ACT = PSYCHOLOGISCHE FLEXIBILITEIT

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1 ACT = PSYCHOLOGISCHE FLEXIBILITEIT

2 Positieve Psychologie
Beck’s Cognitieve Therapie PERMA Model van Seligman Oplossingsgerichte Therapie Veel technieken zonder theoretisch model en theorie Kracht-gebaseerde Benaderingen Acceptance & Commitment Therapy

3 C G T Acceptatie & Commitment Training Beck’s Cognitieve Therapie
Gedragsactivatie Veel andere Compassie gerichteTherapie Mindfulness Based Cognitive Therapie Functional Analytic Psychotherapie Exposure met response prevention Motivationeel Interviewen Dialectische Gedragstherapie Prolonged Exposure Integratieve partnerrelatie geragstherapie Metacognitieve Therapie Rationieel Emotieve Therapie Acceptatie & Commitment Training Schema Therapie

4 Toepassingen van ACT Angst (per specifieke angststoornis meer evidentie nodig, goed alternatief voor andere bewezen behandelingen) Depressie (verschillende studies geven evidentie aan, meta-studie: ACT is effectief) Verslaving Pijn (APA evidence based 2014) Psychose (4 RCT’s ACT minder depressie, betere levenskwaliteit) Autisme Epilepsie Diabetes Agressie Kinderen en jeugdigen (het weinige onderzoek duidt op effectiviteit bij uiteenlopende klachten) Ouders van kinderen met ontwikkelings- en of psychische problemen (pilot onderzoek is veelbelovend) Verstandelijke beperking (weinig toegepast) Preventie (zelfhulpprogramma’s Bohlmeijer)

5 Wat is ACT? Accepteer wat je niet kunt beinvloeden en doe iets wat waar je invloed hebt Actief Vaardigheden leren Krachten en kwaliteiten ontwikkelen Verduidelijken wat belangrijk voor je is Oefening baart kunst

6 Flexibel perspectief innemen
Wees Hier Nu Open jezelf Weet wat er toe doet Neem waar wat je denkt Doe wat nodig is Flexibel perspectief innemen

7 ACT: twee basisvragen Welke richting wil de cliënt op?
Wat zijn de obstakels?

8 ACT: twee basisvragen Welke richting wil de cliënt op?
Wat zijn de obstakels?

9 ACT: twee basisvragen Dus we kunnen beginnen met
V:Welke richting wil de client op? • waarden verduidelijken • doelen stellen & toegewijd handelen

10 ACT: twee basisvragen Of we kunnen beginnen met:
V: Wat zijn de obstakels? • Fusie=> Defusie • Vermijding=> Acceptatie • Automatische piloot=> Bewustzijn/ toewijding

11 ACT: twee basisvragen Bij crisis en paniek: begin met aarden en contact met hier en nu Bij rouw en verlies: begin met zelfcompassie

12 Pl ease take the time to answer these questions for yourself
Pl ease take the time to answer these questions for yourself. If you can't answer them, you are highly likely to run into difficulties doing ACT with your clients. Why? Because you are the best person upon whom to practice ACT. And if you are not applying ACT to yourself, in your own life, (at least to some extent), then you are not likely to be able to apply it well with others. When you are applying ACT to yourself, you should be able to readily answer the questions above. And the beauty is, you can then use these answers to help explain why values are important to your clients. Indeed, in some situations, you might want to share this information with your clients. When we share how living by values has been useful for us, it often inspires and motivates our clients Values are useful because they help you to clarify or remember what sort of person you want to be, and what really matters in life.  They help you to set meaningful goals and do meaningful actions, that give your life a sense of purpose and fulfillment. They provide inspiration and motivation, to do the things that make your life richer and fuller When you let your values guide what you do, you feel a sense of meaning or purpose; or you feel like you're being true to yourself. Values help you to cl arify what sort of relationship you want to build - and how you want to behave in those relationships; how you want to treat yourself and others. Your values are like a compass: they guide you through life. They help you stay on track, and find your way again when you go off track. If you want to make your life richer, and fuller, you need to know what sort of person do you want to be? What do you want to stand for in life? How do you want to behave, deep in your heart? How do you want to treat yourself, others and the world around you? Your values are the answers to these questions. Values help you to be true to yourself; to behave like the person you really want to be; to do the things that really matter to you. If you want to break any self-defeating habit or any type of behavioural pattern that is destructive to yourself or others, you need some inspiration and you need some motivation; your values will give you both.

13 Waarden als professional 100e verjaardag
Waarden oefeningen Waarden als professional 100e verjaardag

14 Waarden oefeningen Zoet moment .
Denk aan een moment dat gevuld is met iets van de rijkheid en de zinvolheid van het leven Bijvoorbeeld: liefde, genegenheid, of een simpel plezierig moment. Maak het levendig, maak ruimte voor alle gevoelens, etc. Vertel het simpel, wat zie je, hoor je, voel je? Alsof je het nu beleeft

15 Waarden oefeningen Zoet moment
Wat zegt deze herinnering over wat jij belangrijk vindt? Welke persoonlijke kwaliteiten liet je zien? Hoe behandelde je jezelf en anderen? Wat suggereert dit over de manier waarop je je wilt gedragen, of over waar je van houdt, om te doen om vooruit te gaan?

16 Waarden Gewenste kwaliteit van gedrag Hoe je diep in je hart wil zijn
Waarden zijn als een kompas, ze geven richting, helpen je om op koers te blijven Doelen versus waarden: huwelijk versus liefhebben Waargericht leven versus doelgericht leven Waarden zijn niet: doelen, wensen, behoeften, ethiek, moraal, gevoel, regels, opvattingen

17 Waarden Waarden zijn hier en nu, doelen in de toekomst
Waarden hoeven niet verantwoord te worden Waarden moeten vaak wel geprioriteerd worden Waarden kunnen we het best lichtjes hanteren Waarden zijn vrij gekozen In ACT komen waarden eerst en dan doelen Als waarden duidelijk zijn volgen doelen: korte termijn en langere termijn

18 Een andere manier om om te gaan met gevoelens en gedachten?
Bij een ‘nee’ ga je door met creatieve hulpeloosheid Geef oefeningen in: * Acceptatie * Defusie * perspectief innemen* Hier en nu

19 Acceptatie . Stap voor stap
Identificeer de problematische gevoelens/emoties/sensaties Normaliseer Identificeer gevolgen van automatische piloot en vermijding Automatische piloot/vermijding is het probleem Nieuwe mogelijkheid . Step-by-step: Acceptance 1. IDENTIFY ‘PROBLEMATIC’ FEELINGS/EMOTIONS/SENSATIONS • Identify them • Where are they? What are they like? • Name them • Validate & normalise them 2. NORMALISE. • Life is painful • The ‘reality gap’ • Inevitability of fear/anxiety when you step out of your comfort zone • Psycho-education on emotions • Q: How would you expect someone else to feel under these circumstances? 3. IDENTIFY CONSEQUENCES of AUTOMATICITY & AVOIDANCE. • When you get pushed around by these feelings, how does your behaviour change? • If I was watching on a video, what would I see or hear? • And what happens after that? And then? And then? • And how does that impact on your life? • When you get into a struggle with these feelings – what happens? • Do you ever try to get rid of them? What sort of things do you do to make them go away? • How long do they go away for? • And do those strategies have any long term drawbacks/costs/side-effects? 4. AUTOMATICITY/AVOIDANCE IS THE PROBLEM • So when these feelings show up, either they push you around/control you/ hold you back/ bring you down … • or you get caught up in a struggle with them, which in the long term makes things worse. • And the more that happens, the more you get you stuck, the harder life gets. 5. NEW POSSIBILITY. • I don’t know how to stop painful feelings showing up. Everybody has them. • But I do know a different way of responding to them .. • So that when they show up, you don’t have to get caught up/ pushed around/ overwhelmed by them … • And you don’t have to struggle with them or fight them, either. • It’s a new way of handling painful feelings, so they have much less impact and influence over you. • It’s radically different from everything else you’ve tried. • Would you be interested in learning how to do that? HEALING HAND SOFTENING THE CHOICE TO FEEL COMPASSION THE STRUGGLE SWITCH ALLOWING EXPANSION METAPHORS THE CURIOUS SCIENTIST PHYSICALIZING NORMALIZING NOTICING BREATHE INTO IT THE OBSERVING SELF

20 Acceptatie . Helende hand Zachter worden De keuze om te voelen
Compassie De vechtschaal Toestaan Ruimte maken Metaforen De nieuwsgierige wetenschapper Verobjectiveren Normaliseren Opmerken Er naar toe ademen Het observerende zelf HEALING HAND SOFTENING THE CHOICE TO FEEL COMPASSION THE STRUGGLE SWITCH ALLOWING EXPANSION METAPHORS THE CURIOUS SCIENTIST PHYSICALIZING NORMALIZING NOTICING BREATHE INTO IT THE OBSERVING SELF

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23 FUSIE Eenzijn (versmelten) met cognities & Letterlijk nemen van taal
Hierdoor ontstaan obstakels

24 FUSIE/DEFUSIE 1. Bepaal ‘problematische’ gedachten
2. Bepaal de gevolgen van fusie 3. Fusie is het probleem 4. Normaliseer negatieve gedachten 5. Geef nieuwe mogelijkheden 1.IDENTIFY ‘PROBLEMATIC’ THOUGHTS • What does your mind say to you about that? • When your mind wants to beat you up/ hold you back/ bring you down, what kind of things does it say to you? • If I could listen in, what would I actually hear inside your head? 2. IDENTIFY CONSEQUENCES of FUSION. • When you get hooked by these thoughts, what happens? • How does your behaviour change? • If I was watching on a video, what would I see or hear? • And what happens after that? And then? And then? And then? • And how does that impact on your life? 3. FUSION IS THE PROBLEM. • So when you get hooked by/pushed around by/ caught up in/ fused with these thoughts, they have a big impact on you. • The more you get fused/hooked/caught up/pushed around by them, the more stressed you are, the more you get you stuck, the harder life gets. 4. NORMALISE ‘NEGATIVE THOUGHTS’ • These are perfectly natural thoughts that most people have • My mind is very much like your mind • Psycho-education: how the mind evolved to think negatively 5. NEW POSSIBILITY. • I don’t know how to stop your mind from generating those thoughts. • But I do know a different way of responding to them, so that when they show up, you don’t have to get all caught up in them. • You don’t have to struggle with them or get pushed around by them. • Would you be interested in learning how to do that?

25 FUSIE/DEFUSIE Pragmatisme Interesse Meditatief Je geest is als een …
Pesten etiket Probleem oplossen Opmerken De klassiekers Ziektewinst Vorm en plaats Computerscherm Inzicht Naam geven aan het verhaal Bruikbaarheid PRAGMATISM If you go along with that thought, buy into it, and let it control you, where does that leave you? What do you get for buying into it? Where do you go from here? Can you give it a go anyway, even though your mind says it won’t work? INTERESTED That’s an interesting thought. MEDITATIVE Let your thoughts come and go like: passing clouds; cars driving past your house; etc. YOUR MIND IS LIKE ....  a “don’t get killed” machine  a word machine  radio “doom and gloom”  a masterful salesman  the world’s greatest story teller  a fascist dictator  a judgment factory BULLYING REFRAME What’s it like to be pushed around by that thought/belief/idea? Do you want to have it run your life, tell you what to do all the time? PROBLEM SOLVING This is just your mind problem solving. You’re in pain, so your mind tries to figure out a way to stop the pain. Your mind evolved to solve problems. This is its job. It’s not defective; it’s doing what it evolved to do. But some of those solutions are not very effective. Your job is to assess whether your mind’s solutions are effective: do they give you a rich and full life in the long run? WORKABILITY If you let that thought dictate what you do, how does it work in the long run? Does buying into it help you create a rich, full, and meaningful life? THOUGHTS THE CLASSICS I’m having the thought that ... Say it in a silly voice. Sing it. Say it very slowly. Repeat it quickly over and over. Write thoughts on cards. Passengers on the Bus Metaphor. Thank your mind for that thought. Who’s talking here: you or your mind? Leaves on a Stream Exercise. How old is that story? SECONDARY GAINS When this thought shows up, if you take it at face value/go along with it/let it tell you what to do, what feelings, thoughts, or situations might it help you avoid or escape from (in the short run)? FORM AND LOCATION What does that thought look like? How big is it? What does it sound like? Your voice or someone else’s? Close your eyes and tell me, where is it located in space? Is it moving or still? If moving, in what direction and at what speed? COMPUTER SCREEN Imagine this thought on a computer screen. Change the font, color, and format. Animate the words. Add in a bouncing ball. INSIGHT When you buy into this thought, or give it all your attention, how does your behavior change? What do you start or stop doing when it shows up? NAMING THE STORY If all these thoughts and feelings were put into a book or movie, titled “the something something story,” what would you call it? Each time this story shows up, name it: “Aha, there’s the XYZ story again!” NOTICING Notice what your mind is telling you right now. Notice what you’re thinking. THE OBSERVING SELF Take a step back and look at this thought from your observing self.

26 DEFUSIE uitleggen van handelingen gedachten als reflexen
je hoofd bedanken handen voor de ogen de zonnebril ik heb de gedachte ... melk melk melk gedachten en gevoelens benoemen buschauffeur demonen op de boot cellofaan defusie gedachten als pop-ups hersenen als probleemmachine die zich verveelt

27 Perspectief innemen

28 ZELF als context oefening:
Observator oefening Kijken naar object oefening Ik merk nu op dat ik opmerk oefening Erna: welk deel van jezelf was telkens hetzelfde? Els als observator.10 minuten bij elkaar inclusief nabespreken

29 Kan niet als een ‘ding’ of ‘object’ ervaren worden Zuiver bewustzijn
Zelf als context Kan niet als een ‘ding’ of ‘object’ ervaren worden Zuiver bewustzijn

30 Observerend zelf metaforen
Schaakbord Wolken in de lucht Soepkom en ingrediënten

31 Kenmerken van bereidheid en toewijding
Bereidheid is springen Ruimte maken voor je gevoelens Jan de zwerver Bereidheidfocus versus barrièrefocus Commitment Exercise PART 1 Pick a value of high importance that you have been neglecting or have lost touch with. My value(s) is(are) to be ... What I’ve been doing that’s inconsistent with my value(s) is .... What that has cost me is ... (Think of relationships, health, wasted time, wasted money, emotional distress, etc) PART 2 My commitment is to take the following action(s). (Be specific: specify when will you do it - day, date, time - and what will you actually do) .... In order to do what I value, I am willing to make room for (accept and defuse) the following thoughts, images, feelings, urges, memories & sensations: I am willing to make room for thoughts & images such as: I am willing to make room for emotions/feelings such as: I am willing to make room for sensations in my body such as: I am willing to make room for urges to: I am willing to make room for memories such as:

32 ACT-EMDRcentrum.nl Cursussen en trainingen
Docent en trainer: Peter Balde