“All things appear and disappear because of the concurrence of causes and conditions. Nothing ever exists entirely alone; everything is in relation to everything else.”
As a therapist, I’m clearly interested in what gives rise to mental health issues and emotional disturbances, and deeply invested in ways to help alleviate psychological and emotional suffering. I’m often asked how I manage to work with troubled people all day without becoming overly troubled myself.
In fact, my clients are not at all burdensome and over the years of practicing therapy, I myself continue to grow and heal through the work I do both in and out of my office. While burnout is common in helping professions and self-care is a vital component of our work, the most beneficial aspect of my clinical practice is creating the conditions with my clients for psychological and emotional healing to occur using the ACT model of therapy.
Most people come to treatment when they can no longer tolerate their anxiety, depression or relationship issues, and their habitual ways of managing their symptoms no longer work. Often clients have been relying on strategies of control or avoidance or are self-medicating with food, alcohol or drugs to cope. Even more common, clients have spent years thinking about their issues, using mental problem solving and ruminating to try and fix them, and are stuck in patterns of unhelpful, negative thoughts that only make things worse.
Tragically, by the time many people begin therapy they feel ashamed and defeated that they haven’t “figured out” how to improve their mood, their relationships or their lives. Despite working so hard for so long to feel better, they end up sinking even further into the quicksand of their difficulties.
What I like best about the ACT approach is that it addresses such unhelpful thinking patterns, difficult feelings and self-sabotaging behaviors by employing mindfulness, self-acceptance, and the unique, personal values important to each individual client to guide behavioral changes. Taken together within the context of a nonjudgmental and caring therapy relationship, ACT promotes the conditions for growth and wellbeing.
So many clients ask, “Why am I like this?” or “Why can’t I change XYZ about myself?” People who struggle with psychological or emotional problems tend to be engaging unconsciously in well-developed habits of self-blame and self-contempt or they believe that others are to be blamed and scorned for their problems. They want to feel better but are unwittingly creating conditions within themselves or in their lives that prevent growth and healing.
The first step to an ACT approach is learning to shift the way we relate to ourselves and our difficulties. Most clients are unaware that they are even “relating” to their thoughts and feelings at all! Until we discover the ability to be mindfully aware that we are having thoughts and feelings and learn to be curious about and compassionate towards our more disturbing inner experiences, we generally operate from a reactive inner state that we dislike and feel helpless to change.
By resisting, judging, controlling, dismissing, or even hating our unwanted thoughts, feelings and experiences, we remain locked in a destructive pattern that works against us. By learning to see, accept and care about our own suffering, we develop a compassionate stance that gives rise to the body’s innate capacity to heal old emotional and psychological wounds. We create the conditions for spontaneous healing to occur.
Think about a physical injury or illness. When we break a bone, for example, we go to the doctor who sets the broken limb with a cast. The cast creates the conditions for the bone to heal; the doctor doesn’t heal the broken bone, your body heals spontaneously once the conditions for healing have been met.
The body is a self-regulating, self-healing organism when the conditions for growth and healing are present. What works for healing physical wounds also works for healing emotional wounds. Growth is nearly impossible under the harsh, unforgiving conditions we create with our inner conflicts.
The ACT model of therapy creates the conditions for psychological and emotional healing to occur by changing our relationship to ourselves. With ACT, we care about our own pain, rather than push it away. We’re curious about our own suffering, rather than blame ourselves or others for it. We open up and feel our uncomfortable emotions, rather than beat ourselves up for feeling bad. We recognize our unhelpful thought patterns and choose not to get caught up in them. We forgive ourselves for mistakes we’ve made, rather than judge ourselves for our imperfections. We choose to take responsibility for our behavior by acting in accordance with our values, rather than reactively acting out in self-sabotaging ways. We aim to stay present in our lives and with ourselves, no matter what.
Using ACT, I’ve profoundly changed my relationship to myself and have developed the capacity to hold space for my clients as they learn to connect to themselves to create the conditions for their own growth and optimal functioning. We can’t escape from ourselves, but we can learn to love and accept ourselves, warts and all.