The Big Book of ACT Metaphors Mindfulness Diary
Mindfulness Diary
Jessica Gundy Cuneo
Over the next week, choose three to five different time periods to complete this form. Be sure to fill in all of the
information each time. Here are the steps for using the form:
1. Choose a mindfulness activity to engage in.
2. Prior to beginning the exercise, decide on a specific time and place where you will do this mindfulness
practice. This may be a quiet place with no distractions or, conversely, a place where distractions are
likely to occur.
3. Just before beginning the activity, note any inner experiences you may be having: thoughts, feelings,
physical sensations, or memories.
4. Note how long you practiced.
5. Did anything help, hinder, or interfere with doing the practice?
© 2014 Jill A. Stoddard and Niloofar Afari/New Harbinger Publications.
Permission granted to the reader to reproduce this form for personal use.
What mindfulness activity When and where will you do What inner experiences are What was the duration of the Did anything help or hinder
will you do? it? you having before beginning? activity? your mindfulness practice?
The Big Book of ACT Metaphors
Permission granted to the reader to reproduce this form for personal use.
© 2014 Jill A. Stoddard and Niloofar Afari/New Harbinger Publications.
Mindfulness Diary
The Big Book of ACT Metaphors ACT Thought Record
ACT Thought Record
Elizabeth Maher
The purpose of this diary form is to help you become increasingly aware of the feelings and thoughts that show
up in a variety of situations you experience throughout the week, and to give you the opportunity to practice
acceptance and present-moment awareness strategies and choose actions that are in line with your values. Over
the next week, choose three to five different situations to examine with this form. Be sure to fill in all of the
information each time.
1. Briefly describe the situation.
2. Record the feelings you notice, including emotions and physical sensations.
3. Record the thoughts going through your mind as you are in the situation.
4. Practice one of the present-moment awareness exercises that help with observing inner experience, rec-
ognizing thoughts as thoughts and feeling as feelings. Note any responses you have to allowing thoughts
and feelings to come and go.
5. Take a few moments to identify your values that are salient in this situation.
6. Choose an action or response that’s in line with your values.
© 2014 Jill A. Stoddard and Niloofar Afari/New Harbinger Publications.
Permission granted to the reader to reproduce this form for personal use.
The Big Book of ACT Metaphors ACT Thought Record
Action
Values
Present-moment
awareness
Thoughts
Feelings
Situation
© 2014 Jill A. Stoddard and Niloofar Afari/New Harbinger Publications.
Permission granted to the reader to reproduce this form for personal use.
The Big Book of ACT Metaphors Music Mindfulness and Defusion Handout
Music Mindfulness and
Defusion Handout
Levin Schwartz
Music, Mindfulness & Defusion
Attitude Culture
Beautiful Good
Bad
Body
Fearful Sensations Sad
Listening
History
Sound Family
History
Vibrations
Happy Relaxed
Touching Moving
Suspenseful
Mood Personality
Expertise
This an
This diagram represents diagram
example represents
of how we an can
example
become of how
fusedwe canour
with become fused
thoughts. The experience of listening to
with our
music can provoke many thoughts.
powerful The experience
sensations, thoughts,of listening toevaluations,
experiences, music can provoke many Consider that this is
and judgments.
powerful sensations, thoughts, experiences, evaluations,
exactly what our minds do—this is programming and it is happening all the time. and judgments.
At the center ofConsider
the circlethat
is this is exactly
the musical whatthat
event our represents
mind does“just
- thisthe
is programming
facts” of “whatand
actually happened.” The
it is happening all the time.
further away the circles are from the musical event, the more variable and subjective the emotions become. This process
accounts for the individual variables
At the centerand factors
of the influencing
circle our experience,
is the musical which make
event that represents up the
“just “our story.”
facts” of “what actually happened.” The further away the circles are from the
musical
© 2014event,
Jill A.the more variable
Stoddard and subjective
and Niloofar the emotions
Afari/New Harbinger become. This
Publications.
process accounts for the individual variables and factors influencing our
Permissionwhich
experience, granted to the
make reader
up “our to reproduce this form for personal use.
story.”
The Big Book of ACT Metaphors Values Words
Values Words
Nicole Rensenbrink
Below is a list of words that may help you generate ideas about your values. Note that some of these words, like
Calm, Patience, and Courage, may refer to internal experiences. In these cases, the value may be to act calmly or
with patience or courage, even if you don’t feel this way. The value should not be to achieve an internal feeling state.
Adventure Discipline Independence Order Serenity
Attentiveness Diversity Integrity Organization Simplicity
Balance Effort Intelligence Patience Spirituality
Beauty Equality Interdependence Peace Spontaneity
Belonging Excitement Intimacy Perseverance Stability
Calm Expansiveness Intuition Play Stewardship
Caring Experience Justice Power Strength
Citizenship Faith Kindness Productivity Structure
Comfort Fitness Leadership Reliability Sustainability
Communication Flow Learning Respect Thoughtfulness
Compassion Forgiveness Love Reverence Tolerance
Connectedness Freedom Loyalty Rhythm Transcendence
Conservation Fun Magic Risk Understanding
Courage Health Meaning Security Warmth
Creativity Honor Nesting Self-expression Wisdom
Curiosity Humor Nurturance Self-sufficiency Wit
Detachment Imagination Openness Sensuality Wonder
© 2014 Jill A. Stoddard and Niloofar Afari/New Harbinger Publications.
Permission granted to the reader to reproduce this form for personal use.
The Big Book of ACT Metaphors The Heroes Exercise Worksheet
The Heroes Exercise Worksheet
Rob Archer
Think about who your heroes are and choose a few people you admire. These may be people you know, celebri-
ties, or even fictional characters. On the following sheet, write in the columns provided:
1. The name of your hero
2. The values this person embodies that you admire
3. Actions you can take to start moving in the direction of being more like this person
4. Obstacles you anticipate (e.g., thoughts, feelings, urges, memories) that might get in the way of your com-
mitted actions
5. Skills and/or exercises you might use to handle obstacles so that you can keep your feet moving toward
being more like your hero
© 2014 Jill A. Stoddard and Niloofar Afari/New Harbinger Publications.
Permission granted to the reader to reproduce this form for personal use.
My heroes What I admire How I can move toward being Obstacles I anticipate What I can do to move
(values) more like my hero (thoughts, feelings, memories, forward anyway
(committed action) urges, etc.) (like my hero would!)
Example: Perseverance, Go after the new job. Fear that I’m not good enough to Mindfulness and defusion.
Oprah Winfrey assertiveness, being Tell my partner how I feel. land the job. The Bold Move
genuine Fear that my partner will get mad
or leave me.
The Big Book of ACT Metaphors
Permission granted to the reader to reproduce this form for personal use.
© 2014 Jill A. Stoddard and Niloofar Afari/New Harbinger Publications.
The Heroes Exercise Worksheet
The Big Book of ACT Metaphors Writing Your Autobiogr aphy Worksheet
Writing Your Autobiogr aphy
Worksheet
Mark Stern
After taking ample time to think about your autobiography as it would appear after you’ve lived a truly meaning-
ful, fulfilling life that was full of vitality, write down the values that were expressed through your personal story.
After taking time to think about your autobiography as it would appear if it were written about you today, write
down what showed up.
© 2014 Jill A. Stoddard and Niloofar Afari/New Harbinger Publications.
Permission granted to the reader to reproduce this form for personal use.
The Big Book of ACT Metaphors Writing Your Autobiogr aphy Worksheet
Now write a few thoughts about any discrepancies that arose when comparing your ideal autobiography to your
present-day story.
© 2014 Jill A. Stoddard and Niloofar Afari/New Harbinger Publications.
Permission granted to the reader to reproduce this form for personal use.
The Big Book of ACT Metaphors Values and Committed Action Worksheet
Values and Committed Action
Worksheet
Jill Stoddard
A copy of the worksheet follows.
© 2014 Jill A. Stoddard and Niloofar Afari/New Harbinger Publications.
Permission granted to the reader to reproduce this form for personal use.
Area of importance How I want to be Things I can do What might get in How I can move Exercises
my way forward
Physical health Treat my body with love Commit to yoga twice a Feeling lazy, Acceptance, defusion, Crying Baby on a
and respect week; walk my dog unmotivated; thinking staying connected to Plane; Watching the
daily; eat fruits and “What’s the point, I bigger values Mind Train; The
vegetables with every always fail” Heroes
meal
The Big Book of ACT Metaphors
Permission granted to the reader to reproduce this form for personal use.
© 2014 Jill A. Stoddard and Niloofar Afari/New Harbinger Publications.
Values and Committed Action Worksheet
The Big Book of ACT Metaphors The Classroom Professor Gr aphics and Worksheet
The Classroom Professor
Gr aphics and Worksheet
Jill Stoddard
Pebble
Spaces in jar = sand
Ping-Pong ball
© 2014 Jill A. Stoddard and Niloofar Afari/New Harbinger Publications.
Permission granted to the reader to reproduce this form for personal use.
The Big Book of ACT Metaphors The Classroom Professor Gr aphics and Worksheet
Ping-Pong Balls
1.
2.
3.
4.
5.
6.
7.
8.
Small Rocks
1.
2.
3.
4.
5.
6.
7.
8.
© 2014 Jill A. Stoddard and Niloofar Afari/New Harbinger Publications.
Permission granted to the reader to reproduce this form for personal use.
The Big Book of ACT Metaphors The Classroom Professor Gr aphics and Worksheet
Sand
1.
2.
3.
4.
5.
6.
7.
8.
© 2014 Jill A. Stoddard and Niloofar Afari/New Harbinger Publications.
Permission granted to the reader to reproduce this form for personal use.
The Big Book of ACT Metaphors The Bubble Exercise Gr aphics and Worksheet
The Bubble Exercise Gr aphics
and Worksheet
Nuno Ferreira
© 2014 Jill A. Stoddard and Niloofar Afari/New Harbinger Publications.
Permission granted to the reader to reproduce this form for personal use.
The Big Book of ACT Metaphors The Bubble Exercise Gr aphics and Worksheet
The Bubble Exercise Worksheet
In the columns below, list committed actions you took over the past week in the “Action” column. Place an X in
the “Vital” column for actions completed in the service of values, and place an X in the “Nonvital” column to
those completed (or not completed) in the service of avoidance. Next, place an X in the “Expansion” or
“Contraction” columns to indicate whether the action created a sense of expansion and vitality in your life, or
one of contraction or limitation.
Action Vital Nonvital Expansion Contraction
© 2014 Jill A. Stoddard and Niloofar Afari/New Harbinger Publications.
Permission granted to the reader to reproduce this form for personal use.
