CBT for Panic, Acceptance, and Commitment Therapy Flashcards
(16 cards)
How would someone interpret fear responses if they had panic disorder?
They misinterpret their body sensation as catastrophic:
- “omg my throat is closing I am going to choke”
- “omg my hear is beating so fast I am going to have a heart attack”
What do people with panic disorder do to alleviate their panic?
safety behaviours: breathing slowly, doing a ritual, going to the emergency room
avoidance patterns: avoiding anything that can trigger these responses (ex: a location)
Solution to panic disorder:
Interoceptive exposures: making the body sensation happen on purpose to change the interpretation of it
- it is actually pushed very far
- let go of the brick wall and kick it down!
ex: do exercises to get the heart going fast to bring on that sensation
- to learn new information about he sensation you must pass the limit and not use safety behaviours like holding your heart and leaning aginst a wall
Acceptance and Commitment Therapy
- A behavioural therapy with a focus on values
- Has a few different approaches that can help with the interaction of peoples thoughts, emotions and behaviours to get unstuck
thoughts in head that may or may not be true
ex: about to go into a social situation and thinking that you must control what you will and won’t say or else others will think you’re weird
ex: belief: I can’t trust anyone at all, or myself, or anyone who looks like this (PTSD)
what does ACT focus on?
Metaphors - it’s easier to understand concepts through a story
They are about what our relationship should be with our thoughts, feelings, behaviours
- There’s a part of you that generates thoughts but then there’s a part of you that can watch yourself generate thoughts
Bus Driver Metaphor
You’re driving the bus and the passengers on the bus are part of you ( thoughts, feelings) shouting at you where to go
- Ex: fear might be shouting at you: “don’t go down that road it’s really dangerous”
- Ex: thought: “you’re going to have a terrible time at that party tonight”
What makes you decide where to steer the bus?
You are the only one allowed to drive the bus, only you have control (behaviour)
- Sometimes you do listen to them and go where they tell you to
- BUT sometimes your values help you decide where to steer the bus, we want to increasingly have a behaviour under the control of values vs. just under the control of emotion with no disconnect from behaviour AND we don’t want to be dominated by our thoughts (many of which are false but can determine our behaviour
Uninvited guest at party metaphor:
Thought or feeling you wish you weren’t having right now = uninvited guest
To escape that, most of the time people use substances and safety behaviors (suppression, distraction) - doesn’t work
ACT says: You can have a fight with that guest or let them stay and sit in the corner and pull up a chair for them
- can’t control if they’re at the party
- can control if you look at them the whole time, stop playing a game, don’t talk to someone you wanted to talk to, etc…
- do the activities that are guided by your values, the guest will leave eventually, and come back, and go again
When an uninvited thought sits in your bus or shows up to your party…. Cognitive fusion vs. cognitive diffusion
Cognitive fusion: “this thought is me:”
Cognitive defusion: “no I’m the thing that’s observing the thought”
Techniques in ACT to help us engage in cognitive diffusion - to remind us that the thought is not us
- state the thought (“i notice i’m having the thought that i’m a failure”)
- say it in a silly voice
- sing it
- say it slowly
- repeat it quickly over and over again
- write it down
- bus metaphor
- thank your mind for the thought
- think “who’s talking here?”
- how old is that story? - it’s not important, don’t get hooked
- name the story: “its the blank’s a failure story” - anytime it comes up just think “AHA, there’s the … story again!”
additional ACT techniques for diffusion:
PRAGMATISM: Ask yourself—If I believe this thought, where does it take me? Is it useful?
WORKABILITY: Does this thought help me build the life I want long-term?
INSIGHT: Notice how this thought influences your behavior. What changes when you buy into it?
PROBLEM SOLVING: Your brain is doing its job—solving problems. But not all solutions are helpful. Assess whether this thought helps long-term.
COMPUTER SCREEN: Visualize the thought on a screen—change fonts, animate it—make it look silly or distant.
YOUR MIND IS LIKE…: Use metaphors to see your mind differently—like a “doom and gloom” radio or a “judgment factory.”
MEDITATIVE: Let thoughts drift by like clouds or passing cars—no need to grab onto them.
INTERESTED: Simply observe: “That’s an interesting thought.” No judgment or reaction needed.
BULLYING REFRAME: Imagine the thought as a bully. Do you want it controlling your actions and life?
high vs. low reactance:
high reactance: likely to not listen to others and do what they say
low reactance: likely to listen to others and do what they say
“Getting Hooked” activity:
takes you through a triggering event and walks you through what your mind said to hook you, how your behaviour changes once you were hooked, what were the costs of getting hooked, could you unhook yourself and how?
ACT metaphor for values and goals
Imagine a map that you’re using to navigate through life and on the map there are specific locations which are your goals (ex: finishing my degree), but there’s also directions on the map which is the value (compass bearing) and you can make a decision in any moment to walk in one direction or another, you can’t make a decision in any moment to achieve a goal, you can walk towards them but you don’t get to control whether or not you achieve it
Example:
- Value: engaging in meaningful relationships - can walk towards this
- Goal: getting married - may not achieve this (don’t have control)
Examples of ways to walk towards values (humour, love, assertiveness)
humour: watch or read something that you find uplifting or hilarious once a week.
love: Spend quality time with loved ones without distractions for at least one evening a week.
assertiveness: identify one personal boundary to set or reinforce each week, and communicate it clearly when needed.
Workability
Helps examine behaviours:
- is this behaviour helping you to have a rich, full life that grabs you? Is this helping you move toward being the person you want to be?
is this helping me travel towards my goals:
ex: drinking a lot before going to a party could be to have a positive emotion, feel less anxious
but workability forced you to ask a question of, is it the BEST solution?
