1. ‘I used to think that the brain was the most wonderful organ in my body. Then I realized who was telling me this’
Emo Philips

2. Undermining cognitive fusion

3. Key targets for cognitive defusion
Help clients see thoughts as what they are – just thoughts – so that thoughts can be responded to in terms of their workability given the clients values, rather than in terms of their literal meaning
Help clients attend to thinking and experiencing as an on-going behavioural process and away from the literal meaning of the contents of the mind

4. What is defusion
ACT argues that the problem with human suffering, as it relates to thoughts, is not that we have the ‘wrong thoughts’, but rather that we spend too much time ‘in them’ or ‘looking from them’, rather than simply looking at them and observing them
Defusion attempts to allow the client see thoughts as an on-going behaviour that can be watched, and not taken too seriously at times when they are unhelpful
Clients are encouraged to look at thoughts from the perspective of workability, and not see them as literal truth

5. A common misunderstanding is that our thoughts cause our behaviour
For example, if we asked someone why they stood in the corner all night at a party, a plausible answer might be ‘I was too worried I would embarrass myself’. This thought (worry) caused the subsequent action – withdrawal
ACT holds that Defusion, being able to stand away from our thoughts, will enable us to take effective action in spite of them
Essentially Defusion involves changing our relationship with our thoughts and understanding that thoughts are just words created from our history.
In each situation we get to evaluate whether our thoughts are being helpful or unhelpful

6. A common technique can be used to illustrate this point
Imagine a glass of milk, think about what it looks like, what it tastes like, what it smells like
Now repeat the word milk over and over for 30 seconds
What happened?

7. Most people find that;
The word temporarily loses some of its meaning,
And other functions dominate awareness, like the strangeness of it sound
In a therapy situation such an exercise would be done with a self relevant word – worthless
The exercise aims to reduce literal content
The idea is to show that this is just a word

8. When, how and why to do defusion
Defusion is most powerful with clients that tend to hold the literal meaning of their thoughts to be true
Some who has the thought that they were ‘bad’, would believe fully such a thought, assuming it is ‘true’
There are many ways to help people become less fused with their thoughts, these include; paradox, meditative exercises, experiential exercises and metaphor

9. Once Defusion is reached clients are encouraged to focus on effective action in spite of the negative thoughts they may be having
Simple example – John’s alarm didn’t go off, he was late for work. Because of this he shouted at his wife, he had fused with the thought ‘she didn’t set my alarm and made me late for work’. If in that moment, John had the ability to see his thought from a distance, and keep in contact with his value of being a loving husband, he would have seen that shouting was not effective action in that context

10. Some defusion exercises
Defusion exercises attempt to reduce the literal quality of the thought, weakening the tendency to treat the thought as what it refers to (truth) rather than what it actually is (a thought)
Note: the result of Defusion should be a lowered attachment to private events, not a change in their frequency or form
Some examples include;
Singing the thought
Buying a thought
Speaking the thought in a silly voice
Watching your thoughts on a TV screen
Giving the thoughts a shape, size, colour or speed
Thanking your mind for an unhelpful thought
Label the process of thinking; I'm having the thought that I'm worthless
Mindfully observing the thoughts like leaves on a stream

11. Lets start a short exercise;
Bring to mind a friend, who has had some psychological troubles that have come to you with. Think of three thoughts that this person has about himself or herself, his or her life, or his or her future that are difficult for this friend. Record these on a sheet. If you cant think of anyone create a client in your head. Try to be specific with the thoughts
We’ll come back to this later

12. Creating distance between the thought and thinker, feeling and feeler
ACT aims to allow clients to see that thoughts and feelings are something clients have rather than something they are
There are a few ways to apply this principle;

13. Objectify language
We all have a great deal of experience dealing with objects in our environment as separate from ourselves
By attributing our thoughts as objects to be viewed the same distance can be achieved
Objectifying thoughts can help clients interact with their thought in a more flexible and practical way
Your thoughts as a tool metaphor
The bullying passengers on a bus metaphor
The taking your mind for a walk metaphor (naming your mind)

14. Looking at thoughts rather than from thoughts
This is the difference between having a thought and buying a thought
We can do this by emphasizing the fact that we constantly speak to ourselves or by practicing various metaphors
Leaves on a stream
Soldiers in a parade
Listen to this transcript

15. Reveal the hidden properties of language
Evaluation versus description
The idea of this is to allow the client to step away from their thoughts and see exactly what is happening when they confuse the two
The ‘bad cup’ metaphor is helpful here

16. Undermining larger sets of verbal relations
Story telling and reason giving
Lets look at a transcript of how story telling builds and can ultimately be unhelpful
Examine the workability of the stories
If God came down from Heaven and said, you are 100% right about why you have a disorder, how would that help?

17. Therapeutic stance
The previous slides detail Defusion metaphors and exercises
However it is important that these be integrated into the general flow of the session
And not just be listed didactically
Importantly, Defusion work in therapy never ends, and is used constantly through each ACT process
In any given situation, the primary focus is on whether buying a thought would move the client toward a more vital, values based life

18. Underneath are some specific techniques used for practicing Defusion in the ongoing flow of the session
Verbal conventions
I'm having the thought that
Thanking your mind
Replacing ‘but’ with ‘and’
Metaphor reminding
Coming back to metaphors used previously
Listen to this manuscript
Teaching the client to recognize fusion

19. Go back to the three thoughts you listed at the beginning of this lecture, now that you have learned a little about Defusion techniques, consider one technique you could use for each of the thoughts you recorded
And no onto the video!