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Wise Counsel Interview Transcript: An Interview with Steven Hayes, PhD on Acceptance and Commitment Therapy

David Van Nuys, Ph.D.

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Dr. David Van Nuys: Welcome to Wise Counsel, a podcast interview series sponsored by mentalhelp.net, covering topics in mental health, wellness and psychotherapy. My name is Dr. David Van Nuys. I'm a clinical psychologist and your host.

On today's show, we'll be talking about acceptance and commitment therapy, or ACT therapy for short, with my guest, Dr. Steven C. Hayes. Steven C. Hayes, PhD, is Nevada Foundation Professor at the Department of Psychology at the University of Nevada and author of 30 books and nearly 400 scientific articles. His career has focused on an analysis of the nature of human language and cognition and the application of this to the understanding and alleviation of human suffering.

In 1992, he was listed by the Institute for Scientific Information as the 30th highest impact psychologist in the world during 1986 through 1990. Dr. Hayes has been president of Division 25 of the American Psychological Association - that's the division of experimental behavior analysis. He also served a 5-year term on the National Advisory Council on Drug Abuse in the National Institutes of Health.

His popular book, 'Get Out of Your Mind and Into Your Life' was the number one self-help book, reaching number 20 overall on Amazon and briefly outselling Harry Potter for several days.

Now, here is the interview.

Dr. Steven Hayes, welcome to Wise Counsel.

Dr. Steven Hayes: Glad to be with you.

David: Yes, it's great to have you here. Now actually I heard about your work from someone else who suggested that you would make a great interview subject and so I must confess to being quite ignorant. I've been to your website and I see that you have a very full, rich, productive professional life, a very elaborate website that would take quite a while to thoroughly plumb and understand everything there, so I'm probably going to ask you some fairly naive questions. Hopefully you'll be tolerant of that.

Steven: Sure.

David: I know that you've developed a new approach to therapy that you call 'ACT', and do you call it 'A-C-T' or do you call it 'ACT'?

Steven: I call it 'ACT', 'A-C-T' to my ears always sounds like 'E-C-T' and I'm waiting to be shocked, but no, we call it 'ACT' just by tradition.

David: Yeah, well, that's good, because there's a theater company in San Francisco called 'A-C-T', so...

Steven: It's unbelievable.

David: Yeah, that's another good reason not to. And I also saw a lot of information about RFT, which somehow A-C-T comes out of RFT. Do you think it makes sense for us? And RFT stands for relational frame theory. A-C-T stands for acceptance commitment therapy.

Steven: Well, see, now you're going to have to call it 'ACT' if you're going to... When you say 'A-C-T'... Or are you going to say ACT?

David: Oh, right.

Steven: It's OK.

David: ACT is an acronym for acceptance commitment therapy. So should we start talking about RFT in order to get into ACT or...

Steven: Well, I think it's difficult work, especially for the lay public, but two things in there that are maybe useful. If I could just do an orientation for ACT, would that be helpful?

David: Yes.

Steven: I can link it a little bit to RFT.

David: Yeah, that'd be great.

Steven: You know, a lot of the therapy traditions that are out there are dealing with the issue of cognition in one way or another because it's just so central to human functioning, but there's been very little careful linking to more scientific approaches to cognition. Those dominant themes that are out there are more information processing kind of models, thinking people are computers and so forth.

And I really early on, although I come out of that tradition, ACT is part of the cognitive behavior therapy tradition, really and behavior therapy more generally, I was dissatisfied with the linkage between our understanding of what you and I are doing right now, or what anybody listening is doing when they're struggling with themselves in their own mind, worried about their own problems, evaluating their own experiences.

I became dissatisfied with understanding that process as how it relates to the process both of creating human suffering and of solving human suffering. So ACT is part of a larger effort to try to create a modern and new approach to thinking itself, and then out of that, trying to create technologies that are linked to those principles that you can test in carefully controlled studies and that we can teach other people through self-help and, of course, through therapy and other means - how to use these techniques.

So I can explain what the essence of RFT is and how it links to ACT, but that's at the level of process. What we're trying to do is go beyond simply a commonsense understanding or some of the scientific ways of understanding cognition that are, I think, harder to turn into real vital treatment programs. I don't think people really are computers and thinking of them as machines can only take you so far.

David: Oh, I totally agree with that. I'm not sure if we need to go into RFT. It sounds like that might be fairly technical. So perhaps we should stick with ACT.

Steven: I can probably do... You'd hurt my heart to completely skip it.

David: OK.

Steven: I can do a one-minute version.

David: OK, do it.

Steven: Here's the thing that we've learned that is very simple and most people would say it's common sense. What we have found, even with research with human babies, is humans do something that, so far as we can tell after 25 years of trying, there's no other living creature on the planet that does this. If you don't do it, you don't develop language, you don't learn how to think, reason and problem solve. The one core ability that humans, even human babies do, that so far as we can tell no other living creature on the planet does, is that if you learn something in one direction, you derive it in the opposite direction.

And so if you don't know that, for example, I have an infant in the house, and when I teach my little guy that this is called a ball, and later I say, "Where's the ball?" he'll look around the room and find the ball. There is no other living creature on the planet, other than human beings, that do that. And if you don't do that, you don't develop language.

Now, how RFT came to that and said, "This is way inside baseball, " there's about 80 studies on it, it's very arcane.

David: Wait a second, I have to stop you there, because I'm not sure I'm getting the example, because if you say to a dog, "Where's the ball?" the dog will do search behavior.

Steven: Sure, but you have to teach the dog when they hear "Ball" to go find the ball. If you put the ball in front of the dog and say "Ball" and then you say later, "Where's the ball?" they will not look for the ball. Even the language-trained chimps, so-called, won't do it. There's about 25 years of effort, about 30 studies, very careful studies.

I come out of the animal learning tradition and I've done about and published about nine animal studies. They simply do not do it. The words that even the language-trained chimps learn, and the dolphins and the rest, are not really symbols. They're communication, but they are not... You don't train it in one direction and get the other direction for free.

David: That's the part I'm not understanding, is when you talk about one direction and the other direction.

Steven: OK, so when, and this is very important to understanding ACT, and it's the reason I asked to actually have the opportunity to talk a little bit about RFT, is because the technology that we've developed, it really targets this specific process.

When you are thinking about the past, for example, as a human being, it's as if the events you're thinking about are actually present. You can get so much into it that you almost disappear into it. The pain is revisited as if you are actually there.

If you're thinking about the future, you can do the same thing, which is both good, in terms of solving problems and creating things, and bad, in terms of struggling with things that may never happen, fearing futures that never will be. "This anxiety's going to happen, I'm going to die, the people around me are going to die." The kinds of ways that we have to bring the past and the future into the present depend upon our unique ability to have the symbols that we use stand for and bring into the present...are interacting with the things that it stands for or is related to.

David: OK, now I'm with you. I think I've got it.

Steven: With me on that? Now, with your dog, you can teach them, when you hear 'slippers', go get the slippers. But when you say 'slippers', he's not imagining slippers, etc. You teach him a new word, you have to teach it in both directions. You could teach a parrot, for example, to say the word 'ball', when they see a ball, but then you'd have to teach them, when they hear the word 'ball', to go get the ball. Both directions would have to be taught.

With infants, at first both directions have to be taught, but by the time they're just 14, 15 months old, you teach it in one direction, you get the other for free. And this leads to these gigantic cognitive networks that we live in. We live inside our heads most of the time, you know - thinking about the past and the future, and evaluating what we're doing, which is great when you're solving a problem in the external world, but leads both to an entanglement with your mind and an attack on your own emotions, very often. Why that happens, we'll unpack.

But ACT is a combination of acceptance and mindfulness processes and commitment and behavior change processes that allow people to interact more flexibly with their world, despite the fact that they have this language-generating engine between their ears that's constantly tempting them to leave the present and go into the past or in the future, even when it's not useful to do that. Or to go off into judgment and evaluation, even when it's not useful to do that.

So that's what we're trying to do, is teach people to be present and sort of leave a little bit of gap between themselves as a conscious human being and this problem-solving ability that comes from allowing symbols to stand for events.

David: OK, I think I'm with you. What I'm hearing so far is that as human beings we live in a very symbolic world, this internal world that we've constructed of symbols, and that we sometimes become so, what, overidentified with it that we get kind of lost and tangled up in it.

Steven: Exactly.

David: And we can develop... Sometimes we need to have a little distance from that.

Steven: Little bit of distance. And part of the things that are... The two ones that are in there that are really big are time and evaluation. It's very hard for human beings to stay in the present moment. I think there's every reason to believe all the rest of the creatures on the planet, that's where they live basically all the time.

David: Right.

Steven: There's a past and there's a history, but we have the ability to rearrange the past, reflect on the past, rethink the past and to deal with a future that's never been. That's great for us in problem-solving, but it also creates a temptation to live somewhere else other than where life happens, which is right here, right now.

David: Yes.

Steven: And the other one is the evaluation part. You know, problem-solving works on the idea of getting rid of bad things and creating good things. But here's the problem - a lot of the parts of your own history and things your body does, some of the feelings you have, you can evaluate.

And so it's a very tempting thing for a human being to say, "I don't like feeling this so I'm going to try to get rid of it." Turns out that's probably the single most destructive thing a human being can do.

David: Really?

Steven: Because it - when we collect measures, what we call an experiential avoidance. Experiential avoidance is the combination of trying to get rid of feelings we don't like and they tend to involve us or entanglement with your thoughts and the inability to act flexibly in the presence of difficulty in some thoughts. Even if it soothes your interest. Even if it's what you want.

That combination will pick up about a 25% of the variance in anything bad you can name, and whether it's learning a new piece of software to pulling out your hair to becoming depressed or drinking too much or almost anything you can name.

Because if you can't fit with your history as you want towards what you really want, if you can't walk through discomfort, anxiety, sadness, difficult thoughts, worries, fears, insecurities, and you're going to live inside the box that established quote good feelings and good thoughts, even if your life would be a lot more expansive to get out of that box.

A lot of things that we think we'd want in our life are going to make us uncomfortable. If you get connected to someone and you really love somebody and you really care about, guess what? You're going to feel vulnerable. The root word of vulnerable is woundable. Because when people are close to you they can hurt you.

David: Yes.

Steven: If you take the human mind's tendency to evaluate things and then to get rid of the bad things, it would say, "Don't let people get close to you. Don't be vulnerable. They might hurt you." And of course that's what we do.

We get betrayed in relationships and what do we do? Instead of -- precisely because we want relationships that hurt to be betrayed and what we do is we decide that what we'll do is never be so vulnerable. And which means you can't have what you really want.

So the human tendency to evaluate your own feelings and then treat them like external objects. Begins to treat your life in an objectified way. It becomes narrower, less flexible, less able to move forward, and that's what happens to part of us.

David: OK. What you're saying is so rich. It stimulates all kinds of thoughts and associations in my mind.

Steven: Yes.

David: And it's hard to follow them all. But I want to go back to when you were, when you first spoke about acceptance you used the word "mindfulness." And of course...

Steven: Yes.

David: ...I'm familiar with that in the context of mindfulness meditation and Buddhism.

Steven: Yes.

David: And I saw on your website you went to, I saw a warning that one should not equate this - what you're describing - with Buddhism, and yet I certainly hear some resonance with that. Maybe you can talk about that a little bit.

Steven: Well there is resonance, but I think there's resonance in the act message with many of the deeper clinical traditions.

David: Yes. Yes, I remember that.

Steven: Also with the, also with the mystical aspects particularly of all of the major religion. All of which, every single major religion has in its mystical aspects ways of reigning in the excesses of human language, especially as it relates to time and evaluation.

So whether it's Zen Koans, which you can't answer literally and evaluatively, or chanting or silence or dancing or -- every single tradition has a way of putting this judgmental problem-solving repertoire on a leash.

David: Yes, and even in the Ewam tradition...

Steven: Yes.

David: Followers of Carl Ewam, there is this, there is a notion of the need to embrace your suffering rather than run from it. To kind of embrace...

Steven: Yes.

David: ...the polarities and all the pieces of yourself.

Steven: Exactly. No, the analytic traditions definitely have this sort of the experiential and existential traditions, and so what act is part of is a wing of the culture I think that's a little wiser than the commercial feel-goodism that we seem to have turned - there's this running rampant and we've turned loose on the world, and increasingly so over the years.

It's linked to these traditions, but part of your job is to open up to your own pain, the difficult areas. Don't buy into them, don't just do what they say, but learn to just observe them, watch them. I think Freud's term was an attitude of dispassionate observation, and then connect with your values and get your feet moving in accord with what you really want to be about in your life, and not just what your history tells you to be about.

So my resistance on the Buddhism part is not that it's not linked. I've actually written articles on ACT and Buddhism. I didn't come from Buddhism, I had no formal training there, other than just being a child of the '60s and reading what anyone would read, Suzuki or Watts or some of the people who were popular in the '70s.

David: OK.

Steven: But...but more recently I've gone back and had to make the relationships, because people ask these questions. But I worry about the message being put into a small box.

The message that's inside ACT is a message of liberation and spirituality, of values-based action, that's in many of our traditions, and across all different cultures that I've ever looked at. And it gets overwhelmed by the judgmental, evaluative, temporal part of the human mind, and by the institutions that feed that, like the commercialism that's, I think, feeding it right now.

David: Yes.

Steven: So if people say, "Buddhism, " and they say, "I don't know, that Eastern stuff, " I would rather not have that be a barrier. Yes, Buddhism, but not just Buddhism. Also the Kabbalah, but not just that, also the Christian mystics, but not just that, also any tradition you can name, it's in there. It's not good for human beings to run away from their own pain and to buy into their own thoughts and to try to live inside a little cognitive box that our minds would tempt us to climb into.

David: Yes, it's very fascinating, because you are articulating some major ideas that, as you say, these major spiritual traditions share, and at the same time, I know how committed you are to the model of science, and the extent to which you have attempted to anchor all of your ideas in research.

Steven: Exactly. And, you know, the traditions that are in the humanities and also in our spiritual and religious traditions, so particularly issues of art and literature and religion and spirituality, have sort of cast a light forward as to what kind of a life do we really want to be living? And also they often have hints of how do we get in our own way of being able to do that.

But what I have become...what I've committed my life to is finding a way to take those sensibilities and bring them out inside Western science and say, "Can we learn some things in this other area that then we can bring back to the culture, back to what we're doing in therapy, but not just that, what we're doing in our homes and our schools and our businesses, what we're doing in life itself, that will help illuminate and make sense of some of what's in these other traditions?"

The very first article I ever wrote that really was an ACT article. It was in 1984. It was called "Making Sense of Spirituality," and it was attempting to try to do a Western-science based monistic analysis of what spirituality really was about, and so I am persuaded that Western science is one of the most progressive things that the human mind has ever invented, but unless you bring it in contact with the deepest issues and ask of it, "How do we live lives that are connected and liberating?" it's not going to give you proper answers. It could easily enough give you answers on how to do an even better job of suppressing your emotions or running away from past pains.

And that's, in fact, what's happened. Inside science and technology is the feel-goodism that I think is harming us. If you think that the only answers are in pills that's a new invention that came from science and technology. So if you don't put it in the service of the right things, it's not going to give you the right answers.

David: Well, you've got me cheering in the stands here. [laughs] As another child of the 60s here, I really like where you're coming from with all of this, and the very ambitious effort that you've made -- a successful effort, it would seem -- in terms of integrating those basic spiritual questions and values, and connecting it to Western science and Western thought.

Steven: Right.

David: That is a major task, and part of the task of our generation, I think. So I applaud you for taking that on. Now I want to make sure I understand acceptance commitment therapy. My understanding of the acceptance part, at this time -- you tell me if I've got it or not -- is the acceptance part about accepting those things in our experience that we would want to avoid?

Steven: Yes, although not everything needs to be accepted. The Serenity Prayer I think has a good example: accept the things you can't change, and change the things you can, and the wisdom to know the difference. What ACT is trying to bring in is perhaps some wisdom. What is the difference?

From an ACT point of view, automatic thoughts and feelings, your own sense of self, your history are all off the table for change. In fact, they do change -- some of these things -- on their own, but it turns out if you directly target them for change, things like automatic thoughts and feelings, they're much less likely to change, ironically. Conversely, when we're talking about situations or behavior, change is 100% applicable.

So sometimes people hear an acceptance message something like this: "If I'm in an abusive relationship, I should just accept that." That's not true, and in fact what we do is teach people to open up to these automatic thoughts and feelings, to watch them more the way you would from an attitude of meditation or prayer. Mindful and aware of them, learn from them, but not entangled with them and struggling with them.

And then go towards what you value, and I'll take the example of an abusive relationship. When we do this kind of work, we find that people are more willing to do the hard work of changing relationships, of stepping out into the unknown, of ending things when they need to be ended. So quite apart from a passive acceptance, or really what I think is more resignation, what we're talking about is an active embrace in the moment of what your history brings to you. But also an active connection to what you really want in your life, and get your behavior aligned with that.

David: Is that the commitment part? Is that where the work comes in?

Steven: That's the commitment part.

David: Yeah.

Steven: The commitment part is this process of building larger and larger patterns of action that are linked to values and not just to past pains, but that are open to those because you learn from them. When you're anxious in a situation, something in your past is showing up in the present. That's good to know. It might be important if...

You have to wonder if people, for example, have an abuse history, often tend to be abused again. There's good evidence that people who are more experienced and are dedicated not to feeling anxiety or feeling bad, are more likely to be re-victimized. And I think it's because people are trying to dampen down the pain and they dampen down your ability to be sensitive to what's going on in the environment.

So that's on the acceptance and commitment therapy because it's both together -- of opening yourself up to what the past gives you, but then turning that whole thing forward and do something that you really care about that you really want to produce in a committed or flexible way.

That combination turns up to be effective in almost everywhere you look. And the ACT work is research-based. We know that it's just helpful for most people; it makes life less difficult for people.

David: What do you say to the person whose reaction is, "Oh, here's another therapist coming down the road. Jeez, there's so many out there." You know... you refer to the "feel good mentality" and so on. You know, why ACT? Why do we need another one?

Steven: Well, I don't know that we need another one but we definitely need progress for sure. Obviously in clinical areas and we're talking anxiety depression and all these things that we have syndromal labels for. I'm not one that really believes in the syndromal labels as received from on high or so forth. Even beyond that if you look at the amount of human suffering that's there and the inability to maintain relationships, with tremendous divorce rate, how difficult it is for us to get together?

As human being on this planet on this planet and the trap that we're facing right now of literally the possibility of... you know maybe we don't get to this exist on this planet if we can't figure out a way to solve problems of hate and aggression inside of the human heart. So it could definitely need progress. Nobody would disagree with that.

You asked why a different therapy. You know one of the things that you'll find in the ACT work is that we're not really interested in just being a brand name and protecting it. We don't for example have multi-leveled certification and all that kind of thing. I'm interested more in understanding the processes that lead to the narrowing of human lives and understanding the processes that lead to the expansion and liberation of them and the things that we do bring to the table are a little different is that we've actively pursued in an open participatory non-hierarchical way of trying to link basic science, applied science and very practical methods that can be learned by anybody.

To link those three together and then just sort of open it up to people and try to get it in their hands at low costs as it possibly can and without a lot of whoa, without a lot of centralization and needless hierarchy. So I think there's something to be said for that. As far as I know we're the only empirically supported method that has its own active basic science program in human cognition, for example.

We have some unique aspects too. You're no longer answering, probably you'd ask for. We did the first randomized trial back in 1986. The next one was done in the year 2000. What we did it in those 14 years is we worked out the basic science program. You can flash to your science work; they'll allow us to talk about some deep issues, issues of spirituality, meaning and so forth from a Western Time point of view. And only now is that paying off when people see, as you did when you looked at the website, that we're about more than simply doing workshops and selling books under a brand name.

David: Yes.

Steven: We're really about time to go to the heart of the matter and give it away and let all the people use it. Put it inside what they are doing, if we can be of some service to human culture.

David: I get that even more strongly talking to you now than I did on the website although it's certainly on the website as well. I was surprised to see really how old this approach is in terms of when you began to work and I guess you've been working at it now for about 20 years. You've been training people for some time and it's really spread.

Steven: The earliest work was around 25 years ago. The first publication was noted 23 years ago. It has spread tremendously and it's sort of the overnight sensation that has anything but overnight. Because the popular books are beginning to come out and we're finally up to that stage but even the professional books - the first book-length treatment of ACT was in 1999, the first book-length treatment of RFT is in 2001. Since 1999 we got about 25 randomized trials in every area that you can think of practically.

And now the popular books are "Get out of Your Mind and Into Your Life" is probably the best known because it was written up in time about a year ago. It went all the way up to 20 of "What's on the List", beating "Harry Potter" for one glorious week.

David: Wow! [laughs]

Steven: If I were a week, I won't ever forget.

David: There's a combination of your career, you beat up Harry Potter for...

Steven: That was one of the things that my mother would understand. [laughs]

But now that I think there's something right now seven or eight popular ACT books out, most not written by me and about another 15 common and so we are beginning to impact on different ways but even that I want us to really continue to stay open, to allow new things to come in and allow people to take what we're learning and take it out wherever it's useful to them without necessarily having to learn a secret handshake or put a special little sign on their forehead or something. That's not what we're doing here. That's not why we're in school.

David: How many ACT practitioners are there out there now?

Steven: That's a good question. There are about a thousand numbers of the society that's 60-year old... That one we've finished on our website problems. There are different accesses, I believe there about 450 therapists on that website. We've trained around 12 to 15,000 people on ACT in at least two day workshops. The work is expanding so quickly. If you're to go on the website you'll see probably 12, 15 training in advance at any one time going on somewhere in the world.

David: So it's international as well as national.

Steven: Oh yes. Absolutely and, in fact, there are ACT books now in Finnish, in Japanese, in German, in Swedish, in Spanish and one coming in Portuguese and some of these are not just translations but actual native language works that people who hope to carry that forward. There's about 1,200 people on the listserv now that takes all about 30 messages a day of professionals. There's also one for the public and people should know that. It's called ACT for the public. You can go to the Yahoo Groups' area and there are no requirements to join. You can sort of engage in conversation about this.

Most of the folks are reading the diary and the life of one of the other popular books. Most of these are very cheap, $10 to $12. So to get involved and to learn about it, it doesn't take a lot. And there are a lot of free things available to people to access that. But indeed it's going on worldwide and people are bringing new things in worldwide. So it's not simply that we're doing workshops everywhere but we're opening up the doors everywhere. In August, there'll be a large convention of ACT and RFT in Australia and a month earlier it will be summarily large on in Houston.

So it's kind of a "how's your life?" in good tone.

David: Let me back up just a little bit not because we're sort of jumping to the end in a way but one thing that I'm wondering about is if I were a client in ACT or if I were the fly on the wall in some ACT therapy sessions, what would I see? What would I experience that might be different from other approaches?

Dr. Steven Hayes: You'll see therapists who are really willing to walk into pain, and to walk in the chatterbox between our ears, and teach people skills to do that without becoming overwhelmed and tangled, dissociative. Without either backing away or disappearing into it. It's not enough just to understand these principles. You can summarize ACT in a very few number of words: accept your feelings, diffuse yourself and your thoughts, show up in the present moment as a conscious person, connect with your values and get your feet moving in a flexible way. That's ACT, I just said it. There you go.

David: That's right, I love it.

Steven: You can't take that long sentence and turn it into anything that'll change your life, unless you know the skills that allow you to do each of those things. And the human mind is going to fight you almost every step along the way, because of just how it's set up to solve external problems, and do such an unfortunately bad job of solving the problems within.

So one reason that "Get Out of Your Mind and Into Your Life," the first popular book I did, was written as a workbook was that I was just concerned that if people didn't actually learn the skills, they would just learn another set of concepts -- yet another one out there, as you said earlier -- to apply to their own problems, and then end up in the same place.

And so in each of these areas, you'd see the therapist working on: how do you open up to your own feelings, and feel them as feelings, not as what they say they are? How do you learn to watch the human mind in the present moment, and sort of thank your mind for that thought and notice that thought, and still take the good -- sometimes in those thoughts, there's some real ideas of things you need to do -- and let go of the part that's just irrelevant? Sometimes it's nothing more than an echo of the past, and the only thing it means is that something in the past is echoing into the present period. End of story.

On the values side, we've developed quite a technology of how to go from your own pain, turn over the card and find underneath it something that you really care about, that you really want to be about, and how to connect with that and begin to live your life in the service of that. That requires a technology. It isn't obvious to you.

If you ask people what they want, so many people will say that they don't want to feel fear, they don't want to be sad. It turns out what they really believe is that if they did that, then they would be able to do something. And in that something is what they really want. It isn't just that they want to get rid of the anxiety, get rid of the sadness. They may want to live a life that's more open, more participatory, contributing to others more and being more connected.

We can take people directly to that, and help distinguish this part of our thinking process, this avoidance and entanglement, and then empower the part of it that creates meaning, creates purpose. That's linked to tension in our deepest desires, the things that we care the most about. Beauty and friendship, values, connection, intimacy. We want to empower people to be about that.

Very quickly, part of what you'll see in the research work in ACT is how quickly some of these things can happen. We have done studies with psychotic patients. Can I give you just an example, to answer your question?

David: Definitely.

Steven: Most people may be familiar with the movie "A Beautiful Mind."

David: Oh, yes.

Steven: Have you seen it?

David: Yes, I have.

Steven: OK. And it's been a few years now, but you could really... If you've seen that movie, to answer your question of what ACT is, ACT is sort of teaching that class as a human community. We may not all be psychotic and hallucinating and so forth, but we all have our little demons following us. And learning A, to let them be there. B, to stop fighting with them and arguing with them. You remember that point in the movie where he says, "I'm sorry. I'm not going to be able to talk to you anymore," to the little girl? And that scene where he's fighting with the voices as he enters into the library as he's trying to learn how to reintegrate? And neither of those are going to work, and so he has to learn to let go of the entanglement.

And then the values part. Because of your family, because of your work - in that case, in the movie - that's what dignifies stepping forward and be willing to let the little girl follow you, but know you can't have deep conversations with her, you have to focus on what you came here to do.

Well, I got into that by mentioning how quickly some of this can happen. We've now done two studies now. Excuse me. I'm on the phone, please. Oh, God.

David: It's OK.

Steven: Cut that part. I've done two studies now, or we've done them in the ACT community, where we've been able to work with psychotic people. It turns out we can teach this message in three to four hours and it reduces re-hospitalization over the next several months by about 50%.

David: Wow.

Steven: If even psychotic folks can learn this, surely the people listening to this podcast can bring some of these skills into the places where they struggle, where they suffer. I don't want to say that it's just a panacea or that it's quick, but the core of it is simple, and then life itself becomes kind of your Zen master teaching you over and over and over again how to disentangle, show up in the present and move forward.

David: Well, Steven, you really whetted my appetite to learn more, and I'm sure of my listeners' as well, so Dr. Steven Hayes, I want to thank you so much for being our guest today on Wise Counsel.

Steven: I had a great time and let me know how I can be of service to you and to anyone listening. If there's a way that we can be helpful, we'll try to be.

David: I hope you enjoyed this interview with my guest, Dr. Steven C. Hayes. As a clinical psychologist myself, I must say that I'm very impressed by what I've learned about this approach, and by the years of research which underlie it.

If you are interested in additional information about ACT therapy, or wish to find an ACT therapist in your area, you should go to his website at www.contextualpsychology.org/ACT. In addition, I want to remind you of his book, written for the lay public - "Get Out of Your Mind and Into Your Life" - and you can find this at your local bookstore or if not there, on Amazon.com or some other online book retailer.

You've been listening to Wise Counsel, a podcast interview series sponsored by mentalhelp.net. If you found today's show interesting, we encourage you to visit mentalhelp.net, where you can add a comment or question to this show's web page, view other shows in this series, or simply page through the site, which is full of interesting mental health and wellness content. Access this show's page and show archive information via the podcast box on the mentalhelp.net home page.

If you like Wise Counsel, you might also like Shrink Rap Radio, my other interview podcast series, which is available online at www.shrinkrapradio.com.

Until next time, this is Dr. David Van Nuys, and you've been listening to Wise Counsel.