Key targets for willingness

Help clients let go of the agenda of control as applied to

internal experience

Help clients to see experiential willingness as an alternative

to experiential control

Help clients come into contact with willingness as choice,

not a desire

Help clients to understand willingness as a process, not an

outcome
 Control
A great deal of suffering and struggle is found in the denial of
the inevitability of human pain.

When we feel a whole range of negative emotions, we generally

try our best to undo these experiences

These attempts at controlling our private experience (via

suppression, avoidance, distraction, re-structuring etc.) can
often back fire

Despite being a perfectly natural coping strategy, and despite

sometimes working very hard to avoid painful events, the
positive effects of avoidance are short-lived
 For example, imagine a social phobic who values relationships with
people. Initially avoiding people may provide relief, but the long
term implication for this action is isolation
Attempts at controlling unwanted, unpleasant experiences
can cost us in two major ways
 Firstly, often when we try to reduce or remove pain it returns
stronger to haunt and distress us. It also leads to the development
of a vicious circle where pain is something to be feared. Therefore
we feel pain about having pain, or anxiety about feeling anxious or
depression about being depressed! ACT calls this dirty pain! In
contrast ‘clean pain’ refers to the discomfort that is natural and the
automatic consequence of living life!

 Second, attempts at avoiding painful experiences comes from our

huge need to ‘feel good’. However, often a life lived in pursuit of
feeling good is not lived in the service of our most deeply held
values. Often, doing what is important or matters is painful and
creates that sense of vulnerability. Ironically, often trying to feel
good via avoidance will only lead to feeling bad!
 What is willingness?
ACT specifically targets letting go of the control agenda,
which aims to get rid of experiences that cannot be gotten
rid of

ACT offers willingness as this alternative

If a client is unwilling then he or she makes choices based

on the avoidance of internal experiences, rather than his
or her core values

Willingness can be defined as ‘being open to one’s whole

experience while also actively and intentionally choosing
to move in a valued life direction’
Willingness is an action and has an all or nothing
quality to it, it is a choice
Clients sometimes confuse willingness for a feeling.
But one does not have to feel willing to be willing
Clients can often mistake willingness for tolerance.
Tolerance implies that negative experience is to be
withstood until something better comes along.
Willingness on the other hand involves openness and
allowing, not as waiting or needing for something to
change to a better thing if we are tolerant enough
Finally willingness is not loss or resignation, as the
word acceptance can sometimes imply. It is life
affirming, empowering and vitalizing
Willingness is a skill to be learned, not just a concept
that provides miraculous results

It therefore takes time and practise

The job of the therapist is to manufacture situations

where clients can choose to experience difficult
thoughts or feelings

But there are steps the therapist employs in order to

manufacture willingness in the client
 The Method
The process of fostering willingness usually involves
two steps;

Firstly, the therapist must undermine control as the

dominant way of relating to one self and ones world.
With the aim of creating an initial openness, this is a
good precursor for introducing willingness

Secondly, willingness is introduced and the therapist

will try to create situations that allow the client to
practice these skills
 Undermining control
Attempts to control are so second nature that
managing and controlling unwanted events is not a
choice, but ‘the way it is’.

Indeed the idea that clients might be able to willingly

accept anxiety is a bit like suggesting they could live
without breathing!

Therefore substantial work is done at the beginning

of therapy, introducing the client to this new way of
thinking.
The therapist will focus on a few issues when trying to
undermine control attempts;
Help the client to become aware of his or her attempts
at control based on their own experience. This is called
‘drawing out the system’
Examining the workability of these strategies relative to
larger life goals
Guiding the client to a place where he or she can let go
of these strategies

The outcome of the process of undermining control is

often a loosened attachment to and confidence in the
control agenda
 Draw out the system
Start with asking the client the nature of the issue i.e. why are you
here?
 Almost always clients will report a struggle with some emotion,
memory or self evaluation (pain, anxiety, self doubt, worthlessness)

Next we move on to the strategies that the client has used to

‘solve’ the problem
 Be careful some of these problem solving strategies may seem
helpful (talking to friends) as well as unhelpful (getting really
drunk!)

Importantly, the client probably isn't aware of the ways that they
struggle to control their private experience. It is the therapists job
to slowly ‘draw these out of the system’
 For example a depressed client may not immediately see how
oversleeping and over eating are intended to modulate a mood state
 Examine workability
At the same time as drawing out the possible ways that
the client has attempted to solve their problems, the
therapist must also examine the workability of these
strategies
 The basic question here is ‘have these strategies worked out as your
mind said they would?’

There are spheres to explore here

 Firstly - has what the client did to reduce or eliminate
anxiety actually eliminated anxiety
 Your are in a win-win here, because the fact they have come to see you
in therapy means that every other attempt at solving their problem
hasn’t worked
 Secondly, in what ways has the client constricted or limited
their lives to deal with the problem?
 ‘What would you be doing with your time if you were not busy managing
your anxiety’
The reason the therapist explores these two avenues is
because the two are linked in the experiential control
agenda

Namely, control strategies often promise us not only

that we will feel good, but that we will be living well
also. The therapist in ACT attempts to undermine
these two promises

Its ironic that most clients/people believe that if they

feel good first, then living well is easy. And some
spend their whole lives trying to achieve the first, at
the expense of actually living
Therapeutic stance and pitfalls
The therapist should view whatever attempts at control the
client has tried as perfectly reasonable and understandable

It is also important to focus on workability. This is not about

being right, or proving that the therapist has a better way. Its
about helping the client to apply the criterion of workability to
their lives

Don’t get caught up in the content of what the client is saying

i.e. don’t get side-tracked into discussing the clients problems
in too much detail, we just want to know if the strategies
worked

 Remember that the client would have verbally rehearsed his or her
stories many times, and may feel threatened and begin to defend
themselves and their strategies, at this point come back to the
issue of workability
 The next step
Discussion is likely to show that past strategies have not worked
too well.

In order to move the clients forward to a place where they can
let go of these attempts, the therapist tries to foster a state of
creative hopelessness, where the therapist suggests that perhaps
those attempts ‘cant work’.

The idea of creative hopelessness is to ask the client to

recognise that their attempts have not been working, and to
suggest that a place of not having a solution is where we want
to be. Because it’s a place where new possibilities are born
 Importantly, at this point the therapist shouldn’t come up with a
solution. Just let the client sit with their not knowing.
 The importance of metaphor
Throughout the entirety of ACT metaphors are used to
demonstrate the principles the therapist talks about.
With creative hopelessness the therapist will want to
convey that usually, the more effort we make with
something the more reward we receive. Yet in this case
the client has made a lot of effort to no avail. The
following metaphors may help
Struggling with quicksand
A person who has fallen into a hole with only a shovel to
get out
Feeding a hungry tiger so that he will leave
Running on a hamster exercise wheel that goes nowhere
Lets look at some transcripts to see if we
can spot what the therapist is doing
 Important point 1
Be respectful and humble even when being
confrontational, otherwise it can seem like your playing a
game

The idea is to let the client know that the strategies

reinforced by the social community are not working, not
that he or she is incorrect
 the agenda is hopeless, not the client

The idea of leaving the client ‘hopeless’ comes from the

fact that when were not busy engaging in avoidance we
can see our lives more clearly

Remember that each client will need different amounts of

time on this. Some are steeped in their avoidance, others
not so much
 Important point 2
Here the therapist moves on from workability to
suggesting that ‘control might be the problem’ rather that
the solution to the clients problems
The problem is that our history tells us that if we have a
problem, then we get rid of it and all will be well, but this
may not be the case with psychology.
In all of these examples, clients think that getting their
internal experiences under control will enable them to live
(just like with physical problems). But what if it was all a
lie!
 When I get my anxiety under control, I’ll get a job
 When the pain stops I’ll find another relationship
 When I don’t feel guilty anymore, I’ll reconnect with my
children
At this point a number of metaphors are available to
the therapist to help out
Chinese handcuff
Tug of war with a monster
The polygraph metaphor
And many more

These all convey the same message – if you're not

willing to have it, you’ve got it!
 Fostering acceptance/willingness
Once the client recognises unworkable strategies and
realizes that control might be the problem, therapy
turns to willingness.
In this phase, attention is turned towards building
new behaviours that are about embracing, holding and
compassionately accepting one’s experience
Clients often enter therapy to feel better (be happier),
acceptance aims to let clients feel better (get better at
feeling) in the service of living better
The therapist guides the client to practise willingness
so that they can apply it broadly to their lives
Remember that the client is taking a big step into the
unknown here.

Not many people allow themselves to come into contact

with their emotions/issues.

The therapist is there to gently guide the client to take

these steps. They will do this in two ways;

Teaching the client what willingness is

Actively practising willingness in the present moment

Willingness involves embracing the moment, in the
here and now, as it unfolds, fully and without defence
What we mean by fully is broad and inclusive, all
emotions and mind content are there to be
experienced, not just the parts we like.

Willingness is a choice – making a selection because

we can

Many clients might provide many reasons why they

do not have a choice, it is your job to allow the client
to defuse from their reasons and take action
There is a quick way you can do this
Tea or coffee?
List the reasons why you would not choose one over the
other
And now ask if the client could still drink that option
despite all the reasons not to
It is not the reason that chooses, but the person

Would you be willing to choose willingness if it

meant you got to live your life?

Lets look at a classic willingness metaphor

Willingness is an action
Just like teaching someone to ride a bike, it is difficult
to instruct and must instead be experienced and
practised
Willingness tends to be practised throughout the
therapeutic process. The therapist will do this by
continually giving clients the choice to do a difficult
exercise or discuss a difficult topic
Popular exercises;
Eyes on exercise
Tin can monster exercise
Looking for Mr discomfort exercise
 Important points
Willingness is often decided by the context i.e. a social phobic
could be willing in a bookstore, but not a shopping centre, he or
she could be willing or five seconds or one hour
 Therapists would usually start by asking the client to be willing in a
small way, then increase the steps with time.

Willingness is on-going – we can never achieve it, simply

continue to choose willingly in each situation

Willingness is heavily integrated into the other parts of the ACT

model
 We will therefore come across many willingness exercises in the
next few weeks

Now lets do some examples!!!!