ACT-Informed Exposure for Anxiety by Thompson Brian L.;Pilecki Brian C.;Chan Joanne C.;Hayes Steven C.;

Author:Thompson, Brian L.;Pilecki, Brian C.;Chan, Joanne C.;Hayes, Steven C.;
Language: eng
Format: epub
Publisher: Context Press
Published: 2023-04-06T19:46:17+00:00

Sometimes clients can’t let go of their control agenda, their focus on avoiding discomfort. The client may appear to be working hard: they understand the rationale, they’re willing to do difficult exposures, and they complete all their homework. After weeks of working through the exposure menu, the client remarks that they don’t feel any better and wonders what else they could be doing. Sometimes, client behavior looks ACT-consistent, but the client is functionally engaging in subtle forms of control or avoidance. Whenever they experience any anxiety, they fuse with the idea that they should be able to make it go away and that there’s something wrong with them if they can’t. Control agendas can be sneaky and subtle. But it’s important to note that this isn’t a problem per se; rather, it’s an opportunity for the client to gain a deeper understanding of how their behavior is keeping them stuck. If you suspect this is happening, assess for it, point it out, and continue to practice. In our experience, the repetition of well-designed exposure exercises is one of the best ways for clients to learn to let go of their focus on control. Regardless, it can be important to address in session. Slow down and direct a client’s attention back to their present-moment experience and focus on the process of what is happening rather than the content they are presenting with. Some prompts might include:

“Would you be willing to spend thirty seconds just being present with the anxiety symptoms that you are feeling right now?”

“Your mind is working hard to try to understand this experience. I wonder if we could take a moment to step back and just witness it—without words, labels, or descriptions?”

“Where in your body do you feel anxiety the strongest right now?”

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