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.
According to ACT, psychological inflexibility is characterized by six factors:
- Experiential avoidance: the desire to escape aversive internal experiences
- Lack of values clarity
- Attachment to a conceptualized self
- Cognitive fusion: attachment to thoughts, difficulty detaching from cognitive experiences
- Loss of connection to the present moment