I decided to start this blog as a way to share some of what I've learned about the nature of human suffering and its alleviation. I'm doing this mostly with an eye on anxious suffering, and my experience with a new approach to psychological health and wellness called Acceptance and Commitment Therapy (or ACT, said as one word). I won't claim to have all the answers. My intent is to share.

Acceptance and mindfulness-based approaches are changing the landscape of psychology, mental health care, medicine, and society. They are based on a very old and radical idea, namely, that a good deal of human suffering is fed by efforts to struggle with and avoid our own psychological and emotional pain. New research from many sources now shows that this war tends to amplify our pain, takes enormous effort, doesn't work very well, and can keep us stuck and suffering.

So, what's the alternative? The alternative is this: paying attention, on purpose, in the present moment, without judgment, with a quality of kindness and compassion (self and other), and with both eyes on living out your values, right here, right now. These are skills that we all can learn and many studies show that people who learn them report more vitality, less illness, better quality of life, and greater freedom too.

Instead of more struggle, we learn to open up to our experience just as it is (not as our minds say it is), to hold our thoughts more lightly, to connect with our values (what we care about in this life), and to carry our minds, bodies, and personal history forward into a more vital and valued life. This set of very simple ideas goes against just about everything we've learned, at least in the West, since kindergarten. That's why they can be so powerful!

We are all in the same soup. Pain, in all its forms, is part of the human condition. Yet, that pain -- whether physical, emotional, psychological -- need not be fed and allowed to mushroom into the suffering that takes over and shrinks lives. There are ways to douse the flames that feed needless suffering -- the spin off that our mind and old history creates -- and to live well with the pains, joys, and sorrows that are part of life. This is where I think ACT can help.

Peace -john

Saturday, February 23, 2008

Acceptance and Commitment Therapy: Hope, Not Hype

I want to write about so many things. Some of what I have to say now is coming from the heart. I tend to find it easier to write that way.

I've spent 40+ years of my life learning a thing or two about human suffering and living well by direct experience. That's my life -- a mix of the vital, less vital, and sometimes ugly. I don't claim to have all the answers. As I said before, my intent is to share.

The last 20 years of my life have been about learning how to be helpful in a way that went beyond my intentions to help and beyond hype and common sense know how. In that time, I learned that good intentions aren't enough. I needed to learn know how to help, and with that I turned to a science of helping. That led me to cognitive-behavior therapy and ultimately to Acceptance and Commitment Therapy (or ACT, said as one word).

ACT is based on a solid research base, where claims are subject to peer review, scrutiny by others, and replication. You can check that out for yourself by going to www.contextualpsychology.org. This is an organization that is non hierarchal (no gurus), has values-based dues (meaning what you pay to access the material is up to you. You can join for as little as $1), and is open to the public and professionals.

The outcomes of this work have been impressive. ACT has been show in research to be helpful not just for anxiety, but also for depression, addictions, chronic pain, epilepsy, diabetes, eating disorders, work stress, burnout, and for some of the more serious problems that we know of, namely schizophrenia. Science has a funny way of reigning in hype and revealing hope.

Hype is false hope. It is the stuff built on testimonials, charisma, and tide commercials about change. Our workbook makes no such claims. It is not about hype, but sobered hope. We believe in the capacity of human beings to change their lives for the better. If we didn't
think that, then there would be no reason for a self-help book, and certainly no reason to spend the time and money to see a therapist.

And, we base the entire workbook on what our best available evidence shows. That evidence shows that there is hope for a better life, even with anxiety and fear. The truth is that change requires no book, no video, no emotional transformation. What it does require is a human being who has had enough and is willing to do something new, to get something new in their lives. Do you need a psychotherapist for that? You may. Ultimately though, it comes down to you - it is you, not a therapist or medication, that must take the reigns and take a stand regarding what you want to be about in this life. No book, video, or person can do that for you.

I am very skeptical of claims. You probably know that there are many in the self-help arena. Tap your way to a better life, change your diet, reprogram your brain. To date, there is no good evidence for any of this. It is what I call hype resting on false hope.

I won't claim that ACT is the answer for you either. You will have to decide that for yourself. You can be confident in knowing that the research base to date shows that ACT can be enormously helpful as a means to alleviate human suffering and restore lives in a way that is whole, dignified, and in a way that does not disavow the pains of life that we all experience now and then as we step in directions that matter to us -- work, family, spirituality, community/nature, recreation, relationships, and on and on. You and your emotional life are not the enemy. You, the person and doer of your life, can learn to live better with what your mind and body does from time to time.

I don't intend to get political here, but the audacity of hope ought to be based on something more than claims and empty promises. Hype is built on promises and testimonials, hope is built on hard work -- showing that something that is thought to be helpful is actually helpful. What's cool is that ACT has done this via basic and applied research and continues to do this in a way that is open, recursive, and subject to the careful scrutiny of others -- not just scientists but the end users like you. That doesn't sound like empty promises to me, but real hope for something different.

This is what ACT offers -- the real, hard won hope for change. That change ultimately rests in your hands, feet, and mouth. Taking a bold step by doing something new is risky, but the science shows that you are not shooting in the dark here. Living out your dreams is risky business, but the greatest risk of all is to not have lived, to remain a prisoner of your mind, body, and old history replaying the same old messages that keep you stuck.

There is hope based on the thousands of people what have benefited from this work. You are not going this alone -- many have gone before you and have found a way to move with their hurts and do what matters to them. That's what the data shows. No hype, just evidence. And, please don't believe me, you can find out for yourself and decide for yourself. It is a risk for sure, but it may be a risk worth taking if your experience is calling you to take a bold step out of the same old -- the stuff that is crimping your life.

Hype is like a wave -- motivated by money, prestige, glory, fame, you name it. It comes and it goes. Hope is solid, radical, transforming, dignified, purposeful, and builds on collective and hard won know how. That kind of hope is what you can get, but you have to take a stand and make a commitment to get a different outcome in our life. We do not promise that your anxiety will go away if you work with our workbook. What we do promise is this: if you really give this a shot, you are likely to find that you life will grow in ways that before now seemed impossible. Living well requires that kind of work. Just take it one small step at a time.

With a Kind Heart,
John P. Forsyth

Friday, February 15, 2008

How Have You Struggled With Anxiety

For the past weeks or so, I ran a little poll asking folks to share how they've struggled to control anxiety, fear, and stress. In a way, what I was asking folks to consider was the tactics they've use to beat the anxiety monster. I launched that poll shortly after this blog started. About 21 people responded.

The sample is a bit small, but I think it reflects some common strategies used by many people who are stuck and suffering with anxiety. I've listed the results below from the most common strategy to the least. As you look the list over, be mindful that most people selected more than 1 strategy.

Here are the results listed from most common to least common tactic with the percentages of people who endorsed each:

1. Distract myself from unpleasant thoughts and feelings 80%
2. Avoid activities or situations that may bring on anxiety/fear 76%
3. Try to suppress or push away unwanted thoughts/feelings 76%
4. Talk or vent with a friend 76%
5. Try to change how I think (thinking good thoughts) 71%
6. Try to talk myself out of my anxiety and fear 71%
7. Educate myself about anxiety and its disorders 66%
8. Sought out psychotherapy 66%
9. Turned to self-help books 61%
10. Take mediations 57%
11. Change diet or use herbal supplements and vitamins 47%
12. Stay close to safe people or situations 42%
13. Turned to alcohol and/or other drugs 42%
14. Run away from scary or frightening situations 38%
15. Join an online support group 23%
16. Carry objects or perform rituals 19%

All of these (and more) are reasonable and sensible strategies. If you are suffering from an anxiety problem, then chances are that you too have tried some of them. You shouldn't beat yourself up for that either.

The real question to ask is this: how have these well-intentioned anxiety management strategies worked for you? Think short and long-term here. Look to your experience and see if you can take stock.

Have they worked in the sense of defeating your anxiety monsters for good? Or, do they tend to buy you a brief honeymoon from your discomfort, with the anxiety monsters eventually coming back again and again to bite you and limit your life? Are you doing more with your life? Or, are you stuck and frustrated, with a nagging sense that the anxiety monsters will show up again and again, and then what?

If you're really willing to look at this and your life, you may find yourself reflecting on what you've given up in the service of managing and controlling your anxiety? Think here about want you'd spend your time doing if it wasn't focused on anxiety. These are the things that you probably care deeply about and that make your life whole and complete. And, these very same things are probably not happening as much as you would like because the anxiety monster seems to be ruling the roost.

I'm not putting these questions out there to make this blog post a real bummer for you. These questions are there for a simple reason. Unless we really take stock and look at the things that are not working in our lives, then we are likely to keep on repeating them. And, if we allow that to go on unchecked, then there's a great possibility that we'll continue to get what we've always got. I'm not sure what that may be for you, but chances are it may be more suffering in anxiety and a sense that you continue to feel stuck while your life is passing you by.

The good news about all of this is that things can be different if we are willing to risk doing something new. Instead of more struggle and resistance with yourself and your emotional life, you can instead opt for a kinder and gentler response. That softer response is what mindful acceptance can offer and what we describe in our new workbook.

And, people I know that have taken the time to nurture those skills tell me that they've gained a new found sense of freedom. They no longer feed the anxiety monster with more struggle. Nope! What they do instead is let it be just as it is and refocus their precious attention, time, and energy doing the things that they care deeply about in this life. Funny, I've never met anyone that put "He finally defeated his anxiety monster" on the top of the list of things they want to be known for in this life.

I've probably said enough for now. See if you are willing to spend some time with these questions. We all probably should do that while we still have the time to change. Watch your mind here too. Watch for "I'm beating myself up" kind of thoughts and judgments about this or that. When that happens to me, I smile, and thank my mind for those thoughts, those old hooks and rusty snares that tend to keep me stuck. And then, when I'm ready, I refocus again on what I want to do, right where I am and with my mind doing its thing.

With a Kind Heart
Dr. John P. Forsyth

Tuesday, February 12, 2008

Mindful Acceptance for Anxiety: Some Thoughts

I have a number of thoughts that I plan to share on this blog in the coming weeks. Much of that will speak to the ways that Acceptance and Commitment Therapy (or ACT) might be helpful to get out anxiety and back into a more vital life.

For now, I just wanted to share a recent interview that I did on the Kathryn Zox show. You can access the podcast by clicking here. The interview is mostly focused on my new book -- The Mindfulness and Acceptance Workbook for Anxiety: A Guide to Breaking Free from Anxiety, Phobias, and Worry Using Acceptance and Commitment Therapy."

As I replayed the interview, I had many thoughts about this or that. You'll see that Kathryn Zox (a very smart woman) was trying to wrap her head around some of what ACT and the workbook has to offer. I could sense the struggle for understanding a bit, and I think I know why it is there.

Most of us think of anxiety as a problem to be done away with, not as an experience that can be had while we live out our dreams. So, she naturally asked about the book in terms of ways to control and manage anxiety. I tried my best to reframe that talk, in part, because in my experience it is more of the same message that hasn't worked for me or many other people -- old wine, new label. You can listen for yourself to see how I did on that front. Right now, I know my mind is feeding me all kinds of stuff about the interview and most of it not good (thanks for the thoughts mind!).

You could certainly use mindfulness and acceptance strategies to defeat the anxiety monsters in your life. In fact, some people promote mindfulness to do just that -- use it as another shovel to dig yourself out of your pain. Yet, you can also use many other strategies too. I know I have. The poll on this page lists just a few of those tactics too.

At some point, and I'm not sure when, I asked myself whether this was just more of the same old -- mindfulness to relax away anxiety is like using relaxation to relax away anxiety. Then, I asked, has that really worked as I had hoped -- I mean worked long-term as a solution? Did the anxiety monster ever go away and for good?

I then asked the same about other sensible looking tactics that I and others have tried: distraction, challenging my thoughts, medications, staying in safe places, avoiding this or that, more medications, alcohol, becoming the expert about anxiety or another human emotion, or countless other tactics -- all about winning the war with my pain -- not just the anxiety, but the other stuff that I and most people don't like very much. My experience told me that these strategies were great at making the anxiety hole bigger, deeper, and more scary. That makes sense because shovels are for digging, not for getting out of holes. All of this is a natural product of struggle -- we are stuck in a nasty pit, watching, waiting, hoping and praying to get out. Yet, anxiety continues to get bigger and our lives continue to shrink. That is, so long as we continue to dig.

Our book is really about doing something radically new -- it challenges the struggle, control, management agenda itself without disavowing human pain. And, it shows a way into a more vital life without struggling to manage your thoughts and emotional experience. Remember from a previous post how I talked about thoughts and emotions being fickle. You can also think of them like ocean waves. Like the waves on the sea of existence, they come and they go without much effort on our part. Yet, they will certainly stick around the more we struggle against them. That is something I and many people with whom I have worked have noticed firsthand and from their experience.

The ideas in the workbook also cut against the grain of the culture of feelgoodism that most of us have grown up with. So, it is understandable why Kathryn was working hard to wrap her ahead about the ideas inside the workbook. The ideas are new, sometimes seeming a bit backwards at first, even upside down. I think that is a good thing. ACT is new, and it goes against the old programming, and that's also why it's also potentially vital as a way out of suffering and back into a whole, dignified, and complete life. I'll have lots more to say about ACT and anxiety later on.

With a Kind Heart
Dr. John P. Forsyth

Acceptance & Commitment Therapy Books