ACT for GAD: Introducing Defusion Exercises

Michelle-Woidneck2

Utah State University
Boys Town Center for Behavioral Health

Key Points

  1. What gets in the way of willingness is fusion with a thought, feeling, or sensation.
  2. “Give your mind a name” and “I’m having the thought that” are practical exercises for introducing the concept of defusion experientially in session.
  3. It is important to be mindful of the timing of defusion exercises, as they can be experienced as invalidating if not introduced carefully.
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Cognitive Fusion and Defusion Exercises

What often gets in the way of willingness to coexist with a feeling is fusion with a thought. Your mind might say it can’t tolerate a particular feeling, that it’s dangerous or carries an unpleasant meaning. In such circumstances, defusion skills become invaluable.

Your Mind Says

You can target defusion from the first session, as part of the intake, through choice of language. You may say, “In this situation, you had the thought that everyone thinks you’re a bad mom, then your mind told you horrible things were going to happen, or created a worst-case scenario.” Through such language you’re already modeling and building some defusion. Clients will often quickly start to use the same language in session, which is encouraging.

When targeting defusion more directly, we can extend this into an exercise to connect with thoughts, such as, “I’m doing a halfway job at home.” Ask the client to notice what it feels like in their body when they say it that way. Then try it again, with them saying instead, “I’m noticing that I’m having the thought that I’m doing a halfway job at home,” and see how that feels. Clients often report that the thought instantly has less power.

Keep in mind that defusion is a functionally-defined term. If we do that technique with Jane, and she says, “Oh, it feels really bad, I’m noticing I’m having, oh, that feels bad too,” so there’s no difference between the two for her, then it wasn’t defusion. And it’s not workable to try to convince her she should experience something different, or continually repeat the exercise hoping for a different outcome. Notice the reaction, then pivot to another exercise.

Name Your Mind

A different exercise might be more effective, like “give your mind a name”. If Jane named her mind, what would it look like? If there was a character on TV that played her mind, who would it be? All you’re doing is helping to create some separation between the self and the mind, and it can also bring some lightness to the exercise. She can do things like say the thoughts in a silly voice, or sing them to the tune of Happy Birthday. Be imaginative.

A Time and a Place

Be cognizant of the timing of defusion exercises. You want to be sure that you’ve heard the client’s concerns and reflected or otherwise validated their experiences, so they feel truly seen and heard. They need to know you understand and accept how hard this is for them, because a poorly-timed or -executed defusion exercise is experienced as invalidating.

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ACT for GAD: Introducing Defusion Exercises

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