Using the ACT Matrix

Tonight is a presentation on using the ACT Matrix. The matrix is my go-to tool. I think if there's one tool that I could pick from all of my learning in acceptance and commitment therapy, this would be it. Acceptance and commitment therapy for people who may not be aware. I did an introductory lecture on this a while back for counselling tutor so you can check that out if you've got your membership. If you haven't seen that or you haven't heard anything of the matrix act then, very briefly, ACT is one of the therapies that forms part of the cognitive behavioural therapy tradition. It's the more contemporary model, contemporary development over the last 20 years and it's very behavioural in its focus. It's really about helping people to choose behaviours that work for them and to have the flexibility to choose a course of action that's helpful in terms of being the kind of person they want to be and pursuing the life you want to live, pursuing the values that are important to you. It's, as I say, an emphasis on the behavioural. It's not really concerned with challenging thoughts or changing thoughts in the way that some other CBTs’ are, but it's interested in helping people choose behaviour that's functional. To that end, ACT draws on behavioural roots so going back to things like Pavlov and Skinner in particular in terms of developing its theory in practice.

It's a lofty ambition if I look down this list for the time, we have available, but I want to help us think about go back to really old school principals around behaviourism and the ideas about the way you can help people classify their behaviour to use that as the basis for introducing the key principles of the ACT Matrix. To think about how the ACT Matrix maps onto Act's broader model of psychological flexibility. Give you a step-by-step procedure for using the matrix in practice. Rather than talk about it, I'm going to invite you to kind of do it so that will be some experiential learning from the inside out. Please treat that as an invitation and not an expectation. If you just don't want to do the experiential bits of the lecture, then that's fine. You can tune out for that. As always, I would say you get out what you put in and the best learning takes place when we step outside of our comfort zone so there's that invitation. The presentation and the slides and the accompanying materials that Rory will give you access to will give you some useful questions to help you use this tool in practice.

What I'm going to invite you to do is to dive straight in with the experiential bits right here and now and to just to draw this on a page. Two arrows horizontally going in different directions. Now, what this represents is a very old behavioural distinction about what organisms do, so you can count yourself among the world of organisms, but this applies across the board to any kind of animal in the whole of the animal kingdom. We do one of two things most of the time. We do behaviour that helps us move towards the things we want. The old word for this was behaviour under appetitive control etymology there is coming from the word archetype. So, we move towards the things that we want. Non-verbal organisms, this is really straightforward, if I put food down in my dog's bowl, the dog will move towards the bowl. In that moment his behaviour is under appetitive control, he is moving towards what he wants, to explore an appetitive stimulus. Now, the other thing that organisms do is they move away from what they don't want. So, you might think of this as being avoidance and that's perfectly functional, too. If I pick up my guitar and start playing, generally my dog leaves the room and it's not because he wants to go outside, it's because he wants to avoid the sound of my guitar playing. He's not being rude right, but me and him and the guitar playing just don't really get on. We either move towards what we want, or we move away from what we don't want, and you don't even need a central nervous system to see this behaviour in action. Single cell organisms have been known, if you track their path through water, they will move towards light and they will move away from toxins, things that are bad for them. Both moving towards what we want and moving away from what we don't want are perfectly functional behaviours and you need a mix of both to stay alive.

Just to summarize that, so we're moving towards what we want to approach, exploring appetitive stimulus or we move away from what we don't want to escape or avoid an aversive stimulus. Just to give you a personal example, I spent some of yesterday afternoon watching West Bromwich Albion on Sky Sports. That was me moving towards what I want. I enjoy football. I've got a passion for that and that was a bit of downtime for me, pursuing a value of relaxation and entertainment. That's what I've done this week, I have avoided doing some marking for the university. I love most aspects of my job. I don't love the marking, so I did a bunch of things like tidy my office, answer emails that I didn't really need to answer in order to avoid the marking. I was purely doing it to get away from doing something that I really don't want to do. I'm sure you can even, given a moment, think of examples from your own week where the same things apply. You're either doing stuff that brings you closer to the things you enjoy, or it takes you further away from the things you don't like.

The interesting thing about this or the slightly complicating things on the face of it, that just sounds easy, but it doesn't mean I can classify my behaviours as towards or away, but actually it's a little bit more complex. If we think about this complex bit really is that any behaviour could be both, a towards move or an away move. I could run through a forest because I have a value of health and fitness and I enjoy trail running and I'm running through a forest to express my value of fitness or I could run through a forest because I'm being chased by a bear. Now, a casual observer is just going to see a guy running through the forest and it's exactly the same behaviour. You can appreciate how it would feel completely different in those two scenarios. Running because I'm pursuing a value of fitness is very different from running for my life, escaping from a bear so experientially it's very different. You could apply this to any behaviour that you can think of. Even something that seems on the face of it, a real towards move, it's exploring an appetitive stimulus like making love, for example, you can do that because that's exactly what you are doing. You're doing something very rewarding with someone that you love very much, but, you know, people do that to avoid an argument or to avoid an abusive situation. So, again, the same behaviour, but there's different functions. You could move to a new house as a real step forward in your life, a real positive development, moving towards greater and better things or you could move to a new house because you've been evicted because you couldn't afford to pay the rent. You can appreciate that the same behaviour of moving to a new house feels very different under those different circumstances. You could diet because you're looking forward to getting beach ready or you could diet because the GP has told you that if you don't lose weight, you're going to die. Again, same behaviour but it's going to feel very different. This distinction is probably one of the most central, most important things I always teach my clients to understand. It's not about it's not about what you're doing it's why you're doing it and to understand why you do the things you do. It's very helpful because it helps you to make functional choices in life.

A couple of things just to remember. The first point I've already gone across the form and function aren't the same thing. So, something that looks the same, doesn't function in the same way, so that running through the forest idea. It looks the same as a towards move and an away move, but the function of it is very different. Intention and function aren't the same thing. I might pat you on the shoulder because I intend to comfort you, but actually the function of me doing that could be really aversive. You could be like, why is this guy touching me? Now you might have a history of abuse, for example, and being touched by someone is highly aversive. So, what you intend and what the actual function of what you do, they're not the same thing at all. Any behaviour, as I said, can be either a towards move or an away move and things that functionally look similar, so things that are functionally similar can look very different. A good example might be when a client displays avoidance in sessions. I don't know about you, but I've had all sorts of experiences of avoidant clients and their avoidant behaviour looks very different. You might have one client who's very intellectual, one client who uses a lot of humour to deflect from discomfort, another client who doesn't turn up for sessions, another one who does turn up but isn't really very present. Someone else who turns up and says they're going to do a bunch of work between sessions and then doesn't. All of those things, they're all very different behaviours, but functionally they are the same. They have the function of avoiding discomfort. This is on the face of it, a very simple idea, but as with most things in life, when you get under the bonnet, it's slightly more complex.

So, back to your drawing. The next thing you can do is to draw a vertical line. It doesn't have to be dotted, but just an intersecting vertical line to create four quadrants on the page.

The distinction I want to make here is anything below the line is a sort of a private event. It occurs inside of you, so this would be your thoughts, your physiological sensations, your emotions, your values, that kind of stuff. I won't know about any of that unless you tell it to me. It's a private event. Anything above the line is an observable thing. It's an observable behaviour via the CCTV or a documentary film crew following around. These are the things I could see. I couldn't see your anxiety, but I might see behaviours that are associated with it. I can't see the thought you might be having about 'I'm a fraud or I'm worthless', for example, but I might be able to see behaviours that are associated with that thought. Anything private goes below the line, anything sort of observable goes above the line.

I'm going to run you through a list of questions. This is the experiential part to sort of illustrate using The ACT Matrix. I'd like you to kind of do it rather than just me talk about it. I'm going to give you a personal example just to illustrate things as well. When I'm using this model with people, this is where I usually start. Thinking of a particular situation, I'm going to invite need to just as you fill this out, to think of a particular situation that is perhaps a bit of a stuck issue for you or a difficult thing you're experiencing at the moment and I'm just going to ask you that question. In the context of this thing, what is it that matters? Who and what is important to you? I'm going to give you an example. My example relates to my job at the university. We have a new cohort of students that just started this term and the whole thing is online. So, they are learning to be therapists, learning to be CBT therapists and the whole experience thus far has been online. I think we have managed to have one lecture live before we went into Tier three restrictions. What I like to think of as a course that's very experienced or very interactive is just now a bunch of people sitting in their bedroom. This is vexingly, this whole thing and I'm finding myself quite stressed about it. Who or what is important? For me, I would say, well, the students are really important. Ultimately, the clients are really important, that's why we're training all these therapists and education is important to me and also connection. I've got two sets of people, students, clients, and then I have two values of mine, education and interpersonal human connection. That's what I would write in that box. Let's give you a moment and in the context of your situation that you want to go through here, who or what's important to you? Just make a couple of notes in there. Usually the briefer, the better. Don't overthink it. Respond to that question in a way that feels right to you.

Just a side note here for a moment talking about values, if this helps you think about what's right. Values are things that are freely chosen. They reflect your desires rather than demands. So, something that you want to do rather than things that you ought to feel that you should do. They act as a stimulus for reinforcing action so it's not something that you can enact. I can enact the value of education by teaching. Teaching is like the goal although the value of education is different. Value indicates a general direction in life rather than just the destination. I'm imagining many of you have values of helping other people. Training to be a counsellor is one way of enacting that value but it's not the only way. Once you know that helping people is important and there is all sorts of different ways that you can act on that. From holding a door open, helping someone cross the road, sending someone a supportive text message, all sorts of different destinations on that journey of helping people. Value is a very mindful process, I think and unlike goals, which are usually either ahead of you or behind you, a value isn't something that you need to wait around for. It's always with you. Helping people is just in you. You might have a plan or a goal to help a particular person later in the week, but the value of helping is always present. Largely they're independent of the context. Helping people always matters. Education always matters to me and it wouldn't really matter where I am, I'm always keen to help people learn things. I don't have to justify it. You don't have to justify your value of helping people. It's one of those sorts of those 'just because' things. There's no particular answer as to why it just is. We might prioritize at certain points in our life. We might choose helping people over other things or we choose other things over helping people because the context may influence it to some degree.

Ok, so back to our diagram. It is fast becoming my catchphrase and I think it's probably the thing I might have put on my gravestone at some point, not too soon, I hope. It's this little saying that in your pain, you find your values, and, in your values, you find your pain. We hurt and care about the same things and usually in a highly correlated way. The people that we care about the most are usually the people that drive us up the wall the most and the people that it would hurt most if you lost them. I think it's Queen Victoria that said, I think that grief is the price you pay for love. The more you love someone, the more it's going to hurt when you lose them. Values and pain are all tied up together. That's the sort of rationale for this next question. Thinking back in the context of whatever you wrote in that first box there, what is that uncomfortable stuff that shows up sometimes and pulls you away from the things that matter? Going back to my example. I care about my students. I care about their clients. I care about education and connection, but what I'm noticing at the moment because I care about those things is that I'm getting a lot of thoughts like this course is rubbish. It's so unfair that these students are in this cohort, the Covid cohort, the course isn't good enough. The experience is poor for them and they don't get a chance to interact. This reflects badly on me as a course lead. Maybe the work they do with clients isn't very good. I notice myself feeling anxious, stressed, guilty. That's the kind of stuff I'd put in this box. Uncomfortable thoughts and feelings and sensations that show up in the context of me caring about the students and their clients and education and connection. So, have a think for yourself, what's the difficult stuff that shows up in the context of you caring about the things you put in that first box? If it helps, there's a little mnemonic which I often use with clients to sort of cover all the bases. Times and thoughts, images, memories, emotions, sensations. You don't have to take them all, it's not like bingo, but it's a little checklist of the kinds of unwanted sensations that you experience in the context of caring about the things in the first box. Let's give you a moment to write something down.

This is one of the weird things about doing things on the internet is that in a classroom I would see you scribbling away a lot of reinforcing feedback that people are on task. I don't know that not and I just sit with the uncertainty. It's another example of my value of education showing up as a sort of bit of discomfort. Yeah, that's like two sides of the same coin. We hurt and care about the same things.

So, next box here, we're moving from the internal stuff to the external the observable. I put a little 1930's film camera there just to remind you. Look at those people reinforcing me. Ruth says I'm on task. Wendy says I'm writing away, loving this. That's great. Thank you. That's good. Some reassurance.

Right, so the question here is when all of that difficult stuff is showing up inside of you, the times, the thoughts, images, memories and emotions, sensations, when all of that is kicking off, what would we actually see you doing? Go with that sort of CCTV documentary film crew analogy, what would we see you do when you're struggling with all of that? Just to illustrate is my personal example. When I'm thinking all of those things, I'm stressing about the quality of the course and I'm feeling anxious, what I've noticed that I do a lot of is I try and read all of my university briefing emails to get up to speed with the university's pandemic plans. I read those kinds of slightly obsessively and I watch the news a lot and keep up with the latest developments to see what's happening with the universities or what's happening with the Birmingham area where I live. I talk to my partner, stress about it and none of it's in a very helpful way, but it's helpful in the sense that it sort of makes me feel better in the short term, but I think there's a cost to it, which I'll come back to in a minute. I do this stuff because it sort of makes me feel better and as I'm worrying about the quality of the course, I convinced myself that I'm informed and I know what's going on and what the university's plans are, it reassures me in the short term. I'm not sure it gets me very far in the long run, but yes. Just have a think for yourself. So, when all of that stuff in that bottom left corner there is going on, all of those difficult thoughts and sensations, what would we see you do in your behaviour? What do your avoidance moves look like? Have a little moment to fill that in.

I think I'd like to invite you to notice, before we progress to the last box there, is that however good those things might be at sort of turning down the volume on the distressing stuff in the second box, I wonder how good they are at connecting you with what's in the first box? When I think of myself and those examples, so there's me obsessively reading emails or watching Boris Johnson on the news, how much of that is really about education and connection? How much of that really serves my students and my clients? I think it might be good at helping me deal with the discomfort, but how close does it bring to my values? I have to say, not close at all. In fact, it's almost like the polar opposite. What's going on with me is just I'm stressing on my own, not connecting with anyone, not really contributing to anyone's education, not really doing anything in the service of my students or their clients. It's really just about me feeling better. There's nothing intrinsically wrong about that, you know, why wouldn't I make myself feel better? It's just that there's a there's a cost to it and the cost of making myself feel better in the short term has to be weighed up against what direction I want to take my life in the long run.

When we get to this point, I would invite you to be self-compassionate at this point, we're assessing the function of the away moves. You do that for a very good reason. You go on Facebook for a good reason, which is because it helps you feel better in the short term, or at least it avoids the distress. It's a way of you turning down the volume on the bad stuff. Away moves are a valid option, there's nothing intrinsically wrong with it. If I think back to a couple of years ago, I had quite a bad time personally and I was quite depressed and I had that thing that I read about in books where I got up one morning and I just didn't get up, I couldn't get up and that kind of thing where nothing was moving and there was absolutely no way, I was going to turn in for work, so I had a week off. I took a week off sick for mental health reasons, which was quite a big thing for me to do, but it was absolutely the right thing to do. It was in a way all about me turning down the distress and the discomfort and I needed to do it. There's nothing intrinsically wrong about that but if I was still doing it two years later, I don't think my life would be rewarding. It's kind of about learning when to move towards, when to move away and to choose well. I think that is the point here. It's not like just give yourself a hard time for your away moves, you probably do this for very good reason. It's just that I would invite you to be kind about it of active and be kind about those decisions. Sometimes whilst there you might not think it's your proudest moment, but maybe it's what you need at the time. This is the self-compassion to counter and people get a bit confused with ideas of having to blame themselves or being self-critical and I want you to make room for a non-judgmental approach to this.

Box four then. So, if you weren't being driven by the discomfort and you weren't doing things at all about avoiding the discomfort and if you were being driven by your values, if you were being driven by the things in that first box, what would we see you do then? How would that be different? Maybe we do see that on the good days. So, going back to my example, I think on the better days when I'm being driven by education connection, I'm reaching out to the students and finding out how they are. For example, the things I've agreed to do this week is put on an extra tutorial ahead of assignment and that's about connecting and perhaps helping them to allay some of their fears, reassure them, give them some more information about the assignment. It's a thing that's not in the timetable. It's an extra thing we're putting on. That feels much more like a value driven move that will help and much more in keeping with sort of how I want to be. I don't have a real way of getting rid of the anxiety, I don't think. I'm just going to take my anxiety with me into that tutorial and I'm going to choose to behave in a way that's consistent with my values rather than behave in a way that's all about just turning down my distress.

So, over to you. I will give you a moment to think about what's in that top box there. If you were acting in a way that's really consistent with the things you wrote in that first box, what would that look like? Again, same CCTV camera idea. What would we see you doing?

A question here is are these slides going to be on the counselling tutor website? I think that's a question for Rory. I'm certainly happy for you to have them. You can have them and distribute them as you wish. They'll be uploaded on Thursday.

Just a little reminder here for those using this with client's, anything above the line is all about observable behaviour, it's actions, rather than intentions. People can't write things like 'I'd be more confident' because that's not that's not really observable. The question would be, if you were being more confident, what would we see on the CCTV?

Hopefully this slide might help with your question about what to put in box four. What kind of actions or behaviours would we see you doing if you were being driven rather by getting away from the distress and turning down the bad stuff, if you were being driven by turning up the good stuff, if you were acting in a way that was consistent with your values? Whatever you put in the first box there, what would that look like? It's towards me and that's what I said right at the top of the presentation. That's what we want to see in that box, things that are driven by you moving towards what you want, and it is things that are intrinsically reinforcing.

One space in the middle. The question to pose to you about this middle box is who's the one person in the world that's got the helicopter view of all this? So, who's the one person in the world who knows really well what it is that matters to you and what's important and who also knows what the difficult stuff is that shows up and gets in the way when you try and act on things that are important? The one person in the world who knows the choices that you have, that you can either do things that are about reducing your distress, or you can do things that are about moving towards the kind of life that you want and who that person is.

It's me or it's you. I'm the only person really that's got the helicopter view here and so are you in terms of your stuff, you're the only person who has got that overall view and can make those choices. That’s there got it me. Absolutely.

ACT is about kind of helping people to tune in to take a sort of cross section and look at this whole situation. What do I care about? How am I hurting? What are my behavioural choices in this moment? What would be the thing that would help me most? Should I make a towards move in this moment or should I make an away move? Should it be some kind of mixture of both? How am I going to respond to this particular context that I find myself in?

That part of me that we're thinking about here is there's that part of you that's sort of in contact with the present and having a helicopter view. It's the sort of me that is distinct from the stuff I think or feel. It's like, I'm the thinker, not the thought. It's that bit of me that's the 'noticer', so if I can notice my stress and my anxiety, I can also choose how to respond to it. Maybe I can't choose whether to be stressed or anxious, that stuff just happens, but I can choose how to respond to that. I can choose to respond to it in a way that's all about just getting rid of that stress and anxiety often in a way that sort of makes my life a bit small or I can choose to sort of notice and accept that I'm feeling stressed and anxious and take a value driven choice anyway. Jenny's got it there like an observer perspective, the observing self or sometimes in Buddhism, this is known as a transcendent sense of self. It's the difference between the sky and the weather, so to speak. The sky is the place where the weather happens and however bad the weather gets; the sky never gets damaged. The sky is like a container for the weather just like I am the container for my thoughts and feelings. It's tuning into that part of us that can make those choices.

A few questions, I'm just going to rattle through these, but you can answer these in your head as I ask them. All those away stuffs, has what you've done to get rid of the unwanted stuff worked? Has it worked? Does it go away? Has it helped you move towards what's important to you? Certainly, for me the answer is no. It doesn't help me at all. It helps me feel a little better in the short term, but it doesn't help move towards what's important to me in the long term. What towards moves or away moves has stopped you from doing? What could you have been doing with your time? Instead of doing all that away stuff. Has it got in the way of you acting in a more constructive way? What would the person you would want to be do? You know, you on a good day and the best version of you. How would that person act in this situation? Could you move with the times? So, coming back to this idea of those uncomfortable thoughts, images, memories, emotions, sensations, could you have all of that and still make a towards move and make a value driven move? Even when your body is saying, no, no, I can't, I can't, I'm too stressed or too anxious, is it possible to still go and do things that matter? Take your anxiety with you, move with the times.

There is a good question. If you think about all that stuff in blue there, what would you have to give up caring about in order to never experience this suffering? What would I have to give up caring about, in order to guarantee that I never had to thoughts like, is this course good enough? Am I doing the best for the students? Are they getting the best experience? Are they learning enough? What would I have to give up caring about in order to never have that? The answer, of course, is I'd have to give up caring about education, I'd have to give up caring about them. Is that a choice I want to make? I often think that about education and I thought about that tonight, I could pitch up with probably a 10-year-old PowerPoint somewhere and I'll just present that or read off the slides and I won't put any effort into it. I won't give any myself to it. I bet my anxiety about tonight would've disappeared. I was quite anxious about tonight, anxious about the fact that it goes well because I care about education and I thought if I just decided 'I don't care whether anyone learns anything or not, Rory will just pay me anyway and I never have to see him again. I could give up caring about any of that. I'm sure I'd be much less anxious.' The question is, is that where I want to be?

If the suffering was merely the cost of the valuing could you just choose to pay the cost in order to pursue what you value? So, like, every time I do some teaching, I get anxious because education matters to me. Now, what I've come to understand, I think for me certainly is that anxiety is just like the price tag of caring about education, so I am happy to have it and you know what? I kind of think that if I go and do some teaching one day and I don't feel at all anxious, then that's probably the day to go and get another job, because I think that's the day, I would have given up caring about it. Yasmin says it's hard to switch that off. It's hard to switch that off. I think it's impossible to switch it off to be honest. If you care about it, it will make you anxious or stressed, or it will be the thing that gives rise to guilt or low mood or whatever. I just think that's part of the deal. Sometimes I will ask clients and maybe I will pose this question to you, think of something that you were really proud of. If you were going to die tomorrow, you could turn around and say, well, you know what, at least I did that. I'm really proud of that. I bet you that whatever that thing is, it's been a difficult journey. It's been a difficult road, something that has given rise to a lot of stress and most people when I ask them that question, they answer with things like, bringing up my kids, learning to drive, getting my degree, my career, surviving childhood abuse, overcoming a difficult illness. The proudest moments in our lives are the things that hurt. They were difficult and I don't have a healthy way of separating that out. I just think that is how it is so it's really about, is it worth it? You've got to figure out. What are the things that are worth suffering for? That's really the only thing we've got to sort out.

The last question is, what do you see as you look at it now? Has this been helpful? Does it point your way forward? Does it say to you that I need to be clear on my values? Does it say to you, I need to do a better job of caring for myself? Does it say that I've got some different choices I could make? I can always choose. What I would like you to go away with is just sort of noticing that you're in the middle. You can always see what's going on here and those things that distress you are just the price tag of the things that you care about. Once you know that, you can figure out what's the most helpful way forward, maybe rather than seeing the discomfort as the automatic cue to go and do a bunch of avoidance, you can see it as the automatic cue to choose whether to do a bunch of avoidance or take a valid towards step in your value direction. That's it really. It's just about how can you choose more wisely and how to navigate this difficult thing called life.

Ok, it has come to the time. I said I was going to wrap up just about there. If you're interested in how the ACT model maps on here, The Matrix is looking at things in this way. We started out thinking about values. We then moved on to thinking about all the difficult thoughts and feelings you get stuck with. Encourage some acceptance of that. That one is the cost of the other and looked at the various things you do to get rid of the discomfort and the actions that you could take that would take you towards your values.

I'm not going to go through these, but these are a bunch of useful questions. They are just on the slides, if you're trying to elicit content for each one of those boxes, won't go through that now but it's for you look at in your own time.

That's me done. Those are my contact details. My website and email address there. Then you can follow me on Twitter. One of the things I always think about ACT is like a value driven thing. If you think something is useful, then tell other people about it. That's why I'm on Twitter. This is a useful model that's really helped me in my professional life and personal life. If it's helped you then tell someone else about it.