Intro to CBT - ACT (Part 2)

Self as Content (Conceptualized Self)

• The Story of Me

• Organized into cognitive networks coherent across time and situations

  • Well-elaborated

  • Multi-layered

• Once we have a story, we don’t like how it feels to be “wrong” about our story: e.g. cognitive dissonance

• We guard and defend our stories with our lives

• We work to construct our worlds in a way that confirms the truth of our self-label

The Documentary of You

Your mind is telling you a story.

• Usually true to a degree, but not the whole truth

• Scenes are selected to maintain the truth and coherence of the story

• The story is not YOU

Common Treatment Interfering Conceptualized Selves

Over attachment to:

• Illness as part of identity

• Victimhood

• Likability

• Everyone else is the problem, not me

• Busyness as a virtue

• Caretaker roles

• Success/things come easy to me

Self as Context

This approach involves understanding that one's identity is distinct from thoughts and feelings, fostering a stable sense of self amidst changing internal experiences.

• This perspective helps individuals maintain a consistent sense of self-identity, even as their thoughts and emotions fluctuate

• Chessboard metaphor: be the chessboard, not the individual pieces

Self as Context - Characteristics 

• The sense of self as perspective 

• Not threatened by aversive content

  • Facilitates willingness, compassion, intimacy

• Moving towards self as context

• Moving away from self as content

Values 

Freely chosen, verbally constructed consequences of ongoing dynamic, evolving patterns of activity.

• Establish predominant reinforcers for that activity that are intrinsic in engagement in the valued behavioral pattern itself

• Tombstone metaphor: What would you like your life to stand for?

  • Not description nor prediction; it’s hope, aspirations, wishes.

Values-Based Decision-Making Skills

• Values Clarity

• Building a Valued Life

• Values-Based Decision Making

• Values Awareness

• Up Votes and Down Votes

  • Every decision is one of these for your values

• Using Values to Address Negative Mood

  • Unpleasant feelings can be a signal that we are about to make a decision about how to act or behave

• Addressing Competing Values

Values-Based Decision-Making

Behaviors as choices

• Consider options

• Consider values and goals

• Engage in behavior congruent with values

Values Conflict 

1. Clarifying Disorder - Specific “Values”

2. Values Integration

3. Values Prioritization

Values Integration

Find ways to integrate multiple values into one activity

• Even if values feel like they are incompatible

Values Prioritization

Prioritize a value when it is hard/impossible to make choices that are consistent with multiple values.

• Don’t always default to same value

Values vs. Goals

• Values = direction

• Goals = milestone markers

Committed Action

• Encourages taking concrete steps toward goals that are consistent with one's values, promoting perseverance and adaptability.

• Involves setting specific, values-driven goals and pursuing them despite obstacles, thereby enhancing overall life satisfaction and achievement

• Means living in line with our values even when we have difficult thoughts and feeling

Committed Action - Goals and Behavior Change

• Unlike values, which are constantly instantiated/followed but never achieved as an object, concrete goals that are values consistent can be achieved and ACT protocols almost always involve therapy work and homework linked to short, medium, and long-term behavior change goals.

• Behavior change efforts in turn lead to contact with psychological barriers that are addressed through other ACT processes (acceptance, defusion, and so on)