Using Language to Heal in Therapy Sessions

For the last couple of weeks we’ve been talking about some of the ways language can play tricks on us and cause suffering, as well as how, alternately, it can be used to our benefit in therapeutic settings. And last week, we discussed mindfulness as one technique that allows the therapist to use language in an experiential way.

Another example of an experiential technique most commonly used in acceptance and commitment therapy is defusion exercises, which often consist of recontacting the nonarbitrary characteristics of verbal stimuli. For example, repeating a word very quickly for thirty to forty seconds decreases the meaning carried by an originally nonarbitrary sequences of sounds. In more general terms, the client is led to perceive that a word is just a word and not the actual event it refers to. Hence, reactions to words evoking danger (e.g., “death”) or fostering rigidity (e.g., “I have to”) can become more flexible. Exercises focusing on the present moment, for example, consist of directing attention to breathing. Since breathing always takes place in the present, this helps clients undermine the control exerted by language when it takes them to the past or to the future, away from present sources of satisfaction or the actual consequences of their behavior.

Self-as-context exercises offer a technique for targeting a specific kind of verbal skill,and often involve observing oneself from another point of view through imagination. This puts clients in contact with the distinction between fleeting descriptions of the self and a more permanent perceptions based on a continuous perspective. Interestingly, some experiential exercises in ACT aim at increasing verbal control over direct contingencies. In this case, the goal is to elaborate a network of verbal relations establishing a connection between a discrete event or action and meaningful but distant or abstract consequences. For example, clients may be asked to set an alarm randomly, notice what they’re doing each time the alarm sounds, and observe whether that action is connected to a value in an important doman of life. If the alarm sounds in the middle of a conversation with a friend, for instance, a client might notice that this action is in a relation of hierarchy with his value for connection in relationships—talking with a friend is part of what he does to be close to his friends.

Such exercises can be helpful for clients who have difficulties connecting with what makes their actions meaningful in the moment, especially if the consequences of these actions are abstract and may never be directly contacted. For example, making time for her children might be aversive for a parent who is devoted to her work, but she can establish a relation of hierarchy between being there for her children and the abstract concept of “being a good parent.” She can also establish an if-then relationship between “if I raise my children well” and the distant consequence that she may never actually contact: “they will have a happy adult life.” As a consequence of such increased awareness, the client might be more able to engage in concrete actions directed toward her values, strengthening the probability that these actions will remain in her behavioral repertoire. This is particularly useful when engaging in valued actions brings about painful emotions. For example, while expressing one’s feelings to a partner may enhance intimacy, it may also trigger anxiety. In this case, verbally connecting with what matters (intimacy with one’s partner) can change the meaning of the immediate aversive experience: feeling anxious becomes a sign that one is moving toward intimacy.

Next week we’ll start discussion of metaphors, an additional—and in fact, crucial—tool in helping clients undermine the negative effects of language.