An Acceptance & Commitment Therapy Workbook for Overcoming Substance Abuse
~Kelly Wilson, PhD, and Troy DuFrene
Reviewed by Don Sheeley, SMART Recovery® Facilitator
Saratoga Springs, New York
Learning about Acceptance and Commitment Therapy (ACT) this summer, and using this workbook in particular, helped me deepen my recovery and broaden the foundation of safety and health that I am looking for in sobriety. In The Wisdom to Know the Difference: An Acceptance & Commitment Therapy Workbook for Overcoming Substance Abuse, Kelly Wilson opens himself up to the reader using his own experiences as engaging illustrations of the pain of addiction, but also as opportunities for personal growth.
After the first chapter, which helps the reader consider whether abstinence will be their goal, Wilson uses the next six chapters to explore ACT, emphasizing the dynamic behavior called for by this model. The chapter goals are, in my words: being able to choose to be still in the present moment rather than reacting to life in our patterns and automatic behaviors; learning to be more psychologically flexible, rather than rigid, predetermined, or stuck; beginning to identify the permanent “You,” able to accept the emotions that create richness in life. The authors remind us why it’s important to learn to not take our “self-stories” too seriously. Self-stories include our self-talk, self-image, and our internal beliefs. The book prompts us to be the authors of our lives rather than passive readers, and to travel our values highway, getting back on without hesitation if we veer off.
Even though the title of the book is a line from the Serenity Prayer, adopted by 12-step programs, the book works well with SMART Recovery ® concepts. The first chapter on whether to choose an abstinent path correlates well with our Cost Benefit Analysis. The authors cite examples that show how most people who tried moderation did not continue to moderate. They either stopped entirely or moved into the heavy-drinking category. Kelly makes some good points about things I see in my face-to-face group, such as a lapse after someone has used an alternate drug that was not their drug of choice. The authors note that automatic behaviors are inhibited less under such circumstances.
The chapter on being in the moment introduces both cognitive and behavioral ways to learn how to be present in life. The authors ask us to reconsider our ruminations about our past, and our worries about the future as preoccupations that we may have habitually used to avoid the “Now” of our lives. They also suggest practicing six breaths, slow and deep, to return to your life in this moment.
In the chapter on psychological flexibility, Wilson and DuFrene uncover some of our self-labeling traps, such as the myth of self-esteeming. They write, “ . . . psychological flexibility. This is a fancy phrase that basically means the ability to do whatever you choose to do, whenever you choose to do it, without being limited in your choices by what’s going on in your head.” This is an extraordinarily powerful, dynamic statement, implying that we will be mindful enough to distance ourselves from our thoughts and realize our thoughts and feelings are not us, but just things that come and go in us. I know that sounds obvious to SMARTies, but in my face-to-face group and in SMART Recovery ® chat rooms, participants commonly describe getting caught in a squirrel-cage of thoughts about their drug of choice, and that they cannot get out. “I can’t stop these urges,” “I am anxious all day,” are common statements from people who suffer from addictive behavior. ACT calls this melding of oneself with one’s thoughts and feelings “fusion.” One goal of ACT is defusion,” or separating oneself from the thought and stepping back from the feeling. In this vein, it is healthier and ACT-consistent to say, “I am experiencing anxiety,” rather than “I am anxious.” Defusion is an important skill and useful in addiction recovery.
Wilson and DuFrene ask readers to begin to practice looking at themselves and their world in new ways, from different points of view, to be flexible enough to pursue personal goals and values with the vigor that will increase life’s breadth and depth. They introduce some interesting exercises, such as imagining a photo of yourself as a youngster, and imagining yourself in that youngster, then writing a letter of compassion to your younger self, who really still lives inside you.
With recovery comes the opportunity to experience a broad range of emotions. The chapter on acceptance helps the reader work on increasing their ability to allow good, sad, and painful things to exist in their life without trying to avoid or expel them.
The sixth point is, in my words, driving on your values highway: Actively steering your life along in the direction you have thoughtfully chosen, according to your Hierarchy of Values. A major point here is, if you get off for any reason—a lapse, for example—don’t torture yourself with judgmental statements. Drive to the next on ramp and get back on your values highway. ACT’s point is that you will best live your life if you are psychologically flexible and exert your dynamic energy in the direction you have chosen. This chapter is much more powerful after doing the prior exercises because they will loosen and focus your thinking energies.
ACT and this workbook are helping me gain a much stronger sense of freedom in recovery, a sense that I can deal with my mind and have a lot of influence over my future. ACT overlays modern science on much older systems such as Buddhism’s concepts of self and one’s path.
Obviously, the title reminds one of 12-step programs. Out of 170 pages, 30 are devoted to the 12-step process, and how ACT and 12-step can be related. In my opinion, this was unnecessary, especially because ACT emphasizes how much influence we can exert over our lives. However, I was around 12-step long enough to learn to take what I can use and leave the rest, and that’s what I did.
The Wisdom to Know the Difference: An Acceptance & Commitment Therapy Workbook for Overcoming Substance Abuse is available as an eBook and in paperback.
Don Sheeley is an Emergency Physician. He has enjoyed learning REBT, loves facilitating the local SMART meeting in Saratoga Springs, NY, and he is currently studying to become a therapist in Acceptance and Commitment Training (ACT).