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Defusion

Editor's note: The following is the second half of a two-part Q&A with John T. Blackledge, PhD, international ACT trainer, associate professor in the department of psychology at Morehead State University in Kentucky, and author of Cognitive Defusion in Practice: A Clinician’s Guide to Assessing, Observing, and Supporting Change in Your Client. Access part one here.

Editor's note: The following is a Q&A with John T. Blackledge, PhD, international ACT trainer, associate professor in the department of psychology at Morehead State University in Kentucky, and author of

It’s not exactly news that mindfulness-based therapies are effective. A recent meta-analysis including 209 published empirical outcome studies indicated that mindfulness-based treatments in general were effective in treating a variety of psychological disorders, and as effective as cognitive behavior therapy and pharmacological treatments in the nine studies in which they were compared (Khoury et al., 2013).

If you use defusion in your therapy sessions, or any other technique aimed at helping clients create distance between themselves and the stories they tell themselves, you may recognize this common pitfall: If our thoughts are not absolute truths, then it may seem that there is no absolute meaning, no right or wrong, and perhaps even no absolute point of reference.

Across the board of contemporary psychotherapy modalities, some iteration of defusion-like techniques have been incorporated successfully to yield behavioral change. But when it comes to cognitive behavioral therapy, defusion and cognitive restructuring appear to be very much at odds: the latter assumes that thoughts must change for behavior to change, while the former assumes that thought change doesn’t matter.

If you use any technique that involves helping clients untangle themselves from the stories they tell about their lives and struggles and realize that their thoughts are not absolute truths, you run the risk of invalidating their subjective experience.

What does the word defusion mean? According to John Blackledge, PhD, acceptance and commitment therapy (ACT) researcher and author of Cognitive Defusion in Practice: A Clinician’s Guide to Assessing, Observing and Supporting Change in Your Client, the fundamental message is that words do not capture absolute truth, and that the words that increase our suffering are therefore not binding.

For the last couple of weeks we’ve been talking about some of the ways language can play tricks on us and cause suffering, as well as how, alternately, it can be used to our benefit in therapeutic settings. And last week, we discussed mindfulness as one technique that allows the therapist to use language in an experiential way.

Editor's note: The following was adapted from the edited volume, Mindfulness and Acceptance in Social Work, edited by Matthew S. Boone. Boone will be presenting a two-day Introduction to ACT Training in Oakland, California on August 1 - 2, 2015. Don't miss your chance to learn the fundamentals of ACT with an award-winning trainer and exceptional clinician.

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