Decoding PTSD: The ACT Hexaflex Model in Action

Matthew-Tull-700-x-700-px

Professor in the Department of Psychology at the University of Toledo

Key Points

  1. Acceptance and commitment therapy (ACT) conceptualizes psychological inflexibility through six main factors: experiential avoidance, lack of clear values, inaction, attachment to a conceptualized self, cognitive fusion, and loss of connection to the present moment.
  2. Experiential avoidance and maladaptive emotion regulation strategies, such as substance use and isolation, provided Mark with momentary relief but ultimately increased distress and lowered self-efficacy.
  3. Cognitive fusion, characterized by an inability to disengage from intrusive thoughts, also intensified Mark’s emotional distress.
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In developing Mark’s case conceptualization, it was crucial to identify factors contributing to the maintenance of his difficulties. Such underlying mechanisms serve as treatment targets. Taking an ACT approach, Dr. Tull identified the perpetuating factors by drawing from the hexaflex model of psychological inflexibility.

Psychological Inflexibility

According to ACT, psychological inflexibility is characterized by six factors:

  1. Experiential avoidance: the desire to escape aversive internal experiences
  2. Lack of values clarity
  3. Inaction
  4. Attachment to a conceptualized self
  5. Cognitive fusion: attachment to thoughts, difficulty detaching from cognitive experiences
  6. Loss of connection to the present moment

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