Dana Bernacchi: Open up. Be present. Do what matters.

As a new member of the Indiana Judges & Lawyers Assistance Program, I attended the Commission on Lawyers Assistance Programs’ annual conference for the first time this year.

I was excited to see there was a session on Acceptance and Commitment Therapy, or ACT, and its efficacy in working with legal professionals. The session focused on ACT being a more effective therapy utilized among lawyer assistance programs, as opposed to other therapy types.

As a therapist, I’ve used this therapeutic approach for years with clients and still apply its components to my daily life.

ACT was developed by Steven Hayes in the 1980s, focusing on increasing psychological flexibility. Psychological flexibility involves having awareness of one’s present thoughts and feelings, being open to inevitable feelings of discomfort, and taking steps towards what’s most important.

Research by Hayes indicates those who show psychological flexibility have better outcomes when it comes to mental health and emotional well-being.

ACT offers six core processes that work together to increase psychological flexibility. This is how I’ve come to understand each of them and their usefulness:

Practice acceptance: Learn what you can change and what you can’t. Acceptance isn’t endorsement, it’s simply an acknowledgement of what is. Acceptance is also about reducing avoidance.

ACT normalizes the idea that to be human is to experience unpleasant emotions and fighting against them often creates more emotional pain. By accepting inevitable discomfort and creating space for feelings rather than trying to get rid of them, feelings tend to be more manageable and less overwhelming.

Be present: All we have is this very moment, indefinitely. Lingering in the past can leave us wallowing in things like shame or regret. Living in the future can keep us filled with fear over realities that may never happen. But if we are right here, right now, we can better tune in to ourselves and what the present has to offer. Being present brings awareness and gratitude.

Thought defusion: We all experience thoughts that plague us or bring us feelings of discomfort. Rather than fighting them, thought defusion suggests we detach from them. By having some distance between ourselves and our thoughts we can feel less overwhelmed by them.

There are several ways to do this, including verbalizing your thoughts or writing them down, but there’s another skill that involves adding phrasing to certain thoughts. For example, take a common anxiety provoking thought like “everybody’s judging me,” now add the phrase “I’m telling myself”, so it becomes “I’m telling myself that everyone’s judging me,” which has a different connotation. Now you have the option to not tell yourself that everyone’s judging you.

Another common add-on phrase for this skill is “I’m noticing that I’m telling myself”. Like the prior example it would change the thought to “I’m noticing that I’m telling myself that everybody’s judging me,” which has a new meaning entirely, and is far less anxiety provoking.

Self as context: How we view ourselves has a profound emotional impact. Seeing yourself as context involves understanding that while you are influenced and impacted by your environment, there is still an unchanged “you” that’s always present.

When you were younger you were very different than you are now, but you were still you. If you were to lose a limb, your body would be altered, but you would still be you. By accessing the “you” that is ever present, we can zoom out a bit from our circumstances, learn from our experiences, have more compassion for ourselves, and recognize our own strength and resilience.

Aligning with core values: Get in touch with what’s REALLY important to you. These are our core values, they enrich our lives, they are our guiding compasses. One could argue they are the foundation of who we are.

For some it’s family, health, and spirituality. For others it may be creativity, adventure, and compassion. A quick Google search of core values will result in lists of examples to contemplate and consider.

It’s easy to become distracted with the demands of life or other people’s expectations such that we forget the things that are TRULY important to us. When we are in touch with our values and living closer to them, life tends to have more meaning, we have a greater sense of purpose, and we tend to show more resilience when experiencing adversity.

Committed action: Avoidance and stagnation tend to leave us feeling frustrated and stuck. If we want to feel differently, we need to DO something differently. ACT encourages people to commit to take action steps in direct alignment with what’s most important to us (remember those values).

Now the action might be uncomfortable (maybe you really don’t want to talk to your boss about scaling back on overtime hours) but if it’s going to move you closer to the things most important to you (spending more time with loved ones), it will have longer term gains than the initial discomfort of the action.

If reading through this interests you, I encourage you to consider finding a therapist who practices ACT. There are also many self-help books based on ACT, one I would recommend is “The ACT Daily Journal, Get Unstuck and Live Life Fully with Acceptance and Commitment Therapy” by Dr. Diana Hill and Dr. Debbie Sorensen.

In short, open up to inevitable discomfort, be present and aware of your thoughts and feelings, and do the things in life that matter the most. Maybe we aren’t meant to feel good ALL the time, but we can still lead meaningful lives with values-based action.•

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Dana Bernacchi is a clinical case manager with JLAP and a licensed clinical social worker. Her experience as a therapist has focused on the treatment of substance use disorders, co-occurring mental health disorders, and trauma.