Editor’s Note: This is a Q&A with Jill Stoddard, PhD, and Niloofar Afari, PhD, the authors of The Big Book of ACT Metaphors: A Practitioner’s Guide to Experiential Exercises and Metaphors in Acceptance and Commitment Therapy.
According to Acceptance and Commitment Therapy, inflexibility arises through entanglement with verbal rules and the traps of language. How do metaphors function to move people away from language traps and a more experiential comprehension of their thoughts and feelings, rather than a strictly intellectual one?
In contrast to some other therapies, ACT focuses not on changing the content of internal experiences (i.e., thoughts and feelings) but rather on one’s relationship to them. Changing that relationship cannot be accomplished by using the very cognitive processes that resulted in psychological inflexibility in the first place. In other words, responding to critical thoughts by criticizing them is counterproductive. Metaphors and exercises, while comprised of language, are not critical, rigid, or literal; they are subtle stories that listeners can connect to their personal experiences to achieve a better understanding of the self (e.g., the ways in which fusion with thoughts may lead to experiential avoidance), to promote identification and practice of alternative, more flexible modes of being (e.g., present-focused attention and observation of internal states), and to facilitate movement toward a more vital existence (e.g., via identification of values and taking committed actions).
Who is this book for, and what can readers expect to get from it?
The Big Book of ACT Metaphors is for any professional who practices, researches, teaches, or supervises ACT. Whether one is new to ACT or more experienced, this book offers a substantial number of new and classic exercises.
The book designed to supplement existing (and future) ACT protocols by providing practitioners with a one-stop resource for finding (or creating) the perfect metaphor or exercise to demonstrate any of the six core concepts of ACT.
Chapter 1 provides an overview of ACT and relational frame theory (RFT). Chapter 2 uses RFT principles to provide a detailed discussion of how metaphors and exercises can enhance experiential learning and psychological flexibility; it also provides instruction in the development of novel, ACT-consistent metaphors that can be tailored to specific client needs. Chapters 3 through 8 each cover one of the six core concepts of ACT: acceptance and willingness, cognitive defusion, present-moment awareness, self-as-context, values, and committed action. Chapter 9 provides a review and summary of the role of metaphors and experiential exercises in ACT. In addition, it provides general guidelines for situating metaphors and exercises in the course of therapy, along with common pitfalls to be aware of.
Each of the core concept chapters (3 – 8) begins with a summary of the core concept, followed by exercises and metaphors demonstrating that concept, usually with scripts for presenting the exercise or metaphor to the client. Some exercises might be especially salient for specific types of clients (e.g., groups, trauma survivors, athletes), and many of the exercises can be tailored to be more relevant to a particular client. In these cases, we mention this in the introduction to the exercise or metaphor.
What are some examples of experiential techniques that can be used in ACT (i.e., mindfulness, defusion, self-as-context exercises)?
Each of the six core concepts can be demonstrated and experienced through metaphor or exercise.
For example, the Ball in the Pool metaphor might help one make contact with the counterproductive nature of struggling to eliminate painful thoughts and feelings. This metaphor likens the struggle to avoid pain to the process of fighting to keep a floating ball under water. You push the ball (a symbol of thoughts and/or feelings) under the water but it keeps popping back up, forcing you to remain engaged in an exhausting and futile fight to keep pushing the ball under.
Noticing the difference between avoidance and acceptance may be practiced with the Yes/No exercise in which clients are encouraged to mindfully notice what shows up as they actively say “no” to the feeling of their body sitting in a chair; this is then contrasted with what shows up as they open up and say “yes” to those same sensations.
Cognitive defusion may be practiced with the For S/He’s a Jolly Good _______________ exercise. In this exercise, the client sings this well-known song, substituting “fellow” with a painful label he has assigned to himself, such as “failure” (or impostor, or junkie, etc.)” The exercise facilitates a “deliteralization” of language, and thus reduces cognitive fusion with this thought.
Metaphors can be genuine experiential triggers that make abstract concepts concrete by evoking thoughts, feelings, and behaviors similar to those evoked by the client’s actual situation. When used in ACT, how do metaphors work to highlight the function of behavior?
Metaphors can be used to direct the client’s attention to the concrete consequences of her actions in a context that’s topographically different from her problematic situation, but contains a similar function. If the client perceives the similarity in function between the two situations, she may see her own experiential avoidance as counterproductive in the long-term, creating an opportunity for behavior change.
When building an efficient, novel metaphor for use in therapy, there are two key principles. What are they?
First, clients must be able to see the consequences of their actions reflected in the metaphor; and second, the function of events in the metaphor must match the function of events in the client’s personal situation.
In the book, you say that the way a metaphor is delivered is key in helping clients perceive the concrete consequences of their actions through the connection between the metaphor and their own situation. What are some of the best pointers for effective metaphor delivery in an ACT session?
It is helpful to deliver a metaphor in the present indicative tense, as if it is happening in the here and now, rather than the conditional tense. For example, you might say, “You keep pushing that ball under the water, but it pops right back up” rather than “Imagine you are fighting to push a ball under the water.”
It is also helpful to involve the client in connecting his experiences to the metaphor as you unpack it. For example, you might say, “What happens when you push the ball under the water?” and “How do you feel each time the ball pops back up to the surface?” This allows the client to connect the metaphor to his experience of struggling to suppress his feelings. This is preferable to making directive statements such as “You see, pushing the ball under the water is like struggling to suppress your feelings”; such statements lead the client to learn via a verbal rule rather than via his direct experience.
For more about The Big Book of ACT Metaphors, check out the book page here.