Therapists use of self in ACT Dr David Gillanders, University of Edinburgh Dr Helen Bolderston, Independent Practice

Beginnings Introductions Consent & choices Self care

An invitation… To notice how things are with you this morning...

A gentle enquiry… Curiosity, reflections, experiences Also introductions to each other 3 or 4 minutes and then swap Reflections together

Why this matters In clinical work and in everyday life We are involved in real relationships We are not just dealing with machines (and neither are we machines) The relationship could be the most important part of the work

Other tradition’s perspectives Other therapeutic approaches have varied in how much emphasis they put on this Psychoanalytic/Psychodynamic Gestalt Behaviour Therapy/CBT 3 rd wave therapies: DBT; FAP

Some ideas about an ACT perspective on use of self Self experience as data About what is occurring right now The 6 processes of ACT for you, your client

Some ideas about an ACT perspective on use of self Self experience as a source of influence =

Some ideas about an ACT perspective on use of self

Self as providing new antecedents: Varying emotional intensity Self as a source of reinforcement Differentially responding to different client behaviours

Some ideas about an ACT perspective on use of self Helicoptering metaphor

Embodying…. Psychological Flexibility Being in the present moment Acceptance / Willingness Defusion Flexible Self Clarity & Contact with Values Committed Actions

And also…

Phenomenological tracking practice 1 Increasing capacity to gather data from yourself whilst in relation to others Noticing direct experience rather than getting caught up in interpretations David & Helen will model

Phenomenological tracking practice Your turn… Enquiry….

Phenomenological tracking practice 2 Moving attention between self and other flexibly Accurate describing (rather than interpreting, assuming, hypothesizing) David & Helen will model

Phenomenological tracking practice 2 Your turn… Enquiry….

Phenomenological tracking practice 3 Increasing capacity to move attention flexibly between self and other, and gather data, as your buddy talks about an evocative experience. My story as a therapist. Begin with any part e.g. –‘A client I dreaded seeing’ –‘A client that I failed’ –‘A client that I fell in love with’ –How I became a therapist Not about the client – about you

Phenomenological tracking practice 3 Person 1 speaks on one of these themes Person 2 listens, tracking, helicoptering, noticing urges to move away, move towards etc. Taking action off the table, but perhaps noticing when and how you might have used yourself to intervene, in the service of greater psychological flexibility for Person 1.

Phenomenological tracking practice 3 Your turn… Enquiry….

A next step... Moving into small groups Introductions and sharing something of your experience so far

Using The Self Therapeutically To move into ACT processes Model, Instigate & Reinforce

Using the Self Therapeutically Practice: My story as a therapist. Begin with any part e.g. –‘A client I dreaded seeing’ –‘A client that I failed’ –‘A client that I fell in love with’ –How I became a therapist Not about the client – about you

Using the Self Therapeutically Person 1 speaks on one of these themes Person 2 listens, responding from themselves Tracking, helicoptering, varying intensity as needed, noticing urges to move away, move towards, Person 2 may use self to model, instigate, reinforce, appreciate etc.

Coaches/supporters Two coaching roles: Paying attention to opportunities for the therapist to use self to intervene. Paying attention to opportunities for the therapist to self-support. Coaches use the skills we’ve already been working on—tracking self and others, gathering data to inform their intervening. We really want to encourage coaches to hit the pause button.

Using self to soothe self In the moment support Ongoing self-maintenance

Using self to soothe self How would you respond to a colleague in a difficult moment in therapy? Imagine you were there behind the one way mirror and could whisper in their ear… Now consider that for yourself…

3-step compassion space 1.Saying to yourself, “This is a time/moment of difficulty, “ and placing your hand somewhere on the body where it’ll feel comforting. 2.Saying to yourself, “Difficulty/suffering/pain is part of being human. All humans struggle.” 3.Asking yourself, “What can I do that would be a kind action, right now?” (Germer & Neff, 2013)

Personal self-care plan In pairs Go through the plan one at a time, supporting each other to be as kind and helpful to yourself as possible Some of this information is very personal – you get to choose what you tell your buddy and what you keep private 15 minutes each

What will you get curious about? Name one thing that you have encountered today that you will take away and allow yourself to be curious about. Take any behaviour change off the table

Appreciation & Gratitude For each other And a moment for yourself

Some Further Reading: 1 Clarkson, P. (2003). The Therapeutic Relationship. Wiley-Blackwell. Germer, C. K. (2009). The mindful path to self- compassion. Guildford. Gilbert, P. & Leahy, R. L. (2009). The Therapeutic Relationship in the Cognitive Behavioral Psychotherapies. Routledge. Hycner, R. (1993). Between person and person. Toward a dialogical psychotherapy. Gestalt Journal Press. Lomas, P. (2001). The Limits of Interpretation. Robinson Publishing.

Some Further Reading: 2 Rowan, J., & Jacobs, M. (2002). The Therapist's Use Of Self. Open University Press. Tsai, M., Kohlenberg, R. J., Kanter, J. W., Holamn, G. I., & Plummer Loudon, M. (2012). Functional Analytic Psychotherapy: Distinctive Features. Routlednge. Wilson, K. G., & DuFrene, T. (2008). Mindfulness for two: An acceptance and commitment therapy approach to mindfulness in psychotherapy. Oakland, CA: New Harbinger Publications.