptance is the tool and willingness sis how you use it

Discuss: What is Willingness

o Willingness is:
 Holding your pain as you would hold a delicate flower in your hand
Embracing your pain as you would embrace a crying child
Sitting with your pain the way you would sit with a person who has a
serious illness
Looking at pain the way you would look at an incredible painting
Walking with your pain the way you walk while carrying a sobbing infant
Honoring your pain the way you would honor a friend by listening
Inhaling your pain the way you would take a deep breath
Abandoning the war with pain like a soldier who puts down her weapons
to walk home
Taking in your pain like drinking a class of pure water
Carrying your pain the way you carry a photo on your phone
__________________________________
o Willingness is not:
Wanting your pain
Liking your pain
Deserving your pain
Resisting your pain
Ignoring your pain
Forgetting your pain
Doing what your pain says
_________________________
o Willingness is the answer yes to the question Will you take me in as I am?

Topic: The willingness scale

o Imagine 2 dials:
Discomfort: this measure problems like unpleasant sensations or
emotions or unpleasant thoughts or memories
Although it looks like an ordinary dial that can move on its own,
many times it functions like a meter- something that just passively
reads the Discomfort level and which you cant resent on your
own
o We think of it in terms of a 0-10 intensity
Willingness: this reflects your openness to experiencing your own
experience as it is, directly without trying to avoid, escape, manipulate, or
change it. Also this scale is 0-10. If you are totally open to your
experience, your willingness is a 10
This one you are in charge of your setting
If you have a high discomfort value, then it helps to have a high
willingness number too. Because, as we have learned, suppression
is not effective and in fact can amplify distress in the long-term
and create suffering
 Example: if you are really, really not willing to feel anxiety, when
anxiety shows up for you, that anxiety becomes something else to
be anxious about. You have a self-reinforcing loop.
Your ability to change the discomfort dial is limited but your ability to
change the willingness dial is unlimited.
o You do not have to be willing all the time
You can accept your present limits of willingness. We have to build up our
muscles to be able to swing the hammer. No one can swing a hammer all
day long
The key is to limiting willingness to time and situation
Ex: I am willing to experience/accept anxiety while asking for
help at the AT&T store to get my phone fixed for 5 minutes; or, I
am willing to experience depression- to fully experience it- for 10
minutes while we do an exercise in group
o That means you allow yourself to feel anxiety as fully as
you can experience it but you are committing to doing it
for the time you specify in advance
If you decide to practe this outside of group today,
do not pick a willingness leap that is beyond you in
the present moment. Let yourself practice small
leaps before you try leaping tall buildings in a single
bound
Remember that starting small means limiting the
time or context, NOT the amount of willingness.
You need to be totally willing to get the full benefit
o You do not have to accept everything
When we say acceptance and willingness we are NOT referring to
accepting situations, events or behaviors that are readily changeable. IF
you are being abused by someone else, acceptance of abuse is not
what is called for. What may be called for is acceptance that you are in
pain, acceptance of the difficult memories that have been produced, and
acceptance of the fear that will come from taking the necessary steps to
stop the abuse

Exercise: Willingness Practice- Physicalizing

o Were going to do an exercise that uses our imaginations to help us defuse from
uncomfortable, unwanted emotions
o The basis of this exercise is the idea of physicalizing- taking something inside us-
a feeling, and imagining that it has a physical form and is outside us for moment
o The reason is, when we look at objects outside ourselves, in our environment,
we dont take them to reflect on us. For example, if we see a pile of trash on the
street, we dont automatically think, Im trashy or Im dirty.
o However, with things inside ourselves, with thoughts and feelings that come up,
we often rush to fusion- to treat them as self-defining facts and explanations. For
 example, if we notice a feeling of self-loathing, we might think, well I guess that
means Im a horrible person. Horrible through and through, thats me, thats all I
am. As you know, again, a feeling is not fact and doesnt define you an more
than seeing some trash makes you trashy.
o So take a moment to identify an emotions or sensation that you tend to avoid
experiencing, and one that has cost you because of your avoidance. Examples:
anxiety, anger, guilt, depression, confusion
Write it down here: ______________________________
This is your target
o Begin by looking at the target item you wrote down. Get in touch with how you
feel when you think about target feeling or sensation
o Now I would like you to imagine taking this feeling and placing it four or five feet
in front of you. Late well let you take it back, so if it objects to being put outside,
let it know that you will be taking it back inside you. See whether you can set it
out on the floor or table in front of you in this room.
o This exercise may seem a little strange, and your may have to crank your
willingness dial up a bit.
o PROCESS: what was that like? How did it feel to have it outside of you? What
effect did it have on you?

HOMEWORK:
o Why Willingness?
Come up with reasons for why willingness is helpful for you