@Patricia Zurita Ona : 我在玻利维亚长大，在高速公路上经历了第一次恐慌发作。从那时起，我就对帮助人们学习应对焦虑而不让焦虑影响他们的生活充满热情。我学习了认知行为疗法（CBT），但后来发现接纳承诺疗法（ACT）更有效。ACT强调接纳情绪，而不是试图对抗或逃避它们。它帮助人们关注自己的价值观，并采取与价值观一致的行动，即使这些行动会带来不适感。通过练习ACT，人们可以更好地管理焦虑，并在生活中体验更多意义和目标。 ACT的核心是接纳和承诺。接纳是指接纳我们所有的情绪和感受，包括焦虑和恐惧。承诺是指承诺采取行动，去追求我们生活中真正重要的事情。这两种方法相结合，可以帮助我们过上更充实、更有意义的生活。 在ACT中，我们不追求持续的平静，而是接受情绪的自然发生，并专注于基于价值观的行动。通过练习ACT，人们可以学会与焦虑共处，而不是试图控制或逃避它。这将使他们能够过上更快乐、更充实的生活。
我与东湾行为治疗中心主任Patricia Zurita Ona博士进行了一次深入的访谈，探讨了接纳承诺疗法（ACT）。Patricia拥有超过18年的经验，致力于帮助儿童、青少年和成年人克服各种心理健康问题，特别是那些源于恐惧的困扰。
Patricia的职业生涯始于学校心理学家，后成为临床心理学家。她撰写了六本书，并被提名为情境行为科学协会的院士。除了临床实践，她还定期参加国内外会议，分享研究成果，确保为客户提供最新的治疗服务。
焦虑的陷阱：生活日渐萎缩
Patricia分享了她20多岁时在玻利维亚高速公路上经历的第一次恐慌发作。这段经历深刻地影响了她，让她意识到焦虑如果不加以有效管理，会如何让人感到不堪重负，甚至让生活日渐萎缩。“如果屈服于恐惧，你的世界每天都会变得更小，”她说道，这正是焦虑的残酷之处。我们倾向于回避任何让我们感到不舒服的情况、物体或活动，最终导致生活范围不断缩小。
对抗焦虑的误区：抵抗只会加剧痛苦
Patricia强调，面对焦虑时，最糟糕的做法就是抵抗或逃避。试图压制或对抗焦虑情绪只会适得其反，让焦虑更加剧烈。她分享了自己在学习认知行为疗法（CBT）后，又接触到ACT的经历。她发现，ACT与CBT的不同之处在于，ACT并非挑战或改变焦虑的想法，而是教导人们与这些想法保持距离，观察它们，并接纳它们的存在。
ACT的核心：接纳与承诺
ACT的核心在于“接纳”和“承诺”。“接纳”意味着接纳我们所有的情绪和感受，包括焦虑和恐惧；“承诺”意味着承诺采取行动，去追求我们生活中真正重要的事情。这两种方法相结合，可以帮助我们过上更充实、更有意义的生活。
实践ACT的策略：觉察、命名、价值观
Patricia分享了一些在恐慌发作时可以使用的实用策略。例如，可以通过觉察和命名焦虑的想法和身体感受来与它们保持距离。我们可以说：“我注意到这个想法：‘我可能会恐慌发作’”，或者“我正在经历恐慌的感受”。这种觉察和命名，而不是对抗，可以帮助我们从情绪中抽离出来。
更进一步，我们可以通过询问“此刻对我来说真正重要的是什么？”来关注自己的价值观。然后，我们可以采取与价值观一致的行动，即使这些行动会带来不适感。这需要我们去评估一个想法或行为是否会让我们更接近想要成为的人，还是让我们远离目标。
ACT的长期影响：更充实、更有意义的生活
Patricia指出，通过持续练习ACT，人们可以更好地管理焦虑，并在生活中体验更多意义和目标。这并非因为焦虑消失了，而是因为我们学会了与焦虑共处，并专注于那些真正重要的事情。这最终会带来更快乐、更充实的生活。 她还强调，ACT并不追求持续的平静，而是接受情绪的自然发生，并专注于基于价值观的行动。
寻找ACT的帮助
对于想要学习更多关于ACT知识或寻找专业人士帮助的人，Patricia推荐了情境行为科学协会的网站：contextualbehavioral science.org。该网站提供了丰富的资源，涵盖了ACT在各种心理健康问题中的应用。
总而言之，Patricia Zurita Ona博士的分享为我们提供了宝贵的视角，帮助我们理解并应对焦虑。ACT并非要消除焦虑，而是要帮助我们与焦虑共存，并活出更真实、更有意义的人生。
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01:40 我对帮助人们学习应对焦虑而不让焦虑缩小他们的人生充满热情。
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02:21 焦虑会让人们的生活越来越小，因为人们会开始避免任何让他们感到不舒服的情况、物体或活动。
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04:56 面对焦虑时，最糟糕的做法是抗拒或对抗这些感受。
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05:53 我利用自己所掌握的技能，这些技能也是我教给客户的，来应对自己的恐慌感。
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06:56 焦虑是人之常情，学习管理焦虑可以改善生活。
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07:42 认知行为疗法对治疗焦虑症有效，但接纳承诺疗法更好，因为它强调了帮助我们与价值观和重要事物保持一致的关键心理过程。
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08:54 接纳承诺疗法（ACT）与认知行为疗法（CBT）的不同之处在于，ACT不挑战消极想法，而是教导人们与这些想法保持距离，观察它们。
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09:46 ACT强调，拥有某种形式的心理挣扎是人之常情，学习管理挣扎可以改善生活，而不是试图摆脱不适感或挑战它们。
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11:21 ACT的一个技巧是通过注意到和命名想法来分散注意力，而不是挑战它们。
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12:40 通过承认和命名情绪和感觉，可以帮助我们与这些感受保持距离，并有空间来选择如何回应。
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14:15 通过有意识地暂停、以身体为中心，并简单地注意到和承认这些经历，我们可以获得更多空间来选择如何回应。
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14:40 在焦虑发作时，问问自己“此刻对我来说真正重要的是什么？”，并根据答案采取基于价值观的行动。
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15:04 通过询问“如果我顺从这个想法，我的生活会扩张还是缩小？”来评估想法的可行性。
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16:07 在ACT中，我们不追求持续的平静，而是接受情绪的自然发生，并专注于基于价值观的行动。
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16:35 ACT鼓励人们在做重要的事情时，为焦虑、担忧和恐惧腾出空间，而不是试图摆脱这些感受。
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17:24 通过接纳生活中的不适感，我们可以避免在日常生活中增加痛苦。
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18:13 我们对痛苦的回应方式决定了我们是否会陷入痛苦的循环。
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19:00 ACT帮助人们在扩张他们生活与缩小他们生活之间做出选择。
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19:34 接纳内在体验，并根据价值观做出回应，可以帮助人们过上更充实的生活。
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20:35 通过ACT，人们可以培养更有目标、更有意义和更快乐的生活。
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21:14 ACT帮助人们更好地管理焦虑，并在生活中体验更多意义和目标。
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23:42 ACT鼓励人们在做重要的事情时，即使感到不适，也要坚持下去。
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24:49 ACT通常会减轻焦虑的强度，使其更容易应对。
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25:31 在焦虑程度过高时，可以使用一些技巧来帮助身体放松，例如深呼吸和肌肉放松。
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26:07 即使在焦虑发作时，我们也可以问自己是否愿意为了成为自己想要成为的人而体验不适感。
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26:34 药物治疗有时可以帮助人们在学习ACT技能时降低生理反应。
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27:49 评判、反复思考或逃避情绪会延长情绪持续时间。
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28:50 ACT帮助人们从观察者的角度看待自己的经历，从而不认同消极想法。
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30:19 ACT的高级技巧包括识别和命名不适感、放松身体紧张部位，并专注于价值观。
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31:40 心理灵活性是ACT的理想结果，它帮助人们适应内外环境。
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32:41 反思行为是否与价值观一致，可以促使人们改变行为习惯。
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34:09 识别价值观，并采取基于价值观的行动，可以帮助人们过上更有意义的生活。
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36:19 追求价值观会带来更多的快乐和更丰富的人际关系。
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37:01 ACT帮助人们过上更快乐、更有意义的生活。
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37:40 心理灵活性帮助人们灵活地应对内在和外在的经历。
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38:25 ACT帮助人们接受生活中的各种体验，而不是只追求快乐。
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39:00 专注于目标和基于价值观的行动可以帮助人们过上更充实的生活。
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39:26 人们可以通过contextualbehavioralscience.org网站学习ACT。
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Forget frequently asked questions. Common sense, common knowledge, or Google. How about advice from a real genius? 95% of people in any profession are good enough to be qualified and licensed. 5% go above and beyond. They become very good at what they do, but only 0.1%. 语法解析
00:16
Hello, this is Richard Jacobs with the Finding Genius Podcast. My guest today is Patricia Zurita Oñar. She's the director of the East Bay Behavioral Therapy Center. 语法解析
00:46
And we're going to talk about acceptance and commitment therapy. It's different from CBT, cognitive behavioral therapy, which is very, very common in psychology today. I think it holds a lot of promise. I've been reading about it. It's fascinating, and I think listeners are really going to benefit. So welcome, Patricia. Thank you for coming. Thank you so much for having me, Rich. I'm very excited to chat with you about ACT and all its applications. Well, good. Well, tell me a bit about your background first. What led you to hear about psychology and psychotherapy and stuff like that? Such a great question. As 语法解析
01:13
As you can hear my accent, I am originally from Bolivia, South America, and my undergrad worked in school psychology. So I was always interested in working with people who are attacked in their head, people who tend to overthink stuff, people that struggle making decisions. You know, I think for me also that was part of my own upbringing, right? While I was a kid, when I was growing up, I had my first panic attack when I was driving on the freeway. 语法解析
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I was 21 or 22 at that time. And when you don't have the skills to manage anxiety, it can be so overwhelming. It feels like a disaster in the moment. It's too much. And it can be really, really scary. 语法解析
01:55
So I think over the years, I have been passionate about teaching people evidence-based skills or science-based skills to learn to live with anxiety without letting anxiety shrink their life. Because I think that's what happens with anxiety, that people stop having authentic life. There's an old saying, you know, if you give in to your fears, your world gets smaller every day, which is sad but true. And that's exactly what happens with anxiety, right? I don't know if you had any panic attacks. 语法解析
02:21
or you have a worry about a financial decision you were making. But when we get stuck in our head, we're basically going to avoid feeling uncomfortable 语法解析
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And we're going to avoid any situation or object or activity that makes us feel uncomfortable. So because we start avoiding and that works in the moment, we don't feel uncomfortable. We don't have the yucky feelings. Then our lives shrink and shrink and shrink. So that's exactly what happens with anxiety. So, okay, well, it's not funny, but in Bolivia, I've learned about the death road, I 语法解析
02:51
I guess there's this road that goes to the mountains that's so narrow that cars almost fall off of it. So when you said you had your first panic attack driving, I was going to say on the death road, because that would give anyone a panic attack even watching it, you know? Yeah, I've been on that road many times. Really? Yeah, yeah, yeah. It's a very, you know, that road takes us into the beautiful area. It's just a gorgeous area. But yeah, the freeway, the road there, it's not a fun road. Although now it's much safer than before. 语法解析
03:17
For now, I had my first panic attack in Santa Cruz, which is a tropical city in Bolivia. And I was driving on a regular freeway. There weren't any obstacles or anything. I literally was driving. And then suddenly I look in front of me and there was a truck and the lights completely shine and blind my eyes. And for a fraction of seconds, I start holding the wheel really, really hard. I start having shortness of breath. 语法解析
03:42
And it may have been that the truck drove by my car maybe, I don't know, like two, three seconds. It felt like an eternity to me. I had to pull over and continue hyperventilating. So that was one of these radical experiences with anxiety. 语法解析
03:56
and also historically my country has a history of having dictators as presidents and I was born in the midst of a dictatorship so while I didn't witness violence first hand I do understand how a culture can be shaped by fear and by worry so I think my experiences with anxiety are very personal and again it's really a 语法解析
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passion of mine to disseminate skills that were effective, that were science-based, that can really help people have a rich life. So what did you try first to help yourself? Like did these panic attacks, once you had one, did they start coming regularly? 语法解析
04:30
You know, I was very fortunate. I think at that time was in the, I think I was in the middle of my undergrad training. So of course I was training cognitive behavior therapy and I knew that the worst thing that you can do is resist or fight those feelings. They're extremely uncomfortable. When anxiety hits us, we want to do all types of things to get rid of the feeling. All that you try to fight, the more that you try, you judge the feeling, the worse it gets. So I 语法解析
04:56
I was fortunate again that because of my training, I knew that you have to open up to those feelings and make room for them without judging them, without criticizing yourself and approach instead of avoid. So you were asking me at the beginning, what is my, my, 语法解析
05:10
my history with psychology. So to undergrad, I learned many skills to manage anxiety and I have been fascinated by it over the years. So at that time when I had my first panic attack, I was in the middle of my undergrad training. I was being trained in cognitive behavior therapy. 语法解析
05:27
And because of that training, I knew that the worst thing that you can do is resist or fight the angst feelings you're having or to start avoiding situations. So in a nutshell, I was very fortunate that I was familiar with the skills that I was teaching my clients that I had to practice to manage my own panic sensation. So I think that's how I managed that. I didn't start having panic attacks frequently because I was using the skills that I knew and that I was teaching my clients. 语法解析
05:53
Well, I think I've had a panic attack maybe once or twice, but they're horrible. I know with heights, I never used to be afraid of them, but it seems like it's similar. I remember I went to this theater with my wife and we sat way up high and the slope down to the stage was really sharp. I was so uncomfortable sitting there. I feel like every few seconds I would grab the arms of the seat as if I was going to fall. But how am I going to fall sitting down, you know? But 语法解析
06:14
know but it got more uncomfortable and i couldn't rationalize it and i was like stop let's stop it but i felt like this fear just taking over my mind and i told my wife i'm like we gotta get out of here before i can't get up oh we get out of there and i was like thank god and they had a bunch of seats for people down at the bottom for people that have that same problem but um so i've experienced it and it's horrible i mean it's just it's like super intense and it's just it's horrible to have a panic attack it's like you feel like you're dying you know the 语法解析
06:38
I don't want to underplay it. That's right. It's extremely uncomfortable experiences and it can be very unfortunate if you don't know how to manage it. And for me, one of the things that happened is that after I was training cognitive behavior therapy in my doctoral program, I was exposed to acceptance and commitment therapy. 语法解析
06:56
or acceptance and commitment training as people call it. And I learned many other skills to manage my own anxieties and to acknowledge that anxiety is a part of being human, right? That as long as we're breathing, as long as we're alive, we're going to be anxious, worried, stressed, and afraid about all types of things. It's part of overcoming humanity to experience some form of anxiety. So what did you try before ACT? Did you try CBT or regular psychotherapy? And what happened? 语法解析
07:23
That's a great question. I did try traditional cognitive behavior therapy and it was helpful. It was effective. But again, I think I was in training, right? I was very familiar with the skills. So we know that cognitive behavior therapy is highly effective for treating and for working with people struggling with anxiety and other struggles as well. 语法解析
07:42
But what is different is that when I learned about acceptance and commitment therapy, everything changed for me. Because within acceptance and commitment therapy, within art, you really, really emphasize that many of our struggles are driven by 语法解析
07:57
Within acceptance and commitment therapy, you really emphasize key psychological processes that help us to be attuned with our values, with what matters to us. It helps us to be present. It helps us to practice acceptance. It helps us to disentangle from our thoughts. It 语法解析
08:12
It helps us to gain perspective about what's happening in our experiences. It really encourages us to step back from all the stuff that is happening under our skin. Those psychological processes are very different within us than traditional cognitive behavior therapy. In a traditional cognitive behavior therapy, you're going to be challenged that. You're going to be looking for the evidence for and evidence against for that thought. 语法解析
08:36
If I have a thought that I am broken, right, the cognitive behavioural intervention would be listing the evidence to prove that I'm not broken. The challenge is that given our mind is constantly relating things up and down, left and right, to language, many times some of those beliefs are resistant to change. 语法解析
08:54
Within acceptance and commutative therapy act, instead of challenging your path, you're actually teaching these kids to be some angle from them, to let trust the path and watch them, to observe them. Because when you're there to do that, you also experience a sense of self that is very different and you can choose what is important to you in the moment. So it's a very, very different approach. And the other key aspect of act. 语法解析
09:18
is that it really emphasizes that to be human is to have some form of psychological struggle. You don't have to meet criteria to have a formal anxiety disorder. Let me just say this. You don't have to meet criteria for a particular anxiety disorder. Just the fact that we are alive means that we are going to experience uncomfortable stuff under our skin all the time, just because we're breathing, just because we're alive. So within us, there is this strong emphasis, again, in our consciousness, 语法解析
09:46
common humanity that to be human is also to struggle. And this, by learning to manage our struggle, we can really improve our life. It's not by getting rid of uncomfortable experiences or challenge them. It's by learning to open up and make room for them that we get better at living life. 语法解析
10:03
Before we continue, I've been personally funding the Finding Genius Podcast for four and a half years now, which has led to 2,700 plus interviews of clinicians, researchers, scientists, CEOs, and other amazing people who are working to advance science and improve our lives and our world. Even though this podcast gets 100,000 plus downloads a month, we need your help to reach hundreds of thousands more worldwide. Please visit findinggeniuspodcast.com and click on support us. We have three levels of membership from 语法解析
10:31
from $10 to $49 a month, including perks such as the ability to see ahead in our interview calendar and ask questions of upcoming guests, transcripts of podcasts you're interested in, the ability to request specific topics or guests, and more. Visit FindingGeniusPodcast.com and click support us today. Now back to the show. So how does ACT work? What's an example of someone with a problem and how would it help them? So for example, let's say that in this moment, I am having the thought that… 语法解析
10:58
Let's say that I have a thought. What if I have a panic attack in this moment, right? If I am practicing at the skills, I will center myself using my body. I may take a deep breath. I may press my feet hard against the floor. And I may look at this thought. The thought that says, what if I have a panic attack? I may notice the thought and I may name the thought. I may say, I'm noticing the thought. I may have a panic attack, right? 语法解析
11:21
Or I may say, I am having a thought. I may have a panic attack. That's noticing. Not challenging, but simply noticing. And I also can give a name to the thought. I could say, here comes Patricia the worry. Oh, that's a Patricia worry thought. Or I may say, that comes Miss Worry. Here is Miss Worry. I may even greet the thought. I may say, hello, Miss Worry. It was a matter of time. Of course, you're going to come. We are out of schedule. I was waiting for you. So 语法解析
11:46
So there is something about acknowledging our things, our images, by noticing and naming them without getting fused or trapped by them. So that would be one skill. We call it diffusion, but everyone can practice that by noticing and naming those thoughts. Is that because, you know, emotions can get trapped in the body? You know, like there was the book, Body Keeps Score, that talks about, you know, when people have trauma, they can get trapped in their body. And later on, let's say they get a massage, they may like break down crying or laughing or… 语法解析
12:14
very angry. Maybe that's why if you acknowledge an emotion, the body is saying like, okay, we didn't know how to process this. This is how we manifest it as anxiety, let's say, or panic. You know, thank you for acknowledging us. And maybe that's why it maybe takes the edge off. Yeah, yeah. That's an interesting take. There are two things that happen. One is that when you start challenging and letting your back rationalize your anxiety, why I'm feeling this, I shouldn't be feeling like this, you're already fighting 语法解析
12:40
fighting anxiety, right? Which doesn't help. The more you don't want to have it, the more you're going to have it. The more you tell yourself, I don't want to have a panic attack, you are going to have a panic attack. So the skill here is to disentangle from thinking and observe thinking as it happens. It's stuff that your mind is coming up with, not the stuff that you have to 语法解析
12:58
fight against. So that's one thing. On another level, when we acknowledge what we're feeling and sensing, when I notice the butterflies in my stomach, when I notice the shortness of breath, and I say things like, I'm noticing butterflies in my stomach, I'm noticing my sweaty hands, by acknowledging that sensation and giving a name with an emotion, it doesn't have to be the perfect 语法解析
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the perfect name of the emotion by just saying that's anxiety noticing this anxious sensation showing up on my body when you're doing that nailing that experience also gives you more space to center and to choose how you want to respond to that moment how you want to respond to those thoughts to those feelings to these images to those sensations because you're not consumed by them that's the 语法解析
13:42
tricky part when working with anxiety and when you experience anxiety, the anxiety comes with this rush, this feeling that we have to do something. It feels like that life and death situation, right? It's like everything 语法解析
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Everything is an emergency. Like I must do something right now. If we pause intentionally, center ourselves with our body again, and simply notice and end those experiences. I'm noticing I'm having shortness of breath. I know that the butterflies are in my stomach. I know that my mind is telling me all types of things. I may even be a little bit silly again. I may say, hello, Miss Warrior. Hello, Patricia the Warrior. And then I ask myself, 语法解析
14:15
In this moment, what is really important to me? That's a values-based question. Every time we're alive, there is something that matters to us, whether that's a conversation, whether that's showing up to the project we're writing on, whether that's the meal that we're making for the family, but we're surrounded by events that are important to us, even the most mundane things. So you may want to ask yourself, what is really important to me in this moment? 语法解析
14:40
And then based on that, you may want to engage in what we call values-based behaviors. You can also ask what we call the workability question. The workability question sounds like when I have the thought, what if I have a panic attack? I may ask myself that question. If I go along with that thought, what if I have a panic attack? Does my life expand or does it shrink? Do I show up to this conversation as I want to show up? 语法解析
15:04
Or does it take me farther away from who I want to be? So notice again that we're not challenging the thought, what if I have a panic attack? 语法解析
15:11
We're looking at that thought comes with a particular action, right? The thought is pushing me to do something. We're checking what happens when you act on the thought, when you go along with the thought, when you follow the thought. Does it help you to be who you want to be or does it take you farther away? So it's just to ask them like, okay, you know, I get very anxious. Let's say, is being very anxious who I want to be? No, I don't want to be like that. I want to be calm and confident and all that stuff. So is like that series of, you know, self-questions and analysis helpful? Yeah. 语法解析
15:39
Yeah, yeah. That is a great point you're making. So one of the things we want to be careful is to acknowledge that, of course, we want to feel calm and peaceful and we want to be calm and zen across all the time, right? Yeah, that makes sense. When we are suffering, we want to be calm. The challenge is that we don't have control of our emotions. Emotions just happen, right? Sometimes when we feel anxiety, it just happens. Sometimes we feel joy. Sometimes we feel excitement. So a values-based action, a 语法解析
16:07
a behavior that helps you to be who you want to be is 语法解析
16:09
is the stuff that you do with your feet, with your hand and with your mouth are your public behaviors. So going back to the example, if I have a thought that says, what if I have a panic attack? That thought may ask me to cancel this conversation, may ask me to hide, may ask me to go and drink a glass of scotch quickly, right? May ask to use some safety behavior. But the balance behavior is to focus on the conversation, to pay attention what you're asking me for, regardless 语法解析
16:35
how I'm feeling under my skin. So that's what we did add. We encourage and invite people to learn to make room for their anxieties, worries, and fears while they are doing what is important to them. It's not getting rid of the 语法解析
16:48
those experiences, is not chasing another feeling either. It's simply taking their internal experiences as it's happening while they're focused on what matters with their public behavior. What does that do for people, though, if they have feelings like that? Yeah, well, that's a great question. So, as you know, I've had hundreds of randomized clinical trials 语法解析
17:07
It's a factor that has improved over and over in many research studies. And what happens when you practice acceptance of life, you don't add shocker into your everyday experiences. So let me say a little bit more about this. When we have the thought, what if I have a panic attack? Or what if I make a fool of myself? 语法解析
17:24
full of myself or when you have butterflies in your stomach or when you suddenly are worried about financial decisions you have to make, that is already uncomfortable. That is what we call primary pain. It's raw pain. It's already painful. It's uncomfortable. But when we're going to avoid that, when I quickly act and do what I 语法解析
17:43
that tools me to do, I am going to add more suffering to my life because then I miss connections. I don't have this interview. I feel lonely. I start developing a, I don't know, a substance abuse problem. So that is why when you learn to open up 语法解析
17:57
and practice these psychological skills, you're actually learning to get better at living with life as it happens to you instead of adding more suffering into your life. It's the way that we respond to our life. It's the way that we respond to our pain that many times can be effective. 语法解析
18:13
or can really perpetuate a cycle of suffering for us so again what does this do like for me well i acknowledge the feelings i have it it reduces their intensity a bit making them easier to handle it doesn't make them go away but again reduces their intensity so it's not like totally overwhelming but what else have you seen people do like i haven't gone through really formal access i don't know like what have you noticed in people what what changes in them and how well 语法解析
18:36
When people ask the question, what is important to me? How do I want to show up to this moment? Am I willing to have this feeling, this uncomfortable feeling and do what matters with my feet, my hands and my mouth? It gives us the space they need to make a choice that expands their life versus doing things quickly or reacting quickly to anxiety. If you ask me, that's one of the things, the most pivotal aspects of this approach. 语法解析
19:00
approach, right? That once you learn to accept your internal experiences as they happen, as they are, we 语法解析
19:06
without judging them, without criticizing yourself. You actually give yourself the freedom to choose how you want to respond in the moment, to choose how you want to show up to life. That's what we call the values-based behaviors. And every time you're taking steps and you're doing things that help you to be who you want to be, those actions have an accumulative effect and we have rich and purposeful and meaningful life, right? Which is the opposite of doing what avoidance tells us to do. If I have to act or do anything 语法解析
19:34
All the stuff that my uncomfortable experience tell me to do, I don't know. My life will be completely, yeah, it will be very small, right? Which is very, very different. Okay. So what happens over a series of sessions with someone in ACT therapy? Like what do you do? Do you review like life situations and how people felt? And what kind of progression do you notice in people? 语法解析
19:54
That's such a great question. So my specialization is on anxiety-based struggles, anything related to worries, fears, and anxieties, right? I primarily work with other thinkers who are overachievers and they are dealing with some form of anxiety. What I can tell you… 语法解析
20:10
So anecdotally speaking, it's that in the work I do, many of my clients or people in general get exposed to acceptance and commitment skills. What they really learn is to nourish a life that is full of purpose, meaning, and a joyful life because they are taking action towards what is important to them. So I think while they're learning these skills, they are really expanding their lives because it's so congruent with who you want to be, right? Yeah. 语法解析
20:35
We help people to identify what is important to them across different areas of their life. 语法解析
20:40
As partners in a relationship, in parenting, hobbies, their health, their spiritual life, in many areas of their life, we figure out what is truly important to them. We invite them to take action towards those values. And every time they are doing that, of course, they are going to experience some anxiety, some worries, some fears, some stressors. And then they learn to make room for those experiences without running away from them. So in 语法解析
21:05
In a nutshell, I would say that people get better at managing anxiety, all types of anxiety-based reactions. And also people… 语法解析
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experience more meaning and purpose in their life because you can live life as it comes to you, right? You just wake up every day and you do what you have to do. You go to work, you go to your family. That's one way of living life. But living a life with meaning and purpose, it's a different experience in our life. So I think with us, people experience that and that has an incredible effect in their sense of happiness, their sense of joy and the sense of meaning that they experience. Well, I've woken up sometimes with a feeling of dread, which is horrible. And sometimes I've woken up 语法解析
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Feeling like really excited about the day. And it's far preferable to wake up being excited than to be full of dread. 语法解析
21:49
I can see why it's a powerful pull. Yeah, yeah. It's incredible, right? When you start thinking about what you're doing with your podcast, for example, you have been doing this for so many years. You have built a company. You go out of your way to interview different people in different fields. You really believe in what you're doing. So there is something so special for you about this work, right? Even though it can be a step at times, there's a lot of logistics. But in my… Sometimes it's… 语法解析
22:15
you know, if I have like four or five like radically different conversations in a day, it's just, it's exhilarating. Sometimes it's really cool, you know. When I find someone that, you know, that's amazingly interesting or smart or whatever, you know, again, it's exhilarating. So it's been a great thing. That's right. And, you know, imagine that even when you feel tired, it's fine. 语法解析
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possible that even when you feel tired and get exhausted, when you think about your podcast, there is the value of sharing knowledge with other people, sharing what is possible, sharing skills that people could learn and try on their own or opening people's minds to different experiences, right? I think if you think about that, 语法解析
22:49
Perhaps you are willing to live your bed even though you don't feel well that day, but you do it because the work of the podcast matters to you. So that's what adding meaning into our life matters, right? You asked me this question before when I had my panic attack. How did you manage them? I did use the traditional cognitive behavioral skills. I knew I had to do, I had to open up to the uncomfortable sensations I was having and I had to do some exposures, right? An exposure looks like I would be driving on the freeway 语法解析
23:18
close to a food truck, close to a humongous truck, right? That was my exposure. What is different with the acceptance and commitment training is that I ask myself, Patricia, if you go out of your way, if you have shortness of breath when you're driving next to a food truck, why is that so important to you? In which way that is going to help you to be who you want to be? In which way that is going to expand your life? So everything 语法解析
23:42
you do with an ad, boil it down to check again. Is this going to add meaning into your life or not? Are you living out authentic life based on what matters to you or not? So that is a very different approach, right? You can approach all the things that you are scared of by putting yourself there, by throwing yourself in that situation. That's one way of doing it. You can white knuckle through it, right? 语法解析
24:04
You are intentionally choosing to be uncomfortable in the service of who you want to be, in the service of living a meaningful life. So imagine that. Imagine when you say intentionally, I may have or may not have shortness of breath when I'm driving the freight 语法解析
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the freeway, but I know it is important for me to do it so I can drive on the San Francisco Bridge, on the Bay Bridge to see my mother who is in the hospital. Very different, right? Right. The van is actually adding so much purpose to this uncomfortable experience. 语法解析
24:34
Is this what most people say is that it takes the edge off or reduces the intensity of the feelings? Is that very common when people do this therapy properly? Great question. I think because we don't want to be attached to controlling our feelings, because we humbly acknowledge that we 语法解析
24:49
we don't have control of our feelings. Sometimes the feelings go down. Sometimes the feelings go up. How intense the feeling is, it's not a criteria for us to engage in a values-based action, right? That's the tricky part of anxiety. What do you do when it's intense, though? It's very, very hard to be like, all right, I'm freaking out right now. Yeah, yeah, yeah. 语法解析
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Well, if a person experiences overwhelming levels of anxiety, overwhelming levels of stress, and they start hyperventilating, we're practicing the moment a lot of ground. There is a lot of exercises that we can do to help our body to slow down, right? We can practice the stress-covering exercise. We can literally press our feet against the floor. We can intentionally try diaphragmatic breathing. 语法解析
25:31
breathing, we can try to breathe in four by four by four by four. There are plenty of skills that we can do in the moment to manage the physiological distress that comes with anxiety. But what is important is that when practicing those skills, you do it with openness and not with the agenda of getting rid of the anxiety or getting rid of the feeling. Certainly anxiety can be extremely overwhelming. We can learn to center ourselves and then we're still 语法解析
25:56
have to ask ourselves, am I willing to experience uncomfortable sensations in order to be the person I want to be? So when you let go of the agenda of having less anxiety, 语法解析
26:07
When people let go of the agenda of controlling the feelings, again, they have much more energy to choose value-based behaviors, even though it can be uncomfortable. Well, again, so this is powerful enough where it will blunt the effects of the negative emotions enough for the person to function. Or does sometimes medication need it to maybe get people started on relaxing and then they can take it further from there? Like, what do you do to take the edge off? Yeah, well, again, sometimes I think it depends. 语法解析
26:34
It depends on a person's history, right? Some people have been dealing with anxiety throughout their lives. If they were children, they were anxious children. They were anxious teenagers. So that is different, right? 语法解析
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And other times people experience anxiety out of the blue, right? They're taking the levator and then suddenly start having panic attacks, right? So it really depends on a person's history. For some people, yeah, they're going to benefit from using some medication to have one dial down in the physiological response enough that they can maximize the skills, right? For some cases, yes, overcome. 语法解析
27:07
times people will get a lot of benefit from trying and learning grounding skills to really go back to the moment and stay present with their bodies. And thank you for asking that question. Anxiety is uncomfortable. It's extremely uncomfortable. It makes us feel that we have to do something right now, that this is impossible, that this feeling is going to stay forever. Emotions don't last forever. Emotions come and go. They have a small duration. What happens 语法解析
27:33
The importance is when I judge the emotion, this is bad, I shouldn't be feeling like this. When I ruminate on the emotion, why I'm having this feeling, what's wrong with me? When I think in terms of avoidant, I don't want to have this feeling, I want it to stop. Those responses make the emotion last longer. 语法解析
27:49
So that's what even though a person may be experiencing a lot of anxiety, you want to check, are you opening up? Are you letting the feelings be? Are you judging, germinating, or going to avoid that, of the feeling in your mind? Because when we do that, the emotion will last longer, right? So that is just in a nutshell something to pay attention to. 语法解析
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attention too. Yes, some people would benefit from having medication, depends on their history. Other people will get a lot by learning how to stay with experience, learning some grounding, learning to center themselves, and then really learning to not 语法解析
28:25
engage in that way of things by really watching the experience, right? It's that thinking that is going to prolong the emotion. What about people that say, I am anxious or I am depressed versus I'm feeling anxiety, I'm feeling depression right now? I think that is also a very unique aspect of this therapy, right? When you let to take perspective of your experiences, when you develop a sense of self as an observer, when you can observe the stuff that you've 语法解析
28:50
feel, that you sense, that you think, your identity is not defined by what you're thinking. When we say I am a diet or I am broken, it is as if our personal identity, our sense of self is defined by a story, right? But when you are practicing 语法解析
29:06
is in this perspective taking skills you really learn to step back from all those narratives from all those stories and you learn to develop what we call the observer self there is a physical self that experience all the stuff like in this moment as i'm talking i'm moving my hands i can notice the temperature because it's hot here i can notice i'm thinking in this moment and there is observer self that watches myself having those experiences it sounds a little bit abstract it 语法解析
29:31
It's not something to explain or talk too much about, but it's something that we teach people as kids. It really nourishes this observer self. So I think that is also very unique of art and very different other approaches for people who are familiar with Buddhist practices. They are familiar with this observer self. 语法解析
29:50
So what does advanced act look like? You learn to acknowledge these emotions and recognize them and speak to them or give words to them. What else can people do to help themselves to feel better? That's a great question. I think the first will be to acknowledge every time there is an uncomfortable sensation and a comfortable emotion or an uncomfortable story. I'm a loser. I'm defective. I'm broken. To know this and name those skills. They can also check if there are any constrictions. They are resisting the fear. 语法解析
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the feelings, right? I can relax those body areas. They really want to ask themselves in this moment, what is important to me? What matters to me? Look at their values. If they don't know what is important to them, they can ask themselves this question. If someone is giving a speech about my life or 语法解析
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or let's say that it's your 80th birthday and your best friend and your partner and a co-worker are invited to this gathering and they are given a speech about you what would you like them to say about you that's one way to really look at our value and we want to be remembered by the 语法解析
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people that matter to us, right? And another exercise to look into our values will be asking ourselves, if I have to write my tombstone today, what would I like it to say? Here lies Patricia. She stood up for blah, blah, blah, blah, blah. So it is important for all of us to look at what matters in each aspect of our life and then look whether our actions and behaviors are congruent with those values or not. 语法解析
31:18
Notice here that I'm not talking about having less anxiety or chase happiness. I'm talking about learning to have the whole human experience as it comes and goes. When we learn to do that, we are also practicing psychological flexibility. Psychological flexibility is the ideal outcome that you want of all these whole psychological processes because you learn 语法解析
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to adapt not only to your external environment, but you also learn to respond flexibly and with fluidity to your internal experiences instead of running away from them all the time, right? So that's another way of thinking that I would invite people to consider when they're experiencing any type of psychological discomfort. 语法解析
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How valuable is this session on discovering someone's value? I would think that alone would be a very hard to do, but comforting thing. People refer to it if they're in alignment with their values of the day. I would guess they would feel better than if they're not. They'd feel sad or ashamed if they weren't. Sometimes in life, we don't have perfect life. Sometimes we do things, we say things that really take us farther away from who we want to be, right? We all have experiences like that. 语法解析
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Once you check, is my behavior consistent with the value of being kind, the value of being generous, the value of being loyal? And you see the gap. Then you have the freedom to choose. Do you want to live in a way that takes your father away from being kind, from being generous, from being loyal? 语法解析
32:41
Or do you want to change and engage in a different behavioral response? Even though it is uncomfortable, it may feel impossible many times. So reflecting on that question can be also a motivator for behavioral change, for changing our habits, for changing the way that we relate to others, right? But it requires self-referencing. 语法解析
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reflection, how I will live in our lives every day. In this night, we can go to a meditation retreat for three, four days. I absolutely love doing that. But we can also practice and check in how we're living our life and our everyday experiences from the moment we open our eyes to the moment we fell asleep. Good. Any examples of a session with someone where they communicated their value? Just like an example for someone just to make it a little bit more material. 语法解析
33:23
Of course. Yes. When we think about values within ads, we're thinking about verbs. We're thinking about ongoing patterns of action that a person wants to engage in. For example, for me as a psychologist, my value is being caring. As a daughter, my value is being compassionate. So in different areas, I have these values and we think of them as verbs and again, as ongoing action. Once you identify your values, you may want to ask yourself, 语法解析
33:48
Today, what are the values-based actions, what are the values-based activities I can do that will help me to live that value? For example, if my value is being caring with my friend, one values-based behavior could be calling them and asking how they are doing or asking my friend and simply sending her a poem that she likes, right? There are different caring behaviors. 语法解析
34:09
One of the things that I do, and I have been doing this for the last nine years, I think, I think so. In my white office, I have a whiteboard. And at the bottom of the whiteboard, I have three areas of my life that are important. My relationship, my health, and my career. And week by week, I just, I make a little X, whether I'm living close to my values or farther away. So week by week, I'm just checking, right? There are different ways that you can reflect on your behavior. 语法解析
34:36
For me, it's a very simple thing. On a Sunday, whether it's in the morning or the afternoon, I will go to the whiteboard, look at the area of my life, let's say relationships and check. Is the X closer to where I want to be or is it farther away? So those are practical things that people can do. Check really what matters and think about the three 语法解析
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the three specific actions that they can take during the day to live those values. Knowing that when you live your values, it is not going to be easy-peasy all the time. It is not going to be comfortable all the time. There will be some form of discomfort that we're also intentionally saying, yes, that discomfort to live our values. Then they can also come up with some form of reflection, right? For me, it's something that I do weekly. It's like a very 语法解析
35:20
It takes me just 10 minutes to look at this. But when I ask myself weekly, am I being the person I want to be in my relationships? Am I being the professional I want to be in my career? Am I relating to my children in a way that matters to me? When I ask myself those two questions, 语法解析
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every Sunday, it really gives me the pulse that I need to realign again, right? To look at my life again the next seven days. This is what I'm going to do. So that short-lived fracture is something that I would encourage people to try as well. What do you notice happens over time with a patient or a person that, you know, they've defined their values. They're asking themselves on a regular basis, am I in line with them? Like, do they tend to align with them and feel better as they do? Like, what do you notice? 语法解析
36:01
Well, when we are pursuing our values, we tend to experience much more joy and we tend to have richer relationships, right? Because again, with anxiety in particular, our life shrinks. I stop being who I want to be. I'm so consumed in my head. I'm living in my head. I'm not paying attention to life absolutely. 语法解析
36:19
happening in front of me or the relationship that is in front of me because I'm so preoccupied with my controlling my anxieties, right? So we know that when we practice these psychological skills, we tend to experience happiness in a different way. And think about this involves meaning. It's a very different level 语法解析
36:36
and a reactive life that is trying to run away from anxiety all the time. So the research shows that over and over and over, psychological flexibility and discourse psychological properties lead people to experience happier, joyful, and meaningful lives. The opposite of that is more constriction. So I can tell you in my personal life, learning ads have been extremely transformative in my own life as a person and in my work. And 语法解析
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and I see that in my clients' lives because when you're learning these skills you're learning also life skills you're preparing always for what life is going to bring to you life doesn't come perfect all types of unrespectful things happen to us how do we respond to a world that brings a lot of 语法解析
37:17
pain to us, a war that many times disappoints us, and we respond to people that disappoint us and hurt us. We can be very, you know, sometimes we can have reactive responses and be rigid about how things are supposed to be. But psychological flexibility invites us once again, over and over, to check in this situation, in this precise moment, in this context, what is important to me, what matters to me. 语法解析
37:40
And many times not what emotion tell us to do. It's really what the value matters. That's really good. I mean, again, if reconnecting with your values over and over and over again, I can't see how it would be hurtful. It would make you to have a much more happy and fulfilling life. Is there a living life that's kind of like, we're out of it or… 语法解析
37:57
anxious all the time or just out of control or angry or depressed or, you know, so you can see this can be very empowering over time. Right. Or the other thing that happens is that we have been told that we should be happy 24 hours, seven days a week, right? We should be happy all the time. And we're chasing happiness. Many times people are chasing happiness like a marathon that we're running with only these good feelings. But that is not consistent with human experience. In life, we experience all types of experiences, the sweet, the sour, the ugly, the 语法解析
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comfortable world, right? Our emotions come and go. Emotions happen. By choosing to live with meaning, that's where we have the capacity 语法解析
38:32
capacity and the freedom to choose how do I respond to things? How do I respond to life? All I think engaging in those body-based actions is really expand our lives and help us to feel much more connected with the people we care about. And again, purpose is something that give us so much sense of the reason why we are alive. Well, very good. We're just about out of time. So where can people avail themselves of ACT? How do they start learning about it? How do they find a practitioner to help themselves? The organization 语法解析
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organization that trains people on acceptance and commitment therapy. It's called contextualbehavioralscience.org. People can go to the website. There is a group for the lay audience, for the public. They want to learn that. There is also another group for professionals that want to learn more about ACT. But that will be the main website to go, contextualbehavioralscience.org. People will see all types of resources on ACT for all types of struggles. Over 语法解析
39:26
Well, very good. And I guess we should tell people to act quickly to help themselves. Take action. That is right. That's right. Let's figure out what matters and let's take action while accepting all the noise that happens and that I want to keep. Well, very good. I really appreciate coming on the call and talking about this because it's just so important. There's so many people that have just, you know, like the experience of being human. Everyone has a hard time and everyone needs mental tools to help themselves so that they don't end up having just out of control or just… 语法解析
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emotionally fraught, you know, churning crazy life. I think people want peace and happiness. So if this helps them even a little bit, it's a great thing. So thank you for what you're doing, for coming on the podcast. I appreciate it. Thank you so much for having me and your question. It really invites me to slow down and to think more about what I think about. Thank you. You're welcome. If you like this podcast, please click the link in the description to subscribe and review us on iTunes. You've been listening to the Finding Genius Podcast with Richard Jacobs. 语法解析
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If you like what you hear, be sure to review and subscribe to the Finding Genius Podcast on iTunes or wherever you listen to podcasts. And want to be smarter than everybody else? Become a premium member at FindingGeniusPodcast.com. This podcast is for information only. No advice of any kind is being given. Any action you take or don't take as a result of listening is your sole responsibility. Consult professionals when advice is needed. 语法解析
Edit:2025.04.21
