336 Acceptance and Commitment Therapy for Trauma

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Goals of ACT for Trauma
~ Recognizing that trying to escape emotional pain will never work. (Creative hopelessness) and exploring the idea of “making room” for past traumas, acknowledge negative internal experiences and pursuing a meaningful life despite their presence.
~ Understanding that problems come not from the emotional pain itself but from attempts to control or avoid it. Besides potentially making the pain worse, people may spend so much time and energy trying to avoid it that they have none left for pursuing positive things in life.
~ Viewing themselves as separate from their thoughts and feelings. Although these thoughts may feel true, they are only thoughts, not a reflection of what is really true. Learning to "take a step back" from their thoughts and not buy into them as truth. (Emotional reasoning… I feel…therefore it must be…)
Goals of ACT for Trauma
~ Stopping the struggle with thoughts and feelings, and practice being both open and willing to experience thoughts and feelings for what they are.
~ Committing to action toward a rich and meaningful life. Avoiding emotional pain requires a huge amount of energy for people with PTSD. It can consume their lives, keeping them from spending much time or energy on living a meaningful and rewarding life.
Understanding Pain Activity
~ Principles
~ Everyone suffers
~ New way to relate to your PTSD pain, so that it doesn’t control their lives and so they are able to fully engage with what matters in their lives.
~ The goal in this approach isn’t to get rid of the pain completely, but to help people relate to it in a new way.
Understanding Pain Activity
~ Principles
~ Two types of pain
~ Pain of presence (clean pain/inevitable pain): Pain we feel in response to losses, anxiety, traumatic memories, and specific problems
~ Pain of absence (dirty pain) The happiness we miss out on because were are focused on and struggling with the pain of presence. (Experiential avoidance)
~ Failed attempts to avoid painful internal experiences can result in an increased sense of failure and perceived “brokenness”
~ Efforts to remove pain take tremendous amounts of energy that interfere with pursuing valued activities and relationships
~ As valued activities decrease, people’s daily life and sense of identity become increasingly defined by their trauma
Understanding Pain cont..
~ When we talk about PTSD pain, we are referring not to specific situations, but experiences of having a memory or image of a past painful experience, and sensations or urges to do something that has caused problems in the past
~ drinking, avoiding places, angry outbursts, negative thoughts about yourself, others, or the world that bother you, and feeling anxious or angry in certain situations
~ Have people list their sources of PTSD pain

Understanding Pain cont..
~ Have people list they ways they have tried to deal with their PTSD pain (Whiteboard list/checklist)
~ What is the main goal of these behaviors? To avoid the pain and anxiety. This is such a natural thing to do!
Understanding Pain cont..
~ Have people list what they miss out on, or ways their strategies for coping with their PTSD pain have kept them from what is meaningful in their lives
~ Which ones cause more problems in the long run?
~ Which ones are ineffective?
~ Which ones keep you from those people things and experiences that make your life rich and meaningful? (cont.)
~ Validate difficult emotions that arise when looking at the pain of absence and reinforce willingness to have them.

Impact of PTSD
~ Write down ways your PTSD has impacted (ball or chart activity)

Willingness to Live in the And
~ “Joe the Annoying Uncle” metaphor
~ The goal of this activity is to help people see that by choosing a stance of willingness, they can have a more meaningful life.

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