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

Thursday, July 8, 2010

Sneak Peak at Results of The Mindfulness & Acceptance Workbook Studies

As some of you know, we've been evaluating the Mindfulness and Acceptance Workbook for Anxiety (MAWA) in two large clinical trials. We wanted to find out if the workbook is helpful when used by people who are struggling with anxiety. And, we wanted to see if the workbook is helpful when people use it more or less on their own.

The first study -- comparing the MAWA to a waitlist control condition -- is done and we are writing up the results. The second study comparing the MAWA to the Cognitive and Behavioral Workbook for Anxiety is near completed too. I hope to share the full results of both studies here too, once we write up the findings and submit them for publication.

In the meantime, I have been presenting the findings at scientific meetings, and most recently at the World Congress of the Association for Contextual Behavioral Science in Reno NV. A colleague, Dr. Brian Thompson, attended the presentations and wrote a blog post about what he learned. I thought to share his blog post here in case you might be interested. You can check out his blog at Scientific Mindfulness.

With a Kind Heart

John P. Forsyth, Ph.D.

Monday, June 28, 2010

Mindfulness and Acceptance Workbook for Anxiety

Last week I attended the Association for Contextual Behavioral Science (ACBS) World Conference in Reno, NV. During the lunch hour for a pre-conference weekend training with Dr. John Forsyth from the University at Albany, SUNY , we had the option of sitting in on a presentation of some unpublished research John and his lab had collected about his recent self-help book, The Mindfulness and Acceptance Workbook for Anxiety, which he co-authored with Dr. Georg Eifert. I have an interest in the effectiveness of self-help books, so I was eager to see what he found.

John presented data from two studies. In the first study, he gave out free copies of his book through a website to participants who agreed to be randomly assigned to either receive his book immediately, or to receive it after being part of a 12-week waitlist condition. Participants were assessed before receiving the book, after 12-weeks, and at 3 and 6-month follow-ups. At the end of 12-weeks, compared to the waitlist, participants who used the book showed dramatic improvements in anxiety, depression, worry, social anxiety, and even PTSD. What's especially interesting about this is that anxiety decreased even though the book's emphasis is on improving one's life through cultivation of mindfulness, acceptance, and compassion rather than on getting rid of anxiety (and depression is not really addressed to my recollection). Readers of the book had significant increases in mindfulness, self-compassion, and quality of life that were maintained over the 3 and 6-month follow-ups. The same pattern happened for people who used the book after getting off the waitlist. Another remarkable thing about this study is that about half the participants were currently in psychotherapy and/or taking meds, suggesting that the book contributed to improvements above and beyond individual treatment. Nearly everyone (91%) had been in therapy before.

In a second study that is still underway, John used a similar design to compare his book to The Cognitive Behavioral Workbook for Anxiety, a respected workbook by William J. Knaus. John's lab is still collecting follow-up data, but results are showing that, although both books appear effective, people using the Mindfulness workbook are showing greater outcomes on virtually all measures.

I think these studies are great for several reasons. For one, the market is filled with self-help books but rarely are they evaluated to determine if people actually find them helpful
. Two, this is the most naturalistic study I've seen, as participants have no additional interaction with John's lab except to complete the online outcome assessments. Some other studies I've seen involve occasional interaction with someone from the lab to help people with a book, but in these studies, people are largely left to their own devices. Lastly, this study is very brave in that John risked finding: 1.) that his book was not helpful after all; 2.) that his book was helpful, but not as helpful as the Cognitive Behavioral workbook. Instead, his commitment to science has paid off for him in a big way. This book is a great illustration of how cultivation of mindfulness, acceptance, and compassion can really improve our lives.

Here's the website: www.actforanxiety.com

Here's the book:

Forsyth, J. P., Eifert, G. H. (2008). The Mindfulness and Acceptance Workbook for Anxiety: A Guide to Breaking Free of Anxiety, Phobias, and Worry Using Acceptance and Commitment Therapy. Oakland, CA: New Harbinger.


Anonymous said...

I am just starting to read this workbook for my stubborn GAD. I am just finishing the third chapter and can say that no other book has explained what I have been going through so well. I had actually bought it a few years ago but did not start it, preferring to continue with a therapist, though I have experienced no tangible improvement. I really understand what is going on much better now just from reading the first few chapters of your workbook. Everything just makes so much sense. It has really described my situation with amazing accuracy. I am feeling very positive about working through this program already. Thank you.

catler said...

Hi John
I'm not suprised at how positive the first comments are on the results. Congratualtions to you and the team. I look forward to seeing the full study results

Dr. John P. Forsyth said...

Thanks for the kind words. Doing the work of doing something new is a process that takes hard work and commitment. But I also think this is true of anything worthwhile.

Sometimes I remind myself that it takes a lifetime to create a life. There is always more to do, more ways to grow. There is no finish line at which we can say, "now I am done." (at least so long as we are living).

Peace -john

Linda Eaton said...

Hi, Dr. Forsyth--I found your workbook at Barnes & Noble a number of years ago and have recommended it to many clients. You and your team put together a wonderful book to help people with anxiety and a great introduction to mindfulness.

We all love the meditation CD that came with the workbook. The woman who does them has a very soothing and pleasant voice and I am wondering if you've used her since to create other meditations. I promised a client I would do my best to find out her name and whether she's done others so we can get them! Any help you could give me would be appreciated.

Acceptance & Commitment Therapy Books