Anyyone have experience with ACT?

October 31, 2008 11:57 PM

Anyone have personal experience with ACT (Acceptance & Commitment Therapy) and/or Stephen Hayes 'Get Out Of Your Mind, And Into Your Life'?

I am halfway through the book and would love to hear about people's experiences with this book and/or form of therapy...

posted by dinkyday to Health & Fitness (2 answers total)

Comment from a user who would prefer to remain anonymous.

I've experienced ACT in therapy, and read parts of the book which my therapist photocopied for me.

I can't recommend it, personally. The book's arguments have a strange, circular quality to them which made me uneasy. Many of his theories are unfalsifiable in a way which raises my logical hackles - he actually asks you to suspend your critical faculties at the very start of the book. I'm sure Stephen Hayes has the best of intentions, but he sure writes like a cult leader. His arguments about language don't gell with my experience of depression, and it bothers me that the model is supposedly applicable to every variety of mental foible, without adjustment. He developed the model to deal with his own crippling anxiety problems, and then extrapolated that to everyone else. The biggest trial of ACT found that among inpatients with psychosis, it reduced re-admittance by half. But I think it's prudent to test it one disorder at a time, rather than assume it works for everything and wait till the complaints roll in.

I did a few months of ACT with my (brilliant, experienced) shrink (previously we'd used CBT). We began by listing every method I'd used to try to beat recurring depression; later I looked up the therapist's handbook for this model in the library, and found a section called something like 'Inducing Hopelessness'. The person having therapy is meant to feel that everything they have tried has failed, so ACT is the only option remaining. Kind of a creepy technique to include in a treatment model, and really not very pleasant for someone who's clinically depressed. Then I had to articulate my values, which was probably the one beneficial part of the treatment.

After that came something the book called 'Radical Acceptance' - an infuriating technique where the therapist just accepts everything you say, without engagement or challenge, and then rearcticulates your 'values' back to you. (Ie: "Hmm, so you feel so depressed that you want to die. So what? Are you willing to feel that way and still write the essay you need to write?" When I was well I found ithis absolutely pointless, because the answer was always the same whatever issue I raised. When I was depressed, I found it downright damaging. It was just too close to the old "Yeah, sure you're depressed, snap the fuck out of it and harden up" attitude that's so prevalent in the rest of the world.

Anyway, it took a few sessions to convince my therapist that I really did want to go back to CBT; it wouldn't surprise me if that resistance is embedded in the model itself. Eventually I told her that I thought it was making me ill, and that I'd stop coming if she kept on using it.

If you're interested in mindfulness therapy, I can absolutely recommend 'The Mindful Way Through Depression' by John Kabbat-Zinn. It applies the (very useful) concept of mindfulness in a much more careful, thought-out way, and Kabbatt-Zinn carefully articulates what it can and can't help with. He mentions at the start, for example, that a person in a depressive episode probably shouldn't meditate until they're on the mend; something that Hayes never bothered to mention.

So yeah, that's a 'no' vote for ACT. I'm interested to read what others have to say.

posted by jessamyn at 6:47 AM on November 1, 2008 [1 favorite]

I don't have nearly as much to say as the anonymous responder, as my experience with it was even briefer, but my reaction to Hayes' book was similar. I found it frustrating, illogical, and circular, and its picture of depression seemed very unlike how I had experienced it for years. For integrating a better sense of mindfulness into my life, I actually found it far more useful to read Pema Chodron.
posted by scody at 11:41 AM on November 1, 2008