Last week I heard a story about Picasso – like a parable but not so ancient.
Picasso was walking through the market when he was approached by a woman who recognised him as one of the greatest artists of all time. She asked him to draw something for her and he very kindly quickly sketched her something on a piece of paper. “That will be 30,000 dollars,” he said.
“But”, said the random lady, “it only took you 30 seconds to sketch this.”
“Actually”, said Picasso, “it took me 30 years!”
This story rang true with me because we so often fail to recognise the effort, perseverance and grit that goes on behind the scenes in someone’s life. Especially if they generally appear happy.
Literally everyone has difficulties in their lives. It is the acceptance of these difficulties that allows us to actually function
At work, we’re so busy, we barely get time to grunt a “hello” before launching into hospital rounds. And yet every person in that hospital has “stuff” (a colloquial term for mental loads). Literally everyone has difficulties in their lives.
It is the acceptance of these difficulties that allows us to actually function, and hopefully, function well.
Pushing our difficult emotions to one side is avoidance. We may appear to function on the outside. We might get through the ops list skilfully and greet our colleagues joyfully. But without acceptance of our “stuff” and of the multiple emotions it brings, all that skill and camaraderie won’t bring us joy and peace of mind. These will continue to elude us.
Acceptance and commitment therapy
As a therapist, we have so many qualifications and different methods of counselling in our toolboxes. One type of therapy does not fit all. Ever.
Usually, my first meeting with a client is two or more hours long and designed to get a history and a real time picture of their emotions and feelings. After that, we can dip into various modes of therapy before deciding which ones might be of help.
We have a plethora of therapies available from cognitive behaviour therapy (CBT) and mindfulness-based stress reduction (MBSR), to internal family systems therapy (IFS), empty chair therapy and person-centred therapy. The list is endless.
One type, not mentioned in the list above, is acceptance and commitment therapy (ACT). ACT is a type of therapy which encourages the patient to face their thoughts and feelings, rather than trying to avoid them or shut them out. Instead of judging ourselves for having these feelings and deeming them as “wrong” or “irrational”, we face them and even embrace them as a natural part of the human existence.
Buddhism talks a lot about human suffering. The Buddha taught the four noble truths, which I explained in a nutshell in a previous article. Basically:
- There is suffering
- There is a cause of suffering
- There is an end to suffering
- The way out is the eightfold path
Sounds not very uplifting, right?
By “suffering” I imagine he meant the daily mental loads which are inevitable as a human. Animals don’t have this mental angst going on in the background (usually), which is why they spend most of their day living in the moment focusing on this walk, this toy or this food. And that brings them contentment and joy in everyday fairly mundane activities. We are not spaniels, and that’s alright.
How can we put this into practice?
If we can learn, using mindfulness techniques, to accept our emotions, then they may cause us pain, but we will not be suffering. The adage goes: “Pain is inevitable. Suffering is optional.”
What does this mean?
Basically, it is implausible to aim for a life without any hurdles or daily problems. However, the degree to which these hurdles hurt us is our choice.
Say you’re running, and you think, ‘Man, this hurts, I can’t take it anymore.’ The ‘hurt’ part is an unavoidable reality, but whether or not you can stand anymore is up to the runner himself.”
Haruki Murakami
ACT develops psychological flexibility and is a form of behavioural therapy that combines mindfulness skills with the practice of self-acceptance. When aiming to be more accepting of your thoughts and feelings, commitment plays a key role.
In the case of ACT, you commit to facing the problem head-on rather than avoiding your stresses. Imagine committing to actions that help you facilitate your experience and embrace any challenge. So, the aim isn’t to fix or change the stressors. Rather it is to accept the emotions they bring non-judgementally. That defuses their hold over us.
As vets and nurses, we have so many stressors inside and outside the workplace. We’re so busy, we can’t even begin to list the stressors. They’re all in that grey cloud hanging over our head raining adrenaline into our brains. It’s counterintuitive that stopping to look at and list the stressors might help us to be less stressed.
Maybe try it just once.
A few decades ago, scientists conducted an experiment in the Arizona desert where they built “Biosphere II” – a huge steel and glass enclosure with purified air circulating, where only purified water ran, the soil was nutrient rich and there was abundant natural light. It provided the perfect climate for plants, insects and animals to flourish. All was well except for one thing: the trees, when they reached a certain height, would simply fall down despite the perfect conditions.
We can then be the people who turn up at work less phased by the enormous ops list and queue of clients snaking down the street. We’ve seen these storms before and got through it many times
While this seems obvious to many, the scientists in Arizona were puzzled. As it turns out, trees grow strong and deep roots not just in search of water. Rather, it is because of winds pushing and pulling the trees in different directions, making life a bit more difficult. The trees respond to that hammering by the elements by becoming stronger with thicker trunks and deeper roots.
So, the hurdles and suffering in our lives can be used as a way of becoming stronger, more resilient and wiser. And we can then be the people who turn up at work less fazed by the enormous ops list and queue of clients snaking down the street. We’ve seen these storms before and got through it many times.
Six core processes
ACT is a therapy based on the concept that suffering is a natural and inevitable condition for humans. We have an instinct to control our experiences, but this instinct does not always serve us. Six core processes of ACT guide patients through therapy:
- Acceptance
- Cognitive defusion
- Being present
- Self as context
- Values
- Committed action
Acceptance is an alternative to our instinct to avoid thinking about negative, or potentially negative, experiences. It is the active choice to allow unpleasant experiences to exist, without trying to deny or change them.
Cognitive defusion refers to the techniques intended to change how an individual reacts to their thoughts and feelings. ACT does not intend to limit our exposure to negative experiences, but rather to face them and come out the other side with a decreased fixation on these experiences.
Being present can be understood as the practice of being aware of the present moment, without judging the experience. We’ve learnt this skill in previous articles.
Self as context is the idea that an individual is not simply the sum of their experiences, thoughts or emotions. We are not only what happens to us. We are the ones experiencing what happens to us.
Values in this context are the qualities we choose to work towards in any given moment. In the veterinary world these may be patience, resilience, calmness, insightfulness, etc.
It’s this commitment to mental well-being which goes on behind the scenes of those happy, carefree, cheerful colleagues you meet
Finally, ACT aims to help patients commit to actions that will assist in their long-term goals and live a life consistent with their values. Positive behaviour changes cannot occur without awareness of how a given behaviour affects us.
It’s this commitment to mental well-being which goes on behind the scenes of those happy, carefree, cheerful colleagues you meet. You know, the person who always has time for you and a hug for you. The receptionist who never gets fazed by the clients, the surgeon who can deal with complications with an aura of calm, the ECC nurse who hits the artery every time and calculates constant rate infusions like a ninja.
Just like Picasso made superhuman efforts to become an amazing artist, the effort put into being happy can be massive.
ACT is just one of the many exciting tools at our disposal.
