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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by pseudoname on June 5, 2006, at 20:36:11
[I marked the *trig* section beginning & ending, and it doesn't describe anything graphic, just a fear of murder.]
On the Books board, I said a few days ago that even if "Acceptance and Commitment Therapy" is ultimately successful for me, I surely will nevertheless prove to have been a VERY hard case. So I'm going to report my recent efforts -- I think progress, actually.
Since there are no other ACT users on this board AFAIK, this post is just a teaser, I guess, or thinking out loud. Or something I'll feel stupid about later.
But I'd rather post here than at the Yahoo group for ACT users. Because I feel *SAFE* here. Not there.
I've been studying and applying ACT off-and-on for a couple years. I didn't really start to make much real progress until earlier this year, when I also found an effective antidepressant. So I guess the cliché is true for me (“Meds + therapy works best”).
•SELF-CRITICISM•
The biggest clear accomplishment I have from ACT so far is that I no longer beat myself up for supposedly stupid or embarrassing things I've ALREADY done. Actually, that's amazing. The self-critical thoughts kick in as usual, but I no longer engage with them, I just sorta relax and say "Oh here they are". The criticisms remain in the air, full of potential, but as far as post-event self-criticism, I have really "dropped the rope" as the ACT people say. Good for me.Yes, that is an amazing accomplishment, now that I actually write it out and know that it's true. You would not believe (Alright, *you* would) how many HOURS in the course of a day I would usually spend excreting gastric acid and cortisol over some allegedly stupid thing I did at any point between 15 minutes and 15 years ago. And I could do this day after day after day. And pick up on a critical obsession right where I left it off in 1998.
I really identified in that way with some of what I read in Deneb's (unfair!) self-critical posts about the APA workshop. That could've been me, word for word. Yes oh yes.
So, clap clap; pat on back. Good job, PN, for felling one tree in your neurotic forest. (The tree fell and is now a bridge.)
But the med helps, too. How much is due to the med? I don't know. I still have lots of other obsessive problems, so...?
•GREATER AWARENESS•
I've generally gotten better at MINDFULLY accepting the emotional discomfort of more & more thoughts that I have all by myself in the privacy of my home.This doesn't yet extend to thoughts that occur when I'm out in the world or that I have in response to interpersonal events as they are occurring. But, starting with self-criticism, my personal awareness and acceptance of scary, painful thoughts and feelings has gradually expanded to other topics that I think about by myself, at home, although even there it's not quite a clean sweep.
This seems to have led for me to something ACT creator Steve Hayes has mentioned informally but AFAIR hasn't discussed in the books & literature: ACT-type progress can sometimes lead to greater "insight" of the psychodynamic-ish kind. Those who have put up with my anti-Freudian reflexes here over the years can imagine the conceptual problems this presents for me. As I accept my scary thoughts about myself and leave them alone, the exposure to them over time has allowed me to realize connections that are probably obvious but that I would previously have been too freaked out by to see, let alone analyze. Like:
[ *trigger warning BEGINS* ]
I believe that as a kid, I was afraid my dad and my brother were ready to murder me.
Yes, really. That is the level of fear I carried with me at the time. I wouldn't be surprised if such fears are sorta widespread or if they developed as an evolution-selected survival mechanism. Such a fear was probably a very healthy assumption when we were swinging from trees and resources (not to mention policemen) were scarce.
I mean, it would be a healthy fear if the person in question was always looking at you like they *would* kill you AND they were big enough to do it AND they routinely physically attacked you AND they routinely expressed hatred for you and fury with you AND you never got much indication otherwise that they really wouldn't kill you.
Whatever its origins, I realize now (thanks to progress with ACT) that I *currently* have, all the time, this huge, high-level of fear of being ... taken out. And it is triggered (imagine the coincidence!) by the same situations that my dad and brother attacked me in.
[ *trigger warning ENDS* ]
•INSIGHT•
So now, I think maybe I have identified the emotional response that I have most desperately, stridently, and destructively tried to avoid for my entire life. Of course I know that I'm physically safe, but because I never allowed those old, residual thoughts & feelings to get anywhere near being experienced in my more grown-up life, I could never get beyond them. (Or *through* them, in the canonical ACT language.)The feelings aren't really overwhelming. It's the fear of them and the avoidance of them that creates and maintains the problem. ACT is not cathartic.
In Acceptance & Commitment Therapy, insights like mine (about my fear's origins) are not emphasized because it doesn't matter how a fear was instilled. All fears are treated with acceptance, even the ones that it still makes sense to heed. But the insight was important for me because it allowed me first to consider and then to acknowledge the constant state of suppressed and avoided fear I have been in all my life. Maybe my theory about its origins is all wrong, but imagining such a plausible, personal scenario allowed me to "have" the fear I spend so much energy dodging and running from.
•A TREATMENT PLAN•
Going forward, I guess I should expect to have that fear whenever I do the things that infuriated Dad and Brother: succeeding; learning things; demonstrating competence and confidence; understanding things that they didn't; being admired or welcomed by others; etc, etc.There are many simple tasks that I often find bizarrely impossible to do, like brushing my teeth. I cannot bring myself to do them. I physically collapse onto the floor the more energy I put into forcing myself to do them. I assume these are situations in which I'm too successful and competent for comfort: Dad & Brother wouldn't like it.
So now, when I move toward brushing my teeth, instead of forcing anything, I can allow whatever scary feelings are present (like from those childhood scenes) to simply show up. I can have them mindfully. If necessary, I can remind myself to take an Observer-Me standpoint in relation to them. I can experience them fully and horrifically, if necessary, but as separate from myself. I won't expect them to diminish or go away, but I can see how to have them AND brush my teeth.
Will it work? It already has, in little ways, here and there. I might let you know.
•OTHER PROBLEMS•
After that, there are other problems that I don't yet see any way to accept: things that maybe stem from my MOTHER'S influences.Hey, I got outside today and walked all around. But I'm still terrified of (and will NOT accept) the thought of people being mad at me. I still have to be "The Best Little Boy In The World". Interestingly, I suspect that that desire developed to help avoid the fear of my father: "Win over Mom's utmost devotion so you'll be safe from Dad!" If so, maybe other trees will soon become bridges, too.
Most days I have suicidal ideation, despite ACT, med, Babble, and Toronto. But if these terrors can actually be accepted like the other feelings I've accepted, then I may soon feel less "need" for a desperate escape.
That's all. I can't believe you read the whole thing! ;-)
Posted by Dinah on June 5, 2006, at 20:48:09
In reply to between ACT and a hard case (trig), posted by pseudoname on June 5, 2006, at 20:36:11
It sounds not dissimilar to radical acceptance in DBT. Which I often try to employ, although I admit that my efforts are not as disciplined as I might wish. Which is true of most of my efforts in most areas. :)
I'm glad you've found a treatment modality that's helpful to you. Your insights sound amazing and important. I hope you keep telling us about ACT.
Posted by fallsfall on June 6, 2006, at 7:32:04
In reply to between ACT and a hard case (trig), posted by pseudoname on June 5, 2006, at 20:36:11
Very interesting. It sounds like you are working really hard and making good progress.
Good for you!
Posted by fairywings on June 8, 2006, at 2:10:08
In reply to between ACT and a hard case (trig), posted by pseudoname on June 5, 2006, at 20:36:11
It sounds like you're doing this on your own, but you have a therapist? Is your therapist an ACT therapist? I've heard of it a few times...it sounds a lot like CBT?
fw
Posted by pseudoname on June 8, 2006, at 10:51:42
In reply to Re: between ACT and a hard case (trig) » pseudoname, posted by fairywings on June 8, 2006, at 2:10:08
Hi, ’wings!
> It sounds like you're doing this on your own, but you have a therapist?
I see a pdoc for meds, but no other therapist. I hunted up an ACT therapist about 18 months ago, one who had gotten her PhD from the ACT developer, but we just didn't hit it off. It was like she was following a script and nothing I said ever put her off that script. I only went 3 times. (I've also had a few other therapists over the years.)
So, I'm doing the ACT stuff on my own. Lots of books & articles. Also I read the ACT forum for clients and used to read the one for therapists.
> I've heard of it a few times...it sounds a lot like CBT?
There are a lot of workbook exercises and assignments and so on, so that's a lot like CBT.
But the goal of the exercises is different. ACT doesn't try to change all those irrational, dysfunctional thoughts like "I can't do this" or "People hate me." ACT tries to teach you how to accept those thoughts and simply observe them and do what you want to even while you're having them. ACT doesn't care so much whether an emotionally troublesome thought is "true" or "false".
As Dinah noted, it has more similarity with Dialectical Behavior Therapy; the ACT creator and the DBT creator have produced a few books & articles together.
(I've put some ACT links in a Books thread: http://www.dr-bob.org/babble/books/20051228/msgs/617218.html)
:-D
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