In acceptance and commitment therapy (ACT), one of the central concepts is recognizing and addressing “stuck spots”—the patterns of thoughts, feelings, and behaviors that keep individuals trapped in cycles of distress. Both therapists and clients are human, and everyone has their stuck spots, making this a relatable and normalizing aspect of therapy. This approach is one of the things that makes ACT so powerful: it focuses on universal human experiences rather than rigid diagnoses.
Understanding Stuck Spots and Experiential Avoidance
The Role of Experiential Avoidance
Experiential avoidance refers to the strategies people use to avoid or distract themselves from uncomfortable thoughts and feelings. For Emory, these might include behaviors like staying in bed, not eating or overeating, or lying in bed all morning to avoid the feelings of sadness or anxiety. These behaviors can be easily mapped onto the ABC model and the Hexaflex, helping both the therapist and Emory understand how avoidance is contributing to their difficulties.
Normalizing DOTS
As part of the therapeutic process, it’s important to normalize these avoidance strategies, known as DOTS (Distracting, Opting out, Thinking, and Self-sabotage). Emory, like everyone else, uses these strategies to cope with distress. The therapist might share their own experiences, such as using phone games or shopping to distract from stress, to help Emory see that these behaviors are common and understandable. However, while these strategies may provide short-term relief, they often lead to negative long-term consequences, reinforcing the stuck spots.
Transitioning to Treatment
Shifting from Avoidance to Acceptance
Once Emory has a clear understanding of how their avoidance strategies are contributing to their problems, the next step is to introduce the concept of defusion—loosening the grip on these thoughts and feelings instead of trying to get rid of them. The therapist might ask Emory if they feel they’ve given their avoidance strategies a fair try and whether these strategies have actually helped them get rid of their distressing thoughts and feelings. This can be a powerful moment of realization for Emory, leading to the suggestion of trying something different.
Introducing Defusion
Defusion involves helping Emory see that trying to control or eliminate their thoughts and feelings is not only ineffective but often counterproductive. The therapist might propose an alternative approach: instead of trying to get rid of these internal experiences, what if Emory could simply let go of the struggle and allow these thoughts and feelings to exist without letting them dictate their behavior? Surprisingly, most clients, including Emory, are open to trying this new approach.
Experiential Exercises to Illustrate Thought Control
The Thought Deletion Exercise
To help Emory grasp the concept of defusion, the therapist might engage them in a simple exercise. Emory is asked to imagine a scene from earlier in the day, such as getting up in the morning or having breakfast. Once they have the image in mind, they’re asked to delete it. Inevitably, Emory will realize that they can’t truly delete a thought—it persists despite efforts to get rid of it. This exercise highlights the futility of trying to control thoughts and reinforces the idea that thoughts are normal and not something that needs to be eliminated.
The Light Switch Metaphor
Another effective exercise involves the metaphor of a light switch. The therapist might ask Emory if they can turn their emotions on and off like a light bulb. This simple, hands-on analogy helps illustrate that emotions, much like thoughts, are not easily controlled. This realization is not only freeing for Emory but can also be a helpful tool for parents who might struggle to understand why their child can’t simply “stop worrying” or “stop being angry.”