Values Exercises
Values clarification was a key element of focus early on in treatment. Dr. Tull encouraged Mark to engage in exercises designed to help him confront his fears, and to recognize that exposure work could help him overcome internal and external barriers to living the life he desired. Mark showed some understanding of his values. However, his primary connection to them – his work – was unavailable to him due to being on leave. This posed a challenge to identifying activities aligned with Mark’s values, so Dr. Tull guided him through exercises designed to explore this.
- Freewriting exercise
Dr. Tull asked Mark to imagine removing all barriers and challenges. If he could escape anxieties, avoidance, and troubling thoughts, how would he spend his time? What would his life look like? His responses helped determine what influenced his choices, thereby identifying his values.
- Imagining a legacy
Mark was guided to envision a book about him written 100 years from now. What would he want it to say about his life? What values would he want his life to represent? Again, this exercise worked to identify Mark’s values, providing a roadmap for valued actions.
Valued Actions
Throughout treatment, Mark was asked to identify weekly valued actions. However small or significant, they were meant to be easily integrated into his daily life. Some were perhaps already part of his routine, but the goal was to bring increased awareness to these activities.
Dr. Tull then encouraged Mark to use values as a guide for his behavior, contrasting this with the avoidance he had previously demonstrated. Upon encountering frightening situations or reminders of the traumatic event, Mark was to ask himself whether his subsequent actions served his values or his avoidance.
Emotions and Values Clarification
Mark’s pain, including feelings of shame and guilt, provided further insight into his values. If he experienced shame, it could be interpreted as a response to an unfulfilled desire to help the man he couldn’t save. Such intense emotional responses could be used to clarify his values by highlighting what was important in his life, what truly mattered to him.
Emotions were also used to guide the selection of valued actions. For instance, if Mark felt shame, he was encouraged to focus on values associated with self-care. This strategy aligns with the opposite action principle of dialectical behavior therapy: acting contrary to the urge associated with a painful emotional response.
In Vivo Exposure
Finally, in vivo exposure exercises were identified that centered around valued actions. Rather than simply placing Mark in situations associated with the traumatic event, the goal was to have him identify valued actions that might bring him into contact with things he feared or wanted to avoid. By these means, he could increase the extent of his engagement in meaningful activities while simultaneously undergoing exposure.
Looking for practical everyday tools? This print-friendly handout is just what you need. Click on the following link to download the PDF:
ACT for PTSD: Clarifying and Acting on Values
This handout summarizes the critical role of values in shaping actions and responses, especially in the aftermath of trauma. Clients are introduced to freewriting and legacy visualization methods to spotlight and map their core beliefs. The handout emphasizes the importance of recognizing and acting upon these identified values in daily routines. Emotions, even those stemming from painful experiences, are presented as signposts pointing toward those values. Furthermore, exposure exercises are redefined, shifting focus from mere confrontation of fears to acting in alignment with one’s values. This approach ensures a holistic healing process that intertwines self-understanding, emotional processing, and practical action.
Instructions
When introducing this handout to clients, initiate conversations about recognizing personal values in healing from trauma. Encourage them to reflect on the exercises mentioned, such as freewriting or envisioning their legacy, as tools to extract their deeply held beliefs. As they identify their values, guide them toward integrating them into daily routines and actions, particularly when confronting traumatic memories or challenging emotions. Emphasize the strategy of opposite action, using emotions as cues for value-aligned behaviors. As they progress, propose in-vivo exposure exercises that intersect with their identified values, transforming mere confrontations into meaningful, value-driven experiences. This approach fosters both emotional processing and functional recovery.