ACT for GAD: The Million Dollars and Loaded Die Exercises


Utah State University
Boys Town Center for Behavioral Health

Key Points

  1. It is essential to employ control as the problem exercises in therapy, to help clients experience the concepts.
  2. The million dollars exercise exemplifies how, the more we try to control internal experiences, the stronger they become.
  3. The loaded die metaphor emphasizes the importance of stepping away from all attempts at controlling internal experiences, and being open to a new approach.

The Million Dollars Exercise

Millionaire Shark Tank

Let’s imagine that you can offer a client a million dollars. There are limits, of course, but they would likely be willing to do quite a bit to have that money, even some of the things they’re coming to you for help with.

For a million dollars, they could leave that email unsent or the house untidy. It might not be easy, but with that much money on the table they could probably do it, right?

The million dollars exercise has simple rules. The client can have a million dollars. All they have to do is not be anxious for the rest of the session. For added motivation and challenge, let’s also imagine they’re in a dunk tank over a pool full of sharks, hooked up to a polygraph that can measure changes in anxiety. If there’s even the tiniest spike, they’re down there with the sharks and don’t get the money.

By this time, they usually say, “I’ve already lost.” Even if someone is really good at thought or emotion suppression, generally what happens is that there’s an anxiety spike, and they shove it down. So it’s already too late, game over.

Millionaire Rose Garden

Let’s give them a second chance. They could still have the million dollars. All they have to do is not think about the next thing that you say, which is: “Don’t think about red roses, or Valentine’s Day, or summer, or anything that might remind you of red roses.”

What pops into their head? Red roses. How much had they even thought about red roses before that session, or even the previous month or more? It’s highly likely that they had no problem not thinking about red roses before. Yet the very moment you tell them not to think about red roses, there they are, thinking about them.

This may seem like a silly exercise. But how often, outside of therapy, does the client think things like, “Don’t think about what my neighbor believes about my parenting,” or, “Don’t worry about what my boss will think of this product,” then those very thoughts appear?

Millionaire in Love

Here’s a final variation to really clarify the concept. I have a million dollars. If you want it, all you have to do is fall madly and deeply in love with the next person you meet. Could you?

If you want to convince me that you’re in love, you may tell me you’re in love, you may tell the person you met that you’re in love, you can act affectionately, and so on. But to make those honest to goodness feelings truly be there? You can’t do it, for any amount of money.

It seems like the rules of the game are different here. When it’s important to not have a feeling, you can’t not have it; when it’s important to not have a thought, you can’t make that thought not arise; and when it’s important to create a feeling, you can’t make that feeling happen. It all works differently when it comes to the world within compared to that without.

Metaphor: The Loaded Die

Omaha, Nebraska is close to the Iowa border. Although gambling is unlawful in Nebraska, you can just hop over the river into Iowa and go to a casino. As long as it’s appropriate with the client, you might use a gambling metaphor.

Let’s imagine that you’re across the river at the casino, and you’re at the craps table, but you’re playing with a loaded die. You keep losing, because you don’t know you’re playing with a loaded die. You lose and you’re going to continue to lose because of this.

Are you to blame for this continuing loss? Of course not. It’s a rigged game.

Let’s imagine that you’ve learned the game is rigged, but you can see yourself with the dice in your hand, about to roll again. You don’t know what you’re going to do about the money that’s already been lost, how you’re going to get any back, how you’re going to solve the problem, yet you’re preparing to roll again.

What’s the first thing you would tell yourself as you’re about to roll the dice? Don’t roll, right? Put the dice down, and step away from the table.

In therapy, a client can see via such a metaphor that their herculean efforts to date have in fact been part of the rigged game of trying to get rid of anxiety. Even if they don’t yet know what a more fair and effective approach might look like, they can at least start by learning to notice when they’ve picked up those dice, and how and why to set them down again.

There are of course many other metaphors that could be used here. There’s no right or wrong metaphor, it all depends on each client and their circumstances. So do create and practice your own metaphors, and tailor them to different clients.

Homework: Tracking Anxiety

Jane is sent home with work during early sessions, to track when anxiety arises and how she responds. She records antecedent situations and her resulting thoughts, feelings, and sensations.

She is asked to reflect on some questions, to guide her in the assignment and solidify the concepts. What did you do when this situation arose? How well did that work in the short term? How about in the long term? Were there any costs associated with that approach?

You can see how this sets the stage for acceptance and an alternative approach. You may then move into more acceptance or defusion. Again, flexibly, differently with different clients.

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