Pre-empting

Your Mind
PRACTICAL TIPS FOR ACT THERAPISTS

By Dr. Russ Harris

 Pre-empting Your Mind
I’m a big fan of this defusion strategy (which is also very useful for
acceptance and committed action). It’s very simple and very practical.

Pre-empting Your Mind | Page 1 © Russ Harris 2018 | imlearningact.com

 What’s Your Mind Likely to Say?
Basically, the therapist asks, in one form or another: “What’s your mind likely
to say about that?” The idea is to pre-empt unhelpful thoughts that are likely
to show up and act as psychological barriers. If we can predict these unhelpful
thoughts in advance, it will be much easier to unhook from them when they
arise. For example, we might ask:

• “What do you think your mind is likely to say if I suggest we practice an

exercise now?”

• “How is your mind likely to talk you out of doing this?”

• “My guess is that as we start to work out an action plan, your mind is going
to come up with a lot of objections. What do you think it’s likely to say?”

If the client struggles to come up with an answer, the therapist can volunteer
one, based on things the client has said in previous sessions, e.g. “It won’t
work”, “What’s the point?”, “It’s too hard” etc.

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 Unhooking from Reason-Giving
Pre-empting the mind is especially useful to help with defusion from “reason-
giving” (i.e. all the reasons your mind comes up with for why you can’t change,
won’t change, shouldn’t have to change, etc.).

E.g. the therapist says: “The human mind is like a reason-giving machine. As
soon as we even think about stepping out of our comfort zone, it cranks out
all the reasons why we can’t change, won’t change, or shouldn’t even have to
change, or why it won’t work, or what might go wrong, and so on. What kind of
reasons do you think your mind will generate not to do... XYZ?”

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 Debating & Intellectualising #1
This pre-empting strategy is also very useful for clients who tend to get caught
up in debating, discussing, analysing or intellectualising things.

The therapist could say: “The human mind loves to debate and analyse. So,
it’s perfectly natural you want to do that. And sometimes it’s helpful to do that.
And sometimes it’s not. Now I just want to check with you... We are a team
here, right? And our aim is to help you XYZ.” ( XYZ = a: the main behavioural
changes the client wants to make, b: life goals the client wants to pursue, c:
thoughts and feelings the client wants to learn how to handle more effectively.)

The therapist continues: “Now the more of the session we spend on debates
or analytical discussions, the less time we’ll have to work on the main issues
you’re here for. So what kind of things do you think your mind will say today to
try to pull us into debates or analytical discussions?”

NB: This strategy will not work if the therapist leaves out the content italicised
above. If the therapist doesn’t know this information, they must take time to
find it out; it’s an essential part of taking a history and almost impossible to do
ACT effectively without it.

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 Debating & Intellectualising #2
If the client insists that it’s important to debate, analyse, discuss, understand,
etc. then the therapist must first validate that: “Yes, it is.”

Then the therapist could say something like, “The problem is, that kind of
discussion is unlikely to help you XYZ.” (XYZ = some or all of a: the main
behavioural changes the client wants to make, b: life goals she wants to pursue,
c: thoughts and feelings she wants to learn to handle more effectively).

The therapist continues: “And the problem is, we only have 50 minutes per
session. So, the more time we spend on discussing and analyzing, the less time
we have to work on effective ways of improving your life. So, there’s a choice to
make here about how we spend this session and how we get the most out of it.”

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 Writing Down Thoughts
It’s often helpful for the client or the therapist to write down the predicted
thoughts, and to keep them handy. Writing them down typically enhances the
degree of defusion. (It’s better if the client writes – it involves them more – but
sometimes the clients don’t want to for various reasons.)

As the client voices these thoughts later in session, the therapist might say:

• “Aha! We predicted that one. There it is, right there on the list!”

• “Is that one on the list? Just check.”

• “Oh! I don’t think we predicted that one! Do you want to just write it down?”

• “Hmmm. The wording is a bit different, but it’s pretty much the same as that
one you’ve written down there”.

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 Naming
It’s often helpful to name these recurrent cognitive repertoires as they recur in
session.

• “There’s your mind ‘reason-giving’.”

• “There’s the ‘not good enough’ story”

• “Ah, the old ‘abandonment schema’”

• Or you can use classic terms such as: ruminating, worrying, castrophising,
judging, black-and-white thinking, predicting the worst, etc. E.g. “Here’s
worrying” Or more simply, “Worrying”

And playfulness, lightness, humour often helps:

• “Gosh, it’s been almost 5 minutes since your mind last told you the
hopeless story. It’s going easy on you today!”

(Note: Be wary of invalidation! Always be respectful, compassionate, sensitive.

If you do this stuff in an uncaring, flippant, sarcastic way – it won’t be
well-received.)

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 Timing and Frequency
Variants can include:

• “How many times do you think your mind will say this in today’s session?
Tonight? This week? In the next ten minutes?”

• “What do you predict your mind will say when we start the exercise? During
the exercise? After the exercise?”

• “How soon will your mind start saying this? Has it already started? Are any
of these thoughts/stories/reasons (pointing to the written list) showing up
right now?”

• “What’s your mind likely to say about this after the session? Tonight?
Tomorrow morning? When you’re really in that challenging situation?”

• “How’s your mind going to try and talk you out of doing that? How’s your
mind going to try to hook you, while you are doing it?”

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 Ticking Thoughts
If the thoughts have been written on a piece of paper, a nice addition is
to ask the client to tick a thought each time it recurs.

• “Ah! There it is again. Give it a tick.”

• “Wow! Four ticks by that one, already. How many ticks do you think will be
there by the end of the session? My guess is about 15.”

• “See how it keeps popping up? Give it another tick for good effort.”

Note: This MUST be done respectfully and compassionately, or it will be

invalidating for the client. Used appropriately, respectfully, kindly, sensitively,
it generally brings lightness and playfulness into the session, and clients often
start joking.

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 Choice
After acknowledging the appearance or reappearance of a predicted thought,
the therapist may like to offer the client a choice:

• “So, there’s a choice to make here; do we give up on this because your

mind says (repeats the thought aloud) … or do we let your mind say that
and carry on?”

• “So, there’s a choice to make here; do we stay focused on what we’ve been
talking about, or do we let your mind pull us off-track with this thought?”

• “So, there’s a choice to make here; do we waste time debating whether that
thought is true or false, or do we let your mind say it and carry on with what
we were doing?”

• “Do we let that thought interrupt our session / pull us off track / pull us into
an argument / interfere with our work here… or do we let your mind say it
and carry on?”

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 Defusion, Acceptance, Committed
Action, Attention Training.
If the client chooses to carry on and refocus even though such thoughts are
present – then you have helped him defuse from those thoughts (i.e. to reduce
their negative influence over behaviour).

• Plus, to some extent, you have helped him accept the presence and
recurrence of the thought.

• Plus, you are developing his capacity for committed action: continuing with
the task at hand even though unhelpful thoughts are present.

• Plus, you are training attention: refocusing on the task at hand after
momentarily being distracted.

(What if the client doesn’t make the choice you’d hoped for? See page 17)

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 Affirming The Client’s Choice
If the client chooses to carry on, be positive about it; express gratitude or
appreciation.

Note: This must be done authentically; if it is fake or insincere it won’t be

helpful.

E.g. “That is so cool for me to see you make that choice. Your mind is trying so
hard to interfere/disrupt this work/pull you off track/ make you give up – and
yet, you are not allowing that to happen. I can see the effort your making. I
appreciate it.”

Some clients do not like compliments or gratitude. So, if your client does not
react well to this type of therapist response, modify it. Tone down or completely
drop the compliments or gratitude. But still find some way to explicitly
acknowledge that: “You are continuing to do the hard work of the therapy
session even though your mind is trying hard to interfere.”

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 Let the Thoughts Sit There
One of my favourite strategies, after the client chooses to refocus or carry on,
is to say: “So, can we let the thoughts sit there, as we carry on?”

Then I leave the paper resting on the client’s lap, or on the couch beside her, or
sticking out from underneath the client’s lap.

Having done this, we can then say things like:

“So, the thoughts are still here; they haven’t magically disappeared. But we can
let them be here without getting hooked by them and carry on the work.”

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 Carrying Over
With many clients it’s useful to carry over this strategy from week to week. You
keep the list of unhelpful thoughts in the client’s file. At the next session, pull it
out, and give it to the client, and ask him to rest it on his lap.

The therapist might say: “This is what your mind said last session. How many
of these things do you think it will repeat in today’s session?”

Again, you could ask the client to tick them, note them as they recur, and write
down new ones.

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 Normalise
It’s good to do lots of normalizing & validating e.g.

• “It’s natural and normal that your mind does this.”

• “Your mind is a lot like mine.”

• “This is what minds do.”

• “This is how the human mind has evolved; it’s a problem-solving machine.”

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 Why Does the Mind Do This?
A valuable part of normalizing and validating is to talk about how the human
mind evolved as a problem-solving machine. Once this is established, we can
use this in many ways:

E.g. “The problem here is… this is an uncomfortable exercise/awkward topic/

difficult questions/a painful emotion is present. Your mind is trying to solve this
problem by coming up with reasons not to do it/telling you to give up/changing
the topic/distracting you from the emotion etc.”

Then we could validate further: This is normal/natural/your mind trying to look

out for you/your mind doing its job.

Then we could segue to workability:

“If you get hooked by what your mind is doing here, is that going to take you
towards or away (your goals, the bull’s eye, the life you want)?”

“If we get hooked by what your mind is doing here, will we be focusing on (your
goals, the bull’s eye, learning new skills etc.) or will we be off-track?”

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 What If the Client Does Not Make the
Choice You Hoped For?
What if the client, when offered a choice as in page 10, does want to give up?
Or does want to go off-track or change topic? Or does want to debate?

Well, first of all we VALIDATE that response.

E.g. “That’s a completely natural choice to make.”

We may validate it further with some self-disclosure, to normalize the choice,

and create a sense of commonality with the therapist.

E.g. “You know, your mind is a lot like my mind. Even though I do this work for
a living, there’s lots of times my mind hooks me just as successfully as your
mind has hooked you right now, with this thought.”

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 What Next?
Having normalised and validated the response, we can respond in many
different ways. How we respond next will depend on:

• What is the function of the thought?

• What is the client’s issue?

• What goal are you working on?

• How much ACT has the client already done?

• What number session is this?

• How motivated/willing is the client?

There is no standard response. The aim is to respond flexibly to each individual

client, to suit the unique demands of that specific moment in therapy.

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 Therapist Flexibility
You can respond to anything that happens in session with any ACT process;
and if you find one process fails, you can switch to another. Here’s an exercise
to develop this ability.

A client, offered the choice to “give up or carry on?” as described earlier, says,
eyes downcast, shoulders slumped, voice faint: “I want to give up.”

Assume the client has had enough sessions of ACT that you can draw on any
aspect of the model without need for explanation or psycho-education.

Come up with at least one possible response based on each of the following
ACT processes: defusion, acceptance, self-as-context, self-compassion,
values, committed action, contacting the present moment, creative
hopelessness.

If you do this exercise and find there’s a process that stumps you - you can’t
think of any possible response with that aspect of the model - that indicates
the need to do a bit more work on that aspect of ACT.

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 Watch Out for Coercion & Conflict
In ACT we want to empower our clients to have more choice in life; more
choice about what they do in life and how they respond to its challenges.

And it is up to them to choose, not up to us. Sometimes they will make choices
we do not like or want. So we really need to apply ACT to ourselves: to defuse
from our own beliefs/ideas about what clients should or shouldn’t do, and
accept our own discomfort around their choices.

If we use any of the strategies in this eBook in a coercive manner, we will

damage the therapeutic relationship. Tension or conflict will replace the
compassionate, respectful alliance we aim for. So always model openness
to and curiosity about the client’s choices. (Obviously if the client is doing
something that compromises us ethically, or that we are legally obliged to
report to the authorities, we need to disclose that to the client.)

Sometimes the wisest course of action when your client makes a choice you
didn’t want them to, is simply to go along with it, and explore its function. How
has making this kind of choice functioned in the past? How is it functioning in
the present?

We might ask: “What is it like to be making this choice? What’s showing up

for you now? How is your mind trying to help you – what problem is it trying to
solve for you.” And so on.

***

Well, that’s all from me, folks.

Hope there’s something useful in this eBook for you.
Good luck with it all,
Cheers, Russ Harris

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