Friday, March 30, 2012

The acceptance part of Acceptance and Commitment Therapy

I've mentioned before that I'm applying Acceptance and Commitment Therapy ideas and practices to my binge eating and overeating problems. I think the Wikipedia article on ACT is fairly informative and it will help any readers out there make sense of what follows.

I recently finished Get Out of Your Mind and Into Your Life: the New Acceptance and Commitment Therapy by Steven C. Hayes and Spencer Smith. Reading this book has made me realize several things, and I believe the advice in the book can help me carry out the high-level instructions contained in Brain Over Binge.

In Brain Over Binge, Hansen describes how she started viewing her urges to binge as "neurological junk" emanating from her lower brain, and how that new perspective allowed her to stop acting on those urges. She explains that she stopped fighting the disturbing thoughts that encouraged her to binge and purge (she was bulimic): she stopped arguing with them and stopped engaging them altogether, instead treating them as not even worthy of her attention. She was no longer frightened of whatever her lower or "animal" brain threw her way because she understood her real self, her Highest Human Brain, to be way more powerful than the animal brain. She could listen to the lower brain chatter as if it were a tape recording and remain calm, and she understood herself to be safe from her urges because her Highest Self was in charge of motor control: no urge could MAKE her use her arms, hands, mouth, and throat to gather food, put that food into her mouth, chew it, and swallow it.

These were (and still are) really exciting concepts for me. For several weeks after reading Brain Over Binge, I enjoyed a very new, very profound sense of security. I am more powerful than my urges! Those seemingly scary urges can't MAKE me do anything! I had never thought or felt that way before.

But as time went on, things got a little messier. I had trouble distancing myself from my urges. I had eating episodes that made me feel unsafe: even if my Highest Human Brain was more powerful, even if "loss of control" was only perceived loss of control and thus an illusion, my lower animal brain was one hell of a contender. Hansen's point, however--and it's a perspective I encountered again in Buddhist meditation training as well as in ACT--is that the tug of war is supposed to stop. It's not supposed to be lower brain versus higher brain in a gruesome fight to the death. A lighter touch is called for here.

On one level, I understood it then and I understand it now. On another level, don't I want my Highest Human Brain to triumph? Don't I want the old addiction wiring to fade away, to leave me in peace? Sure I do.

And that's a big part of the problem. After reading the ACT book, I had to face up to the fact that I never truly ACCEPTED my binge thoughts/urges/cravings. I wanted to disassociate from them and ignore them as fast as possible, because I thought that would de-fang them: Lower brain junk, not worth my attention, moving on... In other words, I would quickly acknowledge "I'm having the thought I want to binge on x or y" but only as an attempt to control or manipulate my internal experience by creating distance between myself and the thought. I used meditation practices with the same intent. In truth, I remained frightened of my thoughts and urges, irritated by their repeated intrusions into my consciousness, and very anxious to eliminate them once and for all.

Honestly, I'm still scared of my cravings and urges. I haven't learned to accept them "fully and without defense". I'm not yet "willing to welcome them unconditionally", in the parlance of the ACT book. (Again, because I still find them threatening and ugly.) I don't really want to listen to what they have to say. Thus far, I've tried to silence my lower brain and its contents in two ways: give it what it's asking for immediately (i.e. binge) so it won't go on howling, or disassociate from it as quickly as I can.

ACT suggests I stop trying to silence it, period. And to be sure, ACT does talk about creating distance between ourselves and our thoughts--the book I just finished calls this process "defusion", because you stop fusing with your thoughts and start looking AT them rather than FROM them. But before you can defuse from the thoughts in your head, you must accept what's there. You must give up the problematic habit of experiential avoidance--of attempting to avoid unpleasant thoughts, sensations, urges, feelings, etc.

So I'm working on acceptance right now. I'm trying to maintain a stance of curiosity: What are my binge thoughts? What are the urges? How can I experience them as fully as possible? How can I get acquainted on all levels? I admit I don't know exactly how to do this, but the ACT book has exercises I can try as a starting point. I'm hoping I can get to a place where I accept that the thoughts and urges might be with me forever, or at least might pop up regularly for the rest of my life. This kind of acceptance is supposed to happen without a hidden agenda; you aren't supposed to "accept" troublesome thoughts or urges on the basis that doing so will make them fade away, for example.

It's REALLY hard to not have a hidden agenda such as this.

I guess, right now, I have to accept how confusing and complicated this all seems to be. I have to accept that a problem 30 years in the making will not vanish overnight.

postscript: To be clear, Hansen's book is not the reason for my struggle and I don't mean to misrepresent anything the author has said. I may have missed some of the nuances of her arguments or I may be having trouble following through with her advice for any number of reasons (differences in temperament, differences between binge eating disorder and bulimia, etc.). I see ACT and Brain Over Binge to be highly complementary: they talk about many of the same ideas and techniques, but ACT provides specific exercises/practices to try while Brain Over Binge illustrates how the underlying principles can help someone overcome an eating disorder. It is an informative memoir rather than a step-by-step manual.

1 comment:

  1. Hi Rachel,
    I too am attempting to use ACT to deal with overeating. I have found that it will work well for me for a few days or weeks (amazingly well, actually. Better than anything else ever has) and then Life will happen (stress, busyness, some sort of catastrophe) and it all goes out the window. I too have realized that I have not fully opened up to accepting everything I think and feel. That 'acceptance' bit is tough!

    So...I keep reading other books about it (I think I've read 6 or 7 so far) and am wondering today if I'm just broken or if it doesn't work.

    There's a group in Australia who give in person ACT workshops about overeating (http://www.theweightescape.com/), and I've been in contact with them about doing a teleclass, so that those of us in North America could partake. One of the organizers said she's working on an online option, but no info about when that might be available. They will be releasing a book specifically about ACT and weight in January 2014.

    Anyway, I just wanted to say I hear you about the 'acceptance' part of ACT and wish there was more support available for this method, b/c I think it could actually work. It's the gentlest, kindest method I have found and it seems to make sense. I think it could work for me if I could get over the couple of hurdles I'm facing.

    I am wishing you all the very best on your journey,
    Alexandra

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