A primer on Acceptance and Commitment Therapy (ACT).
Updated: Aug 11, 2022
Getting to know why we are the way we are.
(Part 2 of the Heal with ACT series).
About three years ago, I fell into a depressive relapse again.
It was something I haven't experienced for a long time, since recovering from the last episode more than a decade ago.
Depression issued a wall of hopelessness, making me feel like there was nothing to look forward to anymore.
It made me feel like there was nothing worth living for.
This was despite having only just gotten married about a year before then, to a wonderful wife that I will forever be grateful for.
Still, I didn't choose to have depression, it just seemed to have wandered into my life again all on its own.
Along with the hopelessness, I also experienced a very low sense of self. I felt absolutely worthless - I mean, think about it, what kind of person gets married and then falls into depression, turning their wonderful newlywed wife into a miserable caregiver?
I was in the pits, not just feeling depressed, but also angry at myself. I hated myself for not being able to pull myself out of this situation.
And then there was the anxiety too - an overwhelming sense of fear. Sometimes, anxiety would paralyse me, causing my skin to crawl and my lungs to hyperventilate.
A rational side of me would try its best to pluck me out of anxiety, but for some reason, the irrational side of me was winning. I would then fall into a spiral of thoughts, sinking deeper and deeper in catastrophic negativity.
As you can imagine, my mind was a noisy place.
Along the theme of all the above, a harsh voice began to develop in my head, telling me to quickly snap out of this situation and get me and my wife's life back to normal again.
It berated me on the days I fell into a low mood, making my mood fall even lower. It took away my enjoyment in the things I used to love, telling me I was not deserving of it.
It made me fall into endless panic on other days, eager to prove to myself that I wasn't a failure in ALL aspects of my life.
And on the days that I caused my wife to break down and cry, it reinforced the idea that I was an utterly useless human being.
Whatever I did, I couldn't get this voice to shut up and be quiet.
On some days, I even had to turn to alcohol to numb this voice. Yet, when the morning comes, this voice was back again.
Why couldn't I get rid of it? Well, it's a bit difficult when this voice is in our heads right?
Especially when this voice itself seemed a lot like it came from "me".
You are not your inner critic - your inner critic is just a "part" of you.
Just for the sake of giving it a name, let me call this voice our "inner critic".
It might be giving you depressive thoughts, or even anxious ones too, but the overall theme is still the same.
It is harsh, critical - blaming ourselves for all the things we are not able to do. My inner critic told me off during the days I was unable to be a loving and useful husband. It made me feel lousy when I woke up and felt unmotivated, and was unable to be productive. It told me I was worthless when I failed in doing any of the above.
It's the voice in my head, full of negativity - spinning stories of how bad my day is and how if I don't do something about it, things will just get worse.
I hated my inner critic. I wished it would just go away and leave me alone.
Yet, it is here that I'd like us to take a pause.
It is time for us to take the first step into healing. Because we'll be discussing our very first concept in Acceptance and Commitment Therapy (ACT).
This concept is known as Cognitive Fusion.
Taking the two words apart, it basically represents the idea of the times we get joined (fused) with our thoughts (cognitions).
In a state of fusion, we think that the voices in our head are "us".
That I am my inner critic. That my inner critic is me.
That's not surprising, since the only thoughts that we've been able to hear all our lives are our own.
Yet, we've come to believe that all the thoughts in our head are real - for example, if you are a person who experiences anxiety, you know how real your worries can get.
If you have the thoughts tomorrow is still going to turn out bad no matter how hard you try today, your worries no longer seem like worries. They seem like reality instead.
In that way, when we are "fused" to our thoughts, they also often seem like orders to be obeyed.
Again with anxiety, we often feel the need to do something to address our worries - whether it is to panic, overwork, go into a frenzy, or even breakdown because of how futile our efforts seem.
As for my depression, the idea of a hopeless future seemed so real that somedays I felt absolutely paralysed from doing anything meaningful or productive.
Luckily, for all of us on this healing journey, there is an opposite to Cognitive Fusion. As you can imagine, it's called Cognitive De-fusion instead.
What we need to learn to be able to do is to defuse from our thoughts, and see it not as "me", but as a "part" of me instead.
As a very first step to getting better, I want you to try this practice with me.
We'll spend the next few minutes writing down on a piece of paper - ask yourself, what are some of the thoughts, beliefs, or ideas that your own inner critic has been telling you?
See if you can make a list of on the various whispers it has been saying to you.
Try and make it as comprehensive as you can.
Don't worry if you're still identifying this "voice" as "me", we'll get to more on cognitive defusion later.
For the moment, the idea is this - we want to get to know this inner critic intimately. Instead of it being just a random bunch of musings or concerns in our mind, we want to get in down on paper.
We want to make it concrete and structured.
As an example, here's a list of some of the things my inner critic has been telling me:
I am a bad husband who fails my wife alot.
I am a deeply damaged person and my progress can disappear any day.
I am an imposter and people will find out that I'm not good enough.
Go ahead, write down your list.
Done? Now notice from my examples above, how I started each sentence with "I am". That's very much the nature of how we've regarded our thoughts so far isn't it?
That's very much what Cognitive Fusion is.
Now let's just make one simple adjustment.
In front of each sentence that starts with "I am", add in a prefix that can be either "My inner critic says" or "I'm having the thought that".
It should say something like this:
My inner critic says "I am a bad husband who fails my wife a lot".
I'm having the thought that "I am a deeply damaged person and my progress can disappear any day".
My inner critic says "I am an imposter and people will find out that I'm not good enough".
Any difference? Read them aloud to yourself if you can.
How do you feel?
It's a very small adjustment, but we've taken the very first step to gain some clarity of what's happening in our minds.
We are paying attention to a part of us that is dragging us down.
And note how this is just a "part" of you. It isn't "all of you". Because now, you are able to differentiate the particular voice of the inner critic, and see it talking rather than you talking.
This is a small step, but it's going to lead to a major change as we progress on from this - creating separation between ourselves and our thoughts, and our inner critic.
Our inner critic is not "us" - it is just a part of us.
It is not something we have to always obey and act upon - but rather, a part of us we should come to know better.
Because from knowing it better, it gives us the choice to do something differently, right?
Does that sound scary or hopeful? At this stage, perhaps a bit both hey?
Well, in the next article - I'll explain why this process of getting to know our inner critic is so important.
Take care for now,