Understanding the Shortcomings of Words

What does the word defusion mean? According to John Blackledge, PhD, acceptance and commitment therapy (ACT) researcher and author of Cognitive Defusion in Practice: A Clinician’s Guide to Assessing, Observing and Supporting Change in Your Client, the fundamental message is that words do not capture absolute truth, and that the words that increase our suffering are therefore not binding.

From this perspective, it would seem that any brand of psychotherapy that implicitly or explicitly acknowledges that our thoughts and impressions contribute to our problems might be able to make use of defusion strategies. But defusion is more relevant to certain types of therapy. Constructivist treatments, for example, actively target the role we play in constructing the narratives of ourselves and the world around us, seeking to deconstruct problematic narratives and build more adaptive ones. Defusion could be of great help in deconstructing an old narrative, and could also make new narratives more flexible and continually adaptive.

Other, more “postmodern” approaches to therapy could also benefit from the use of defusion strategies, since such strategies may help weaken the hold of prescribed yet problematic ways of thinking. Existential therapists have acknowledged the vital importance of a struggle for meaning in a world where meaning is not etched in stone. Defusion strategies might help an existential therapy client realize that even the thought “Life has no meaning” is suspect, and that meaning arises in the vitality of living and embracing life.

Defusion could play a role even in treatments where the notion that words are misleading does not take center stage. A psychodynamic therapist working toward her client’s emotional insight could use defusion to help the client unhook from troublesome interpersonal appraisals learned in past relationships and problematically applied in current ones. A humanistic therapist helping a client see and accept himself as he is could use defusion to cut through his negative self-evaluations and thoughts about who he should or must be. And a Gestalt therapist could use defusion to help a client become more reliant on her direct experiences and less reliant on verbal interpretations, especially those interpretations that cause problems.

The rationale and caveats for using defusion techniques in conventional cognitive behavior therapy apply to other forms of therapy as well. Therapists who adopt a position that thoughts cause behavior and must be changed for psychological progress to occur will likely send counterproductive mixed messages to clients if they use defusion techniques. Therapists who assume that thoughts do not need to change prior to behavior change, who make this assumption consistently clear to the client, and who do not use other techniques in a way that implies that thought change is a necessity may well be able to successfully integrate defusion into their practice.

For all of these reasons, we’ve decided now is a good time for an in-depth exploration of one of six core principles of the ACT model, defusion, within the broader context of a range of psychotherapy modalities. Stay tuned during the next few weeks for more on defusion and helping clients create distance between themselves and the stories they tell themselves.