Dr. David Van Nuys:Welcome to Wise Counsel, a podcast interview series sponsored by, covering topics in mental health, wellness and psychotherapy. My name is Dr. David Van Nuys. I'm a clinical psychologist and your host.
On today's show, we'll be talking about and commitment , or ACT therapy for short, with my guest, Dr. C. . Steven C. Hayes, PhD, is Nevada Foundation Professor at the Department of at the University of Nevada and author of 30 books and nearly 400 scientific articles. His career has focused on an analysis of the nature of human language and cognition and the application of this to the understanding and alleviation of human suffering.
In 1992, he was listed by the Institute for Scientific Information as the 30th highest impact psychologist in the world during 1986 through 1990. Dr. Hayes has been president of Division 25 of the American Psychological Association - that's the division of experimental behavior analysis. He also served a 5-year term on the National Advisory Council on Drug Abuse in the National Institutes of Health.
His popular book, 'Get Out of Your Mind and Into Your Life' was the number one self-help book, reaching number 20 overall on Amazon and briefly outselling Harry Potter for several days.
Now, here is the interview.
Dr. Steven Hayes, welcome to Wise Counsel.
Dr. Steven Hayes:Glad to be with you.
David:Yes, it's great to have you here. Now actually I heard about your work from someone else who suggested that you would make a great interview subject and so I must confess to being quite ignorant. I've been to your website and I see that you have a very full, rich, productive professional life, a very elaborate website that would take quite a while to thoroughly plumb and understand everything there, so I'm probably going to ask you some fairly naive questions. Hopefully you'll be tolerant of that.
Steven:Sure.
David:I know that you've developed a new approach to therapy that you call 'ACT', and do you call it 'A-C-T' or do you call it 'ACT'?
Steven:I call it 'ACT', 'A-C-T' to my ears always sounds like 'E-C-T' and I'm waiting to be shocked, but no, we call it 'ACT' just by tradition.
David:Yeah, well, that's good, because there's a theater company in San Francisco called 'A-C-T', so...
Steven:It's unbelievable.
David:Yeah, that's another good reason not to. And I also saw a lot of information about RFT, which somehow A-C-T comes out of RFT. Do you think it makes sense for us? And RFT stands for relational frame theory. A-C-T stands for acceptance commitment therapy.
Steven:Well, see, now you're going to have to call it 'ACT' if you're going to... When you say 'A-C-T'... Or are you going to say ACT?
David:Oh, right.
Steven:It's OK.
David:ACT is an acronym for acceptance commitment therapy. So should we start talking about RFT in order to get into ACT or...
Steven:Well, I think it's difficult work, especially for the lay public, but two things in there that are maybe useful. If I could just do an orientation for ACT, would that be helpful?
David:Yes.
Steven:I can link it a little bit to RFT.
David:Yeah, that'd be great.
Steven:You know, a lot of the therapy traditions that are out there are dealing with the issue of cognition in one way or another because it's just so central to human functioning, but there's been very little careful linking to more scientific approaches to cognition. Those dominant themes that are out there are more information processing kind of models, thinking people are computers and so forth.
And I really early on, although I come out of that tradition, ACT is part of the cognitive behavior therapy tradition, really and behavior therapy more generally, I was dissatisfied with the linkage between our understanding of what you and I are doing right now, or what anybody listening is doing when they're struggling with themselves in their own mind, worried about their own problems, evaluating their own experiences.
I became dissatisfied with understanding that process as how it relates to the process both of creating human suffering and of solving human suffering. So ACT is part of a larger effort to try to create a modern and new approach to thinking itself, and then out of that, trying to create technologies that are linked to those principles that you can test in carefully controlled studies and that we can teach other people through self-help and, of course, through therapy and other means - how to use these techniques.
So I can explain what the essence of RFT is and how it links to ACT, but that's at the level of process. What we're trying to do is go beyond simply a commonsense understanding or some of the scientific ways of understanding cognition that are, I think, harder to turn into real vital treatment programs. I don't think people really are computers and thinking of them as machines can only take you so far.
David:Oh, I totally agree with that. I'm not sure if we need to go into RFT. It sounds like that might be fairly technical. So perhaps we should stick with ACT.
Steven:I can probably do... You'd hurt my heart to completely skip it.
David:OK.
Steven:I can do a one-minute version.
David:OK, do it.
Steven:Here's the thing that we've learned that is very simple and most people would say it's common sense. What we have found, even with research with human babies, is humans do something that, so far as we can tell after 25 years of trying, there's no other living creature on the planet that does this. If you don't do it, you don't develop language, you don't learn how to think, reason and problem solve. The one core ability that humans, even human babies do, that so far as we can tell no other living creature on the planet does, is that if you learn something in one direction, you derive it in the opposite direction.
And so if you don't know that, for example, I have an infant in the house, and when I teach my little guy that this is called a ball, and later I say, "Where's the ball?" he'll look around the room and find the ball. There is no other living creature on the planet, other than human beings, that do that. And if you don't do that, you don't develop language.
Now, how RFT came to that and said, "This is way inside baseball, " there's about 80 studies on it, it's very arcane.
David:Wait a second, I have to stop you there, because I'm not sure I'm getting the example, because if you say to a dog, "Where's the ball?" the dog will do search behavior.
Steven:Sure, but you have to teach the dog when they hear "Ball" to go find the ball. If you put the ball in front of the dog and say "Ball" and then you say later, "Where's the ball?" they will not look for the ball. Even the language-trained chimps, so-called, won't do it. There's about 25 years of effort, about 30 studies, very careful studies.
I come out of the animal learning tradition and I've done about and published about nine animal studies. They simply do not do it. The words that even the language-trained chimps learn, and the dolphins and the rest, are not really symbols. They're communication, but they are not... You don't train it in one direction and get the other direction for free.
David:That's the part I'm not understanding, is when you talk about one direction and the other direction.
Steven:OK, so when, and this is very important to understanding ACT, and it's the reason I asked to actually have the opportunity to talk a little bit about RFT, is because the technology that we've developed, it really targets this specific process.
When you are thinking about the past, for example, as a human being, it's as if the events you're thinking about are actually present. You can get so much into it that you almost disappear into it. The pain is revisited as if you are actually there.
If you're thinking about the future, you can do the same thing, which is both good, in terms of solving problems and creating things, and bad, in terms of struggling with things that may never happen, fearing futures that never will be. "This anxiety's going to happen, I'm going to die, the people around me are going to die." The kinds of ways that we have to bring the past and the future into the present depend upon our unique ability to have the symbols that we use stand for and bring into the present...are interacting with the things that it stands for or is related to.
David:OK, now I'm with you. I think I've got it.
Steven:With me on that? Now, with your dog, you can teach them, when you hear 'slippers', go get the slippers. But when you say 'slippers', he's not imagining slippers, etc. You teach him a new word, you have to teach it in both directions. You could teach a parrot, for example, to say the word 'ball', when they see a ball, but then you'd have to teach them, when they hear the word 'ball', to go get the ball. Both directions would have to be taught.
With infants, at first both directions have to be taught, but by the time they're just 14, 15 months old, you teach it in one direction, you get the other for free. And this leads to these gigantic cognitive networks that we live in. We live inside our heads most of the time, you know - thinking about the past and the future, and evaluating what we're doing, which is great when you're solving a problem in the external world, but leads both to an entanglement with your mind and an attack on your own emotions, very often. Why that happens, we'll unpack.
But ACT is a combination of acceptance and mindfulness processes and commitment and behavior change processes that allow people to interact more flexibly with their world, despite the fact that they have this language-generating engine between their ears that's constantly tempting them to leave the present and go into the past or in the future, even when it's not useful to do that. Or to go off into judgment and evaluation, even when it's not useful to do that.
So that's what we're trying to do, is teach people to be present and sort of leave a little bit of gap between themselves as a conscious human being and this problem-solving ability that comes from allowing symbols to stand for events.
David:OK, I think I'm with you. What I'm hearing so far is that as human beings we live in a very symbolic world, this internal world that we've constructed of symbols, and that we sometimes become so, what, overidentified with it that we get kind of lost and tangled up in it.
Steven:Exactly.
David:And we can develop... Sometimes we need to have a little distance from that.
Steven:Little bit of distance. And part of the things that are... The two ones that are in there that are really big are time and evaluation. It's very hard for human beings to stay in the present moment. I think there's every reason to believe all the rest of the creatures on the planet, that's where they live basically all the time.
David:Right.