ACT Methods

Valued Living Questionnaire-2

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Below are areas of life that are valued by some people. We are concerned with your quality of life in each of these areas. There are several aspects that we ask you to rate. Ask yourself the following questions when you make ratings in each area. Not everyone will value all of these areas, or value all areas the same. Rate each area according to your own personal view.

Possibility: How possible is it that something very meaningful could happen in this area of your life? Rate how possible you think it is on a scale of 1–10. 1 means that it is not at all possible and 10 means that it is very possible.

Current Importance: How important is this area at this time in your life? Rate the importance on a scale of 1–10. 1 means the area is not at all important and 10 means that the area is very important.

Overall Importance: How important is this area as a whole? Rate the importance on a scale of 1–10. 1 means the area is not at all important and 10 means that the area is very important.

Action: How much have you acted in the service of this area during the past week? Rate your level of action on a scale of 1–10. 1 means you have not been active at all with this value and 10 means you have been very active with this value.

Satisfied with Level of Action: How satisfied are you with your level of action in this area during the past week? Rate your satisfaction with your level of action on a scale of 1–10. 1 means you are not at all satisfied and 10 means you are completely satisfied with your level of action in this area.

Concern: How concerned are you that this area will not progress as you want? Rate your level of concern on a scale of 1–10. 1 means that you are not at all concerned and 10 means that you are very concerned.

Addressing Pliance and Counterpliance

The therapist should also constantly assess other factors that may influence the client’s value statements, particularly those involving pliance and counterpliance. The therapist should be on the lookout for, among other indicators, the following signs that pliance or counterpliance might be influencing the process:

  • Values statements controlled by the presence of the therapist, in conjunction with the client’s assumptions about what might please the therapist. Relevant consequences would be signs indicating the therapist’s approval and/or the absence of the therapist’s disapproval.
  • Values statements controlled by the presence of the culture more generally. Relevant indicators would include the absence of cultural sanctions and broad social approval or widespread prestige.
  • Values statements controlled by the stated or assumed values of the client’s parents. Relevant consequences would be parental approval—either actually recorded and/or verbally constructed.
  • Values statements that have a “have to” quality that might indicate either fusion or avoidance.
  • Values statements that are heavily laden with rumination about the past and/or worry about the future.

It is difficult to imagine a client who would have values that were not controlled in part or at times by all of these variables. The key question is whether removal of the relevant influence would significantly affect the potency of the value as a source of life direction. The task of assessment cannot be completed in only one discussion. The issue of “ownership” of the value is likely to resurface time and again. Some of these issues might be best addressed by asking the client to talk about the value while imagining the absence of a relevant social consequence.

To illustrate, consider a client who endorses the value of being well educated. The therapist might ask if the level of valuing (or the value itself) would change if it had to be enacted anonymously: “Imagine that you had the opportunity to further your education but you could not tell anyone about the degrees you had achieved. Would you still devote yourself to achieving it?” Or, “What if Mom and Dad would never know you pursued an education—would you still value it?” A different tack might also provide some insight into controlling variables. So, for instance, the therapist might ask: “What if you were to work very hard for a degree, and Mom and Dad knew and were proud, but the day after you received the degree you forgot everything you had learned. Would you still value it to the same extent?” As the client considers various imagined consequences, he or she may be chagrined to find that parental approval is the “straw that stirs the drink.” In this case, “becoming well educated” is not a value at all but rather a goal in the service of some other value (i.e., “being loved by and loving those who are in my life”). Once this value is clarified, it is written down as a desired end. It is not uncommon for some values to change in valence over the course of therapy or even as a function of the initial assessment.

Missing Values

The VLQ-2 asks the client to generate responses covering many separate life domains. Often, clients may come in with forms showing one or more domains left blank, or unresponded to. With more dysfunctional clients, all the domains’ response slots might be empty or might contain only very superficial answers. Here, the therapist needs to patiently discuss each domain in order to elicit responses from the client. Often, it helps to go back earlier in the client’s life and look for examples of dreams, wishes, or hopes that have disappeared because of negative life events. At other times, the therapist may have to assist the client either in identifying hidden values that underlie his or her specific life goals or, conversely, in generating specific goals based on well-described but ungrounded values.

It is not unusual for clients to list specific life goals that cannot be achieved. For example, a woman might say that she wanted to regain custody of a child she gave up for adoption 10 years earlier. In these instances, the therapist tries to find the underlying value and goals that might be achievable if one were moving in that direction. Another variation of this problem exists when the client focuses on unattainable life goals as evidence that irreparable damage has been done and yet there are no real meaningful life outcomes available in that domain. This latter possibility is more difficult to address clinically because values are now being employed in the service of the status quo, whereas the client’s perspective is that no change or only superficial change is possible. In such circumstances, it is often useful come into the present moment and have the client identify the specific feelings that appear in him or her whenever this sense of permanent loss is encountered. The therapist might ask the client to identify the value at the source of the pain (e.g., “I wanted to be a good mother and felt my meth addiction would eventually damage my child; that’s why I put her up for adoption”). Sometimes the source of the pain is a closely held value that the client followed at great personal cost. The therapist can help the client “connect” to the expression of this value without necessarily taking a pollyannaish stance on what has happened.

Distinction Between Awareness and the Content of Awareness

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You can do this next mini-exercise with your eyes open or closed, and you can practice it anywhere it is safe to engage in reflective thinking. Take a breath or two, notice who is noticing that sensation, and then note your experience. Whatever your mind settles on–an external object, an internal sensation, a thought, a feeling, a memory, or so on-get clear on it. Then restate the experience in three forms: first, “I am aware of [state the content],” and then, after a pause, add “I am not [state the content],” and then after another pause, add “I contain awareness of [state the content].” For example, “I am aware of the television. I am not the television. I contain awareness of the television” Or “I am remembering a memory of being five. I am not a memory. My awareness contains a memory of being five.” Five or ten minutes is plenty of time for this exercise, and after the first engagement with it, you should practice it regularly for several days. Then, for ongoing practice, you can simplify the task. Just notice the experience and then state “I’m not that; my awareness contains that.” Don’t get drawn into an argument— instead see if you can touch a deeper awareness that your attachment to any content is distinct from awareness itself.

Catching Self-Awareness on the Fly

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Begin to regularly ask yourself the following question as you go your daily life: “And who is noticing that?” You can set reminders on your phone or computer to do this. Or you could set a rule for times to ask it, such as whenever you touch your phone, or keys, or wallet. When the cues appear, take a moment to notice your experience and touch awareness for a split second as you ask, “And who is noticing that?” Be careful not to let the question lead to an extended mental treatise about who you are-that is your judgmental mind trying to tell a self-story. Shut that process down if it kicks in by using your defusion skills, such as by listening to the mental treatise in the voice of Donald Duck, or imagining that you are a pompous professor holding forth.

The goal is to touch the “I/here/nowness” or your transcendent self, even if just for a millisecond. Over time you will find that asking yourself this question becomes second nature and your connection to your authentic self keeps strengthening.

Inside/Outside

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This last exercise helps build our ability to be aware of our internal experience while also attending to whatever tasks we’re engaged in, not getting rigidly fixated on either.

While you’re engaged in some task, say gardening or a household chore, keep paying attention to what you’re doing but also shift some focus to what’s going on inside your body. This is very much like focusing on both your feet. Allow any physical sensation to step forward but without grabbing all of your attention. Where do you feel this sensation? Notice the edges. What is the quality of the sensation? Hot/cold? Tense/calm? Throbbing/ constant? Tight/loose? Rough/smooth? Remember to stay with the activity as you do this.

Now bring your attention more fully again to the task, but also continuing to be aware of the sensation. How is the sensation related to the task? How are your feelings about the task, and your degree of focus on it, related to the sensation?

Your insides are reacting to the task, and your feelings about the task are impacted by that. Maybe you’re feeling deeply satisfied by seeing how well your flowers are growing and you notice that you have a physical internal sensation of pleasure even while you are also feeling some pain in your knees and arms. Or maybe you’re feeling bored with the task and you notice that you’re also feeling a slight sensation of hunger. It’s important that you allow your awareness of these interconnections to emerge from just shifting your attention around from inside to out and that you don’t start problem solving and giving yourself a rule-“I’ve got to find a connection!” This exercise is one of attentional focus, not of diagnosis. It helps us keep our attention limber so that we’re more fully present in the moment, with both our bodies and our minds. Over time, this helps us experience the present moment more fully, staying alert about whatever information may be presenting itself to us that can be useful, like that scent of roasting coffee my sailor friend picked up on.

Getting Present with the Past

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One of the most difficult challenges in focusing on the present is that our minds are so often “hooked” by the past-memories, emotions, and thoughts are all embedded in our mental networks and easily triggered. A helpful way of reminding ourselves of these hooks is the acronym I’M BEAT. If you notice you are being pulled from the present moment, see if you didn’t just get hooked by Interpretations, Memories, Bodily sensations, Emotions, Action urges, and Thoughts of other kinds (such as predictions and evaluations). Once you make yourself aware of them, you are back in the present! Said another way, the way to get unhooked is to bring full awareness to the hook itself. Almost always you will find the hook inside the I’M BEAT list (which is not a bad acronym since without awareness, these reactions will beat you down). Here’s a great exercise for learning to counter the pull of the hook.

Deliberately bring a memory to mind and then say to yourself, “Now I’m remembering that….,” continuing the statement by briefly describing the memory in one short sentence. For example, you might say, “Now I’m remembering that my boss told me I would never amount to anything.”

As you do this, be on the lookout for any emotions triggered; any bodily reactions, such as a tightening of your gut; thoughts that may arise; or an urge to do something. Also be alert to other memories that might pop up. When you’re done with the statement of the memory, attend to these emotions, thoughts, and other sensations one by one, saying, for example, “Now I’m having the emotion of sadness.” If you had the thought, “That should never have happened,” you should state it as “I’m having the thought that that should never have happened.” If you lost track of the responses you wanted to describe, o back to the memory and restate it to capture them again if you go can. For other memories that pop up, go through the same exercise.

This simple phrasing “I’m having the thought that . . .” is a powerful means of bringing defusion into mindfulness, creating a little distance from our thoughts and emotions and impulses that allows us to be in the present moment with them. The thought or feeling may be about the past, or the future too, but by these tags you are alerting your mind that this reaction is occurring in the now. Cultivating that awareness develops a powerful habit of mind that can help us stay on course even when the most difficult memories, thoughts, and emotions present themselves.

Open Your Focus

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Many attention practices teach you to narrow your attention, instructing you to focus on and repeat specific words (a mantra), or to look only at a small spot on the wall. But as I’ve been saying, it’s just as important to broaden your attention. One practice I rather like is called Open Focus. In this approach you consider entire sets of events at once (you have to soften the focus on any particular event to do this). The set can be composed of people, objects, sequences of thoughts, notes in music-really anything. Once you have a set you are interested in, focus on the physical or temporal space between the events: the physical space between objects, for example, or the empty gaps between thoughts or notes.

To clarify how to do this: look at the room you are in, focusing sequentially on specific objects. Then soften the focus on any particular object, and focus on the relationship (the “space”) between most or all of the objects in the room. With a few minutes’ practice of alternating between these two sets you’ll sense you’re using different attentional strategies. You can feel a softening and expansion of your attention as you adopt an open focus, and then a sharpening and narrowing as you focus on each particular object. A good way to practice this in daily life is during work meetings. In the next meeting you are in, see if you can flip back and forth between focusing on a specific speaker or listener and then on all the attendees at once.

How Helpful is That Thought?

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Ask yourself, “Is this thought helping me go in the direction I want to go?” Think back to your epitaph. Look at the consequences of being your thoughts, rather than having your thoughts. Simply allow the thought to be there and keep moving.

Thoughts as Spam Email

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You may have heard of a type of spam email called “phishing.” The initial ploy in phishing is actually quite simply: you are send an email message that results in a powerful emotional response. For example, you are informed that someone appears to be using your credit card illegally or there is a new virus out there that from which you are not protected. The email asks you for private information like you SSN, credit card number, date of birth, and driver’s license number so they can help keep you protected. Of course, this is all so they can steal your identity. What if your mind sometimes acts like this phisher? If can put an upsetting message in front of you and get you to impulsively attach to a thought, emotion, memory, or body sensation. Like the phisher, your mind will tell you that what it has to say is the absolute truth and requires a response. Like the email, you don’t have to respond to your internal experience. Slow down, step back. See if you can notice where responding will take you. You might be able to start to notice when your mind is throwing these at you, just as you’ve learned to spot spam emails. These experiences probably have somethings in common. Are they all-or-none, negative, provocative, urgent? Remember that the mind is not you, the mind is a tool. But it isn’t helpful tool 100% of the time.

The Little Kid

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This exercise will help you develop self-compassion. It’s vital to be aware that defusing from our thoughts should not involve self-ridicule or being hard on ourselves for having such thoughts. You are not ridiculous. You are human, and human language and cognition are like a tiger we’re riding that inevitably leads us into some dangerous territory. None of us can entirely prevent unhelpful thoughts from forming in our minds.

Take a difficult thought that goes back a long way in your history, and picture yourself as young as you can while having that thought, or others like it. Take a little time to picture what you looked like at that age-what your hair was like, what you dressed like. Then, in your imagination, have those words come out of that child in the voice of you as a child. Actually, try to do it in his or her little voice. If you are in a private place, try to reproduce the voice out loud-otherwise, try to hear it in your mind. And then focus on what you might do if you were actually in such a situation and your goal was to be there for that child. Picture yourself helping the child, such as by giving him or her a hug. Then ask yourself, “Metaphorically, how can I do that for myself now?” and see if some useful ideas come up.

Carry It with You

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Now write the thought on a small piece of paper and hold it up. Look at it the way you might look at a precious and fragile page from an ancient manuscript. These words are an echo of your history. Even if the thought is painful, ask yourself if you would be willing to honor that history by choosing to carry this piece of paper with you. If you can get to “yes,” put it care fully in your pocket or purse and let it come along for the ride. During the days you carry it, every so often pat your purse or pocket or wherever you keep it, as if to acknowledge that it is part of your journey, and it is welcome to come along.

The Hand Exercise

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Imagine writing down your thought on the palm of your hand (you don’t have to actually write it as long as you know it is there). Then bring your hand close to your face. In that posture, it is hard to see anything else-even your hand and the thought written on it in imagination are hard to see. This is a physical metaphor for fusion: thought dominating over your awareness.

Now move your hand with the thought still on it straight out away from your face. It is a bit easier to see other things in addition to your hand. Now move your hand with the thought on it just a little to the side so you can focus on it if you need to but you can also see ahead clearly. Those actions simulate the stance you want to establish toward your thoughts. Whenever you catch yourself being dominated by a thought, note how close to you it is. Is it like that hand in your face, or off to the side? If it is in your face, see if you can move it off to the side. Note that you do not get rid of the thought this way-in fact, you see it as a thought even more clearly. But in this posture you can do many other things as well, which is the core point of defusion.

Look at it as an Object

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Put the thought out in front of you and ask some questions about it. If it had a size, how big would it be? If it had a shape, what shape would it have? If it had a color, what color would it have? If it had speed, how fast would it go? If it had power, how much power would it have? If it had a surface tex ture, how would it feel to the touch? If it had an internal consistency, what would that be?

If after answering these questions the power of the thought is unabated, focus on your reactions to the thought-especially your judgments, predictions, negative emotions, or evaluations (e.g., “I don’t want that! I despise it!”). Hold those in your mind. Then pick a core reaction that seems central. Move the first thought to the side and place the core reaction in front of you. Now answer the same questions: If it had a size, how big would it be? And so forth.

After you’ve answered them all, peek back at the first thought. Is it the same size, shape, color, speed, power, texture, and consistency? Often you will find that it has changed in ways that give it less of an impact.

Sing It

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This method is powerful when you’re having a really sticky thought. Turn it into a sentence and try singing it-out loud if you are alone, in your head if you have company. Any tune will do. My default is “Happy Birthday.” Don’t have worry about trying to be clever about the wording, like coming up with a rhyming scheme. This is not going to get you on America’s Got Talent! Just repeat the thought to the tune. See if you can find a thought that is nagging y now and try it. Try different tunes; sing it fast or slow. The measure of “success” is not that the thought goes away, or loses all punch and becomes unbelievable. It is that you can see it as a thought, and do so just a bit more clearly.

Appreciate What Your Mind Is Trying to Do

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Now listen to your thoughts for a bit, and when your mind starts to chatter, answer back with something like “Thanks for that thought, George. Really, thank you.” If you speak to your mind dismissively, it will continue right on problem-solving. Be sincere. You might want to add, “I really get that you are trying to be of use, so thank you for that. But I’ve got this covered.” If you’re alone, you could even say this out loud. Note that your mind will probably push back with thoughts like That’s silly. That won’t help! Respond again with, “Thanks for that thought, George. Thank you. I really do see how you are trying to be of use.” You could also even invite more comments with dispassionate curiosity: “Anything else you have to say?”