Institute 7 - Healing the Soul: Using ACT-CI to Promote Personal Growth in Times of Personal Crisis

As the COVID-19 pandemic crisis has taught us, no one is safe from the “slings and arrows of outrageous fortune”. A crisis, by definition, demands that we respond in new, flexible ways that not only can help us “weather the storm”, but also can open the world up to us in ways not thought possible. Indeed, the Greek root of the word crisis literally means “turning point”. However, the urge to avoid and escape emotional discomfort is a constant threat to this rare opportunity for personal growth and transformation. In this institute, participants will learn the basic clinical principles of ACT-CI (ACT for Crisis Intervention), a brief, focused approach that emphasizes the important role that mindfulness, acceptance and life engagement play in the healthy resolution of a life crisis. ACT-CI is based in the psychological flexibility model as well as the precepts of predictive coding theory, a neuroscience account of human emotions. In this approach, emotions are thought to signal a discrepancy (or synchrony) between the client’s mental model of the “desired and expected” world, versus what is actually in the world. Social rules, norms and mores transmitted via language form the prior learning basis for our mental models of what is desirable and expected in the world (i.e., freedom from unwanted change, ability to control suffering). Avoidance and escape strategies function as ineffective attempts by clients to make the world fit their prior mental model (i.e., crisis instigation), whereas the processes of acceptance, mindful being and life engagement allow clients to change their mental models to more closely fit the world (e.g. crisis integration). In this institute, we will demonstrate how to help clients in crisis be mindfully aware of, and accept their intense bodily sensations and “feelings. We will show how to help clients make genuine contact with who and what matters to them in life and use the crisis as “fuel” to propel them towards what they value and aspire to in life. The clinical challenge, which we will explore on multiple levels using role play demonstrations, experiential exercises and skill practice, is to calmly and compassionately insert these three transformative processes into the clinical conversation with clients in crisis.

Outline:
1. An ACT consistent model of crisis formation and instigation
a. Over-identification with the literal meaning of emotional experience
b. Emotional and behavioral avoidance as self-amplifying processes underlying crisis
c. Emotions as “signals” rather than “reality”
d. Loss of bodily awareness

2. Predictive coding theory and human emotion
a. How the brain gets ahead by predicting the immediate to distant future
b. Interoception as the basis for alerting the organism to threat and safety cues
c. Crisis level emotions as indicators of predictive coding gaps
d. Resolving gaps as the overriding purpose of emotional experience
e. How avoidance leads to a destructive form of resolving predictive coding gaps that elongates the crisis response

3. The role of acceptance, life-engagement, moderated by increased mindful awareness, in crisis integration
a. Acceptance allows the person’s “mental model” to be changed to fit the world
b. Engagement promotes agency to resolve predictive coding gaps in a healthy way
c. Mindful awareness and mindfulness of the body are central mediators

4. Developing mindfulness of the body during a crisis is central to resolving gaps
a. Guidelines for sequencing mindfulness of the body during a crisis session
b. Role play demonstration
c. Dyadic skill practice in mindfulness of body sequencing during a crisis session

5. Introducing acceptance as a way of explaining and resolving a predictive coding gap
a. Using acceptance “talk” to reshape the client’s mental model of the world
b. Legitimizing emotional anguish as the “flip side” of closely held personal values
c. Pain is inevitable; suffering is optional

6. Promoting a sense of personal agency at time of life crisis using values
a. The essential link between values, predictive coding and human emotion
b. What is the call to action in response to this emotional experience
c. Role play demonstration of using acceptance and life engagement going hand in hand
d. Dyadic skill practice in integrating acceptance and values “talk” during a crisis session