Where does Suffering Come From?

By Dr. Rob Purssey

The ACT model predicts that a lot of suffering is caused by becoming entangled in difficult and painful thoughts and feelings, and then is further exacerbated by trying to push those thoughts and feelings away.

In ACT terminology getting caught up with difficult thoughts is called ‘cognitive fusion’, and trying to push unwanted thoughts and feelings away is called ‘experiential avoidance’. Fusion with difficult thoughts and struggle with painful feelings are very likely to be key processes in all human psychological struggle. What can we do to keep moving forward when facing pain and suffering in our lives? More than a thousand studies suggest that a major part of the answer is learning ACT – psychological flexibility skills.

An exciting recent study of a large sample of community adults recruited via the internet (N=955) examined the interaction between cognitive fusion and experiential avoidance in relation to psychological distress – and found, as predicted by the model:

“The predicted interactive effect was found across all four symptom measures, with the significant positive association between cognitive fusion and symptom measures being strongest at higher levels of experiential avoidance. These results provide support for proposals that individuals with high cognitive fusion and high experiential avoidance may be particularly prone to experiencing psychological distress.”

You can check out the study here: http://www.sciencedirect.com/science/article/pii/S2212144716300035

ACT aims to help people to more effectively handle difficult thoughts and feelings by learning key psychological flexibility skills, and with self compassion and resilience, keep doing what is important, even with their  tough inner experiences. Our skills coaching at the Brisbane ACT Centre directly addresses both cognitive fusion and experiential avoidance, and our resources page is a great place to start.

Directly undermining fusion with defusion, and directly increasing psychological flexibility with willingness and acceptance – key ACT skills – can quickly improve your life, easing struggling with suffering, enhancing more vital living. If that interests you get in touch with our friendly staff at the Brisbane ACT Centre today.

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Abstract

http://www.sciencedirect.com/science/article/pii/S2212144716300035

Acceptance and Commitment Therapy, a popular transdiagnostic treatment approach, is based on the central tenant that human suffering develops and is exacerbated by psychological inflexibility. Cognitive fusion and experiential avoidance are two interrelated processes central to psychological inflexibility. Despite substantive theoretical rationale that these two processes impact one another’s association with emotional distress and psychopathology, the interaction between cognitive fusion and experiential avoidance in relation to psychological distress has yet to be empirically examined in the extant literature. As such, we examined this interactive effect in relation to four indices of psychological distress (anxiety, depression, stress, and posttraumatic stress) in a large sample of community adults recruited via the internet (N=955). The predicted interactive effect was found across all four symptom measures, with the significant positive association between cognitive fusion and symptom measures being strongest at higher levels of experiential avoidance. These results provide support for proposals that individuals with high cognitive fusion and high experiential avoidance may be particularly prone to experiencing psychological distress.

Can ACT and Mindfulness Help Ease the Burden of Common Medical Problems?

ACT is closely related to other mindfulness-based approaches, sometimes called “fellow travellers” and two in particular are Mindfulness-based Cognitive Therapy and Mindfulness-based Stress Reduction – MBCT and MBSR.

An important recent review article in the highest profile open source Journal, “Plos one”, showed “Conclusion – The evidence supports the use of MBCT and MBSR to alleviate symptoms, both mental and physical, in the adjunct treatment of cancer, cardiovascular disease, chronic pain, depression, anxiety disorders and in prevention in healthy adults and children.”

13 RCTs showed significant beneficial effect on anxiety. 17 RCTs showed benefit. In this review mindfulness were shown to be helpful with psychological adjustment to cancer, chronic pain, cardiovascular disease, also various mental disorders and mixed populations. Mindfulness helped subclinical anxiety in healthy populations, also depressive symptoms and stress. In children and adolescents significant intergroup improvement in stress, anxiety and several symptoms were found, with more time spent in sitting meditation predictive.

Important review of the evidence of mindfulness based clinical psychology interventions for many conditions, with many countries across the globe, showed beneficial effects mostly in mental health outcomes: depression, anxiety, stress and quality of life all improving significantly. And chronic care mindfulness helped coping with pain, depression, anxiety and stress, and improved quality of life.

Similarly, the most recent meta-analysis of the ACT literature found ACT was superior to waitlist, to psychological placebo and to the standard treatment as usual. ACT was also superior on secondary outcomes, life satisfaction/quality measures and process measures compared to control conditions.

All of the recent meta-analyses have similar findings and some meta-analyses have found superiority for ACT over traditional CBT methods.

To read the Plos one article in detail go to this link