If you use any technique that involves helping clients untangle themselves from the stories they tell about their lives and struggles and realize that their thoughts are not absolute truths, you run the risk of invalidating their subjective experience.
Helping clients defuse from their thoughts, if not conducted in proper fashion, can be easily misinterpreted to mean that you think your client’s particular story is not true. Giving a client the impression that you doubt her ability to correctly identify the facts in a life that she has lived a long time and that you are just getting familiar with typically does not bode well.
Defusion techniques can seem to trivialize a client’s distress if used in a cavalier fashion. Imagine asking a client, in the first session, to sing his most distressing thoughts to the tune of his favorite pop song. A deep sense of invalidation might well result. The effectiveness and appropriateness of more invasive defusion techniques depend on a good therapeutic relationship in which the client knows that the therapist empathizes very well with him.
Clients should understand the rationale behind the idea that it’s important to defuse from their thoughts. They should understand that the misleading character of words and thoughts is not a personal shortcoming, but something we all grapple with.
Attempting to change the way another person thinks about his experiences tends to be a default mode for human beings. We are all taught from a young age to try to think about things accurately and rationally, and this sensibility may seep into our therapeutic work even when we use a theoretical approach to treatment that does not explicitly aim at thought change. One example of this tendency might occur when we encourage a client to “make sense” of what has happened to her in a way that either provides comfort or that “allows” her to move forward in a relatively constructive manner. While it is certainly nice to find an “accurate” and relatively constructive way of thinking about your difficulties, it might be counterproductive to send the message that you must arrive at such a way of thinking to move forward. From a defusion perspective, thoughts do not have to change in order for constructive movement to be made. They simply need to be held lightly.
A similar example might involve clients believing they must have insight into exactly why they have their current psychological problems before they can rise above them. While knowing some causes of our problems can be beneficial (for example, when an ongoing contributor to distress and disability can be identified and changed), often the perceived causes are rather distant and immutable. We generally believe we must have thoughts that accurately capture the reality of what caused our current situation. Yet from a defusion perspective, many of these thoughts are simply part of a semi-fictional narrative—a narrative which may make sense, but which is not necessary for moving forward through our current problems. Regardless of which variation of the need and the effort to have the “right thoughts” arises in therapy, the “necessity” of those “needs” should explicitly be held lightly by both therapist and client if defusion strategies are in use.
Otherwise, the central message defusion is intended to convey—that the problematic and distressing thoughts we struggle with are not absolute truths and do not need to change—can be undermined.
For more, check out Cognitive Defusion in Practice: A Clinician's Guide to Assessing, Observing, and Supporting Change in Your Client.