BN#50: Why People Change: The Most Important Skill in Mental Health and Wellness

One of the most important studies in the history of psychology, yet most people, even therapists and coaches, don't know about it.

From ACT Public Forum, posted by Steve Hayes, May 22, 2022

Key Points:

1. Psychological flexibility is the most important skill in mental health. It accounted for about 55% of the reasons why people change and when you add up similar attributes—it could be argued, it makes up to 85%-90% of the mental processes of why people change.

2. After examining 54,633 psychological studies (i.e. all the mediational studies up to 2019) to determine why people change, the results were published in August 2022 by Steven Hayes et al (the founder of Acceptance and Commitment Therapy-ACT). This study can be found here. Summary article here: https://stevenchayes.com/the-most-important-skill-set-in-mental-health/

3. It is one of the most important studies in the history of psychology and I believe the largest meta-study that has ever been undertaken. This is often called the “DeathStar Project” (ala Star Wars) because it took 4 years and up to 50+ people working on this project to complete it and for its importance.

4. Psychological flexibility is about 3 main things: greater awareness, openness, and values-based engagement in life.

5. Psychological flexibility can also be defined by the 6 main skills of ACT: 1. Self as Context (your observer or True Self) and 2. Present Awareness—Mindfulness (1 & 2 for greater awareness); 3. Cognitive Defusion and 4. Acceptance (3 & 4 for openness); 5. Values and 6. Commitment (5 & 6 for values-based engagement in life).

6. Financial planners/advisors and entrepreneurs (I have observed in my own practice) are very good at values and commitment (getting things done i.e. having a successful financial practice). However, they are average or below average in self-as-context, awareness, cognitive defusion, and acceptance. This accounts for much of their trouble with relationships, their sense of being overwhelmed, and not feeling fulfilled despite their external success.

7. A major part of greater awareness for Psychological flexibility begins with your observer or True Self which is a higher level of awareness that opens up an advanced set of mental and emotional such as those used in Acceptance and Commitment Therapy (ACT).

8. This new study provides immense support for my True Self Mind Mastery framework. I had already adapted using the ACT model, as one of the 3 stools of my work (Internal Family System and Positive Intelligence being the other two), within the Process Based Framework (PBT). This study now indicates that these ACT tools used in my program are THE most important tools to help someone change.

9. Because the results were published only in August 2022 — most people do not know that psychological flexibility is the most important skill and will probably not know for another 10 to 20 years, which is how long it takes for studies to go from lab to general knowledge. Now that you know, you can do something about it including taking a psychological flexibility assessment.

The Death Star Project

“It turned out to be a huge effort that took the work of nearly 50 people over the next four years to complete. We jokingly called it the “DeathStar Project” because, just like the space station in the Star Wars movies, the project was gigantic, took forever to build, and (we hoped) would have a major impact on how we think of psychotherapy. 54.633 studies were each rated twice to see if the analyses were properly done.

Initially, it appeared a bit over 1,000 of these were in the running, but as we kept digging in more fell away (for example, we put aside studies in which one outcome mediated another). To get at the core findings we focused on process measures that were replicated at least once in our database. We ended up with 281 clear findings using 73 different measures. Finally, a couple of weeks ago, the results of one of the largest reviews I’ve ever seen attempted appeared in the well-known journal Behaviour Research and Therapy.”

“We can now say with certainty that psychological flexibility is the single most commonly founded skill of importance to your mental health and emotional well-being (emphasis added). Whether you suffer from anxiety, depression, addiction, or any other kind of mental distress; psychological flexibility helps you deal with these issues more effectively, and move your life in a meaningful direction.”

Above From: https://stevenchayes.com/the-most-important-skill-set-in-mental-health/

The Importance of This Study

“ACT is the public face an attempt to distill down processes of change into the smallest set that does the most good in the most areas. (bolded for emphasis in this blog)

We just finished a review of the entire world's literature on processes of change….We looked at every randomized trial for every psychosocial intervention method for any mental health related outcome ever done anywhere that used the accepted gold standard method of determining the functionally important pathways of change (that is, they used a statistical method called "mediational analysis") --and claimed to have  found a positive answer in their particular study to the question "why did this work?" 

…If you take only the measures obviously related to psychological flexibility (regardless of the specific words people use to describe their measures) and combine the finding for acceptance, defusion, values, mindfulness, self-compassion, behavioral activation, being excessively sensitive to and avoiding anxiety, etc) what percentage of the world's high quality  knowledge about how to change is captured? What percentage of successful findings are in that small set of processes ACT is focused?

The graphic (above with the elephant in this article) shows the answer. 55%

The next biggest group was social support / interpersonal functioning / therapeutic alliance etc and then entanglement with negative thoughts (both low teens); then health practices (8%); self-efficacy, or believing you can change (5%); and a smattering of small things each around 2%.

Mind you, most of the others are friendly enough to ACT (I can explain why ... but that is for another day).

I think a broad ACT perspective can get to 85-90% without breathing hard and to nearly 100% if you give me 5 minutes to walk thru why.

So, look, when you look around at things that are reasonably helpful to people —spiritual traditions, clinical traditions, peer support traditions like AA, and so on and on --virtually ALL of them will look a bit ACTy in some areas. Why? Because people are people and how change happens is not nearly so complicated as our minds, or the 1,001 specific methods out there suggest. 

We worked on the basic processes that sit underneath these flexibility ideas…in this case, trying to understand why it was so hard to be human.”

From a comment by Steve Hayes, the lead researcher of the DeathStar Project and founder of ACT, to the ACT Public Chat Group, May 22, 2022.

Psychological flexibility is considered to be the most important mental health skill for a few reasons. Why?

First, it is the ability to adapt to and cope with the demands of the environment, and to adjust one's behavior in response (E + R = O, event + response = outcome) to changing circumstances. This means that it is a key factor in the ability to handle stress, adapt to change, and maintain overall well-being.

In Canfield’s success model, the number one factor is taking 100% Responsibility for your life. This means that you are responsible for your response to the events that happen. We cannot necessarily change the event, we are 100% responsible for our response. Psychological flexibility is a major factor in how we respond.

Second, psychological flexibility is closely linked to emotional regulation. It allows individuals to experience difficult emotions, such as sadness, anger, and anxiety, while still being able to function and engage in meaningful activities. This is important because it allows individuals to acknowledge and validate their emotions, rather than repressing or denying them, which can lead to negative outcomes.

Being able to accept our feelings and thoughts and then moving toward what matters to us is different than what is normally done. Many times, we try to avoid our experiential experiences or the avoidance of uncomfortable thoughts, feelings, and experiences, instead of having acceptance of what is. In avoiding it, we not only experience the pain but also suffer.

Third, psychological flexibility is also associated with resilience, which is the ability to bounce back from adversity. Research has shown that individuals who possess higher levels of psychological flexibility tend to be more resilient, and are able to recover from stressors and setbacks more quickly.

Finally, psychological flexibility is also associated with better physical health. Studies have shown that psychological flexibility is linked to healthier immune function, better sleep, and improved overall physical health.

In summary, psychological flexibility is considered the most important mental health skill because it enables individuals to adapt to the demands of their environment, regulate their emotions, build resilience, and maintain physical health.

The Psychological Flexibility Model: Aware, Open, and Actively Engaged

“The “hexaflex” concept in Acceptance and Commitment Therapy (ACT). The six core processes of ACT are listed at the six corners of the hexagon. The four processes on the left are taken to be mindfulness and acceptance processes; the four on the right are commitment and behavior change or behavioral activation processes. All six working together are “psychological flexibility.” Pairs of processes can be grouped into the response styles Open, Centered, and Engaged. This figure is a combination of the Figs. 3.2 and 3.3 in Hayes et al. (2012)”

Journal of Neural Transmission, June 1, 2022 in article by Dijkstra, Johannes and Nagatsu, Tshiharu)

The ACT Hexaflex Flexibility Model

The ACT hexagon model of psychological flexibility (as seen in the diagram above) is a theoretical framework that depicts the six key processes that constitute psychological flexibility. These processes are categorized into three overarching pillars: awareness, openness, and engagement.

The awareness pillar involves two processes: contact with the present moment and self-as-context.

The openness pillar involves two processes: acceptance and defusion.

The engagement pillar includes two processes: values and committed action.

These processes are interrelated and interdependent and can be depicted as a hexagon to illustrate how they work together. The six processes form the points of the hexagon, with the central point representing psychological flexibility. The model suggests that by cultivating these six key processes, individuals can enhance their psychological flexibility, leading to greater well-being and more fulfilling lives.

Pillar 1: Awareness

The first pillar of psychological flexibility is awareness. This is called in the hexagon model in the picture above “Centered” aka Awareness. Awareness involves observing, first, what is happening in the present moment, such as thoughts, emotions, and bodily sensations. Second, this requires experiencing them from a spiritual aspect of oneself, known as the witness or noticing a sense of self, or self-as-context. I call this spiritual aspect of Self your True Self or observer Self.

In my True Self Mind Mastery Program, the Positive Intelligence app program is used to train the brain to have increased awareness via PQ reps and also how to get into self-as-context mode which PQ calls Self-Command mode/Sage Mode.

Present Moment Attention (be here now)

Merely describing the present moment with words is insufficient, as it requires one to attentively experience it. It's akin to describing the flavor of an orange versus actually tasting it - the latter is far more enriching than the former. Rather than being caught up in one's own thoughts, awareness involves living in the present moment, and it also involves intentionally directing, expanding, or focusing on various aspects of one's experience.

Moreover, this awareness comes from the part of an individual that links them with others in consciousness. Building greater awareness begins with developing flexible, fluid, and voluntary attention to the present moment.

Some of these exercises include:

a) Attentional training exercises. E.g. focus on the soles of your feet and then gradually shift from one foot to the other, and from either foot to both feet.

b) Meditation exercises. E.g. focus on your breathing, in and out.

c) Wheel of Awareness. E.g. Daniel Siegel’s Wheel of Awareness.

Self-as-Context (Your Observer or True Self—pure awareness)

Relational Frame Theory (RFT), the fundamental theory for ACT, suggests that awareness stems from the "I/here/now" perspective. Self-as-context entails the cognitive relations of person (I/You), place (Here/There), and time (Now/Then). Instead of focusing on the conceptualized self (such as "I am a good person"), which can lead to judgmental distinctions between oneself and others, ACT emphasizes the perspective-taking sense of self (self-as-context) that links an individual's sense of awareness with that of others.

The conceptualized self, also known as the false self, comprises self-narratives and comparisons to others. It is often characterized by cognitive fused verbal descriptions and evaluations of one's identity, qualities, and how they relate to others. Statements such as "I am unlovable" or "I am in a gifted and talented class" exemplify characteristics of the conceptualized self.

I believe that the True Self is a fundamental shift in consciousness and is the most important factor in creating true transformation. I wrote about the True Self in a previous article here (Discovering my True Self Changed Everything for Me). Also, see below for further comments.

Pillar 2: Openness - Cognitive Defusion and Experiential Acceptance

The second crucial aspect of psychological flexibility is being open. This entails accepting difficult thoughts and painful emotions as they are, without feeling the need to alter them before moving forward toward the life you desire. This can be challenging to comprehend as people typically seek therapy to eliminate negative thoughts and feelings, but the mind doesn't work that way.

In fact, the more you try to push away the pain, the more it can dominate your life. Instead, being open is about relinquishing the internal battle and permitting thoughts and feelings to exist as they are - simply thoughts and feelings - without allowing them to control you. Interestingly, in this open state, thoughts and feelings often shift in a more positive direction.

Cognitive Defusion (watch your thinking)

In the initial stages of developing processes for change in Acceptance and Commitment Therapy (ACT), the focus was on modifying or decreasing cognitive control over behavior, specifically the influence of thoughts, to better align with the client's current objectives.

This was achieved through the use of "cognitive defusion" techniques that helped enhance cognitive flexibility by reducing unwanted thoughts without altering their form or frequency, which is typically done in Cognitive Behavioral Therapy (CBT). Conversely, cognitive fusion was believed to be the opposite of cognitive defusion and a contributing factor to the constriction or development of psychopathology.

“unlike CBT (Cognitive Behaviorial Therapy), there is little emphasis in mindfulness-based cognitive therapy on changing the content of the thoughts; rather, the emphasis is on changing awareness of and relationship to thoughts.” (Mindfulness-Based Cognitive Therapy: Theoretical Rationale and Empirical Status. Segal, Teasdale & Williams, 2004, emphasis in bold). Defusion is one main skill that allows one to have a different experience. In other words, third-wave CBT therapies emphasizes context (thinking about thinking) versus the content (what is the meaning of the thought). Steven Hayes article.

For example, sometimes I do not want to have a shower before going to bed. Rather than get into figuring out why I do not want to have a shower and what it means, I look at my thoughts like a casual observer. “Oh, that’s interesting, a Part of me doesn’t want to have a shower.”

“OK. Well, it is just a thought and while the Part of me doesn’t want to have a shower, there is no danger or reason why that Part of me doesn’t want to have a shower”, says the observing True Self. However, I value being clean (being healthy) before I go to bed, so I will move towards my value of being healthy by having a shower. “I will let that thought of not having a shower, just float away, and have a shower, as I move into the shower and take a shower.”

Some of these cognitive defusion methods are:

a) distilling an unhelpful thought down to a single word that is repeated rapidly aloud until it loses its meaning. E.g. try to say “I am unlovable” and kept repeating “unlovable” faster and faster and faster.

b) singing a difficult thought, or saying it in the voice of a cartoon - e.g. try to say “I am not enough” and sing it with a Mickey Mouse voice

c) rewrite your life story several times while maintaining the facts and emotional reactions but changing the storyline itself. E.g. In PQ, we find the gift of inspiration, knowledge, or power in every event/story, even adverse events. Think of a past difficult event for you and find the gift in that event.

d) describing one’s inner voice as an advisor that one may choose to listen to, or disregard, depending on what builds value. E.g. in Jack Canfield's and Clear Belief’s training, we have learned to turn our inner critic into our inner advisor.

Experiential Acceptance (accept what is - open up)

As individuals frequently utilize reasoning and private experiences (such as anxious thoughts) as justifications for their actions (such as avoidance), Acceptance and Commitment Therapy (ACT) have aimed to reduce the significance of reason-giving and experiential avoidance, instead promoting an enhanced capacity to tolerate or acknowledge psychological occurrences, including emotions, memories, or bodily sensations, without resulting in negative behavior. Conversely, experiential avoidance was considered to be the opposite of experiential acceptance and a potential cause of restriction or the development of psychopathology.

Some of these experiential acceptance methods include:

a) Use of rationales, metaphors, and exercises for emotional openness. E.g. A classic ACT metaphor is viewing struggling with anxiety much as one would viewing struggling in quicksand.

b) Graded emotional exposure is a therapeutic technique commonly used in Cognitive Behavioral Therapy (CBT) to help individuals gradually confront and overcome their fear or anxiety toward a particular object or situation.

For example, a person who has a fear of heights may start by looking at pictures of high places or watching videos of people doing activities at great heights. Once the person is comfortable with this level of exposure, they may progress to standing on a balcony of a building, and eventually, to climbing a ladder or going on a rooftop.

By gradually increasing the level of exposure in a controlled and supportive environment, individuals can develop the necessary skills to manage their anxiety and fear and eventually face the object or situation that previously caused them distress. This technique can be effective in treating various anxiety disorders, including phobias and post-traumatic stress disorder (PTSD).

c) Social sharing of feelings. E.g. After the death of loved ones or trauma, most people would like to share their emotions or feelings with others.

d) Deliberate deepening of emotional experiences. E.g. Treat feelings as objects and ask in detail about their size, color, shape, or temperature. This is often also an exercise done in somatic experience i.e. find in your body where you are feeling those emotions. Describe the size, color, shape, material, movement, etc.

Pillar #3 Valued Engagement

The third and final pillar of psychological flexibility is valued engagement. It looks at your motivation (values in ACT) and behavior (commitment in ACT). This means knowing what is most important to you, and taking steps in this direction. It involves being in contact with your goals – objectives you want to reach or achieve – and your values – those personal qualities you choose to manifest and be guided by, regardless of a specific outcome. These matters need to be freely chosen, rather than being forced on by others, or mindlessly followed out of custom. But once you have clarity about what matters, you can take action to build sustainable habits that make your life more about what gives it meaning. I like to think of this pillar as taking action toward what is most important to you.

Values (know what matters)

Values refer to chosen qualities of being and doing that establish intrinsic consequences for behavior. In RFT terminology, values are a type of "augmental" - verbal constructions that modify the function of events as consequences. For example, a behavior can be augmented with the statement, "I may find this exercise boring, but it will keep me fit and let me play sports with my daughter," thus transforming the negative consequence into a positive one. Several RFT studies have demonstrated the efficacy of augmentals in promoting behavior change (Paraphrased From Death Star Study).

This pillar is considered the "heart" of the ACT model as values provide the driving force for the rest of the model, establishing intrinsic reinforcers. Values are qualities of action, expressed as adjectives and adverbs, such as behaving lovingly, genuinely, honestly, creatively, kindly, and so on. Even brief interventions focused on values can have long-lasting effects.

In clinical practice, various methods can be employed to work on values, such as:

a) exploring significant moments,

b) identifying role models,

c) affirming values,

d) recognizing desires within painful experiences,

e) experimenting with new activities to identify preferences, and

f) taking ownership of one's life story.

Steve Hayes, founder of ACT has a free ACT toolkit that contains experiential ways of practicing ACT. This can be found here. One of the easiest and best is the Writing your Story. The description of this exercise is copied below. In happiness studies, just by writing your study for one year in advance has been shown to increase your happiness.

Writing your Story Exercise

Imagine that the next year is going to be a key year in defining who you are in your life. If you were to become more fully you during this year, while at the same time still supporting those you care about, what would your process of “becoming more fully you” look like over this next year? Where do you wish to grow? What kind of person are you yearning to be? If you were writing the chapter of the next year of your life, what would the theme be?

Now that you have the set, do 10 minutes of writing about the next year and what you hope to become.

Commitment (do what it takes)

The engagement pillar also involves committing to building increasingly larger patterns of values-based action. Committed action is a clearly defined behavior or activity that is measurable and aligns with an individual's chosen values, with the aim of establishing persistent habits. This is where the actual implementation of values takes place, and it is essential in moving towards a valued life. Committed action has been studied in various contexts, including procrastination, chronic pain management, and depression.

Therapists working with individuals on committed action may use a variety of behavior change strategies, such as:

a) publicly sharing goals,

b) setting achievable goals that represent incremental steps towards larger goals,

c) gaining social support,

d) using creative values triggers to remind individuals of their commitments, scheduling activities, tracking progress, anticipating barriers and benefits to achieving goals, and more.

These strategies are rooted in a broad range of research on behavior change.

Tiny Habits, Atomic Habits, Power of Habits

In creating change of habits, perhaps the best book to read is Atomic Habits by James Clear, which is really based on the combining the work of The Power of Habit by Charles Duhigg and Tiny Habits: The Small Changes That Change Everything by B.J. Fogg.

Charles Duhigg, in his book "The Power of Habit," identifies a habit loop that consists of three steps:

1. Cue: A trigger or a signal that tells your brain to go into automatic mode and which habit to use. This can be a specific time of day, a location, an emotional state, or an action by someone else.

2. Routine: The behavior itself, which can be physical, mental, or emotional.

3. Reward: The outcome that reinforces the habit and tells your brain whether this particular loop is worth remembering in the future.

Duhigg argues that by identifying and understanding the elements of the habit loop, individuals can intentionally create new habits or change existing ones. He suggests that individuals can modify their habits by experimenting with different cues, routines, and rewards until they find a combination that works for them.

The "Tiny Habits" formula for creating new habits is:

1. Start with a tiny habit: Choose a very small, specific behavior that you can do in less than 30 seconds, such as flossing one tooth or doing two push-ups.

2. Find a trigger: Choose a trigger, or an existing routine in your day, that will remind you to do the tiny habit. For example, doing push-ups after brushing your teeth.

3. Celebrate: Immediately after completing the tiny habit, celebrate your success in some way. This can be as simple as saying "I did it!" or giving yourself a high-five.

By starting with a tiny habit and attaching it to an existing routine, you make it easier to incorporate the new behavior into your daily life. Celebrating the completion of the tiny habit also reinforces positive feelings associated with the behavior, making it more likely to become a lasting habit.

The "Atomic Habits" formula for building effective habits consists of four steps:

1. Cue: Make the desired behavior obvious. This can be done by creating a visible reminder or setting up a specific environment that triggers the behavior.

2. Craving: Create a positive association with the behavior by linking it to a reward that you enjoy. This will increase your motivation to perform the behavior.

3. Response: Develop a specific action plan for the behavior. This plan should be simple, clear, and easy to execute.

4. Reward: Provide an immediate reward for performing the behavior. This will reinforce the habit and make it more likely to be repeated in the future.

By following these four steps and consistently repeating the desired behavior, it becomes easier to turn it into a habit that becomes automatic over time.

I believe James Clear added an important part that is not emphasized. In order to create a major change, you need to first change your self-concept or belief of who you are (self-identity). For example, a smoker who is quitting will say: I am a smoker trying to quit. A non-smoker will say: I am a non-smoker. You need to change your identity.

When I first read Atomic Habits, I was living in Taipei and I wanted to start running. So, my trigger or cue was to lay out my running gear beside my bed before going to sleep, so that when I woke up, I would see it first thing and put on my running gear. I also said I was a runner. It worked like magic. That is when I really understood the power of creating habits using these research techniques.

The ACT Hexaflex InFlexibility to Flexibility Model

I understood the ACT Hexflex model best when I learned about the Inflexibility model. This is just the opposite and the presenting issues that most people face when they have not learned the skills or processes of the ACT model i.e. when people are psychologically inflexible.

This is presented below illustrating psychological inflexibility and movement towards psychological flexibility.

Psychological Inflexibility

The ACT hexaflex model highlights six key areas that can be impacted when individuals are psychologically inflexible.

The first issue is experiential avoidance, which refers to the tendency to avoid or suppress uncomfortable or unpleasant thoughts, feelings, and experiences. This can lead to emotional and psychological distress, as well as a diminished quality of life.

The second issue is cognitive fusion, which involves becoming overly attached or fused to one's thoughts and beliefs, and losing perspective on reality. This can lead to rigid and unhelpful patterns of thinking and behavior. This is the area where I find that most people have difficulty unfolding because their core beliefs of I am lovable, I am enough (self-worth), I am safe, and I am whole are all compromised.

The third issue is living in the past or future (anxiety) or a lack of present-moment awareness, which involves being disconnected from the present moment and becoming caught up in worries about the future or shame/guilt/sadness of the past. This can result in an inability to fully engage in the present and can lead to feelings of dissatisfaction and disconnection, anxiety, and depression.

The fourth issue is an excessive attachment to the conceptualized self, which involves being overly focused on one's self-concept and identity and becoming preoccupied with self-evaluation and self-criticism. This can lead to a lack of self-compassion and self-acceptance, as well as difficulties in interpersonal relationships. This of course is the majority of the population. We all have had little “t” traumas and this leads to the separation of us from our True Self and begin to identify with our “mask” or saboteurs.

The fifth issue is a lack of direction or lack of values clarity, which involves not having a clear understanding of one's personal values and what matters most in life. This can result in a lack of direction and purpose, leading to feelings of emptiness and dissatisfaction.

The sixth issue is inaction or being stuck from a failure to take committed action, which involves not taking meaningful steps toward achieving one's goals and values, due to fear or avoidance. This can result in a sense of being stuck or stagnant in life.

Taken together, these issues can contribute to psychological inflexibility, which can lead to a range of negative outcomes in life, including increased stress, anxiety, and depression, as well as difficulty in relationships and a lack of fulfillment in life.

Conceptualized Self, Masks, and Core Wounds

For example, instead of being our True Selves, when we are psychologically inflexible we are what is technically called seeing ourselves as Self-as-Content. In my terminology, I like to use conceptualized mind or Conceptualized Self. The Conceptualized Self is the stories we make up about ourselves. The biggest story is normally the masks we use to present ourselves to the world to hide our core wounds.

In my case, my masks (Positive Intelligence identifies as saboteurs) were to be hyper-rational (i.e. look very smart) and hyper-achiever (try to hit the goals everyone else had set as a sign of success i.e. be a millionaire). Underneath my mask was Little Mark whose core wound was “I am damaged and a failure” and “I am dumb (literally and figuratively) and stupid”. The mask and my core wound were what I created for my self “concept” or my conceptualized self of who I was. This I now know is NOT me. I am the observer, not my self-image or self-concept or conceptualized version of myself. My True Self is much more and provides me with a limitless range of possibilities.

The shifting of my self-identity to being my True Self versus my conceptualized self often occurs when we are conscious and then work on shifting our thoughts and behaviors based on our True Self versus our conceptualized self. This shift involves building new neural pathways (done in True Self Mind Mastery via PQ app) and then rewriting our stories (using primarily Internal Family Systems, Clear Beliefs, and RIM in True Self Mind Mastery (TSMM)), and then learning new skills to be psychologically flexible (by learning the ACT based skills in the TSMM Program).

Stuck or Inaction to Committed Action

Similarly, those who are psychologically inflexible are often Stuck/Inaction and not moving towards what is important to them. Often to get to Committed Action, one often needs other psychological flexibility skills to help to move towards what matters.

How Psychologically Flexible Are You?

Acceptance and Action Question: AAQ-2

The AAQ-2 is the most frequently used measure of psychological flexibility. An average score is about 18, and a score of 24 to 28 normally indicates anxiety or depression possibilities. The lower your score the better.

The ACT Advisor

In my practice with permission from David Chantry (the creator), I use the ACT Advisor, which provides not only an overall score but pretty accurately measures the 6 individual components. What is important is not the absolute score for each skill, but how well the person is progressing.

Assessments will be Available in a Free Assessments Workbook at www.markhughsam.com

Sample ACT Advisor Score in Process-Based Therapy (PBT) Framework

In process-based therapy which looks at the underlying processes that create change, there are 6 categories looking at the human mind: self (spiritual), cognition (mental), attention (awareness), affect (emotions), behavior, and motivation. In addition to the human mind, there are processes that affect biophysical (the body—sleep, eat, move, recovery) and sociocultural (relations with people), and context (the environment surrounding the person).

In each of the 6 categories of the human mind, there is an ACT process. So under Self, there is an ACT process called self-as-context. Under Cognition, there is an ACT process called Defusion (Cognitive Defusion), etc.

Note that under each PBT Category, you can have other none ACT processes. For example, in Cognition, you have cognitive reappraisal which is one of the main processes used in cognitive behavior therapy.

Financial Planners and the Hexaflex Model

True Self Mind Mastery (TSMM) is a process focused on improving the overall performance of individuals by increasing their ability to change their behaviors. Therefore increasing psychological flexibility is especially important to change their behaviors.

In TSMM, we normally do a before and after ACT Advisor score. This means their psychological flexibility or their ability to make changes.

Below is a typical real-life example taken from the booklet “James Case Study” (study will be posted shortly here).

The increased psychological flexibility generally shows up in how their saboteurs are running their life, which for the James case study can be seen below.

Generally speaking, successful financial planners know what matters (Values) and are able to do what is important to them (Behavior). Therefore on the outside, financial planners often are materially very successful (money, material possessions, etc.).

On the inside they silently struggle with burnout, feeling unfulfilled and broken relationships. They normally need work in the other 4 categories: Self-as-Context, Defusion, Mindfulness, and Acceptance.

Interestingly, some of the other externals also change. In the last month, two clients have now lost 20 pounds and 30 pounds after not losing weight for the last 20 years. Also, two clients have had their blood pressure medication significantly reduced as their “stress” levels have dropped.

My favorite stories are those that are able to do things that they have not been able to do for years such as reconciling and improving relationships or figuring out processes in their practice in one week that they have not been able to fix for years.

ACTION ITEMS:

1. Take the ACT Advisor Assessment: See Above.

2. Take the PQ Saboteur Assessment https://www.positiveintelligence.com/saboteurs/

3. Create a plan to increase your psychological flexibility and immediately improve your mental health and your life.