Act with faith excerpts

A with Faith C T

Acceptance and Commitment Therapy with Christian clients:

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A Practitioner's Guide

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INGRID RHEA ORD

Contents About the Author..................................................................... iii Introduction............................................................................. ix Preparing for the Journey...................................................... ix

Section 1 Setting the Scene

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Chapter 1 Why ACT with Faith?............................................... 19 Why a Specific Protocol for Christians?..................................... 20 My ACT Epiphany............................................................... 23 Chapter 2 Christian Worldview.............................................. 25 What is a Christian?............................................................. 25 The Covenant of Grace......................................................... 26 Personal Relationship with God.............................................. 28 Strategic Relational Qualities................................................. 28 The Importance of the Covenant of Grace in Working Through the ACT Process with Christians.............................................. 30 Christians and the Bible.........................................................30 Chapter 3 Mindfulness, Rule�Governed Behaviour & Psychological Flexibility.......................................................... 33 Psychological Flexibility........................................................ 33 Mindfulness.......................................................................34 Rule-Governed Behaviour..................................................... 37

Section 2 Being Present

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CHAPTER 4 Present Moment Awareness............................. 51 Introducing the Hexaflex in a Christian Context.......................... 51 Hexaflex (Diagram)............................................................. 52 Grace: A Tool for promoting Psychological Flexibility.................... 53 Clinical Relevance of Being in the Present Moment ..................... 55

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Contents Chapter 5 Perspective of Self................................................. 59 The Christian Experience..................................................... 60 The Three Senses of Self in ACT.............................................. 64

Section 3 Opening Up

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Chapter 6 Acceptance with Willingness............................... 75 The Path From Pain to Values................................................. 78 Christians will Suffer.......................................................... 80 Spiritual Abuse................................................................... 82 Chapter 7 Defusion................................................................. 85 What is Defusion?............................................................... 85 The Christians approach to Thoughts........................................ 87 Defusion and the Perspective of Grace.......................................88

Section 4 Doing What Matters

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Chapter 8 Values.................................................................... 97 The pragmatic Truth Criterion and Christians............................ 98 Other Problems That may be Encountered with Christian Clients in Values Work................................................................... 101 Why the ACT Approach to Values is Very Important for Christians in Therapy......................................................................... 107 Why Values are Important to Everyone...................................... 108 Fusion with Goals and Rules...................................................109 Chapter 9 Committed Action................................................. 111 Committed Action and Creative Hopelessness............................. 111 Setting Goals – Small Steps.................................................... 114 Identifying What Behaviour is Goal-Oriented.............................. 116 Building Larger and Larger Patterns of Flexible Behaviour............... 121

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Contents Chapter 10 Summary and Conclusions..................................

The Route Through The Six Processes......................................

What’s In A Name?............................................................

Working with Clients of Different Faiths..................................

123 123 127 129

Section 5 Client Handouts

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Appendix 1................................................................................. 135 Mindfulness for Christian Clients Appendix 2................................................................................ 153 The Perspective of Grace Appendix 3 ............................................................................... 157 Present Moment Awareness Appendix 4 ................................................................................ 159 Awareness of Compassion Appendix 5 ................................................................................ 163 Perspective of Self Appendix 6................................................................................. 169 Willing Acceptance Appendix 7 ................................................................................. 175 Cognitive Defusion Appendix 8 ................................................................................. 181 Values in ACT and Christian Ethics/Virtues Appendix 9 ................................................................................. 187 Values and Committed Action Quotations

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Contents REFERENCES............................................................................

Bible Versions....................................................................

References.......................................................................

Further Resources:.............................................................

197 197 197 201

More About Ingrid Ord........................................................... 203 Acknowledgments.................................................................. 205 Your Notes............................................................................... 206

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Introduction Preparing for the Journey

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will begin our journey by discussing a general summary of the Christian’s worldview. I have kept this as short and as factual as possible and urge the reader not to skip this. Even if it is of no personal interest, it does explain the importance of certain concepts, such as grace, in the life of a Christian. ACT practitioners know that ACT is really only effective if, and when, it is incorporated into the daily experience of life.

This discussion of the Christian’s worldview will describe how Christianity is also experiential. Christianity revolves around a relationship that is lifechanging and experienced daily.

We will then go on to consider psychological flexibility, mindfulness, and rule-governed behaviour.These seemed logical companions for discussion at the beginning of a protocol for Christian clients. I was excited by the actual experience of mindfulness (in a workshop) and how it brought me into an experience with the God I believe in, long before I had read anything about it. Appendix 1;‘Mindfulness for Christian Clients’ explores this more fully, and this chapter discusses the dangers of using terminology which may deter the client from the practice, or cause them to terminate therapy prematurely.

Rule-governed behaviour is very significant in the lives of Christians, especially those who spend time in Christian communities. Guilt, selfjudgement and condemnation are, ironically, characteristic of many Christians who have approached me for help, and seem, perhaps, to be an unfortunate side-effect of belonging to these communities. The practice of mindfulness promotes flexible sensitivity to self-judgement, and the development of compassion for self and others. Hence, this protocol has been named ‘Compassionate Awareness Training’.

The next six chapters will concentrate on each of the six main processes identified in ACT, one at a time, beginning with awareness of the present moment, then moving on to perspective of self, willing acceptance and defusion, and then values and committed action. Each of

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the processes will be identified, for the client, by one part of the Bible memory verses which is outlined below. These will be clearly marked at the heading of each of the six chapters in question.

“Are you tired?Worn out? Burned out on religion? Come to me. Get away with me and you'll recover your life. I'll show you how to take a real rest.

Walk with me and work with me--watch how I do it. Learn the unforced rhythms of grace. I won't lay anything heavy or ill-fitting on you.

Keep company with me and you'll learn to live freely and lightly.”

(Matthew 11:28-30) (MSG) (‘The Message Bible’ – just a note here on which translation I use – I understand that the Message Bible is an interpretation and not a literal translation. I use it because it is very readable and understand that it may not be the favourite version of others. Of course a more literal translation is recommended for deeper study into the meaning of individual words and phrases).

For the sake of clarity, the applicability to the six processes is as follows: 1) Present moment awareness: “Are you tired?Worn out? Burned out on religion? Come to me.” (verse 28a) 2) Perspective of self: “Get away with me and you’ll recover your life. I’ll show you how to take a real rest.” (verse 28b) 3) Willing acceptance: “Walk with me and work with me – watch how I do it.” (verse 29a) 4) Defusion: “Learn the unforced rhythms of grace.” (verse 29b) 5) Values: “I won’t lay anything heavy or ill-fitting on you.” (verse 29c) 6) Committed Action: “Keep company with me and you’ll learn to live freely and lightly.” (verse 30)

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Chapter 1 Why ACT with Faith?

God delights in concealing things; scientists delight in discovering things.

Proverbs 25:2 (MSG)

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welve years ago I began a journey that was to change my life. I discovered ACT, started practising mindfulness, and began to notice gradual changes in my thinking and behaviour patterns. Over time, I noticed that these changes were taking me consistently towards what I wanted my life as a Christian to look like. I gradually introduced what I was learning into my professional practice, when I had Christian clients who gave their consent. I have no research, yet, to quantify what happened, but I have seen, and received a lot of feedback about, more flexibility and vitality in the lives of my Christian clients.

After many requests to make this protocol available to a wider audience, I gathered the material I use in therapy and group work, and sat down to write (after many false starts). It started out as a self-help handbook for Christians; however I soon realised that the work I was producing was more suitable for therapists who already know ACT, rather than for the average layperson. I saw tricky areas that can really best be worked through with a therapist and decided that, by trying to explain in self-help language, I may be doing a disservice to all. I therefore decided to take the more technical route.

There are excellent ACT textbooks already published and so, in order not to reinvent the wheel, I have not included detailed discussions of the processes of ACT. Some resources for learning ACT are listed in the references, although this list is by no means conclusive. My aim in this text

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Section 1

is to facilitate a knowledge base for use with the Christian population, and to provide reference material for all therapists, whether they are familiar with Christianity or not.

Why a Specific Protocol for Christians?

Making sense of the world through Christianity is an important part of life for a large proportion of the population in many Western countries.

According to a Pew Forum study, dated December 2011, 77% of the population of the USA, 75% of Europe, 63% of sub-Saharan Africa and 90% of Latin American/Caribbean populations identify themselves as Christians.

For those who consider Christianity as defining their worldview, help is most likely to be welcomed from those who can best speak their language.

The Bible provides a ready reference for what this language may be and, in reading it through, I have found evidence of what ACT researchers are discovering. The verses from the Bible at the start of the chapter, indicate that the things that are revealed, or those things which ‘scientists delight in discovering’ are important to Christians in their everyday lives. The connection between ACT and what has been revealed in the Bible forms the backbone of the information provided in this book.

Albert Einstein reportedly said: “Information is not knowledge.” I saw a need for a protocol for Christians that was not based on information alone. In this book I am offering you the knowledge that I have gained by putting into practise the information gained by simultaneously learning ACT and reading the Bible over the past 8 years. I have learned experientially, through a number of workshops and conferences, how to apply ACT in my life. At the same time I have studied the Bible and have developed the habit of reading it right through once a year.

In re-reading passages of Scripture, in the context of the book in which they are written and that of the whole Bible, their applicability to the different processes in ACT has become more and more clear. These verses and passages have been well received by numerous Christian clients as aids, and discussed with clergy from different denominations in three different countries. This process of refinement has resulted in groups of verses relating to each of the six processes of ACT, which are offered in the appendices for your use and as hand-outs for your clients.

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Chapter 2 Christian Worldview “A Christian in the New Testament sense is literally a stranger and a pilgrim, he feels himself a stranger, and everyone involuntarily feels that this man is a stranger to him.''

Attack upon Christendom. Instant no 7. Soren Kierkegaard. 1854‐1855.

What is a Christian?

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t is not an easy task to describe how people who identify themselves as Christian approach life, nor is it easy to categorize them in any way. Part of the reason for this is the sheer diversity of human beings, which is perhaps what is behind the development of the many different forms of practising Christianity which exist today. The purpose of this chapter is not to provide inclusion or exclusion criteria, but to provide the therapist who might possibly consider Christians as strangers an insight into how their Christian client may view the world.

This very brief outline of the Christian worldview applies to someone who would identify themselves as a Christian in the New Testament sense. Not everyone who calls themselves 'Christian' would, necessarily, describe themselves as ‘a New Testament Christian’. Clinical judgement may be required about whether or not to ask the client directly how they would identify their own approach to Christianity. Any discussion on this topic would, naturally, be instigated by the client, with the therapist’s assurance that what is important in the process of therapy is the guiding principles of the client.

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Section 1

The Importance of the Covenant of Grace in Working Through the ACT Process with Christians The covenant of grace provides a helpful basis for working with Acceptance and Commitment Therapy (ACT) with Christians. Focussing on the present moment, acceptance, defusion and experiencing of the observer self are all greatly facilitated by this understanding.

The power of grace is seen as being freely given when the Christian stops struggling against the human condition, accepts life as it is and not how her/his mind says it should be, clearly defines what is important in life and then takes committed action towards those values.

Christians and the Bible Relevant verses and teachings from the Bible will be clearly marked throughout this book. A few versions of the Bible are used in these references, including many from ‘The Message’ Bible.The language is very much that used in everyday modern life, and is easily understood. There are other more direct translations and more familiar texts and I apologise to those readers who would have preferred these. I opted for readability.

Every quotation is referenced by an abbreviation of version’s name, for example MSG refers to the Message Bible, NIV refers to the New International Version and so on. A list of the Bibles referred to in the text, together with the abbreviation for each is given at the beginning of the references section at the back of the book. The list is in alphabetical order.

The Bible is the final authority for all Christians. Having said that, great caution is to be exercised in utilising the words from the Bible as there is a veritable minefield of literal and symbolic meanings, translation differences and perhaps inaccuracies, and then, of course, the Old and the New Testaments representing law and grace respectively. Unless you are a theological scholar, it is not recommended that you even try to navigate your way through your client’s interpretation of what the Bible actually says.

Firstly, any arguments or attempts to dissuade are not consistent with the ACT therapeutic stance. Secondly, consistently pointing your client towards reading the text within the context in which it was written is

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Above all, therapists need to remember that for Christians the Bible is the Word of God, written by the inspiration of the Holy Spirit. Christians believe that it is not a book of suggestions, or anecdotes, or metaphors, but that everything in it has a divine purpose. It is seen as a complete life manual for Christians. This may not apply to all who call themselves Christians, and is not necessarily an issue for those who do not raise their spiritual beliefs as clinically relevant.

Chapter 2: Christian Worldview

usually very helpful. Problematic advice or quotations from others are often quoted out of context, and it is good practice for your client to become accustomed to examining the text within the context and, if needs be, to consult reference works on what the original text actually meant.

Thirdly, it is useful to know about texts such as: "Here is a simple, rule-ofthumb guide for behavior: Ask yourself what you want people to do for you, then grab the initiative and do it for them. Add up God's Law and Prophets and this is what you get.’’ (Matthew 7:12) (MSG)

However, Christians in therapy who mention that their spiritual beliefs are important to them, are very likely to view the Bible as extremely important, if not their ultimate authority on life. Any suggestion that the Bible may be less than this is likely to alienate your client from you.

The last point is extensively illustrated in Appendix 4; ‘Awareness of Compassion’.

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Chapter 3 Mindfulness, Rule‐Governed Behaviour & Psychological Flexibility I Prefer a flexible heart to an inflexible ritual.

Matthew 11:29 (MSG)

Psychological Flexibility

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his chapter naturally lent itself to being a ‘psychological flexibility sandwich’. In other words it begins and ends with a discussion of this concept.

The focus of ACT interventions is to help a person to move from psychological inflexibility to psychological flexibility. When looking at each of the six processes involved in the practice of ACT, it becomes clear what this move from inflexibility to flexibility looks like. What is less obvious, however, is how this is achieved and what is involved in moving the focus from outcome (as in many other therapies) to process.

For Christians, Acceptance and Commitment Therapy poses certain challenges and unique opportunities. The next six chapters will consider a detailed discussion of each of the six processes, and important aspects to note when working with Christian clients. Before doing that, however, it seemed fitting to look more closely at two aspects of the whole process that will affect the work done in each of the six areas – namely mindfulness and rule-governed behaviour.

This will then lead back to a further consideration of psychological flexibility.

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CHAPTER 4 Present Moment Awareness Are you tired? Worn out? Burned out on religion? Come to me.

Matthew 11:28 (MSG)

Introducing the Hexaflex in a Christian Context

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his verse and the following two verses make up the model devised for Christians, to encompass the six main processes in the practice of Acceptance and Commitment Therapy (ACT). It is based on the ‘hexaflex’ (a name coined to describe the diagram illustrating the interaction of the six ACT processes - see next page). The full model reads as follows: a. “Are you tired?Worn out? Burned out on religion? Come to me.”

(Present moment awareness); b. “Get away with me and you'll recover your life. I'll show you how to take a real rest.” (Perspective of Self); c. “Walk with me and work with me - watch how I do it.” (Willing Acceptance); d. “Learn the unforced rhythms of grace.” (Defusion); e. “I won't lay anything heavy or ill-fitting on you.” (Values); f. “Keep company with me and you'll learn to live freely and lightly."

(Committed Action).

(Matthew 11:28-30) (MSG) These verses are a memory aid for all of the six processes, and should be easily learned throughout therapy in order to help the client, and therapist, to move around the ‘hexaflex’ at will. This chapter and the following chapters will illustrate how to do this

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Chapter 5 Perspective of Self Get away with me and you'll recover your life. I'll show you how to take a real rest.

Matthew 11:28 (MSG)

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he importance of a sense of self for Psychologists is well described in the following quotation, from the excellent book by Louise McHugh and Ian Stewart, ‘The Self and Perspective Taking’: “The emergence of a sense of self is a core strand in human development and an assumed prerequisite for sound mental health and human functioning (Dymond & Barnes, 1997; Hayes, 1984).

By contrast, clinical researchers have often argued that dysfunctional (rather than underdeveloped) aspects of self are associated with, and contribute to, poor mental health. For instance, in ‘The dialectical model of personality disorder’, Linehan (1993) proposed that sufferers demonstrate deficiencies in taking the perspective of others and in emotional self-regulation.This presents a picture of mental distress as imbalances in the functioning of a sense of self that have both cognitive and emotional ramifications.” (p156) Psychology and theology have been uncomfortable with one another over this very issue for many years. Some theologians (making a gross generalization of course), tend towards believing that Psychologists are soft on sin, by calling it problem behaviour which the person cannot help (again, over-generalizing their individual arguments). In addition, the concern is that the self will be elevated to a position where there will be no perceived need for God. Conversely Psychologists (generalizing again), have been reluctant to study or work with an abstract concept like spirituality and have shied away from discussions on this topic.

It appears to this author, after extensive study of what is available in the Christian counselling literature (from Christian publishing sources, not secular sources), that this is partly the reason why Christian counselling

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Section 2

models tend not to be based on secular, evidence-based practice; and tend to avoid in-depth discussions of a sense of self. This is of course, also a generalization, and not a criticism but an observation of what may be a problem; notice needs to be taken of the possibility that Christian clients may be negatively biased toward adopting a non-judgemental or compassionate attitude towards the self. They may also be reluctant to work with secular therapists, for the reasons discussed throughout this book.

It is the sincere hope of this author that this discussion may help to promote an end to this historic estrangement, so that the millions of Christians who are suffering will be able to access the excellent professional help available in the secular world. As an additional nudge in this direction and in order to alleviate concerns about lack of Biblical support; and/or about the theological accuracy of the protocol being proposed here, appendices and client hand-outs with extensive Biblical references have been included.

As mentioned in chapter 1, these references were collected over time through experiential learning of applying ACT to the author’s own life.

One thing that was particularly guarded against was the following danger, as described by Oswald Chambers: “One of the greatest dangers in dealing with the Bible is to exploit it, that is, to come to it with a preconceived idea, and take things out of it only what agree with that idea.” (p100, 101, ‘Biblical Psychology: A series of Preliminary Studies; God's Revivalist Office’, Cincinnati, Ohio, 1914)

The Christian Experience The essence of the Christian experience is a relationship with a God who is believed to be a living entity. The following invitation, from the Bible, is extended to humans in order to establish this relationship, together with certain promises.

The memory verses for this entire protocol for Christians refer to the inner man, the ‘soul’: “Are you tired?Worn out? Burned out on religion? Come to me. Get away with me and you'll recover your life. I'll show you how to take a real rest.

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! Self-as Context: This refers to a process whereby the person develops the ability to adopt a sense of self which encompasses and at the same time is detached from experiences related to the self. Some have described this as a ‘transcendent’ sense of self. One metaphor describing this is that of the chessboard. Self-as-context describes the board on which the game is played, and the pieces are self-experiences such as thoughts, and evaluations about the self.

So the judgements and evaluations about the pieces and their moves are not applicable to the board.

Chapter 5: Perspective of Self

The Christian client may be reminded that grace is promised as an enduring process which frees a person from judgement on a moment-by-moment basis, thus promoting an increasingly stable description of ‘private events’ where judgements are released as having no power.

A sense of self as context is sometimes facilitated by encouraging the person to ‘notice yourself noticing’; ‘notice what it looks like to see from another's eyes’; ‘view yourself the way a kind friend would view you’. When this awareness of self as context is attained, it is accompanied by a freedom from the judgements and evaluations that may affect the other two senses of self.

This sense of self is particularly important for the Christian, as it has been described as a ‘spiritual’ experience. This is described further in Appendix 1;‘Mindfulness.’

The identity of ‘Christian’ is added to a person when they accept the invitation to begin a relationship with Jesus, but then the process of learning how to behave in this role begins. This makes a person very vulnerable to the verbal community, as the temptation may be to shortcut experiential learning and to model their behaviour on that of more experienced Christians, or on arbitrary rules. This means that Christians are especially challenged by self-judgement. Focussing on developing a flexible, non-judgemental sense of self is an extremely important process when working with Christians. This, together with present moment awareness, is invaluable in the move from rigid inflexibility to

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Section 2

psychological flexibility.The phrase ‘burned out on religion’ (Matthew 11:28, MSG) very succinctly describes the rule-bound inflexibility that can develop.

Accessing grace in the present moment as a source of power, and as a transformational agent results in experientially learning how to take different perspectives on oneself. It is not difficult to point clients in this direction, and the verse from Matthew that describes this process (Matthew 11:28) can be a helpful cue when needed: “Get away with me and you’ll recover your life. I’ll show you how to take a real rest.” (MSG). Reference to the transformational grace of God is a great advantage when working with Christians, and a primary agent of change. It is a great relief for many Christians to really understand that from God’s perspective, there is no need to judge themselves: “My dear children, let's not just talk about love; let's practice real love.

This is the only way we'll know we're living truly, living in God's reality.

It's also the way to shut down debilitating self-criticism, even when there is something to it. For God is greater than our worried hearts and knows more about us than we do ourselves.

And friends, once that's taken care of and we're no longer accusing or condemning ourselves, we're bold and free before God!” (1 John 3:18-21) (MSG) In conclusion, Christians are especially challenged by self-judgement.This may be exacerbated by membership within a religious verbal community that adopts arbitrary rules about all aspects of behaviour. Within many Christian groups, there is strong emphasis on ‘right’ and ‘wrong’ ways to behave, both externally and internally, and pressure is applied to the individual to conform. This is not a criticism, merely an observation of what is characteristic of some verbal communities. Teachers and personal advisors may strongly encourage the elimination of unwanted thoughts, emotions, and other internal events.

ACT practitioners understand that this may result in a useless struggle, which increases distress, and psychological suffering. This suffering may be exacerbated if the client themselves, or others in the community,

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Chapter 6 Acceptance with Willingness Walk with me and work with me‐‐watch how I do it.

Matthew 11:29 (MSG)

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hen considering acceptance on its own, one needs to remember that it is not something separate and distinct as a process or an outcome, but it is intertwined with the other five ACT processes and is revisited many times during therapy (and in life, of course!). Defusion can be part of this process too, but that is dealt with in a separate chapter.

Acceptance is inextricably bound up with willingness in ACT, and looks nothing like resignation or stoicism for the sake of it. The kind of acceptance described here shifts the focus from just tolerating difficult emotions and thoughts, to a genuine interest in what they are teaching about the past and the present. Emotions are full of information about how the past is impacting the present moment experience.

Acceptance, with willingness, can be a very difficult process for many Christians, especially if they have been taught, or believed, that converting to Christianity would be a life-enhancement. Many find that it is quite the contrary, and that Christians suffer just as much as others, and sometimes even more so (especially if there is persecution, even within the religious communities).This can be a great disappointment to many Christians, and some even give up their beliefs for that reason.

The question of suffering is ubiquitous in Christian literature and teaching.

Many books have been written, Bible studies executed and sermons preached, on why God allows his ‘children’ to suffer. Some teachers have answered this question by claiming that Christians have the right to eliminate suffering from their lives, and intrigued many listeners by the solutions they advocate. These will not be discussed here for fear of

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appearing disparaging about what are legitimate spiritual practices: for example prayer and spiritual warfare. The ACT therapist is cautioned, however, to notice when these become yet another technique adopted by a distressed client who wants to avoid the pain in their lives, without willingly accepting it as an important source of information.

The whole of the book of Job in the Bible is devoted to discussing just this topic, in the form of an epic poem. Job suffered immensely, in every way, physically and with loss of all his children and possessions. His friends offered him comfort in the form of spiritual advice, which became censure and rejection, as they sought to solve his problems; eventually even his wife urged him to reject God and die.

After a period of questioning God, Job came to the following conclusion: in spite of there being no reason for him to be punished, God was sovereign and to be trusted, no matter how the circumstances appear: “Though he slay me, yet will I trust in him.” (Job 13:15) (KJV).

Likewise with three young boys who were taken as exiles to Babylon, and who refused to bow down to a gold statue of King Nebuchadnezzer of the Babylonian empire. In his anger the King threatened to pitch them into a fire that he had ordered to be extra hot. When Nebuchadnezzer told the three boys to bow down or die, this is what happened: Shadrach, Meshach, and Abednego answered King Nebuchadnezzar, “Your threat means nothing to us. If you throw us in the fire, the God we serve can rescue us from your roaring furnace and anything else you might cook up, O king. But even if he doesn't, it wouldn't make a bit of difference, O king.We still wouldn't serve your gods or worship the gold statue you set up.” (Daniel 3:16-18) (MSG) (bold by me).

They maintained that their God, the God in whom Christians believe, was sovereign and would decide upon their fate. On their part, they decided to remain faithful and to hand over control to God. As it happened, they were thrown into the furnace, which was so hot that it killed the men who threw them in. After that was done, the King saw four figures walking around inside the flames, and ordered them to come out. Three stepped out unharmed, without any sign of having been in a furnace, without even the smell of burning; one figure had disappeared.

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Chapter 7 Defusion Learn the unforced rhythms of grace.

Matthew 11:29 (MSG)

What is Defusion?

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he word ‘defusion’ refers to a specific process in Acceptance and Commitment Therapy (ACT), where the focus is on noticing that words are just that: words. Responding to the content of words is something humans do naturally, and it is sometimes very helpful with activities such as problem solving and other practical tasks. Sometimes, however, this can be unhelpful.

In other words, when an instruction on a door says ‘push’, it is helpful to respond to the content and push the door if one wants to go through; similarly, when reading a menu at a restaurant one assumes that a dish said to contain chicken, will, indeed contain chicken and not fish. These could be considered helpful forms of ‘fusion’ with language.

In ACT unhelpful forms of fusion with words tend to be targeted, such as believing global judgements about ourselves and others, considering evaluations of a person’s worth as ‘true’, stubborn refusal to change opinion and insisting on unreasonable demands, amongst others.The client is coached in how to recognise fused thoughts, to notice when they occur, and to observe their influence on behaviour.This is one way of talking about fusion as being neutral, and sometimes useful and sometimes problematic.

The effects of unhelpful fusion can be understood, in behaviour analytic terms, if one considers how behaviour patterns are narrowed when a stimulus is introduced into the environment which is particularly aversive (not desired) or appetitive (desired).

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The Christians approach to Thoughts Identifying unhelpful thinking has long been a source of intervention for Christians, both in secular and pastoral counselling, with different methods proposed for facilitating the change towards helpful thinking. Many methods and theories are based on the assumption that thinking needs to be changed first, in order for behaviour to change. This view is very prevalent in the Christian community and is backed up by verses such as:

Chapter 7: Defusion

The cognitive fusion at work in all of the above examples can strongly influence behaviour so that it becomes very resistant to change.

“And do not be conformed to this world, but be transformed by the renewing of your mind.” (Romans 12:2) (MKJV) The inference and, often, direct instruction in Christian communities, using this verse as authority, is that Christians, especially those in trouble (i.e. not already transformed) should work hard at changing their thoughts, usually by eliminating them. The assumption is also made that this is entirely possible, furthermore this is strongly asserted by some popular teachers as being an irrefutable fact, based on their own personal experience. This is being mentioned as this particular type of Christian teaching can promote lack of compassion for those who are suffering, together with judgement.

With Christians presenting for therapy who have consistently attempted to eliminate unwanted thinking and failed to do so, this censure from others has resulted in more self-judgement, condemnation and possibly shame than before.

If one carefully considers the wording in the above quotation from Romans, however, it will be noticed that the passive verb ‘be’ is in front of the word ‘transformed’; this indicates that the suggested transformation will occur through the intervention of an external agent. In Strong’s concordance, he indicates that the Greek word from which ‘transformation’ has been translated is the root word for, what in English, reads as ‘metamorphosis’ (1890).The Greek word literally means ‘change’ (meta), and ‘form’ (morphose). Metamorphosis is a process of change which is empowered entirely by the actions of an external agent, without any overt ‘work’ expected from the body which is being changed.

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Chapter 8 Values I won't lay anything heavy or ill‐fitting on you.

Matthew 11:29 (MSG) For My yoke is wholesome (useful, good‐‐not harsh, hard, sharp, or pressing, but comfortable, gracious, and pleasant).

Matthew 11:29 (AMP)

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alues work is intrinsically tied up with the other processes identified as clinically significant in Acceptance and Commitment Therapy.

Once again, this process is being discussed separately, as has been done with each of the six processes, purely to give a certain structure to the approach. Present moment awareness, perspective of self, acceptance, defusion and committed action are all very important processes in helping the client to verbalise specific details about what they value.

The definition of the word ‘values’, in ACT, can be tricky, as a number of factors are important to remember and need to be included; this can make the wording seem clumsy, unwieldy and quite difficult to understand. A few different examples might aid with clarity in this area and, fortunately, these have been provided by different ACT professionals restating the same definition, but in different ways.

To start with, the definition on the Association of Contextual Behavioural Science website (see ACBS) reads as follows: “Values are chosen qualities of purposive action that can never be obtained as an object but can be instantiated moment by moment.” (ACBS)

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Chapter 9 Committed Action Keep company with me and you'll learn to live freely and lightly.

Matthew 11:30 (MSG) For my yoke is easy, and my burden is light.

Matthew 11:30 (AMP)

Committed Action and Creative Hopelessness

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he last process to be included in this model brings the focus back to the central principle in the life of a Christian: the belief in a relationship with a living Deity (Jesus) who is available and who communicates on a moment-by-moment basis. The memory verse above expresses this as being an essential part of living ‘freely and lightly’.

The King James Version refers to the metaphor explained earlier, that of a young ox yoked together with an older ox who will lead and train the young one how to work. The yoke could be heavy and uncomfortable (suffering) and it could have heavy burdens attached (burdensome committed action), but instead it is said to be easy (acceptance and defusion) and light (feasible committed action).

Reminding the Christian of the link between committed action and intentionally being mindful of the help available through the relationship with God, may provide just the confidence needed to undertake the difficult work of committed action.

It is important to note that, as with the other five processes already discussed, committed action is intricately intertwined with present

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moment awareness, perspective of self, willing acceptance of difficulties, defusion from ‘sticky’ internal events and, especially, with verbal identification of values. It is discussed separately as there are aspects which are unique to committed action with Christians, but it does not necessarily occur as a separate entity within the therapy process.

By starting therapy (if doing so is a voluntary decision), a person is displaying committed action. This commitment may well be towards getting rid of difficult feelings and thoughts and sensations, in which case it may be necessary to take him/her through a process of creative hopelessness; nevertheless the act of starting therapy, in itself, can be used as an example of committed action.

The process named ‘creative hopelessness’ is often the first of many places where the temptation to give up therapy may be very strong, as disappointment and despair at the realization that the therapist cannot offer a quick fix become evident. It may take skill, together with a trust in the therapeutic alliance, to translate this desire to give up into a commitment to continue trying a new way of dealing with problems.

Throughout therapy the question of commitment to the process may repeat itself over and over again, especially if clients find it difficult to let go of their original ineffective strategies to control unwanted experiences, and/or inflexibly persist with behaviours that are not taking them towards desired goals. It is not easy to maintain commitment to a framework that feels counterintuitive, especially with the first difficult steps. This underlines the need to obtain informed consent and to clarify what clients believe they are committing themselves to. It is helpful to point out, again, that the action of ‘showing up’ for therapy sessions may be counted as showing commitment, very often with whatever doubts may be brought along into the room.

The very word ‘commitment’ may have connotations for Christians, which are specifically related to the teachings of their Christian community (verbal community), as it is a word that is very often used in Christian contexts. If one looks for the word in a thesaurus (e.g. Thesaurus.com) there are only five synonyms offered for the word ‘commitment’: devoted, pledged, bound, faithful, and attached. These are very descriptive of what Christian clients may understand as commitment to their spiritual beliefs,

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Chapter 10 Summary and Conclusions GOD, our God, will take care of the hidden things but the revealed things are our business. It's up to us and our children to attend to all the terms in this Revelation.

Deuteronomy 29:29 (MSG)

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t the end of a journey it’s time to relax, reminisce and review what has happened or been experienced along the way. We have taken a specific ‘route’ through and around the six processes identified as important in Acceptance and Commitment Therapy (ACT). It has been emphasised that, in reality, they work together and more than one process may be the focus at any one time. This can be rather a lot to think about all at once, however, and so we focussed on one process at a time.

The Route Through The Six Processes We started with ‘Present Moment Awareness’, because clinical experience with Christian clients has shown this to be a good basis for much of what follows. It is also the least problematic of the six processes for Christians.

Most are aware of the scripture: “...do not be anxious about tomorrow; for tomorrow shall be anxious for its own things. Sufficient to the day is the evil of it.”

(Mark 6:34) (MKJV) It may surprise you that, no matter how readily Christians accept the positive aspects of focussing on the present moment, they still find the process as difficult as many other clients do. The big question is “yes, but how?” and mindfulness provides an immediate tool for working towards this.

‘Perspective of Self’ follows, as this process forms a ‘functional’ unit with contact with the present moment. The two processes together, as a unit, are sometimes referred to as ‘being present’. The function of focussing on

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the perspective of self, in the present moment, is to notice and observe who the client thinks he is, together with what he thinks about himself in that moment.

At this point it may become very clear what the person in front of you thinks about God, about rules and being judged. This is often a problem area for troubled Christians who, for one reason or another, may see themselves from the perspective of a condemning and vengeful God. Such a perspective lends itself to self-judgement, guilt and shame. The introduction of mindfulness right from the beginning often facilitates a more compassionate view of self.

“These processes are in the center of the hexa(flex) because issues of being are central to all of the other processes and at one level of analysis ACT can be distilled down into a single word: Be” (Hayes, 2000). This is certainly of central importance to many Christians who identify themselves as ‘being’ Christian. If this identification of self as a ‘Christian’ is perceived as ‘inadequate’, or ‘not quite making it’, then generalized shame and guilt may be observed.

Experience has revealed that this can be very intransigent and is best approached by facilitating a thorough investigation of just what kind of a god is the one believed in? If the therapist is known not to be a Christian then this kind of discussion could alienate the client, and could also be a very emotive and difficult experience for the therapist. That is why Appendix 2; ‘The Perspective of Grace’ has been included. There are plenty of Scriptures which portray a very different view of God than the vengeful and spiteful judge who may be in your client’s mind.

Once we have taken a good look at who the client thinks they are and who they think God is, we are ready to consider ‘Willing Acceptance’ and ‘Defusion’. The functional unit formed by these two facilitates the overall process of ‘opening up’ to unhelpful thoughts and whatever habits the client has developed in the quest to avoid unpleasant feelings, thoughts and sensations. Some Christian clients, in their attempt to be ‘good Christians’, become more and more adept at behaving in accordance with what they believe is expected of them. Thinking and emotions, often labelled ‘attitudes’, may have been directly challenged by teaching, counselling from others, or unwritten, arbitrary rules within their verbal communities, resulting in redoubled efforts to comply.

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Section 5 Client Handouts Appendix 1: Appendix 2: Appendix 3: Appendix 4: Appendix 5: Appendix 6: Appendix 7: Appendix 8: Appendix 9:

Mindfulness for Christian Clients The Perspective of Grace Present Moment Awareness Awareness of Compassion Perspective of Self Willing Acceptance Cognitive Defusion Values in ACT & Christian Ethics/Values Values & Committed Action

References Further Resources Your Notes

This CD spells out in simple terms what the Bible has to say about meditation and how the practice of mindfulness can help.

Mindfulness is explained and different exercises provided to simply demonstrate the process, showing how mindfulness can be used to prepare the mind for Christian meditation.

Further Resources

Further Resources:

Topics for meditation are suggested and some further exercises detailed as a basis for future meditation.

Contents: 1. Introduction 2. What is the point of Mindfulness?

3. What is Christian Meditation?

4. ‘Be Still’– a Meditation 5. ‘Words’ – a Meditation 6. Doing your own Meditation 7. Meanings of the word Meditation’ in the Bible 8. ‘TheWord of God’ 9. ‘TheWorks of God’ 10. ‘The Son of God’ 11. ‘ Things that Please God’ 12. ‘Eternal Things’ 1.29 13. Examples of Exercises 1.05 14. ‘Awareness of Breathing’ 6.09 15. ‘Mindfulness of Thoughts’ 7.44 16. Final Bits from other Christians Available from

www.actwithfaithbook.com 201

ACT with Faith Have you ever been faced with a Christian client who really wants to include their beliefs in therapy, but all your best efforts at understanding what these are end in frustration for both of you? Have you ever been tempted to, or felt it in the best interests of your client, to refer them to someone who may be better placed to understand their Christian beliefs? This book is for the ranks of highly qualified and highly skilled ACT therapists and practitioners who have, or will have this dilemma.

Be there, with what is needed. An experienced ACT therapist and committed Christian maps out the territory, directs you to well‐ prepared highways and warns of the potholes and wasteful detours along the way.

‘This book is an incredible resource for anyone who seeks to speak the language of their Christian clients in therapy. Ingrid Ord has done a superb job bringing functional contextualism and Acceptance and Commitment Therapy to Christians in a way that supports, and is supported by, their religion, and she expertly guides ACT therapists working with Christian clients who identify strongly with their faith.

Through a rich assortment of scriptural references and client handouts, this book provides invaluable tools for working with Christian clients in a way that not only does not undermine or contradict Christian religious beliefs, but beautifully supports them.’

Dr Jennifer Gregg PH.D; Associate Professor, San Jose State University, San Jose, California, USA. “…. this I think is one of the most powerful tools you have ever shared with me, and… others. It's so tangible and provides clarity when you are feeling 'messy'. It's a cross and yet feels like an anchor when you use it. I especially notice how men relate to a model that is so clear. The model and the 'name' provide relevance and respect for what this model is, does, and stands for. It is Christ centred and the name highlights this fact.”

Joy R, ACT with Faith, pg 127,

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