Mark Dombeck, Ph.D. was Director of Mental Help Net from 1999 to 2011.
Dr. Dombeck received his Ph.D. in Clinical Psychology in 1995
I’m a little late on this one, but not too late to be useful. While in the gym the other day I came across the February 13th, 2006 issue of Time Magazine, and found therein a nifty article called “Happiness Isn’t Normal” about Dr. Steven Hayes’ Acceptance and Commitment Therapy (ACT). Hayes is an accomplished Clinical Psychologist with a pedigreed research background and about a thousand publications to his name. He’s also a maverick by nature, brilliant, and quite charismatic too. He has been developing ACT for over a decade now, largely in response (so far as I can tell) to what is perhaps an over-rational streak in modern cognitive forms of psychotherapy. Conventional (and dominant) cognitive therapy works by helping people to become aware of core beliefs that drive them towards painful emotions. Once a patient can become aware of a core belief, that belief can be analyzed and subjected to argument; a process known as cognitive restructuring, or reframing. If a thought is faulty or biased or based on shoddy evidence or a lack of evidence, that thought can be restructured and replaced by more accurate assessments which lead to better emotional outcomes. Cognitive therapy works – and works well – for many people, but there are also many people who don’t take well to the techniques for one reason or another and need other options. ACT is a good starting place for such people.
People who are able to effectively benefit from cognitive restructuring techniques by definition are able to regard their beliefs somewhat dispassionately; to stand away from those beliefs and look at the basis for holding them in the first place. Some people cannot do this sort of thing too easily. Some people are so deeply in the sway of their core beliefs that they cannot question them at all. Others fail to appreciate what their actual situations are (like the alcoholic who cannot come to grips with his or her inability to control drinking). In either case, such folks fail to get much traction with cognitive therapy.
In contrast to cognitive therapy which tries to beat one set of thoughts into submission with another, more accurate, set of thoughts, ACT takes the different tact of calling attention to the fact that all manner of thoughts can be a trap, and that the harder you struggle with your thoughts and beliefs, the more they will ensnare you. In this manner, ACT is the therapeutic version of the “Chinese Finger Puzzle” toy that some children play with (where you put your fingertips into both sides of a flexible fabric tube and then find that the harder and faster you attempt to pull your fingers apart, the more tightly the tube binds them). ACT tries to help patients slip out of the puzzle cage of their thoughts by helping them dis-embed themselves from their thoughts and to become a more playful witness of them instead of their prisoner. Instead of saying “I’m depressed” (by which you objectify yourself and define yourself by identifying yourself with depression), Hayes and company would encourage you to say “I’m having the thought that I’m depressed” (which detaches you from the thought, though acknowledging its’ presence just the same. In teaching people to witness their thought processes as a detached observer, Hayes is essentially copying some of the central tenants of Buddhist thought, albeit without the reincarnation and other mystical aspects that come with Buddhism.
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The reason Hayes is in the news is because he recently wrote a book for lay people on the subject of ACT called “Get Out of Your Mind and Into Your Life“. I haven’t read it, but I’m sure it’s good. ACT itself is not news however. It’s been around for over a decade and I’ve been impressed with it all that time. Back in 1996 or 97 when I was an assistant professor at Idaho State University, I joined several students and colleagues for an amazing weekend retreat with Dr. Hayes near Lake Tahoe which pretty much blew my mind (in a very good way). I’ve never forgotten that weekend, and I have never forgotten Dr. Hayes. I’m very glad to see the ACT approach gain some popular acclaim.
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