- 例如： 狗在我面前，我很害怕！
- 例如。 这里没有狗，但在拐弯处可能有狗！
当然没有人喜欢感到恐惧或焦虑，我们都不想拥有它们。 然而，恐惧和焦虑都不危险。 他们完全正常，每个人都经历。
想一想：在你的生活中，是否有些时候恐惧和/或焦虑在某些方面帮助到你、拯救了你、 保护你、 激励你？
I generally try to avoid using the word “acceptance” in my everyday clinical work. I found that people can become resistant when I say “accept it”, normally when I follow it with “allow it to be, let it be, without struggling”, they immediately get it, or at least become more “accepting” to the idea of acceptance.
Acceptance is not wanting or liking. You accept how things are going for you, doesn’t mean you like or want things that way. I accept that my cat has to be put down due to lymphoma, doesn’t mean I like or want him to be put down. I accept the sadness that comes with the loss, doesn’t mean I like or want to be sad.
Acceptance is also not tolerating. They are very different, do you want people to accept you, or tolerate you?
Acceptance is more about allowing things to be that way, accommodating it without struggling (so much) with it. Normally it applies to things that you can’t change directly (external events which you have no control on, e.g. your cat has lymphoma; but also includes your internal thoughts and emotions, which you can’t simply chuck away like a piece of paper, e.g. sadness, fear, anxiety, thought of “I’m not good enough”).
Most researchers in the field agree that there are differences between fear and anxiety. Here are some of the key ones.
- Generally seen as a response to danger here and now.
- E.g. the dog is right in front of me, I’m scared.
- Orientation: Here and now
- Higher sympathetic arousal, higher level of fight or flight.
- Generally seen as a response to a predicted/anticipated threat.
- E.g. no actual dog here, but at the corner there might be a dog.
- The degree of sympathetic arousal is lower
Of course nobody likes feeling fear or anxiety, we all don’t want to have them. However, both fear and anxiety are not dangerous. They are completely normal and everyone experiences them.
Think about this: Are there times in your life where fear and/or anxiety have been useful/helpful in some ways? Where fear and/or anxiety saved you? Protected you? Motivated you?
Here are some short Dropping Anchor recordings, suitable to be used when you’re feeling intense emotions and wanting to ground yourself to the here and now, and make the most of the situation you are in. (Ideally you’d have done more extensive version of it with me in sessions. )
Dropping Anchor recording 3.5mins
Dropping Anchor recording 2.5mins
Essentially it’s about these steps:
- Notice and acknowledge your painful thoughts. What is your mind telling you? (“I notice that my mind is having the thought of I’m not good enough, I’m a failure”)
- Notice and acknowledge your feelings and emotions. What are you feeling in your body? (heavy chest? tensed shoulders? headache? numbness? etc)
- Come back into your body, straighten your back, put your finger tips together, have a stretch, take a couple of breaths.
- Using your senses, connect with the external environment. What can you see? What can you hear? What can you touch/taste/smell?
- Action: Now that you’re grounded in this situation, what are you going to do to make the full of this situation?
Please note that it’s not necessary to follow these steps, when I do it I tend to move around. Sometimes you can quickly do this, or even repeat a few times within 30 seconds or so.
It’s important to notice that the pain hasn’t gone away, but despite what the mind is saying and how you’re feeling, you can still notice so many things else going on and take effective actions moving towards a more meaningful and fulfilling life.
近几年在北京当助教和翻译的时候，常遇见学生问说除了药物以外，还有什么方法可以帮助精神分裂患者，尤其许多患者用药虽然很重，但还是有幻听(auditory hallucination) 和妄想(delusion) 的症状，严重困扰着生活。
其实现在有越来越多的研究表明接受和承诺疗法（ACT）对于精神病患者很有帮助。作为干预，ACT不是特别针对症状减轻，而是强调对精神病症状更灵活的反应，以鼓励价值驱动的行为（就是你的生活由你的生活意义和价值来决定，而不是完全被你的病状所控制）。许多的案例研究显示，用ACT帮助偏执狂 (Paranoia)，妄想 (Delusion) 和相关的情绪障碍，虽然症状没有完全缓解，精神病依然存在，但却相当程度的减轻了患者的痛苦，而且生活的功能性和基于价值的活动(Value-based activities) 显著增加。
所以如果你，或者身边的家人或朋友患有精神分裂症，尤其幻听和妄想的症状在用药后依然对生活造成相当的困扰，可以考虑留言或电邮联系，因为只要患者有心改变，6到10次基于 ACT 的心理治疗就可以学习新的应对方式，减轻痛苦，活得更有意义。
I came across Acceptance and Commitment Therapy (ACT) in 2011 and fell in love with it almost immediately. Since then I have been practicing it on myself, then subsequently learning it from books, and started to incorporate it into my daily clinical practices.
Now I’ve also completed the course with Russ Harris. I’m wondering if there’s any ACT therapists in Malaysia out there, and if yes, please get in touch (my email: email@example.com, my mobile 017-2757813) and let’s form a Malaysian ACT community together!
- It stands for Acceptance and Commitment Therapy, pronounced as “act” (one word)
- It’s a type of psychotherapy, not a long-term treatment
- 3rd wave of CBT (Cognitive Behavioural Therapy)
- It focuses on 6 processes, which can be combined into these:
- Being present
- Opening up
- Doing what matters
- As of late 2018, there are over 250 RCTs (randomized controlled trials, the gold standard of research) published in peer-reviewed journals, that show the effectiveness of ACT with many disorders, such as depression, anxiety, stress, OCD, chronic pain and psychosis.