Cognitive defusion Sources: Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. New York: Guilford. Luoma, J. B., & Hayes, S. C. (2008). Cognitive fusion. In W. T. O’Donohue & J. E. Fisher (Eds.), General principles and empirically supported techniques of cognitive behavior therapy (pp. 181-188). Hoboken, NJ: John Wiley & Sons. Cognitive defusion

Cognitive defusion ‘Cognitive defusion involves a change in the normal use of language and cognition such that the ongoing process is more apparent and the normal functions of the products of thinking are broadened.’ Relating to language and the world in a more flexible way without a need to change the form or frequency of thoughts

Theoretical Focus There is a difference between language and languaging. “When the derived functions of language dominate, humans fuse with the psychological contents of verbal events.” Words Facts

Cognitive distancing in Cognitive Therapy Help clients to monitor and evaluate thoughts as hypotheses rather than objective realities/facts of the world Hayes’ proposed a therapy, Comprehensive Distancing (Hayes, 1987) in which the use of cognitive distancing is elaborated and extended, Then Hayes renamed the therapy and proposed ACT, including acceptance, mindfulness, and committed action to values were included in add to cognitive distancing

Outcome Evidence Psychosis, chronic pain, workplace stress, OCD, social anxiety, drug abuse, nicotine addiction, depression, coping with physical illness Defusion was a mediator in studies on depression, counselor burnout, stigma, and psychotic beh Rapidly repeating a word, physicalizing and ‘leaves on the stream’ reduced the intensity of targeted thoughts

Who might benefit? Any problems that are exacerbated by cognitive events Cognitive defusion aims to reduce the negative behavioral impact of harmful thoughts without attempting first to change the form, frequency, or situational sensitivity of them Contraindicated for approaches which are focused on content of thoughts/literal meanings of thhoughts

How it works? Therapist targets the contexts that generate literal meaning and the contexts that relate thoughts to undesirable overt behavior via providing alternative contexts such as meditation, experiential exercises etc.

ACT Goals, Strategies & Interventions STEP-BY-STEP PROCEDURE Language may not hold all answers Thought and emotions are objectified via various experiences Language conventions and experiential exercises are introduced to differentiate ‘buying a thought’ from ‘having a thought’ 1.Teach limits of language with direct experience. 2. Undermine fusion of self and language: “Milk, milk, milk exercise”

Techniques Thinking vs experience Objectifying thought Milk milk milk Objectifying thought Passengers on the bus metaphor A thought is a thought is a thought Leaves on a stream Soldiers metaphor

For example, Mary had a little _______. Client: Lamb. T: Did you choose to have that thought? C: No, I suppose not. T: Are you that thought? C: No. T: Are you this box of Kleenex? T: Right, because you can notice it! You can notice something, you are not that thing, right? In some ways it’s almost like our minds are separate entities. Sometimes we can start to think we are our thoughts – but notice who’s telling you that! That’s a thought too! Of course, our minds think they are the most important things.

Focus on the functional utility of thoughts What is the thought/story in the service of? Is this helpful? Have you told these kinds of things to yourself or others before? Is this old? If your thought is 100% true, how would this help you? Let’s have a vote. And Vote that you’re correct. Now what?