Get Out of Your Mind and Into Your Life
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What do you have to lose? Wouldn’t it be a good thing if you could get out of your mind, and into your life?
Chapter 1
Human Suffering
You’ve probably opened this book for this reason: You are hurting and you’re not sure what to do about it. Perhaps you’ve been suffering from a chronic depression or an anxiety disorder. Perhaps a struggle with drug abuse or alcohol has been costing you your life in your futile attempt to numb your pain. Perhaps a relationship is stumbling, or you are wondering whether life itself matters. It may be that you’ve been in and out of therapy trying to cope with your inner turmoil. Or perhaps, you’re one of the millions who just feels stuck—not vital and engaged in life, but distant, deadened, numbed, or overwhelmed.
If you’ve been struggling for some time, you’ve probably plagued yourself with different forms of the “why?” question: “Why can’t I just get over it?” “Why can’t I feel better?” “Why is life so hard?” “Why hasn’t therapy worked?” “Why can’t I be a normal person?” “Why can’t I be happy?” You may feel victimized somehow by questions that seem not to have any ready answers. Cornered by your own emotional pain and your struggle with it, you may feel as if your life is narrowing in around you.
If you’ve been fighting a war inside your head, what would it be like if instead of trying to win that war, you knew a way to step out of it? This doesn’t mean that the war would stop; it may continue. Rather, it means that you would no longer try to live inside a war zone, with your psychological survival seemingly dependent on the outcome of the war. What if that were possible?
This book invites you to examine your perspective not only on what psychological pain is and how it operates, but on the very nature of your consciousness, even your identity, that is, who you take yourself to be. No issue is too “basic” if it seems necessary to address it. The concepts and methods you will find here may shake you up a bit. Initially, some may be hard to swallow and may even fly in the face of what you’ve been taught are the “solutions” to your problems.
We have three requests to ask of you. The first is for you to agree to persistent, active engagement with the text. At times, it may be a bumpy ride. We ask only that you stick with it and really try the methods we will put on the table. There may be something here for you, but you will not know if that is so unless you learn and use the concepts and methods before you try to evaluate their actual impact on your life.
The second request is to ask for unrelenting honesty from you. We don’t ask you to believe what we’ve written here; we do ask you to look directly at your experience without blinking. Use this book as an opportunity to explore what is really true for you. For the moment put aside what others expect, what the world around you demands, what you’ve long been told is true, or even what your own mind tells you—if it contradicts what your direct experience suggests.
Since we can’t actually be there as you try out these methods, you will need to rely on your own experience to know whether the approach described here is helpful to you in the long run. There is a growing base of empirical support for the basic concepts discussed here, and some of the methods have been evaluated in laboratory studies (see appendix) presented outside of a therapeutic relationship, using written or oral presentations of these ideas and exercises, much as you might encounter them in this book. Today, there is enough scientific evidence that we believe this is the time to introduce these ideas and methods to the public. But your experience is the actual bottom line.
Our third request concerns your intention: we ask that you intend this book to make a difference in your life. You don’t have to believe that it will. Rather, we ask you to remain open to that possibility by answering yes to this next question: While you are learning and trying out these methods, if you see in your actual experience the possibility of using them to transform your life for the better, will you be willing to move forward in that direction? If your answer is yes, we are ready to begin. If it is not (remember: be honest), it would be worthwhile to know how deep your resistance to change may be, and it would be worth considering whether such resistance is in your best interest.
Before we begin, we think that a bit of consumer education may be in order. ACT is part of a school of clinical psychology that is committed to delivering treatment methods based in science. If you have a significant area of difficulty, and you haven’t undergone a well-planned course of therapy with a behavioral therapist, cognitive behavioral therapist, or other professional who used methods supported by scientific research, you should seek that out. In that instance, this book can be used as an adjunct to a course of therapy with a therapist who understands this approach. (See the appendix for suggestions about finding such a therapist.) A growing base of scientific evidence supports the use of these methods in a psychotherapy context.
HUMAN SUFFERING IS UNIVERSAL
Often many people we meet in our daily lives seem to have it all. They seem happy. They look satisfied with their lives. You’ve probably had the experience of walking down the street when you’re having a particularly bad day, and you’ve looked around and thought, “Why can’t I just be happy like everyone around me? They don’t suffer from chronic panic (or depression, or a substance abuse problem). They don’t feel as if a dark cloud is always looming over their heads. They don’t suffer the way I suffer. Why can’t I be like them?”
Here’s the secret: They do and you are. We all have pain. All human beings, if they live long enough, have felt or will feel the devastation of losing someone they love. Every single person has felt or will feel physical pain. Everybody has felt sadness, shame, anxiety, fear, and loss. We all have memories that are embarrassing, humiliating, or shameful. We all carry painful hidden secrets. We tend to put on shiny, happy faces, pretending that everything is okay, and that life is “all good.” But it isn’t and it can’t be. To be human is to feel pain in ways that are orders of magnitude more pervasive than what the other creatures on planet Earth feel.
If you kick a dog, it will yelp and run away. If you kick it regularly, any sign of your arrival eventually will produce fear and avoidance behavior in the dog by means of the process called “conditioning.” But so long as you are out of the picture and are not likely to arrive, the dog is unlikely to feel or show significant anxiety. People are quite different. As young as sixteen months or even earlier, human infants learn that if an object has a name, the name refers to the object (Lipkens, Hayes, and Hayes 1993). Relations that verbal humans learn in one direction, they derive in two directions. Over the past twenty-five years, researchers have tried to demonstrate the same behavior in other animal species, with very limited and questionable success so far (Hayes, Barnes-Holmes, and Roche 2001). This makes a huge difference in the lives people live as compared to animals.
The capacity for language puts human beings in a special position. Simply saying a word invokes the object that is named. Try it out: “Umbrella.” What did you think of when you read that word? Alright, that one’s pretty harmless. But consider what this means if the named object was fearful: anything that reminded the person of its name would evoke fear. It would be as if all the dog needs to feel fear is not an actual kick, but the thought of being kicked.
That is exactly the situation you are in. That is exactly the situation all humans are in with language.
Here is an example: Take a moment now to think of the most shameful thing you have ever done. Take a moment to actually do this.
What did you just feel? It’s very likely that as soon as you read the sentence, you felt some sense of either fear or resistance. You may have tried to dismiss the request and quickly read on. However, if you paused and actually tried to do what we asked, you probably began to feel a sense of shame while you remembered a scene from your past and your actions in it. Yet all that happened here was that you were looking at patterns of ink on paper. Nothing else is in front of you but that. Because relations that verbal humans learn in one direction, they
derive in two, they have the capacity to treat anything as a symbol for something else. The etymology of “symbol” means “to throw back as the same,” and because you are reacting to the ink on this paper symbolically, the words you just read evoked a reaction from you; perhaps they even reminded you of a shameful event from your past.
Where could you go so that this kind of relation could not take place? The dog knows how to avoid pain: avoid you and your foot. But how can a person avoid pain if anytime, anywhere, pain can be brought to mind by anything related to that pain?
The situation is actually worse than that. Not only can we not avoid pain by avoiding painful situations (the dog’s method), pleasurable situations also might evoke pain. Suppose someone very dear to you recently died, and today you see one of the most beautiful sunsets you have ever seen. What will you think?
For human beings, avoiding situational cues for psychological pain is unlikely to succeed in eliminating difficult feelings because all that is needed to bring them to mind is an arbitrary cue that evokes the right verbal relations. This example of a sunset demonstrates the process. A sunset can evoke a verbal history. It is “beautiful” and beautiful things are things you want to share with others. You cannot share this sunset with your dear friend, and there you are, feeling sad at the very moment you see something beautiful.
The problem is that the cues that evoke verbal relations can be almost anything: the ink on paper that made up the word “shame,” or a sunset that reminded you of your recent loss. In desperation, humans try to take a very logical action: they start trying to avoid pain itself.
Unfortunately, as we will discuss in some detail throughout the rest of this book, some methods of avoiding pain are pathological in and of themselves. For example, dissociation or illegal drug use may temporarily reduce pain, but it will come back stronger than ever and further damage will be caused. Denial and learned numbness will reduce pain, but they will soon cause far more pain than they take away.
The constant possibility of psychological pain is a challenging burden that we all need to face. It is like the elephant in the living room that no one ever mentions.
This doesn’t mean that you must resign yourself to trudging through your life suffering. Pain and suffering are very different. We believe that there is a way to change your relationship to pain and to then live a good life, perhaps a great life, even though you are a human being whose memory and verbal skills keep the possibility of pain just an instant away.
The approach we will explore in this book is suggested by the word “suffering.” The primary root of suffer is the Latin ferre, which means “to bear or carry” (the English word “ferry” comes from the same root). The prefix “suf” is a version of “sub” and, in this usage, means “from below, up (hence) away.” In other words, suffering doesn’t just involve having something to carry; it also involves moving away. The word “suffer” connotes the idea that there is a burden you are unwilling or unable to carry, perhaps because it seems “too heavy,” “too unfair,” or it just seems “beyond you.” That connotation refers to more than pain alone; in fact, it provides a different way to address the problem of pain.
EXERCISE: Your Suffering Inventory
We would like you to write down a list of all of the issues that are currently psychologically difficult for you. Use the left-hand side of the space provided below. Do not write about purely external or situational events, independent of your reactions to them. In this book we will focus on how you react. Some of your psychological issues will be clearly related to specific situations; others may not be. For example, “my boss” would not be a good example of a difficult issue you experience; but “getting frustrated with my boss” or “feeling put down by my boss” might be. The left-hand column can include any of your thoughts, feelings, memories, urges, bodily sensations, habits, or behavioral predispositions that may distress you, either alone or in combination with external events. Don’t overthink it. Just write down what plagues you and causes you pain. Be honest and thorough and create your “suffering inventory” in the space below.
After you’ve completed your list, go back and think about how long these issues have been a problem for you. Write that down as well.
Now we would like to ask you to organize this list. First, go back and rank these items in terms of the impact that they have on your life. Then, in the space provided below, write down the same items, but rank them in order. The order should range from those items that cause you the most pain and difficulty in your life to those that cause you the least trouble. You will use this list as a guide throughout the remainder of this book. We’ll ask you to refer back to this list as your touchstone for the events and issues that cause you pain.
_________________________________________ _________________________________________ _________________________________________ _________________________________________ _________________________________________ _________________________________________ _________________________________________ _________________________________________ Finally, in the area to the right of this list, draw arrows between every item on the list that is related to another item. You will know that two items are related if changes in one might alter another. For example, suppose one of your items is “self-criticism” and another is “depression.” If you think the two are related (that is, the more self-critical you are, the more likely you are to feel depressed, or vice versa), draw a two-headed arrow between self-criticism and depression. You may find that this area becomes cluttered with arrows. That’s fine. There is no right or wrong way to do this. If everything is related, it’s important to know that. If some items relate to only a few others, that is useful information too. The higher on your list the items are and the more other items they connect to, the more important they become. This may suggest a reranking of your problems and you may find that you now want to combine some items or to divide them into smaller units. If that is so, you can create your final working list below, ranked from highest to lowest in order of impact on your life.
_________________________________________ _________________________________________ _________________________________________ _________________________________________ _________________________________________ _________________________________________ _________________________________________ _________________________________________ This is your personal suffering list. For you, it is what this book is about.
THE PROBLEM WITH PAIN
Psychological pain hurts, by definition. But it does more than that. Often pain holds you back from living the kind of life you want to live. There is no question that a person with a panic disorder would rather not experience the feeling of extreme fear, because it is so unpleasant. But that discomfort is compounded by the fact that the panic seemingly gets in the way of living itself.
If you have a panic disorder, you may have begun feeling too afraid to engage in the activities you normally would because of your fear that you might panic. It may be that you no longer go to the supermarket because you are afraid you might have a panic attack there. Perhaps you are uncomfortable in social situations, because you don’t want anyone to see you panic. You cultivate friends with whom you feel safe, but then you are dependent on their schedules and availability. You start to live your life in ways to accommodate your problem, and, as a result, your life becomes narrower and narrower, less and less flexible.
It is worth noting how much of the pain we feel is a focus of attention because it seems to interfere with other activities. One way to get at this core issue is to imagine how your life would be different if your pain went away. Imagine that someone has waved a magic wand over you, and your pain has vanished. Imagine that you wake up one morning and suddenly, for no reason at all, the chronic depression you’ve suffered from all these years (or the anxiety, or worry, or whatever your core struggles may be) is gone. The cloud has lifted and the pain is over. What would you do? This question isn’t a rhetorical one, we mean it literal
ly: What would you do? What would you want your life to be about? How has your current psychological struggle interfered with your goals and aspirations? Let’s explore that in the exercise below.
EXERCISE: The Pain is Gone, Now What?
If ________________________________________________ weren’t such a problem for me, I would _______________________________________________________________________________________________________________________________________________________________________.
If I didn’t have _______________________________________________________________, I would _______________________________________________________________________________________________________________________________________________________________________.
We would like you to fill in the blank lines above in the sentences you’ve just read, but first let us describe how to do that. Take an item from your suffering inventory. It could be any item, but it might be best to start with an item high on your list and connected to other items. This is probably an issue that greatly inhibits your life. Go ahead and fill in your problem, but don’t fill in what you would do if it were gone.
Now, think about what you would do if that pain were suddenly lifted. The point of this exercise is not to think about what you might like to do on a given day if your problems weren’t plaguing you. The idea isn’t to celebrate by saying, “My depression is gone, I’m going to Disneyland!” The point is to think more broadly about how your life course would change if your constant struggle with emotional pain was no longer an issue. Don’t worry if you think that you don’t have a good grip on this yet. We will do a whole lot more work on these issues later in the book. Just go with your gut instinct. Somewhere within yourself you have some idea about the things that really matter to you. Concentrate on those.