Tag Archives: 接受与承诺疗法

What Acceptance is and is not?

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”).

Fear & Anxiety: Differences

Most researchers in the field agree that there are differences between fear and anxiety. Here are some of the key ones.

Fear:

  • 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.

Anxiety:

  • 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.
  • Future-focused
  • 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?

How to ground yourself during an emotional storm?

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:

  1. 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”)
  2. Notice and acknowledge your feelings and emotions. What are you feeling in your body? (heavy chest? tensed shoulders? headache? numbness? etc)
  3. Come back into your body, straighten your back, put your finger tips together, have a stretch, take a couple of breaths.
  4. Using your senses, connect with the external environment. What can you see? What can you hear? What can you touch/taste/smell?
  5. 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.

中文版:5分钟固定船锚录音

用于精神病患的接纳与承诺疗法 (ACT)

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。

ACT Therapists in Malaysia

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: hello@huibee.com, my mobile 017-2757813) and let’s form a Malaysian ACT community together!

 

What’s ACT?

  • 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:
    1. Being present
    2. Opening up
    3. 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.

冥想 VS 正念

“如何区分正念与冥想?”

这是一个我被问过几次的问题,下面的解答是基于我的实践和理解。

从广义上讲,冥想有两种类型。一是集中注意力。例如,当你专注于你的呼吸,一个单词,一个咒语,一个烛光,你放开任何引起你注意的事物,并将你的注意力集中在这一个事物上。(这种类型的一个例子:本森放松法

另一种冥想,是广泛的注意力(意识)。这就像你处于没有在进行比赛的体育馆里。你看着这整个空间。你可以像观察者一样观察整个体验,不评判,不反应。你允许事物来去自如。

第二种冥想,就是一种正念练习!正念的定义通常包括处于当下、带着觉察、不批判和接受(不过度反应)。当你在进行河流上的飘叶时,你注意并观察着你脑海中正在发生的事情。你当然可以将它概括到你的日常生活中,注意到你在哪里,你在干嘛,觉察你的想法/感受等等。

你可以随时随地练习正念。带着正念地吃,喝,工作,打字,开车,锻炼,运动,行走(即处在当下,觉察,并接受)。但是,你不能冥想着进行这一切。

有些人在走路,跑步或游泳时可能会冥想。这可以是第一类型的冥想(集中、狭隘注意力)或第二类冥想(扩大注意力)。第一类,你可能会在心里重复“一,二,一,二,一,二……”,或把注意力放在你的呼吸。第二类,你观察你的整个经历,比如你的肌肉如何运动,你看到,听到什么,觉察你的感受等等。

我会说两者都是冥想,但只有第二类是正念。希望我有把我的理解厘清吧… 欢迎分享你的看法!