Acceptance & Commitment Therapy (ACT) for Chronic Pain Joel Guarna, PhD

Chronic Pain Pain Injury Time

Acceptance & Commitment Therapy (ACT) for Chronic Pain In 60 seconds or less… What is ACT?

Six Core Processes Contact with the Present Moment Acceptance Values Committed Action Defusion Self-as-Context

Six Core Processes Psychological Flexibility Contact with the Present Moment Acceptance Values Psychological Flexibility Six Core Processes Committed Action Defusion Self-as-Context (Flexible Perspective-Taking)

Matrix www.DrKevinPolk.com Kevin Polk’s www.youtube.com channel Resources Matrix www.DrKevinPolk.com Kevin Polk’s www.youtube.com channel

Me Noticing

Outside (5 senses) Me Noticing

Outside (5 senses) Me Noticing

Me Noticing Inside (mental, emotional

Me Noticing Inside (mental, emotional

Outside (5 senses) Me Noticing Inside (mental, emotional

Outside (5 senses) Toward Me Noticing Inside (mental, emotional

Outside (5 senses) Away Toward Me Noticing Inside (mental, emotional

Outside Away Toward Me Noticing Inside

Outside Toward Away Me Noticing Inside

Outside Inside Toward Away Me Noticing Body Pain Tension Spasms Fatigue Soreness Numb Inside

Outside Inside Toward Away Me Noticing Body Pain Tension Spasms Fatigue Soreness Numb Moods/Emotions Depression Anxiety Anger Irritability Shame Hopelessness Inside

Outside Inside Toward Away Me Noticing Body Pain Tension Spasms Fatigue Soreness Numb Moods/Emotions Depression Anxiety Anger Irritability Shame Hopelessness Thinking Concentn Worries Negative “I can’t stand this” Inside

Outside Inside Toward Away Me Noticing Body Pain Tension Spasms Fatigue Soreness Numb Moods/Emotions Depression Anxiety Anger Irritability Shame Hopelessness Thinking Concentn Worries Negative “I can’t stand this” Inside

Outside Inside Toward Away Me Noticing Body Pain Tension Spasms Fatigue Soreness Numb Moods/Emotions Depression Anxiety Anger Irritability Shame Hopelessness Thinking Concentn Worries Negative “I can’t stand this” Inside

Outside Inside Moving less Isolating Avoiding Canceling plans Taking meds Short tempered Yell F/F/F Drinking Drugs Self-harm Suicide Toward Away Me Noticing Body Pain Tension Spasms Fatigue Soreness Numb Moods/Emotions Depression Anxiety Anger Irritability Shame Hopelessness Thinking Concentn Worries Negative “I can’t stand this” Inside

Acute Outside Inside Away Moves Moving less Isolating Avoiding Canceling plans Taking meds Short tempered Yell Drinking Drugs Self-harm Suicide Toward Away Me Noticing Body Pain Tension Spasms Fatigue Soreness Numb Moods/Emotions Depression Anxiety Anger Irritability Shame Hopelessness Thinking Concentn Worries Negative “I can’t stand this” Acute Inside

Chronic Outside Vicious Cycle Inside Away Moves Moving less Isolating Avoiding Canceling plans Taking meds Short tempered Yell Drinking Drugs Self-harm Suicide Toward Away Vicious Cycle Me Noticing Body Pain Tension Spasms Fatigue Soreness Numb Moods/Emotions Depression Anxiety Anger Irritability Shame Hopelessness Thinking Concentn Worries Negative “I can’t stand this” Chronic Inside

Outside Toward Away Me Noticing Inside

Outside Toward Away Me Noticing Inside

Outside Inside Toward Away Me Noticing Roles/Resp Parenting Work Being productive Providing Health Active Strong Self-care Moving Relationships Connection Love/Caring Warm Fun Purpose Meaning Spirituality Rec Creativity Entertainment Inside

Outside Inside Toward Moves Hanging with friends Hunting/Fishing Playing with kids Time with Family Making good meals Going to Church Going to work Painting/crafts Toward Walk the dog Away Exercise Me Noticing Roles/Resp Parenting Work Being productive Providing Health Active Strong Self-care Moving Relationships Connection Love/Caring Warm Fun Purpose Meaning Spirituality Rec Creativity Entertainment Inside

Outside Inside Toward Moves Hanging with friends Hunting/Fishing Playing with kids Time with Family Making good meals Going to Church Going to work Painting/crafts Toward Walk the dog Away Exercise Me Noticing Roles/Resp Parenting Work Being productive Providing Health Active Strong Self-care Moving Relationships Connection Love/Caring Warm Fun Purpose Meaning Spirituality Rec Creativity Entertainment Inside

Outside Inside Away Moves Toward Moves Hanging with friends Moving less Isolating Avoiding Canceling plans Taking meds Short tempered Yell Hunting/Fishing Drinking Drugs Self-harm Suicide Playing with kids Time with Family Making good meals Going to Church Going to work Painting/crafts Toward Walk the dog Away Exercise Me Noticing Body Pain Tension Spasms Fatigue Soreness Numb Moods/Emotions Depression Anxiety Anger Irritability Shame Hopelessness Roles/Resp Parenting Work Being productive Providing Health Active Strong Self-care Moving Thinking Concentn Worries Negative “I can’t stand this” Relationships Connection Love/Caring Warm Fun Purpose Meaning Spirituality Rec Creativity Entertainment Inside

Continuum Outside Inside Away Moves Toward Moves Hanging with friends Moving less Isolating Avoiding Canceling plans Taking meds Short tempered Yell Hunting/Fishing Drinking Drugs Self-harm Suicide Playing with kids Time with Family Making good meals Going to Church Going to work Painting/crafts Toward Walk the dog Away Exercise Me Noticing Body Pain Tension Spasms Fatigue Soreness Numb Moods/Emotions Depression Anxiety Anger Irritability Shame Hopelessness Roles/Resp Parenting Work Being productive Providing Health Active Strong Self-care Moving Thinking Concentn Worries Negative “I can’t stand this” Relationships Connection Love/Caring Warm Fun Purpose Meaning Spirituality Rec Creativity Entertainment Inside

Outside Inside Away Moves Toward Moves Hanging with friends Moving less Isolating Avoiding Canceling plans Taking meds Short tempered Yell Mixed 50/50 Hunting/Fishing Drinking Drugs Self-harm Suicide Playing with kids Time with Family Making good meals Stretching Heat/Ice TENS unit Mindfulness Distress Tolerance Going to Church Going to work Painting/crafts Toward Walk the dog Away Exercise Me Noticing Body Pain Tension Spasms Fatigue Soreness Numb Moods/Emotions Depression Anxiety Anger Irritability Shame Hopelessness Roles/Resp Parenting Work Being productive Providing Health Active Strong Self-care Moving Thinking Concentn Worries Negative “I can’t stand this” Relationships Connection Love/Caring Warm Fun Purpose Meaning Spirituality Rec Creativity Entertainment Inside

Outside Menu of Behaviors & Actions Away Toward Me Noticing Inside

Away Moves 50/50 Toward Moves (Mixed Functions) Outside Inside Toward Me Noticing Inside

Outside Away Toward Me Noticing Inside

Outside Inside Moving less Isolating Avoiding Canceling plans Taking meds Short tempered Yell Away Toward Me Noticing Inside

✗ Outside Inside Moving less Isolating Avoiding Canceling plans Taking meds Short tempered Yell Away Toward ✗ Me Noticing Inside

✗ Outside Inside Moving less Isolating Avoiding Canceling plans Taking meds Short tempered Yell Away Toward ✗ Me Noticing Inside

✗ Outside Inside Moving less Isolating Avoiding Canceling plans Taking meds Short tempered Yell Away Toward ✗ Me Noticing Inside

Outside Away Toward ✗ Me Noticing Inside

✗ Outside Inside Phase 1 Moving less Isolating Avoiding Canceling plans Taking meds Short tempered Yell Away Toward ✗ Me Noticing Inside

✗ Outside Inside Moving less Isolating Avoiding Canceling plans Taking meds Short tempered Yell Away Toward ✗ Me Noticing Inside

✗ Outside Inside Phase 2 Moving less Isolating Avoiding Canceling plans Taking meds Short tempered Yell Away Toward ✗ Me Noticing Inside

Outside Phase 3 Away Toward ✗ Me Noticing Inside

Outside Phase 3 Away Toward ✗ Me Noticing Inside

✗ Outside Inside Phase 3 Stretching Heat/Ice TENS unit Mindfulness Distress Tolerance Away Toward ✗ Me Noticing Inside

Outside Phase 3 Away Toward ✗ Me Noticing Inside

Outside Phase 4 Away Toward Me Noticing Inside

Outside Inside Phase 4 Hanging with friends Hunting/Fishing Playing with kids Time with Family Making good meals Going to Church Going to work Away Toward Painting/crafts Walk the dog Exercise Me Noticing Inside

Outside Phase 4 Away Toward Me Noticing Inside

Outside Phase 4 Away Toward Me Noticing Inside

Outside Phase 5 Away Toward Me Noticing Inside

Outside Phase 5 Away Toward Me Noticing Inside

Away Moves 50/50 Toward Moves (Mixed Functions) Outside Inside Toward Me Noticing Inside

Six Core Processes Psychological Flexibility Contact with the Present Moment Acceptance Values Psychological Flexibility Six Core Processes Committed Action Defusion Self-as-Context (Flexible Perspective-Taking)

Away Moves 50/50 Toward Moves (Mixed Functions) Committed Action Outside Away Moves 50/50 (Mixed Functions) Toward Moves Away Toward Committed Action Me Noticing Acceptance Defusion Values Inside

Away Moves 50/50 Toward Moves (Mixed Functions) Committed Action Outside Away Moves 50/50 (Mixed Functions) Toward Moves Away Toward Committed Action Me Noticing Acceptance Defusion Values Contact With Present Moment Inside

Resources Books Accessible: Books by Russ Harris Happiness Trap

Resources Books: ACT

Resources Books: ACT for Pain

Matrix www.DrKevinPolk.com Kevin Polk’s www.youtube.com channel Resources Matrix www.DrKevinPolk.com Kevin Polk’s www.youtube.com channel

Resources ACBS is the professional home for ACT Many videos, protocols, articles, list servs, other resources

Resources www.div12.org References for the science behind ACT for chronic pain

Resources References for the science behind ACT for chronic pain

Resources References for the science behind ACT for chronic pain

Resources Resources on understanding pain differently

Resources Resources on understanding pain differently

Acceptance & Commitment Therapy (ACT) for Chronic Pain Questions? joel.whitepine@gmail.com