Saturday, February 14, 2009


I recently had the privilege of being trained in Acceptance and Commitment Therapy, otherwise known as ACT, at the Togus VA Hospital in Augusta, Maine by Dr. Kevin Polk and his colleagues. Dr. Polk and his staff provide a five day, 13 session group treatment program for veterans suffering from post traumatic stress disorder (PTSD).

ACT is a mindfulness and acceptance-based form of psychotherapy based on a contextual understanding of language and cognition. The basic idea behind ACT is that human psychological suffering is largely due to our tendency to fuse our identities with verbal descriptions and evaluations of our behavior. We come to believe that we are what our verbal descriptions and evaluations say we are. For example, when we experience the feelings, thoughts and related images of a depressed mood we fuse our identity with verbal descriptions of those feelings taking them to be the literal truth of our identity. So rather than saying that we are having a depressive thought, feeling, etc., we conclude, "I am depressed."

Once we have fused with our thoughts in this way we take them to be literal statements of our self identity when in fact they are nothing more than verbal descriptions of thoughts. In addition, the culture is constantly giving us the message that psychological health and well being requires that we get rid of our negative psychological experiences like the feelings, thoughts, etc., associated with depression.

The argument goes like this ... I am depressed. ... I won't be able to function well and be happy unless I get rid of my depression. ... I must find a way to get rid of my depression. ... until my depression is gone, I won't be able to have a meaningful life.

Part of the problem with this view of difficult internal experiences and our sense of self is based on what has been called the RULE OF THE MIND. In the world outside of our skin we can get rid of things we no longer want. For example, if we don't want a jelly donut, we can simply throw it away. However, try to not think of a jelly donut after someone tells you not to. It's impossible. As soon as you say to yourself, "don't think of a jelly donut," guess what? You immediately think of one.

In the same way, as soon as you try to use your mind to get rid of your depressive thoughts, feelings, etc., guess what? You evoke and elicit them. So the RULE OF THE MIND says, if you don't want a difficult feeling, thought, image, etc., you've got it!

So now what do we do? Well here is the good news. Your thoughts, feelings and associated images really can't hurt you. The only thing that can hurt you is your behavior. For example, in an attempt to get rid of depressed feelings you can engage in the behavior of drinking. The effects of alcohol will temporarily suppress those feelings. Unfortunately, they haven't gone anywhere. As soon as you sober up, they are still there waiting for you. You really haven't gotten rid of them at all. The alternative is to simply accept those feelings as "things" that come and go, like clouds in the sky, and move (take action; i.e., behave) in a valued life direction like having a fulfilling career. So rather than waiting for "your depression" to finally and completely be resolved, you start engaging in those behaviors that will move you towards your life value of having a fulfilling career. For instance, you start looking at the classified ads, polishing up your resume, contacting a career counselor, etc., even as you experience feelings of depression.

Yes ... you can experience feelings of depression AND have a valued life. Why, because you can control your behavior and take the steps necessary to move in a valued direction even if you can not control the appearance of your depressive thoughts. You just learn to take those thoughts with you as you move in a valued life direction.

There is an old Zen story that points to the truth of the RULE OF THE MIND. It can be found in the Gateless Gate, a collection of Zen koans compiled by Mumonkan:

Bodhidharma sat in zazen facing the wall. The Second Patriarch, who had been standing in the snow, cut off his arm and said, "Your disciple's mind is not yet at peace. I beg you Master, please put it to rest." Bodhidharma said, "Bring me your mind and I will put it to rest." The Second Patriarch said, "I have searched for my mind but can not find it." Bodhidharma said, "I have completely put it to rest for you."

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