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It’s better to focus on where you are going than how you are feeling
A therapist explains acceptance and commitment therapy (ACT).
The notion that emotional pain and suffering reflect a deviation from a default happy baseline has been referred to as the 'assumption of healthy normality'.
But it's a mistaken assumption. Estimates of the lifetime prevalence of psychiatric disorders indicate that around one in two adults will meet the criteria for a mental-health condition at some point in their lives. Given that psychological pain is so ubiquitous, we should focus less on what might make us happy, and more on achieving a sense of meaning, regardless of how we're feeling. Psychotherapy should help people manage effective functioning while they are distressed, above and beyond aiming to reduce symptoms such as difficult thoughts, emotions and sensations. Acceptance and commitment therapy (ACT) takes this approach, using mindfulness, acceptance and other behavioural strategies to promote more flexible and value-driven behaviours. The goals in ACT are not necessarily to change or reduce one's problematic thoughts or emotions, but to foster meaningful and effective behaviours regardless of mood, motivation or thinking. In other words, the primary goal is to promote what therapists call 'valued living'.
Think of valued living as going about your daily life in the service of values that you find important, whereby engaging in these actions creates a sense of meaning and purpose. From an ACT perspective, symptoms of psychiatric disorders, and psychological suffering more broadly, are problematic when they are linked to rigid behaviours that pull us away from valued living. We might not have any control over the pain we experience – in fact, our emotional pain is profoundly human – but one area where we can exert some control is what we do in response to that suffering. Many common responses to difficult thoughts and emotions – such as avoidance, substance abuse, withdrawal and aggression – can alleviate distress in the short term, but also lead to long-term damage in our relationships, our jobs, our freedom and our personal growth – the very areas that provide that sense of meaning and purpose. By letting go of an agenda guided by minimising pain, and recalibrating toward a more value-driven agenda, our choices can be based on who we want to be, rather than how we want to feel.
In their 2013 study, the psychologists Todd Kashdan and Patrick McKnight of George Mason University in Virginia examined the day-to-day relationships between valued living and wellbeing in a sample of individuals with social anxiety disorder. This is a common but debilitating condition that's marked by intense fear of social situations that might involve being negatively judged by others. People with social anxiety disorder often want and value positive relationships but considerable distress makes them avoid social interactions, so this is an excellent group in which to examine values and meaning.
In the study, participants began by identifying their central aim or purpose in life (eg, 'trying to be a good role model to others'). Then, each day over the next two weeks, they rated their daily efforts and progress toward this goal, and provided daily ratings of their self-esteem, meaning in life, and experience of positive and negative emotions. On days when they reported investing greater effort toward their main life goal, they also tended to enjoy greater wellbeing: they said their life had more meaning, and they scored higher on self-esteem and the experience of positive emotions. Importantly, support was not found for the reverse path – greater wellbeing did not predict greater effort or progress toward strivings. This study highlights that sometimes we need to make the value-guided choice, regardless of how we feel.
If only it were so easy, though. For this reason, in ACT-based treatments, there is substantial focus on skills and techniques that can assist one in cultivating a more aware, willing and tolerant stance toward difficult feelings and other internal experiences. This stands in explicit contrast to a 'do X and your distress will alleviate' approach. The ACT techniques are not in the service of changing emotional states – they are in the service of facilitating valued action.
The effectiveness of ACT across different diagnoses and problem areas shows that committing to the benefits of valued living transcends traditional diagnostic categories. In addition to anxiety disorders, in studies of post-traumatic stress disorder, depression and resilience, chronic pain, suicidal ideation and many more, engaging in behaviours consistent with personally held values has been linked to a range of positive outcomes.
Which brings me back to my work as a therapist. While the breadth of exercises and techniques employed in ACT is beyond the scope of this article, there is one exercise I'd like to share that has helped some of my clients see the inextricable link between valued living and painful experiences. In this activity (of which there are different variations), the therapist first asks the client to write on an index card some of the internal experiences they are struggling with most – difficult thoughts and judgments, emotions, memories.
I ask them, what do you notice when you read that index card? I feel awful, I don't want this. What do you want to do with the card? I want to throw it in the trash. Then the client flips the card over, and I ask them to write out some of the things that are most important, most meaningful to them – being a parent, caring and supporting others, learning, growing, etc. What do you notice when you read this side? Warmth, it feels right, this is who I want to be. Where is the pain, where is the other stuff? Still here, on the other side of the card. What happens if you push that pain away, escape or avoid it? I push the meaningful stuff away too. In your heart of hearts, what does your experience tell you right now? If I'm going to do the things that are important to me, be the person that I want to be, I also have to make room for the painful stuff.
In my experience, this is both an emotionally difficult exercise and also one that helps a person grasp that it's impossible to disentangle pain and valued living. Sometimes it is hard to engage with those struggles in session, but we regularly return to the rationale of the approach – that maybe a different stance toward pain is necessary. And that is the crux of the work in ACT – opening up to the demons, judgments and suffering that lie underneath, all for the purpose of moving toward that which is meaningful.
The valued path is not necessarily the happy path. Social connectedness sometimes brings us in contact with memories of abuse and trauma. Being a parent stirs up doubts, uncertainty and feelings of anxiety, fear, anger and shame. Advocating for social justice requires repeated exposure to the inequities in our societies and the feelings of helplessness that can come from fighting for an equality that might not exist until after you're gone. But a growing body of psychological research suggests that the valued path is the more workable one, whereas the happy path can be more of an illusion.
For readers who would like to find out more, I recommend the book Get Out of Your Mind and Into Your Life (2005) co-authored by the founder of ACT, Steven Hayes, and also Things Might Go Terribly, Horribly Wrong (2010) co-authored by another ACT pioneer, Kelly Wilson. And here is the international directory of ACT therapists, maintained by the Association for Contextual Behavioral Science.
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- Psychological perspectives: why are you the way you are? - Big Think ›
- On acceptance: Should we all be 'taking life as it comes?' - Big Think ›
A man's skeleton, found facedown with his hands bound, was unearthed near an ancient ceremonial circle during a high speed rail excavation project.
- A skeleton representing a man who was tossed face down into a ditch nearly 2,500 years ago with his hands bound in front of his hips was dug up during an excavation outside of London.
- The discovery was made during a high speed rail project that has been a bonanza for archaeology, as the area is home to more than 60 ancient sites along the planned route.
- An ornate grave of a high status individual from the Roman period and an ancient ceremonial circle were also discovered during the excavations.
Foul play?<p>A skeleton representing a man who was tossed face down into a ditch nearly 2,500 years ago with his hands bound in front of his hips was dug up during a high speed rail excavation.</p><p>The positioning of the remains have led archaeologists to suspect that the man may have been a victim of an ancient murder or execution. Though any bindings have since decomposed, his hands were positioned together and pinned under his pelvis. There was also no sign of a grave or coffin. </p><p>"He seems to have had his hands tied, and he was face-down in the bottom of the ditch," <a href="https://www.livescience.com/iron-age-murder-victim-england.html" target="_blank">said archaeologist Rachel Wood</a>, who led the excavation. "There are not many ways that you end up that way."</p><p>Currently, archaeologists are examining the skeleton to uncover more information about the circumstances of the man's death. Fragments of pottery found in the ditch may offer some clues as to exactly when the man died. </p><p>"If he was struck across the head with a heavy object, you could find a mark of that on the back of the skull," Wood said to <a href="https://www.livescience.com/iron-age-murder-victim-england.html" target="_blank">Live Science</a>. "If he was stabbed, you could find blade marks on the ribs. So we're hoping to find something like that, to tell us how he died."</p>
Other discoveries at Wellwick Farm<p>The grim discovery was made at Wellwick Farm near Wendover. That is about 15 miles north-west of the outskirts of London, where <a href="https://www.hs2.org.uk/building-hs2/hs2-green-corridor/" target="_blank">a tunnel</a> is going to be built as part of a HS2 high-speed rail project due to open between London and several northern cities sometime after 2028. The infrastructure project has been something of a bonanza for archaeology as the area is home to more than 60 ancient sites along the planned route that are now being excavated before construction begins. </p><p>The farm sits less than a mile away from the ancient highway <a href="http://web.stanford.edu/group/texttechnologies/cgi-bin/stanfordnottingham/places/?icknield" target="_blank">Icknield Way</a> that runs along the tops of the Chiltern Hills. The route (now mostly trails) has been used since prehistoric times. Evidence at Wellwick Farm indicates that from the Neolithic to the Medieval eras, humans have occupied the region for more than 4,000 years, making it a rich area for archaeological finds. </p><p>Wood and her colleagues found some evidence of an ancient village occupied from the late Bronze Age (more than 3,000 years ago) until the Roman Empire's invasion of southern England about 2,000 years ago. At the site were the remains of animal pens, pits for disposing food, and a roundhouse — a standard British dwelling during the Bronze Age constructed with a circular plan made of stone or wood topped with a conical thatched roof.</p>
Ceremonial burial site<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yMzUzMTk0Ni9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY0NDgwNTIyMX0.I49n1-j8WVhKjIZS_wVWZissnk3W1583yYXB7qaGtN8/img.jpg?width=1245&coordinates=0%2C82%2C0%2C83&height=700" id="44da7" class="rm-shortcode" data-rm-shortcode-id="46cfc8ca1c64fc404b32014542221275" data-rm-shortcode-name="rebelmouse-image" alt="top down view of coffin" data-width="1245" data-height="700" />
A high status burial in a lead-lined coffin dating back to Roman times.
Photo Credit: HS2<p>While these ancient people moved away from Wellwick Farm before the Romans invaded, a large portion of the area was still used for ritual burials for high-status members of society, Wood told Live Science. The ceremonial burial site included a circular ditch (about 60 feet across) at the center, and was a bit of a distance away from the ditch where the (suspected) murder victim was uncovered. Additionally, archaeologists found an ornately detailed grave near the sacred burial site that dates back to the Roman period, hundreds of years later when the original Bronze Age burial site would have been overgrown.</p><p>The newer grave from the Roman period encapsulated an adult skeleton contained in a lead-lined coffin. It's likely that the outer coffin had been made of wood that rotted away. Since it was clearly an ornate burial, the occupant of the grave was probably a person of high status who could afford such a lavish burial. However, according to Wood, no treasures or tokens had been discovered. </p>
Sacred timber circle<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yMzUzMTk0Ny9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY2MDAwOTQ4Mn0.eVJAUcD0uBUkVMFuMOPSgH8EssGkfLf_MjwUv0zGCI8/img.jpg?width=1245&coordinates=0%2C149%2C0%2C149&height=700" id="9de6a" class="rm-shortcode" data-rm-shortcode-id="ee66520d470b26f5c055eaef0b95ec06" data-rm-shortcode-name="rebelmouse-image" alt="An aerial view of the sacred circular monument." data-width="1245" data-height="700" />
An aerial view of the sacred circular monument.
Photo Credit: HS2<p>One of the most compelling archaeological discoveries at Wellwick Farm are the indications of a huge ceremonial circle once circumscribed by timber posts lying south of the Bronze Age burial site. Though the wooden posts have rotted away, signs of the post holes remain. It's thought to date from the Neolithic period to 5,000 years ago, according to Wood.</p><p>This circle would have had a diameter stretching 210 feet across and consisted of two rings of hundreds of posts. There would have been an entry gap to the south-west. Five posts in the very center of the circle aligned with that same gap, which, according to Wood, appeared to have been in the direction of the rising sun on the day of the midwinter solstice. </p><p>Similar Neolithic timber circles have been discovered around Great Britain, such as one near <a href="https://bigthink.com/culture-religion/stonehenge-sarsens" target="_blank">Stonehenge</a> that is considered to date back to around the same time. </p>
Being skeptical isn't just about being contrarian. It's about asking the right questions of ourselves and others to gain understanding.
- It's not always easy to tell the difference between objective truth and what we believe to be true. Separating facts from opinions, according to skeptic Michael Shermer, theoretical physicist Lawrence Krauss, and others, requires research, self-reflection, and time.
- Recognizing your own biases and those of others, avoiding echo chambers, actively seeking out opposing voices, and asking smart, testable questions are a few of the ways that skepticism can be a useful tool for learning and growth.
- As Derren Brown points out, being "skeptical of skepticism" can also lead to interesting revelations and teach us new things about ourselves and our psychology.
New study suggests the placebo effect can be as powerful as microdosing LSD.
- New research from Imperial College London investigated the psychological effects of microdosing LSD in 191 volunteers.
- While microdosers experienced beneficial mental health effects, the placebo group performed statistically similar to those who took LSD.
- Researchers believe the expectation of a trip could produce some of the same sensations as actually ingesting psychedelics.
Psychedelics: The scientific renaissance of mind-altering drugs<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="92360c805fe66c11de38a75b0967f417"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/5T0LmbWROKY?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>For the study published in eLife, the team recruited 191 citizen cosmonauts to microdose either LSD or a placebo over the course of several weeks and note the psychological effects. Volunteers were already microdosing LSD, so there was no true control. Each volunteer was given instructions on creating their own low-dose gel capsules, some containing LSD, others not. Then they mixed the capsules in envelopes so they didn't know if they were taking the real thing or not.</p><p>The trial design was ingenious: each capsule featured a QR code that was scanned after the addition of ingredients but before they were placed in the envelope so that researchers knew what they were ingesting.</p><p>The problem: volunteers sourced their own LSD. Lack of quality control could have had a profound effect on the results. </p><p>The results: LSD microdosers reported feeling more mindful, satisfied with life, and better overall; they also noticed a reduction in feelings of paranoia. </p><p>The catch: the control group felt the same thing, with no statistical difference between the groups. </p><p>Lead author Balázs Szigeti comments on the findings: "This suggests that the improvements may not be due to the pharmacological action of the drug but can instead be explained by the placebo effect." </p>
Credit: Alexander / Adobe Stock<p>Psychedelics are notoriously difficult to control for given the intensity of the experience. Yet there is precedent for the above findings. A <a href="https://link.springer.com/article/10.1007/s00213-020-05464-5" target="_blank">2019 study</a> found that 61 percent of volunteers that took a placebo instead of psilocybin felt some psychedelic effects, with a few volunteers experiencing full-on trips.</p><p style="margin-left: 20px;">"Several stated that they saw the paintings on the walls 'move' or 'reshape' themselves, others felt 'heavy. . . as if gravity [had] a stronger hold', and one had a 'come down' before another 'wave' hit her."</p><p>The Imperial team believes the expectation of a trip might have been enough to produce similar results. Senior author David Erritzoe is excited for future studies on the topic, believing they tapped into a new wave of citizen science that could push forward our knowledge of psychedelic substances.</p><p style="margin-left: 20px;">"Accounting for the placebo effect is important when assessing trends such as the use of cannabidiol oils, fad diets or supplements where social pressure or users' expectations can lead to a strong placebo response. Self-blinding citizen science initiatives could be used as an inexpensive, initial screening tool before launching expensive clinical studies."</p><p>As investments into the psychedelics market explode, with one company <a href="https://www.bloomberg.com/news/articles/2021-03-03/thiel-backed-magic-mushroom-firm-atai-hits-2-billion-valuation" target="_blank">reaching a $2 billion valuation</a>, a recurring irony appears in the long arc of psychedelics and research: the power of our minds might be enough to feel greater life satisfaction and a deeper sense of mindfulness. If that's possible with a placebo, we have to question why the rush to create more pharmacology is necessary. </p><p>This is, mind you, a separate conversation over the role of psychedelics and rituals for group bonding. The function of group cohesion around consciousness-altering substances will continue to play an important role in many communities. </p><p>Of course, we should continue to explore the efficacy of psychedelics on anxiety, depression, suicidal ideation, PTSD, and addiction. <a href="https://bigthink.com/surprising-science/antidepressant-effects" target="_self">Pharmacological dependence</a> is a stain on the psychiatry industry. Whether or not psychedelics can be prescribed for daily use remains to be seen, but we know a moneyed interest is expecting a return on investment—the above company, ATAI Life Sciences, raised $157 million in its Series D round. </p><p>When it comes to wellbeing, some things money just can't buy. How we navigate the tricky terrain of mainstreaming psychedelics remains to be seen. </p><p>--</p><p><em>Stay in touch with Derek on <a href="http://www.twitter.com/derekberes" target="_blank">Twitter</a> and <a href="https://www.facebook.com/DerekBeresdotcom" target="_blank" rel="noopener noreferrer">Facebook</a>. His most recent book is</em> "<em><a href="https://www.amazon.com/gp/product/B08KRVMP2M?pf_rd_r=MDJW43337675SZ0X00FH&pf_rd_p=edaba0ee-c2fe-4124-9f5d-b31d6b1bfbee" target="_blank" rel="noopener noreferrer">Hero's Dose: The Case For Psychedelics in Ritual and Therapy</a>."</em></p>