Today’s podcast features Dr. Steven C. Hayes, the founder of ACT (Acceptance and Commitment Therapy), and author of 46 books, including his most recent book, The Liberated Mind, which is available on Amazon. We are joined by Dr. Jill Levitt, the Director of Training at the Feeling Good Institute in Mountain View, California.
Dr. Hayes began by describing ACT, a form of psychotherapy aimed at increasing something he calls “psychological flexibility.” He defines psychological flexibility as the ability to stay consciously in contact with the present moment, including the difficult thoughts, feelings, memories, and bodily sensations you may be experiencing. At the same time, you direct your attention toward actions and behaviors based on your personal values.
I think it is fair to say that Rhonda, Jill and I had a more than a little difficulty understanding what Dr. Hayes was saying at times throughout the interview, particularly when he was describing the six dimensions of his concept of psychological flexibility. This is unfortunate, because Dr. Hayes has a great personal story to tell, and he has done a tremendous amount of interesting and important research as well.
Dr. Levitt did a tremendous job in tracing some overlap between ACT and TEAM in several areas. One is the idea that feelings like depression, anxiety, shame, and even anger are not bad but are actually good. These feelings can be telling us things that are tremendously valid and important about our core values as human beings. In TEAM, we call this Positive Reframing.
Another overlap between ACT and TEAM-CBT has to do with what Dr. Hayes calls “cognitive defusion,” a concept that has to do with the capacity to realize that your negative thoughts, like “I’m a loser,” or your anxious thoughts, like “I’m about to go crazy,” are simply thoughts, and not statements that are literally true.
This is consistent with one of the goals of TEAM-CBT, which is to recognize that these kinds of thoughts are nearly always distorted, and the moment you stop believing them your negative feelings will diminish or disappear. ACT suggests that you need to simply “defuse” from your thoughts, while TEAM-CBT utilizes many techniques to help you crush the distorted thoughts that trigger negative feelings, since everyone is different, and you can rarely predict which approach will be effective for a particular individual.
I sadly have to confess that after this face-to-face interview with Dr. Hayes, I still have extremely limited understanding of ACT, and apologize that I can’t be a more effective translator of his many excellent ideas and methods!
A touching moment came at the end of the interview when Dr. Hayes spoke about his own journey into a dark place in 1981, and why the ineffective therapy that he received at that time inspired him to create ACT. We all felt really close to him at that very human and vulnerable moment.
If you would like to contact Dr. Hayes, you can reach him at stevenchayes@gmail.com or visit his website at http://www.stevenchayes.com. You can also link to his new book A Liberated Mind.
Thanks for joining us today!
Rhonda, Jill, and David
You can reach Dr. Burns at david@feelinggood.com. Dr. Rhonda Barovsky practices in Walnut Creek, California, and has recently opened the Feeling Great Therapy Center, a collective of TEAM therapists, and can be reached at rhonda@feelinggreattherapycenter.com. She is a Level 4 Certified TEAM-CBT therapist and trainer and specializes in the treatment of trauma, anxiety, depression, and relationship problems. She also does forensic work in family court, but finds TEAM-CBT to be way more rewarding!
If you like our jingle music and would like to support the composer Brett Van Donsel, you may download it here.
I appreciated this podcast in a couple ways.
First of all, it was some evidence I’m not alone in having difficulties with understanding some of the intellectual and philosophical ideologies in psychotherapy. I felt so connect to you, Dr. Burns, when you said, “I still don’t understand….” I use that a lot when speaking to those who have PhD’s and felt less alone!
Secondly, I think this podcast showed a willingness to listen and even connect with those of different ideas and that’s living what you preach! We can’t learn new things if we think we got it all figured out.
Third, it is a reminder that lingo can inhibit learning until the lingo is explained but you can’t explain lingo with MORE lingo. This can happened for ALL of us and I need to remember this when teaching other therapists or educating clients!
Thanks for the self reflection so I can be a better communicator!
most unhelpful guests for patient – maybe therapists understand. go glad Dr. Burns.. hey I did not understand what you just said. I was thinking that and you said it..thank you!
Thanks Shelley, you are SO RIGHT! I have always valued the teachers who could make this simple and crystal clear!
In college, I always told myself that if I couldn’t understand what the teacher was saying, it meant the teacher had a problem. When I write or talk, I try to use simple words, and feel like big words are nearly always a cover-up of some type!
Just my take on it.
Warmly, david
Thanks Angela. I really resonate with your words of wisdom! Warmly, david
Heavy stuff for a Monday morning. My brain is ossified!!
Mine, too! Totally agree! Warmly, david
Yes thank you Dr. Burns for speaking up and saying you dd not understand. I did not understand either. I am not familiar with Dr. Hayes work but honestly this does not make me eager to learn more.
If you cannot explain the main thesis of your work in a simple and understandable manner then maybe its not that understandable.
It sounded like someone put a dash of CBT, Buddhism and psychology terms into a blender and what came out was a word salad of psycho jargon. I honestly would like to see how a therapy session goes because just understanding the model seems like would take several sessions.
When Dr. Hayes was reciting the 6 pillars with the example of someone who has lifted you up and stated that when you looked into the person eyes ¨were you conscious of their consciousness and were they conscious of your consciousness and vice a versa¨ I said to myself wow! I really started to question what was being discussed. This starts approaching mystical charlatanism.
Sounds like a therapy tool created by psychiatrists for psychiatrists not patients. I still don´t know what he means by flexibility.
“The definition of genius is taking the complex and making it simple.”
― Albert Einstein
Cheers, Prometheus! Your comment is mind-blowing! Right on! Cheers again! Warmly and with great respect, David
I attempted to integrate some of Dr. Hayes’ ACT work into a therapy group that I had run for a few years at a community mental health center. The most valuable tool from his work that I had found was an assessment that broke one’s life struggles into categories which mainly included things a person could take direct action on, such as activities and health-improving behaviors, and those one could work on accepting, which, as we all know, is the thoughts, feelings and actions of others we interact with. It did give some of my patients valuable insight as to the things that they could focus on that were within their control to affect change on.
BTW: I met you several years ago at a Feeling Good Now training you facilitated in Westminster, CO. It was definitely a high point of my career, as the original Feeling Good book had been personally helpful, as well as something that I could wholeheartedly recommend to my clients over the years. Please keep up the good work.
Hi James, Thanks! Good thinking. It might be useful to focus on thoughts / feelings that respond to acceptance, ones that respond to self-defense, ones that respond to a combo, and ones that respond to a myriad of other techniques. Good to hear from you, too! Warmly david
I normally love your podcast, however this one failed to hit the mark for me. This is the first time I’ve ever commented on your website, and I’d hoped that my first comment would be something a bit more positive, but I genuinely feel like this podcast was just awkward.
There was a clear aggression coming across from you, David, in what felt like some kind of showdown between two opposing cult leaders. In all honesty, I felt that Dr Hayes was far more respectful in his approach, whereas it felt like you were intent on making him seem like a bit of a charlatan. Don’t get me wrong, I was definitely confused at certain points with what he was trying to convey, it’s not that I’m just supporting him completely; rather, I feel like you were on the offensive from the get go, and this was reaffirmed at the very end, when you asked the question about why he developed ACT given that he’d seen panic disorder treated so effectively in the video you showed him.
Realistically, ACT is shown to be pretty beneficial for a lot of people. Whether or not he can explain that process in simple terms is, whilst a little confusing and disappointing, not really relevant that much to the findings of the many studies conducted that have shown ACT to be effective.
I love the concept of TEAM CBT and your work has certainly benefitted me greatly, however as I mentioned, this podcast disappointed me. I’m not sure if you were just in a bad mood, but it really felt like you invited Dr Hayes onto the podcast just to try and make his approach seem foolish and counterintuitive, rather than to discuss through an open dialogue where your approaches may coalesce. This is especially obvious when Dr Hayes asked you to remember a time somebody had lifted you up, and you said that every time somebody has lifted you up, they’ve been a charlatan – that was a completely unnecessary comment that was ultimately untrue, you even went on to admit you could divert your attention to the ones you loved, e.g. Jill, Ronda etc., so it ended up feeling like you were just refusing to even take part in the example he was providing.
As mentioned, I normally love your podcast, but this one definitely missed the mark. I think Dr Hayes deserves an apology.
I agree, and well stated! Guilty as charged.
I think the world of Steven Hayes, but was reluctant to schedule a podcast since I have had a hard time understanding him, but decided to give it a shot after multiple requests from his pr agent. I didn’t do a good job of expressing my confusion and doubts / questions about ACT.
I also admit I was frustrated at times. I was curious if ACT therapists use assessment tests, like the empathy scale, following sessions, since therapists’ perceptions are usually not at all accurate. I was just looking for a yes or not, and asked twice, but did not get a straight answer. I think the answer was no, but that wasn’t at all clear.
Thanks so much for the feedback! I will definitely learn from your observations!
David
“Every time someone has lifted me up they’ve turned out to be a charlatan”
All or nothing thinking
Overgeneralization and labeling
Hi NYC Educator, Good point! You’re right. Thanks!
Perhaps I can restate my sentiment. Many people who present themselves as gurus or leaders of a religion or school of therapy, have, in my experience, turned out to have a kind of dark underbelly that they are hiding. Charming on the surface, so they attract many followers, but perhaps not as genuine or honest as one might have hoped, or believed initially. So, they’re not “all bad,” as you point out, and are only charlatonoid, or charlatanish! Or, to use a technical term, pretty strongly narcissistic, sometimes to the exclusion of truth or integrity.
Personal experience only! Take it with a grain of salt, as I am often wrong!
Just to be crystal clear, I am not referring to Dr. Hayes, a person for whom I have great liking and respect. I just wish he’d speak in a somewhat more understandable way, so his message will be heard! I simply cannot understand what he is saying most of the time, and that is, in part, a product of my own limited intellect. But at the same time, I suspect that many people will have trouble grasping what he is saying much of the time.
At any rate, thanks for listening and chiming in, and best wishes for a fantastic 2021.
Warmly, david
This is a textbook “The Five Secrets of Effective Communication” response.
Respectfully – I’m not buying it.
You *don’t* think the world of Steven Hayes. You think he’s peddling a load of crap! Anybody who listened to this episode knows that.
Obsequious compliments and servings of false modesty around your “own limited intellect” (when in a recent episode you classified yourself one of the few able to understand Wittgenstein) make you appear disappointingly disingenuous here.
It is honestly quite jarring to alternately experience “stroking/agreeing” David Burns and “on the attack for truth” David Burns.
Even as a periodic listener, I knew we were in for a wild and uncomfortable ride when I saw in this episode’s title that the guest came from a different therapeutic approach.
I wonder, why do we keep hearing repeated “incidents” (for lack of a better term) like this one on the podcast? While I have a theory, we are all here for Dr. Burns’ theories, not mine : )
I do have tremendous fondness for Steven Hayes, and find a lot of his ideas appealing, especially his emphasis on process research rather than outcome research, which has been for the most part disappointing. But you are absolutely right that I am not impressed with ACT, and I’m not convinced it’s the right solution for the main problem in most of psychotherapy, which is trying to promote some form of “help” without addressing the massively important problem of therapeutic resistance. In addition, I am not in favor of “schools of psychotherapy,” and feel it is time to give them up and move to a science-based, data driven approach to treatment. I have many concerns about ACT, and perhaps will list them at some point, although I am aware that there are multitudes of ACT enthusiasts!
Thank you for your open and honest comment! Many people are afraid to criticize! Apologies too for obsequiousness or false modesty, which is always a turnoff! will try to state my views in a more straightforward and respectful way.
David
I completely agree. It was hard to listen to. I reached out to Dr. Hayes to let him know that I felt as if the podcast was rather unprofessional on Dr. Burn’s part. There is not need for defensiveness in our field. All evidenced based modalities have a place in the field and NONE of them have all of the “answers”.
right! Sorry I did not do a better job showcasing his work! Sadly, the three of us could not understand what he was trying to say. All the best, david
I’ve had your books for years, pulled them off the shelf to reread a few years ago, then found your website and have been listening to the podcast weekly since the Fabrice days. I’ve also read Feeling Great. So, I’m a big fan of TEAM-CBT. I have also recently been curious about ACT and have read A Liberated Mind. I’ve been trying to reconcile some TEAM-CBT ideas and ACT ideas and when I saw Dr. Hayes was on the podcast I was really looking forward to it. From Dr. Hayes’s book, and watching some of his videos, I do find him difficult to understand at times. He really could not seem to provide simple answers to your questions. It was indeed frustrating. Yet I must say I tend to agree with James as far as you having been on the attack.
I’ve just barely scratched the surface with ACT, but if I understand correctly ACT holds that one need not evaluate the truth or believability of thoughts. A person can recognize a thought as such and decide if it is useful or not, helpful or not. If that is indeed what ACT proposes, then I would say that would be similar to using your Cost-Benefit Analysis. It seems to me ACT and TEAM-CBT also have similar views about the inadvisability of trying to avoid anxiety. You have always been adamant about the importance of exposure.
I admire Dr. Hayes and he has a powerful video on his website. Thanks for having him on. I’ve found that ACT therapist Dr. Russ Harris has a knack for explaining concepts in easy to understand ways. He has a few interviews and some short animated videos out there that I’ve watched. He also has written several books, including ACT Made Simple.
Thanks for the podcasts. I really look forward to Mondays!
Phil
Thanks, love your thoughtful comment, and I think there are definitely areas of overlap as well as extreme differences. Dr. Jill Levitt was prepared to outline many areas of overlap, but we barely scratched the surface due to the difficulty with language. All the best, david
I love your podcasts though concur with James and Phil in that I also felt your attitude towards Dr Hayes was a little disrespectful, dismissive and hostile. I agree that Dr Hayes was pitching the concept of ACT at a level that was confusing at times (myself included) and always appreciate the crystal clear and simple version if I can get it! I think Dr Hayes was trying to explain a little of the underlying theory of ACT (Relational Frame Theory – RFT), which can get a little geeky on the science side! I always think of ACT as being the car and RFT as being the engine. You don’t have to know how the engine works to drive the car (though it can certainly give you a much deeper understanding!).
I have also had the benefit of attending workshops with Dr Russ Harris, who has a talent for putting the complex processes of ACT across in a clear and simple way. Dr Harris wrote a good, introductory paper on ACT entitled “Embracing your Demons; An overview of Acceptance and Commitment Therapy”, which is readily searchable on the internet and gives a good introduction. His book “The Happiness Trap” also gives an excellent user friendly, self help guide to ACT.
My bookshelf has room for both ACT and CBT 🙂
All the best, Simon.
Thanks, and well stated!
I hope you can find room for TEAM on your bookshelf, too, as I’m not an ACT or CBT therapist. TEAM is not a new school of therapy, but a structure for how therapy works. I’m not much in favor of any “school” of therapy.
All the best, d
David, I love your podcast!! I don’t think your app is working properly on apple podcasts. I downloaded Google to listen, but it’s not working there either!! Help!!!!!
I’m not a techy, so don’t know what to do about your problem, but one fix would be to sign up on my website, in the right hand panel of every page. Then you’ll get notifications of each podcast and blog, etc. You mention my “app” but not sure what you are referring to. I use Libsyn for syndication. d
Hello Dr Burns,
Personally, while I felt a little bit of sympathy for Dr Hayes, I must admit I was kind of glad to hear you saying what many listeners, myself included, were thinking. It makes me realise that we are fortunate that you, Rhonda and co are so straight-talking and that you avoid jargon or overly-complex language as much as possible.
I find it extremely irritating when people try to cover up lack of knowledge with jargon, but I must say in Dr Hayes’ defence that I don’t believe he was doing that, as he seems to be extremely knowledgeable. Also, I have bought his audiobook, and while I’ve only listened to an hour or so of it, I think it’s necessary to point out that his writing is far clearer and easier to follow than how he explained his concepts in your interview.
Anyway, thanks again, I’m working my way through your book and, little by little, I think it’s making a difference.
Thanks, Brian, well-stated, thanks for info, and best of luck with your audio of Dr. Hayes book plus Feeling Great! d
Hi david, thankyou for that great podcast ,the meeting of minds of two pillars of modern day psychological wisdom:-0. Thankyou for asking those questions as i too was bamboozled by those concepts (i did some ACT training along time ago and forgot them). I am a TEAM-CBT enthusiast from the UK 🙂 and agree with you that simplicity and clarity is the most powerful way to connect and help anyone understand theoretical concepts(patient or therapist).
I have been interested in Buddhism for over 25 years, and i find TEAM-CBT complements buddhist ideas regarding the ego and death of the ego is a beautiful and accurate description. TEAM-CBT helps me integrate even more self compassion and kindness to my clinical practice. Thankyou so much for sharing TEAM-CBT with the world:-). Its starting to take off in the UK now:-)
Thanks, Derek! Lovely and thoughtful comment, much appreciated! Warmly, david
Hi Dr Burns
I have done some reading of works by both you and Stephen Hayes.
If I might, let me try to serve up what I have perceived as the main distinction.
My take is, that you believe that suffering is caused by distorted thinking and if we can realize the fallacies of that thinking we can feel better.
In a nutshell, I believe that ACT doesn’t really care about why we feel bad or about trying to convince ourselves of our distorted thinking.
But rather, ACT recommends not get involved in any deep struggles with our thoughts but instead accept our feelings, make room for them and just go on.
I suspect one is a more intellectual approach and the other somewhat more instinctive.
I’d be curious if both you and Dr Hayes would agree with that very basic and maybe simplistic analysis.
Hi Harvey, thanks for your thoughtful comment. I believe that distorted negative thoughts (NTs) cause depression, anxiety, and other negative feelings, and the very moment you discover that your NTs are not valid, you will immediately feel better. I use many forms of acceptance in TEAM-CBT. It is one of more than 100 techniques I use, and one of the first CBT techniques I created in the mid-1970s called “Externalization of Voices” and “Acceptance Paradox.” It is one of more than 100 techniques I use. Exposure can be very helpful for all forms of anxiety, along with the cognitive, motivational, and hidden emotion models. I do not use formulas or non-specific techniques. therapists and patients often struggle due to unaddressed resistance. That’s why I created TEAM-CBT, and why ultra rapid recovery is now possible for many (most) patients I treat. More than 90% experience a complete elimination of symptoms, plus feelings of joy, in a single two hour session. This is an intensely emotional and anti-“intellectual” approach. I greatly appreciate your dialogue. People often are hungry to synthesize and find the commonality in apparently different approaches. Appreciating the radical differences can be useful, too. I am reluctant to do this for fear of being seen as overly critical, but hope my comments might be useful to a few people at any rate! david
I did appreciate the Podcast. I am glad to see more/other work is done in the areas of testing and dealing with resistance. Pragmatically said, I am always happy to hear when people find healing or relief, even when I do not understand the method (although preferably not placebo). In my opinion usually fair competition stirs up the creativity among colleagues,
Dr. Burns, you are an extraordinary teacher. Not everyone is as gifted as you in this aspect.
Thanks, William. Appreciate your thoughtful words! Best David
I am not a mental health professional, but I think it could be helpful for others to point out those ideas.
I think that in ACT, the content of the thought doesn’t matter that much, but the key is rather the thoughts are helping me to function better, if not, then defuse or distance from the thought, in a way that it led to less behavioural response, it is not about getting rid of the thought, but just to view the thought as product of the mind, as sounds and words.
In CBT, I think there is much more emphasis on the factual evidence for each thought, like whether a thought is accurate, and the belief behind the attitudes are realistic or not, this is the cognitive part of the treatment. But regarding the behavioural part of CBT, it is likely that expose to the feared stimuli is actively used, either in a self-help book format, or in a therapy format.
I think that in obsessive-compulsive disorders, the behaviour part is the most troubling situation for the one who are experiencing them, as they will lead to decrease of functioning in life, so in that case of scenarios, I think the best approach would be to stop the behaviours that causes daily disruptions, but not stop the thoughts, as I think typically in ACT there is a use of a thought experiment called, do not think of something for 30 seconds and see what comes up as a result, & typically for me, I will end up thinking about that thought as a result of the instruction of not thinking about something, that is when I think that ACT contains an important idea of not obeying some of the thoughts that was floating through my mind, while there is a likelihood that those thoughts are not helping me to function better.
Thanks for the podcast, I enjoy hearing all of you chatting about different ideas.
Thanks for the kind and thoughtful words! d
After reading the comments and listening to this podcast. A lot of people are getting after good ole’ Burn’s for being on the attack and it’s confusing to me. It’s really hard to not be on “the attack” as you folk call it when Haye’s, in the impression I have was being evasive. I understand the concepts of ACT and it’s great, although Haye’s could have done much better explaining it Barney style and could have answered some of Burn’s questions.
Any imperfect human being will get annoyed and frustrated when someone FAILS to answer the same question multiple times. Haye’s PR agent pushed to get him on Burn’s is podcast and fails to explain it simple and not answer some questions?? Yet, Burn’s is the bad guy?? Haye’s PR Agent pushed this. Adds some questions in there.
Thanks, I agree with you, but I notice that when you criticize someone’s hero, you get attacked sometimes! People want you to admire their heroes, no matter what! d