Finding a Career by Way of a Panic Attack
Question: What led you to explore this field of psychology?
Steven Hayes: Well, I'm in psychology probably the way a lot of people get into psychology: you're interested in why there's so much pain and suffering around you. And I certainly saw that at home, just growing up, and decided early on that it was a place to put my science interests and also just my humanitarian interests, and you could put those two together in one field. After I was a psychologist I developed a panic disorder, and that changed a lot of -- what kind of work I do, because I was trained as a behavior therapist and as a cognitive behavior therapist. And when I applied the methods that I would apply with others when they had panic disorder, it didn't really fully hit what I thought was needed for me.
And I turned back towards several things that were sort of in my experience from more eastern traditions, human potential traditions, and then tried to marry that up -- I'm a child of the '60s and grew up in California, so was exposed to the kind of garden variety eastern thinking that most folks in my generation were exposed to, and I actually found more in mindfulness and acceptance methods that were directly of benefit to me than in the traditions I was nominally part of.
So that really changed my thinking, and it caused me to set out on about a 30-year journey as to how dig down to the essence of what's inside some of our deepest clinical traditions, but also our spiritual and religious traditions, particularly these eastern traditions. But not just that; all of the mystical wings of the major spiritual and religious traditions have methods that are designed to change how you interact with your logical, analytical, linear thinking. And I didn't want to leave that just intact; I didn't want to simply be a meditation teacher or something. I wanted to understand it, and we spend a lot of time kind of pulling at its joints and trying to understand why these things might be helpful to people, I think particularly helpful to people in the modern world who are exposed through the media and the kind of chattering world that we've created to a lot of horror, a lot of pain, a lot of judgment, a lot of words, and need to find a place to go that is more peaceful and more empowering, being able to lives their lives in an intimate, committed, effective way. So that's kind of how I came there, or I ended up where I ended up.
Question: What is ACT and how does it differ from traditional forms of cognitive therapy?
Steven Hayes: Sure. Well, the empirical clinical traditions, especially in the cognitive behavioral tradition, early on they were trying to apply behavioral principles mostly developed with animal models directly to people. And there's a lot of benefit that happened there; it's still relevant today. You can do a lot of good things for people who suffer with anxiety, depression and so on using those methods. I'm old enough to have seen all three of these steps, and somewhere in the late '70s and mid-'80s people realized that you had to have a better way of dealing with cognition, and they couldn't find it in the animal models. So they went to more commonsense clinical models where they would sort of divide thinking styles up into rational and irrational processes, making cognitive errors and so forth. And they thought if we could just get people to think more rationally and focus on the evidence and take some of those over-expansive thoughts that are creating difficulty for them and change them, then they'd do better. And some of it was -- the techniques were helpful, but the theory didn't work very well.
Increasingly over time we learned that the components that theory tells you to put in and the processes that should change didn't really explain the outcomes and add to the outcomes. And it had this potential for a downside: people can get even more self-focused, even more caught up in their own thinking. And we're part of a newer sort of third generation of tradition that is using acceptance and mindfulness practices and values, commitment, behavior change practices and marrying them up. So the difference between traditional CBT and the acceptance and commitment therapy, or ACT -- but not just ACT; also mindfulness-based cognitive therapy, dialectical behavior therapy, a number of the other more kind of modern acceptance and mindfulness approaches -- instead of teaching people to detect, to challenge, to dispute and change their thinking, we teach people to notice what they're thinking and to notice what they're feeling, what their body is doing, learn from it, but then focus also on their values and getting their feet moving towards the kinds of lives that they want to produce to have a life worth living.
And it turns out that that's, we think, a quicker and more direct way, a more certain way, to moving ahead in your life than first trying to get the cognitive ecology inside this skull of ours all lined up with an ability to detect our logical errors and correct them and so forth. Meanwhile, the clock is ticking. There's relationships to have, children to be raised, work to be done, contributions to be made, and you're waiting to get the world within all lined up. We think it's more effective to find a way to back up from that a little bit; notice it, see what's there, learn from it, and move ahead directly towards the kind of lives that you want to produce. And it turns out those processes are not just in therapy, but in this office, in your home, in the schools and organizations. And so the ACT work has very quickly expanded out from psychotherapy into behavioral medicine, and from that even into organizational work and now into prevention work and into communities and schools. So it's kind of exciting to see psychology touching people where they are, in the streets, in a way that is empowering and sort of simplifies what it is that people need to learn to be more effective and happy, successful, vital in their lives.
Question: How can a therapist help someone realize their values?
Steven Hayes: You know, a couple of things: if someone watching this were to focus on what pains them the most, and then would take the time to look inside -- what do I care about such that that's particularly painful? -- they're probably going to find a significant area that they value. I'll give an example: most people are hurt deeply by betrayals in relationships. And what your mind tells you to do is, don't be so vulnerable; don’t be so silly; don't open yourself up; don't be so trusting; you can be betrayed. In fact, the reason why you hurt so much is that you want relationships that are loving, committed, intimate; you want trust. And what your mind's telling you to do in a way is, don't care about that so much so that you won't be hurt so much. It might be better to really get up against and sort of contact that caring, and maybe take a more loving stance even with your own pain, and keep your feet moving towards what you really want, because the cost in terms of intimacy and connection and caring that comes when you try not to be vulnerable, when you're constantly looking out for betrayals of trust, is too great. It makes it very hard to have relationships of the kind that you really want. So there's an example. One, look where the pain is. Flip it over; you'll find that's where the values are.
Another one is just to think of the times that you've felt most with yourself, most connected, most vital, most energized, most flowing, natural. And if you take some of these specific memories and you walk inside them, you're going to find that there's things in there that you care about. There's things in there that, when it's really working well, are kind of a lighthouse, like a beacon in the distance, that you can move towards. You never fully reach these things. I mean, I'll give you an example. There are times when you felt especially important to another person, or cared about or loved or accepted. Well, loving relationships aren't something you can have like a precious little jewel you put in a box and then put on your shelf. It's something you walk towards. And there's always difficulties; there's always pain in relationships. But you can keep walking towards that beacon in the distance. That process, that journey, is called life. And if you're moving towards the things that you value, life is more vital, flowing; it's more empowering. And so that's another way: go inside the sweetness of life, catch the places where you genuinely were moved by or connected with life, and you'll find in there kind of a light that can direct you when the cacophony gets very noisy and you get confused and lost, that can direct you towards what you care about.
Question: How does the role of an ACT therapist differ from the role of traditional psychologists?
Steven Hayes: It might be a little bit, because this psychology is a psychology of the normal. A lot of the psychologies that are out there are built on the psychology of the abnormal. We have all these syndromal boxes that we can put people in and so forth. The actual evidence on syndromes is not very good. I mean, there's no specific biological marker, for example, for any of the things that you see talked about in the media. Even things like schizophrenia -- there's no specific and sensitive biological markers for these things. So yeah, there may be some abnormal processes involved in some of them, but vastly more of human suffering comes from normal processes that run away from us. Like normal processes of problem-solving work great on the world without; when it's applied within, you too easily get into a mode of mind where you can start living when the problem of your history is solved.
But your history's not going to go away; it isn't the same thing as dirt on the floor or paint peeling off the walls; it's not going to be solved in that way. It's more like learning how to carry it, to contact it, to see it. Because it's based on the psychology of the normal, the therapist is part of that too. And so when the therapist gets in there and is working on acceptance and mindfulness and values, they too are working with those very same processes. And so it requires a therapist not to be a master at it -- you don't even have to be good at it -- but just to see the value of it and to be willing to look at their own difficult emotions and thoughts and find a way to carry them gently in the service of the clients that they're serving.
So for example, if a therapist is feeling insecure in therapy, a lot of therapists will try to sort of push that aside to try to do the therapy. Instead, we would ask people to get with that feeling of insecurity, because after all, the client is being asked to do the same thing. So it tends to be relatively intense, interactive, horizontal. It's not one up; the therapist is in the same soup. And it has a kind of a quality of two human beings in the same situation, really, working through these psychological processes. And yeah, I'm working for you; you hired me; I'm working for you as a therapist. But I'm not up here and you're down there. And what you're struggling with, at other times and with other areas I'm struggling with.
Psychology professor Steven Hayes turned to a new way of thinking when traditional methods of cognitive therapy didn’t work for him.
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