Demystifying ACT: A Practical Guide for Therapists
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Why Is Psychological Flexibility Important in ACT?
By DJ Moran, PhD
This presentation is an excerpt from the online course “Demystifying ACT: A Practical Guide for Therapists“.
- Increasing psychological flexibility is an aim of Acceptance and Commitment Therapy.
- Psychological flexibility can be measured. The more psychologically flexible you are, the lower your scores will be on psychopathology and the higher your scores will be on quality of life.
- Finally, psychological flexibility is the capacity to contact the present moment while also being aware of thoughts and emotions without trying to change those private experiences or be adversely controlled by them. Depending upon the situation, the psychologically flexible individual might persist in or change behavior in the pursuit of chosen values.
Acceptance and Commitment Therapy is based on empirically supported principles aiming to improve psychological flexibility by leveraging the influence of mindfulness practice while utilizing evidence-based applied behavioral science.
Let’s take a look at that second clause in the definition. ACT aims to improve psychological flexibility.
Psychological flexibility is a fairly new construct in Psychology. I don’t recall people measuring it or talking about in the literature in the 20th century. So it’s a fairly new construct. And psychological flexibility can be measured with a few approaches. One robust-open source measure is called the Acceptance and Action Questionnaire, 2nd Edition, otherwise known as the AAQ-II.
It was written by Bond and others and published in 2011. It is free and on the internet and you can also find copies of it on the Association for Contextual Behavioral Science website.
People with higher psychological flexibility measured by the AAQ have been shown to have lower psychopathology measures and higher quality of life measures. So if you’re the kind of clinician who wants to reduce suffering and improve quality of living for your clients, psychological flexibility is a good measure for you to use.
One definition for psychological flexibility can be found in Moran, 2015 and it describes psychological flexibility as “the capacity to contact the present moment while also being aware of thoughts and emotions without trying to change those private experiences or be adversely controlled by them and depending upon the situation, persisting in or changing behavior in the pursuit of values and goals.”
Now, let’s unpack that definition right there.
Psychological flexibility relates to the ability to contact the present moment fully. ACT therapists teach mindfulness exercises in order to help clients be in the present moment. ACT is not teaching about mindfulness because the therapist wants to proselytize people to become Zen Buddhists and it’s not because we’re trying to have the therapy lead to enlightenment. Not that either one of those things is bad but this behavioral science is pragmatic and teaches mindfulness for practical reasons because now is the only time behavior happens. Now. You can’t behave tomorrow. You can’t behave yesterday. Now is the only time that action happens. So mindfulness exercises lead to the ability to contact the present moment because the present moment is the only time behavior occurs. You can’t behave in five minutes. You can’t behave five minutes ago. Now is the only time that action happens.
Now, you might protest and say, well, I will be behaving in five minutes. And I will challenge you. Okay, set your watch, set your smartphone to go off in five minutes and do that behavior that you think you will be doing then. And then I would ask you while you’re doing that behavior, is it now or is it in five minutes? All behavior happens in the present moment. And here’s the catch.
According to some of the research like Killingsworth and Gilbert, 2010, 47% of the day, our thoughts are not about the here and now. 47% of the day, our thoughts are about there and then, at other moments. We’re not contacting the present moment almost 50% of the day. Now, I’m not criticizing that outright. Sometimes, it’s okay for us to plan the future and reminisce about the past. But sometimes, our language, our thoughts can be about worries related to the future and ruminations about the past and that takes away from opportunities in the present moment to do things that we find vital and meaningful. So we teach people about mindfulness exercises so that they contact the present moment more fully and that leads to broader psychological flexibility.
And the next clause in this definition states that psychological flexibility is influenced by being aware of thoughts and emotions without trying to change those private experiences or be adversely controlled by them. So we’re going to take a moment in this training to do a simple exercise. I hope you are able to do it where you are right now.
What I’m going to invite you to do is go ahead and take a nice full clean deep breath. And when you exhale, close your eyes. And I’m going to invite you to make a commitment. This commitment is to do one thing, one single solitary behavior exclusively. And that is to attend to your breathing. Notice what it feels like to inhale and exhale. Notice the rise and fall of your chest. Notice how the air is cooler as you inhale and warmer as you exhale. And I want you to recall the exercise to make a commitment to do one single solitary behavior exclusively. Attend to your breathing. That means if your mind has wandered and you’ve thought about other things, see if you could just gently bring yourself back to what you are doing right here, right now. Breathing. Now, maybe some thoughts came up. This isn’t how I learned how to do mindfulness in the past. Or how am I going to apply this to my clients in the future? But notice those thoughts took you to the past and to the future and took you away from the present moment. And the present moment is when valuable behavior happens. See if you can notice that you’re having those thoughts. Just gently bring yourself back to the commitment you made, attending to your breathing which is a behavior that’s happening right now.
Maybe some other thoughts came up, judgments. This is a silly exercise. This is weird. See if you could simply do the following. Any thought that comes up that’s about there and then, the past or the future or a judgment, see if you can imagine that thought being printed out on a poster and that poster is being carried by toy soldiers in a parade and that thought just marches right on by distance from you. And watch it go away and then bring yourself back to your commitment to attending to your breathing right here, right now. Maybe some other feelings or thoughts came up. See if you can be aware that they are there. Distance yourself from them. Observe them and then bring yourself back to the commitment to pay attention to your breathing right here and right now. And then go ahead and take a nice full clean deep breath. And as you exhale, open your eyes. What we did right there was a traditional mindfulness exercise. And what I’d like to have you embrace is the idea that part of that teaching was about being aware of thoughts and emotions, noticing them without necessarily getting hooked by them.
That’s one of the components of mindfulness and that is one of the components of psychological flexibility. So we teach mindfulness exercises in order to increase psychological flexibility because the more psychologically flexible you are, the lower your scores and measures of psychopathology and the higher your scores in quality of life inventories.
So now, let’s turn to a third part of the definition of psychological flexibility.
Psychological flexibility suggests that depending upon the situation, the person will be persisting in or changing in their behavior in the pursuit of their own values. Earlier, we discussed how ACT is a functional contextual therapy.
So all of our analyses about behavior are of course going to suggest that people’s actions will depend upon the situation. The antecedents and consequences to human behavior are always going to have a strong effect on whether or not certain behaviors happen more or less often.
And then psychological flexibility has something to do with persisting or changing certain habits or repertoires. Now, changing one’s behavior just sounds like flexibility. When something is flexible, it means it bends, contorts and changes. So of course, our definition of psychological flexibility will include that component. But persisting, staying the course, being unbending and unyielding, that is also psychological flexibility. When a client says that they aim to achieve a particular objective because it is really vital in their life, then they keep working at it even though the goal is difficult, even if the winds of change blow them this way or that way, they stay determined to those actions, that is psychological flexibility too. When we ask people what they care about in their life, what are their chosen values, that helps people persist and change. So that is an important part of the definition at the very end that we care about values because they influence behavioral change. People begin to start saying what’s important in their lives and they become influenced by meaningful endeavors which assist them in changing their actions even if it’s tough and persisting in other actions even when it is difficult.
In the next module, we will take a closer look at a metaphor to really understand the concept to teach others about psychological flexibility.
But in this module, there are three key points.
Increasing psychological flexibility is an aim of Acceptance and Commitment Therapy.
Psychological flexibility can be measured. And the more psychologically flexible you are, the lower your scores on psychopathology and the higher your scores on quality of life.
Finally, psychological flexibility is the capacity to contact the present moment while also being aware of thoughts and emotions without trying to change those private experiences or be adversely controlled by them and depending upon the situation, persisting in or changing behavior in the pursuit of chosen values.
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- The Inflexahex Model and ACT: 6 Converse Dyads to Understand Psychological Inflexibility
- The Inflexahex Model in ACT: Acceptance vs Experiential Avoidance
- The Journey of Life: A Metaphor for Values in ACT
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- ACT Is an Empirically-Supported Therapy: Background and Clinical Evidence