1. Workshop ACT for people with severe personality problems Annika Cornelissen Lucas Goessens Scelta Nijmegen, the Netherlands Berlin, july 16th, 2014

2. Evaluate yourself, from the perspective of your perfectionistic, “not-good-enough’ self Go to a proud, successful moment, and evaluate yourself. Go back to a moment when you had a strong sense of failure. How do you judge yourself today, up till now? Go back to a moment when a loved one left you Go back to a moment you fell in love, and this love was answered. Go to a very difficult moment in your role as a therapist, feeling desperate and powerless. Go to a very rewarding moment in your role as a therapist From the perspective of you as a 18 year old: how would you evaluate yourself as you are now? Intro: 9 questions exercise

3. ACT for PPP (people with severe personality problems) 1. Why is it difficult 2. Why is it important 3. Why is it inspiring Workshop outline:

4. ACT for PPP 4. Our treatment: structure, vision, tailoring! Experiential exercises Continued: workshop outline:

5. ACT: “BOTTOM LINE” = PSYCHOLOGICAL FLEXIBILITY “Helping people to maintain meaningful behaviours in their lives, even when difficult private experiences (thoughts/feelings/memories/pain) show up”.

6. 1. Why is it difficult? *behaviour patterns of Short Time Survival *e.g. self-hate, paranoia, impulsivity *patterns give sense of self *little contact feelings, needs, values ACT for PPP

7. 2. Why is it important? *Tiny steps can make a big difference *meaningful contacts, value-based behavior *EA undermines therapy process *ACT can stimulate therapy process

8. Why is it important? *DBT = ACT for borderline problems?? → ACT extra value in creating meaningful lives.

9. 3. Why is it inspiring? ACT for PPP

10. 4. Our treatment: structure, vision →weekly group →2- day clinic: ACT for PPP *start low, go slow, don’t overflow! *ACT Treatment plan

11. Value Area 1: Value area 2: WAVES BEACONS LIGHTHOUSE 1._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 2._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 2._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 3._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 3. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 4._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 4. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ WAVES BEACONS LIGHTHOUSE 1._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 2._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 2._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 3._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 3. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 4._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 4. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

12. Start low, go slow: essential is: the first beacon!! ACT for PPP

13. *cycle: every two weeks 1 hexaflex item *Clear and simple hexaflex ACT for PPP our treatment: structure, vision

14. Default Hexaflex Psychological flexibility Mindfulness Acceptance Defusion Self as context Values Committed action

15. HEXAFLEX SIMPLE HEXAFLEX SIMPLE From staying alive to living a life Stay aware when needed Deal with difficult emotions Deal with difficult thoughts Put on the right spectacles Know what matters Do what it takes

16. HEXAFLEX SIMPLE: flexibility poles HEXAFLEX SIMPLE: flexibility poles From staying alive to living a life awareness vs. automatism allowing vs. rejecting hooking vs. unhooking being me instead of who I should be knowing what matters vs, ‘I don’t care’ keeping on track vs. letting go

17. Experiential exercises → Tailoring!! (light-medium-heavy) ACT for PPP

18. Questions? Workshops? l.goessens@ggnet.nl a.cornelissen@ggnet.nl