Questions for Steven Hayes

Amazon.com: Can you give us a lay person's primer on acceptance and commitment therapy?

Steven Hayes: Acceptance and Commitment Therapy (ACT) is based on a rather remarkable fact: when normal problem solving skills are applied to psychologically painful thoughts or feelings, suffering often increases. Our research program has shown this in thousands of patients, in almost every area of human suffering. Fortunately, we have discovered why this is and we have developed some ways of correcting it.

The basic research underlying ACT shows that entanglement with your own mind leads automatically to experiential avoidance: the tendency to try first to remove or change negative thoughts and feelings as a method of life enhancement. This attempted sequence makes negative thoughts and feelings more central, important, and fearsome--and often decreasing the ability to be flexible, effective, and happy.

The trick that traps us is that these unhelpful mental processes are fed by agreement OR disagreement. Your mind is like a person who has to be right about everything. If you know any people like that you know that they are excited when you agree with them but they can be even more excited and energized when you argue with them! Minds are like that. So what do you do?

ACT teaches you what to do. I will say what that is, but readers need to understand that these mere words will not be useful in and of themselves. Minds are too clever for that! That is why the book has so many exercises and why we have a free discussion group on line for people working through the book (http://health.groups.yahoo.com/group/ACT_for_the_Public/). What ACT teaches is acceptance of emotions, mindful awareness of thoughts, contact with a transcendent sense of self, and action based on chosen values. This constellation of skills has shown itself in controlled research to help with an amazingly large range of problems, from anxiety to managing the challenges of physical disease, from depression, to stopping smoking.

Amazon.com: Some of this work is said to have come from your own battles with anxiety and panic. How did these ideas apply to your own struggles?

Steven Hayes: It was my own panic disorder that first put me on to the problem we have now confirmed in our research. My panic disorder began a little over 25 years ago. I watched in horror as it grew rapidly, simply by applying my normal problem solving skills to it. Anxiety felt awful and seemingly made it impossible to function, so it was obvious to me that I first needed to get rid of it before my life would improve. I tried lots of things to do that. But this very effort meant I had to constantly evaluate my level of anxiety, and fearfully check to see if it was going up or down as a result of my efforts. As a result, anxiety quickly became the central focus of my life. Anxiety itself became something to be anxious about, and meanwhile life was put on hold.

After two or three years of this I'd had enough. I began to experiment with acceptance, mindfulness, and valued action instead of detecting, disputing, and changing my insides.

I remember a moment that symbolizes the change in direction. In the middle of a panic attack, with a guttural scream like you hear in the movies, I literally shouted out loud to my own mind. "You can make me feel pain, you can make me feel anxiety," I yelled. "But you cannot make me turn away from my own experience."

It has not been a smooth path and it was several years before anxiety itself was obviously way down (getting it to go down was no longer my purpose, remember, but ironically when you stop trying to make it happen, often it does), but almost immediately life opened up again. ACT is the result of over 20 years of research, following the lead this provided.

Amazon.com: You are a language researcher and chapter two of Get Out of Your Mind and Into Your Life is called "Why Language Leads to Suffering." Can you tell us why you suggest that language is a source of human suffering?

Steven Hayes: Human language (by that I mean our symbolic abilities generally) is central to effective human cognition. It evolved to keep us from starving or being eaten--and it has done a pretty good job of that.

The key to symbolic processes is the ability to relate events in new and arbitrary ways. Our research program has shown this ability even in 14 month old babies, and we now know it comes from direct training from parents and others as part of normal language development. It is a wonderful skill. It allows us to imagine futures that have never been, and to compare situations that have never actually been experienced. That is the every essence of human verbal problem solving.

But that same process has a downside for human beings. For example, it allows us to fear things we have never experienced (e.g., death). It allows us to run from the past or compare the dull present to a fantasized future and to be unhappy as a result. And in my case it lead to the common sense but ultimately unhelpful idea that I needed to get rid of anxiety before I could live well.

We get a lot of training in how to develop and use our minds, but we get very little training in how to step out of the mental chatter when that is needed. As a result, this mental tool begins to use us. It will even claim to BE us. The overextension of human language and cognition, I believe, is at the core of the vast majority of human suffering in the developed world and human technology (the media) is only amplifying the problem by exposing us to an ever increasing stream of symbols and images. Learning how to get out of your mind and into your life when you need to do that is an essential skill in the modern world.