Practitioners using the acceptance and commitment therapy (ACT) approach often comment about how hard it is to identify and utilize present moment experience during therapy. Clients may momentarily “show up” at a selected point then just as quickly “disappear” into the ether of experiential avoidance. What makes it so hard for clients to get and stay present is often the same thing that brings them into therapy in the first place: experiential avoidance. What tends to show up immediately in the present moment is the client’s pain and, quite naturally, the kneejerk response is to check out of the moment in order to avoid making contact with the pain.
Beyond that problem, however, is another glaring truth: most clinicians have difficulties reading and/or eliciting present moment cues and clues that might promote radical change. Part of the problem is that we often talk about the present moment as if it were a thing. In reality, it is an unfolding process which involves the flexible use of three main attributes of attention: orienting toward an aversive emotional stimulus, using focused observer-level attention, and shifting attention between meaningful components of the emotional stimulus.
As if this weren’t challenging enough, present moment interventions require clients to move through a series of stages that will permit the entire emotional experience to be reframed, such that it is turned into a strength and not a weakness. As we’ve outlined in our upcoming book on how to use present moment interventions in ACT, these stages of integration run roughly parallel to the five facets of mindfulness proposed several years ago by Dr. Ruth Baer and colleagues.
First, clients have to be able to sustain their attention on the feared experience in a non-judgmental way. Second, clients must be able to use words to label their experiences so they can cognitively interact with and integrate their experiences. Third, clients must learn to let go of harmful verbal products such as evaluations and predictions. Fourth, clients must be able to soften and practice self-acceptance in response to self-defeating narratives and self-evaluations. Finally, clients must utilize the previously avoided experience in ways that expand their sense of purpose. In a world where emotional avoidance is no longer necessary, could the feared experience be utilized to strengthen contact with value-based life motives?