Mental Health Acceptance and Commitment Therapy (ACT)

[SixBuckets]

Hi all,

Is anyone familiar with this therapy model? It's the model used by my new pain management clinic, and from what they've told me (and my own research) it seems to pretty much boil down to "just don't worry about negative thoughts, do things you like instead". Which might be useful for people who "just" have chronic pain, but seems wildly inappropriate and uninformed when it comes to people living with mental illness.

Does anyone know if there's more to it? I'm able to opt out of the therapy component of pain management, so it's not really a big deal - I'm just wondering what I'll be missing out on if I do.

 

[NOtoInvega]

Sounds like group.... Probably the usual positive thinking and "coping skills" run-around. Why would they have u go to group for pain management? Talking about how ur pain feels won't make ur pain go away.

 

[SixBuckets]

Sounds like group.... Probably the usual positive thinking and "coping skills" run-around. Why would they have u go to group for pain management? Talking about how ur pain feels won't make ur pain go away.

I think this is the first time I've agreed with you. I think it's a one-on-one session, though, not group... not sure.

Eh, the therapy (in combination with medication/physical therapy/chronic disease self management approach) is really helpful to some people living with chronic pain. I don't personally find techniques like mindfulness or meditation very useful, but they help some people whose pain is closely connected to negative self talk and things like that. I guess the whole "learning to accept the things you cannot change" thing has some value, even if it's too closely associated with AOD abstinence for me.

 

[NOtoInvega]

Pain can be caused by negative thoughts? Are you sure they aren't trying to get people to trick themselves into believing that? That reminds me of people lying to people who are dying and telling them they will be fine - trying to make them think positive to "improve their chances." Makes no sense. "He's dying, we better lie to him."

 

[SixBuckets]

Pain can be caused by negative thoughts? Are you sure they aren't trying to get people to trick themselves into believing that?

I think it's more common for pain to cause negative thoughts, not the other way around, but it can turn into a really nasty feedback loop where the pain and the negative thoughts become linked and make each other worse. Basically, if you're in pain, it makes you miserable, then your pain feels even worse because you're depressed about it. Does that make sense?

There are some chronic pain conditions that are more common in people with some mental illnesses, but I don't believe the mental illness causes the pain.

 

[jammin83]

SixBuckets if you decide to go through with it let me know how it goes for you. My old therapist was pushing it on me pretty hard but I ended up not going through with it. Would be interested to hear if it goes well for ya.

 

[SixBuckets]

I'll definitely let you know. My next appointments with pain management are at the end of the month, so I guess I'll talk to them about whether the therapy is something I want to do at that point.

 

[herbavore]

IME just about every therapy model from ACT to primal screaming () has some kernel of value. Therapy is like religion--perhaps a good and useful model/insight that then might be completely derailed and fucked up by the adherents and proselytizers ( us humans). I like reading about any particular therapy before allowing someone else to present it to me--that way I have given myself the opportunity to sift through the concepts. I find that almost everything is useful when you give yourself permission to use concepts "cafeteria style". I'm also not religious but haven't seen a religion yet that did not contain at least something that I could use for my own betterment.

I'm anxious to read about your experience with this. If it is not too personal, is there any particular problem that you are trying to address with it? (Anxiety for example, or is it just for general discomfort/imbalance?)

 

[SixBuckets]

IME just about every therapy model from ACT to primal screaming () has some kernel of value. Therapy is like religion--perhaps a good and useful model/insight that then might be completely derailed and fucked up by the adherents and proselytizers ( us humans). I like reading about any particular therapy before allowing someone else to present it to me--that way I have given myself the opportunity to sift through the concepts. I find that almost everything is useful when you give yourself permission to use concepts "cafeteria style". I'm also not religious but haven't seen a religion yet that did not contain at least something that I could use for my own betterment.

I'm anxious to read about your experience with this. If it is not too personal, is there any particular problem that you are trying to address with it? (Anxiety for example, or is it just for general discomfort/imbalance?)

I've found almost every type of therapy completely useless for me, but I recognise that that's my response and not an indication that the therapy model is busted. I did get a little benefit out of a self-directed CBT course I did for anxiety related to PTSD, in that it gave me some exercises I can do if I find myself fixating on things that freak me out.

This ACT therapy isn't really something I'm seeking out - it's something offered by the pain clinic I'm attending. I have fibromyalgia (chronic widespread pain and fatigue condition) and have been having trouble getting treatment because a lot of doctors don't want to take on patients with comorbid psych conditions. The pain management clinic has accepted me as a patient, but they want me to be assessed by their psych team as well as the clinical physicians. I've expressed that I'd prefer them to consult with my psych, but they're nudging me towards doing a course of ACT with their psychologist anyway.

So basically it's therapy for 'coping with chronic pain'. I don't think it will help much, but I don't want to rule it out without at least considering it.

 

[herbavore]

I have an auto-immune disease that shares some of the symptoms of fibromyalgia and arthritis--stiffness and pain in all my joints, fatigue and the concurrent psychological effects from those (lack of motivation, mild depression). I have found the techniques offered by mindfulness to be life-changing even when it comes to lessening physical pain and discomfort. About a year ago I had an epiphany in the form of a childhood memory. I was talking to a friend about tickling. We were talking about how as children it can either be fun or traumatizing depending on the kid as well as who is doing it and why, as it is certainly a loss of control on the part of the tickled and an act of physical control on the part of the tickler. I was so afraid of being held hostage to tickling as a kid that I determined to be unresponsive to it by using the power of my mind over my physical sensations. Basically, I used the strategies of mindfulness before I'd ever heard the term or knew anything about it, by entering completely into the experience and then stepping outside of it in my mind as an observer. I would ask myself questions about each facet of the sensation--and by separating each strand from the whole I could completely disassociate from the usual uncontrolled reaction. I have found this same strategy to be useful in how I perceive pain now. Certainly it has not removed pain from my life but it really has helped. My reason for telling the tickling story is that I sometimes think we have so much wisdom in ourselves as kids--our relationship with our own minds is still so fresh and new that fatalism and negativity are not the hurdles they become later.

I do hope it helps you--fatigue and chronic pain are so wearing.

 

[SixBuckets]

I'm sorry to hear that you deal with these things as well, but really happy to hear that you've found techniques that work!

I'm pretty familiar with mindfulness techniques through trying to use them to manage anxiety, but they just don't really work for me. They definitely work for other people, though, and the efficacy data is in their favour.