Q&A: John Blackledge, PhD, author of Cognitive Defusion in Practice, Part Two

Editor's note: The following is the second half of a two-part Q&A with John T. Blackledge, PhD, international ACT trainer, associate professor in the department of psychology at Morehead State University in Kentucky, and author of Cognitive Defusion in Practice: A Clinician’s Guide to Assessing, Observing, and Supporting Change in Your Client. Access part one here.

When we defuse from verbal rules about how we “should” and “shouldn’t” behave, do we enter into a territory of moral relativism in which nothing is truly “right” or “wrong”?

That’s certainly a possibility. If moral and ethical rules aren’t Absolute Truths etched into the fibers of the universe, then why do we have to obey them? This is actually an issue that transcends ACT. It’s essentially a tension between the belief that ethics and morals are handed down from on high and are thus inviolable truths, and the belief that ethics and morals are socially constructed. If you view ethics and morality as a social contract that we enter into because treating others well (and being treated well) matters to us, then defusion is counterbalanced by values. Why should I be kind to others and try not to hurt them just because my mind says I should? Because it feels meaningful, vital, and important for me to do so, as it does for so many others when they get into contact with their direct experiences. There’s a section on this issue in Chapter 2 of the book. It’s a very interesting and very important issue to think about. A resoundingly recurrent experience amongst ACT therapists I’ve talked to is that they have not seen their clients (or themselves) use defusion for “evil.” That’s why it’s important to link it to values. When you dig down, humans are, with some exceptions, prosocial creatures. Certainly, as an ACT therapist, you would not want to facilitate antisocial behavior on the part of your client, even if he truly valued it. But I’ve not yet met an ACT therapist who has been faced with that dilemma. 

How does practicing present-moment awareness help with defusing from thoughts and language?

Thinking is not as vivid and tangible as living in the moment. The more you practice directly experiencing the world with your five senses—and pulling yourself back to the moment after your train of thoughts pulls you away—the more you realize how much more real the present moment is. You can actually touch it, see it, smell it, hear it, taste it. You can’t do any of those things with your thoughts. Well, you can see them written down and hear them being spoken, but even the process of noticing those written words as scratches on paper and hearing those spoken words as audible sounds is different than unknowingly buying into them and viewing them as comprehensive facts. Essentially, it comes back to what the construct of defusion is. When you’re in the moment, you’re approaching your thoughts from a different perspective. When you’re not carried away by them, they are simply one more thing you are noticing. That’s not normally how we view our thoughts—and because that’s not normally how we view our thoughts, it helps us defuse from them.

Because so much overlap exists between experiencing a sense of self-as-context and defusing from language, is it even necessary to clearly distinguish between self-as-context and defusion techniques with clients?

I don’t think it’s necessary at all to help clients distinguish between the two sets of techniques. In fact, I (and most ACT practitioners) don’t even use the terms “defusion” or “self-as-context” with clients. It’s much more important just to help them have the experience of defusion and a sense of self-as-context, with all of their benefits—and to use techniques that invoke them when they need them. 

Across the range of scientific definitions of mindfulness, what is mindfulness, essentially, and how does it differ from or fit into the definition of defusion within ACT?

Lindsay Fletcher and Steve Hayes wrote an article years ago that defined mindfulness as the confluence of increased contact with the present moment, acceptance, defusion, and self-as-context. So, you could say that defusion is a component of mindfulness, but it’s more than just defusion.

Defusion strategies run the risk of invalidating a client’s subjective experience—what are some ways practitioners can avoid conveying the message that they think their client’s story is simply untrue?

First and foremost, the client has to know you’re on her side, and that you really understand and empathize with the struggle she’s going through. You can imagine how invalidated a client might feel in the first session, for example, if she disclosed heartfelt feelings of hopelessness only to have the therapist flippantly say, “Okay, let’s say ‘hopeless’ over and over for a minute and see what happens.” The example points to another way you can keep defusion techniques from being invalidating. I think it’s often important, at least at first, to introduce the use of a less-subtle defusion technique (as discussed in the “Laying the Foundation for Defusion” chapter). After empathizing with a distressed client, for example, I might say something like: “If you’re willing, I’d like to try something that might help us look at this problem from a little different perspective, and see what happens.” If the technique is particularly odd, I might even add something like, “It may seem a bit odd at first, but there’s a method to my madness.” If a client isn’t clear that you are empathizing with him, and he’s not yet used to more robust defusion techniques being used in session, it’s possible he could think you are making a game out of his suffering.   

Another potential trap you mention in the book is meaninglessness (i.e., if my values are simply made up of words, and words do not capture absolute truth, how do I know they truly matter?). How can practitioners steer away from this common pitfall?  

It all comes back to the client’s direct experience of what it’s like when they act consistently with a given value. Was his experience one of increased vitality, meaning, or purpose? If so, then maybe his thought that, “nothing really matters” (for example) is just another thought to defuse from—another example of his mind trying to take him for a ride. It’s an interesting little existential dilemma that is readily solved by realizing, experientially, “How can I really know that nothing really matters—especially when I’ve had repeated experiences of things really mattering to me?” The book goes into more detail on this.  

For more from John T. Blackledge, PhD about using cognitive defusion in sessions, check out his book, Cognitive Defusion in Practice: A Clinician’s Guide to Assessing, Observing, and Supporting Change in Your Client.