Recently, a colleague had asked me if it were necessary to have a certain level of cultural, educational or intellectual development in order to understand, and thus be able to benefit, from ACT.
This is a question commonly asked to various psychotherapy models: what does one do when the person we are trying to help has a restricted lexicon, or weak abstraction skills, since the main tool of psychotherapy is language? Essentially, my colleague’s question was:
Is ACT only beneficial to those who have the language capacity to engage in articulated and elaborate responses to conceptually abstract questions?
It is true that some components of ACT could give off the impression that one must engage in high rates of reflection and thought in order to benefit from them. This is the case for example when engaging in perspective-taking; or for the unusual way of considering one’s psychological events in order to touch upon Self-as-Context, or within certain defusion exercises as well. Metaphors can also be challenging to some clients.
However, to begin, not all components of ACT are as potentially complex. One doesn’t need a high level of competency to explore that which is important to them, to observe what is occurring in the here and now, or even to evaluate how effective our efforts at controlling our psychological experiences are, as is done when exploring creative hopelessness.
Furthermore, let’s remember that ACT is teeming with experiential exercises whose goal is to allow distance from language, in order to achieve a very “physical” understanding of a psychological mechanism.
Finally, and most importantly, one must keep in mind the foundational hypothesis of ACT: thanks to language and the mechanisms of deriving functions that compose it, meaning is automatically added to the stimuli of our environment, for better (recognition of one’s values-directed behaviors) or for worse (painful emotions triggered by stimuli or a priori harmless situations). The moment we become verbal we can no longer prevent ourselves from relating stimuli, and we often do so in order to detect what is wrong, to keep ourselves safe. Thus, the majority of psychological suffering in Western culture has little to do with hunger or with being confronted with a vital risk. Our psychological suffering is generally the product of our language skills; our ability to assess, compare, associate, analyze, etc…
Ultimately, one could understand this equation as follows: if psychological suffering exists at all, in a way apparently mismatching what really happens here and now,- then it means that a certain level of relational learning skills, sufficient to create such suffering, also exists
As a result, these capabilities can furthermore be used to develop a distance from painful thoughts and emotions, and to aide a person to move in the direction of their values.
So, of course, if a therapist is deprived of certain conceptual tools, their role in helping their patient develop new behaviors (defusion, acceptance, commitment towards valued-ends, selfing) will be more difficult. However, these new behaviors are completely accessible, because the language skills needed to access them are indeed present, otherwise the suffering would not have appeared in the first place. It is the therapists roleto be creative in helping such clients achieve behavioral change by relying less on the tools that therapists know best (conceptualization, abstraction, analogies, metaphors, etc.) and seek modes of transmission that are adapted to the individual in front of them.
Translated by Chelsea Davis-Laurin
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