What We Resist Persists; Acceptance And Willingness – Get Out Of Your Mind & Into Your Life (Chapter4) By Stephen Hayes

This article focuses us on the pragmatic idea that we must be willing to accept our pain to begin to heal as we move from a life of being a pain killer to become a pain healer. Experience avoidance and denial do not work. What we resist persists. The truth can set us free but often first it hurts. The acronyms for fear you hear in the rooms, ‘face everything and recover’ as you discover that so much of your misery and suffering is ‘false evidence appearing real’. The Big Book suggests that we have been perhaps unconsciously ‘manufacturing our own misery’(BB p.133) in the distortions of reality that we create in our minds. The isolation and conscious separation from life, others and ourselves that characterize our alcoholism and addiction are also undeniable in our experience of enlarging our misery.

In the 4th step, the Big Book asks to to get down to ‘causes and conditions’(BB p.64). This article explores the problem of ‘experience avoidance’ and the solution of an unconditional willingness to face ourselves and our lives. As an alcoholic and drug addict, I have spent a lot of energy in finding ways to create a ‘pretend world’ in my mind that rationalized and justified to avoid the reality of seeing myself and my life with clarity. I suspect I’m not alone and that this issue of ‘experience avoidance’ is quite common with those of us in recovery.

This article helps us deepen our awareness of how crucial it is for us to develop a different relationship with pain that allows us to learn and benefit from our painful experience not avoid and deny this pain. The research presented is quite compelling. I love the simplicity of taking an area I am having trouble accepting about myself and then exploring how I avoid experiences that confront me with unpleasant realities.

Perhaps, a simple one, easy for many of us to relate to, is weighing myself daily when I have a weight problem. I lose weight when I face the reality of seeing what I weigh and committing myself to the actions that result in daily changes that help me understand the reality between what I do and what appears on the scale – Bruce M.

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Accept” comes from the Latin root “capere” meaning “take.” Acceptance is the act of receiving or “taking what is offered.” Sometimes, in English, “accept” means “to tolerate or resign yourself” (as in, “Aw, gee, I guess I have to accept that”), and that is precisely not what is meant here. By “accept,” we mean something more like “taking completely, in the moment, without defense.” We use the word “willing” as a synonym for “accepting” to stay true to that meaning of accept.

“Willing” is one of the older words in the English language. It comes from an ancient root meaning “to choose.” Thus “acceptance” and “willingness” can be understood as an answer to this question: “Will you take me in as I am?” Acceptance and willingness are the opposite of effortful control.

What follows is a description of what “to take me in as I am” really means.

In our context, the words willingness and acceptance mean to respond actively to your feelings by feeling them, literally, much as you might reach out and literally feel the texture of a cashmere sweater. They mean to respond actively to your thoughts by thinking them, much as you might read poetry just to get the flow of the words, or an actor might rehearse lines to get a feel for the playwright’s intent.

To be willing and accepting means to respond actively to memories by remembering them, much as you might take a friend to see a movie you’ve already seen. They mean to respond actively to bodily sensations by sensing them, much as you might take an all-over stretch in the morning just to feel your body all over. Willingness and acceptance mean adopting a gentle, loving posture toward yourself, your history, and your programming so that it becomes more likely for you simply to be aware of your own experience, much as you would hold a fragile object in your hand and contemplate it closely and dispassionately.

The goal of willingness is not to feel better. The goal is to open up yourself to the vitality of the moment, and to move more effectively toward what you value. Said another way, the goal of willingness is to feel all of the feelings that come up for you more completely, even—or especially—the bad feelings, so that you can live your life more completely. In essence, instead of trying to feel better, willingness involves learning how to feel better.

To be willing and accepting is to gently push your fingers into the Chinese finger trap in order to make more room for yourself to live in, rather than vainly struggling against your experience by trying to pull your fingers out of the trap. To be willing and accepting means to give yourself enough room to breathe.

By assuming the stance of willingness and acceptance you can open all the blinds and the windows in your house and allow life to flow through; you let fresh air and light enter into what was previously closed and dark. To be willing and accepting means to be able to walk through the swamps of your difficult history when the swamps are directly on the path that goes in a direction you care about.

To be willing and accepting means noticing that you are the sky, not the clouds; the ocean, not the waves. It means noticing that you are large enough to contain all of your experiences, just as the sky can contain any cloud and the ocean any wave.

We don’t expect this foray into poetic metaphors to make any difference yet. But the sense conveyed by them may give you an idea of what we are aiming for in pursuing acceptance in this way.

If you find your mind agreeing or resisting, just thank your mind for the thought. Your mind is welcome to come along for the ride. But willingness and acceptance are states of being that minds can never learn how to achieve. Fortunately, there is more to you than just your repertoire of relating and symbolizing. Even if your mind can’t learn how to be willing and accepting, you can learn.

Why Willingness?

One reason willingness is worth trying is that it is remarkable how consistently the scientific literature reveals its value and the danger of its flip side—experiential avoidance. One reason this book is not about anger, depression, anxiety, substance abuse, chronic pain (or any of the other disturbances and disorders that thrive in modern life) is that we are trying to teach a set of skills that has extremely broad applicability, and that should empower your work or self-directed efforts to change your life.

We first reviewed the literature on experiential avoidance about a decade ago (Hayes et al. 1996) and since then it has exploded. We’ll discuss just a few areas to show how broadly applicable this process can be for psychological suffering.

Physical pain. In virtually every area of chronic pain, physical pathology (the objectively assessed physical damage) bears almost no relation to the amount of pain, reduced functioning, and disability (Dahl et al. 2005). The relationship between the amount of pain and degree of functioning is also weak. What predicts functioning is (a) your willingness to experience pain, and (b) your ability to act in a valued direction while experiencing it (McCracken, Vowles, and Eccleston 2004). These are precisely the processes targeted in this book. Training people how to accept their pain and how to watch it or “defuse from” their thoughts about it (see chapter 6) greatly increases their tolerance of pain (Hayes et al. 1999) and decreases the amount of disability and sick leave downtime caused by their pain (Dahl, Wilson, and Nilsson 2004).

Physical trauma, disease, and disability. In head injury, spinal injury, heart attack, and other areas of physical illness or injury, the degree of physical pathology is a very poor predictor of rehabilitation success and long-term disability. What is predictive is the patient’s acceptance of the condition and the willingness to take responsibility for her or his predicament (Krause 1992; Melamed, Grosswasser, and Stern 1992; Riegal 1993).

In chronic diseases like diabetes, your acceptance of the difficult thoughts and feelings the disease gives rise to, and your willingness to act in the presence of these thoughts and feelings predict good self-management of the disease (Gregg 2004). Other health-care problems, such as smoking, show the same results (Gifford et al. 2004). ACT promotes better health management as a result of changes in your willingness to accept discomfort, unhook from your thoughts, and move toward what is most personally meaningful to you (Gifford et al. 2004; Gregg 2004).

Anxiety. Unwillingness to have anxiety predicts having anxiety in many different forms (Hayes, Strosahl, et al. 2004). For example, when exposed to the same levels of physiological arousal, experiential avoiders are more likely to feel panic than those who willingly accept their anxiety (Karekla, Forsyth, and Kelly 2004). This is particularly true if experiential avoiders are actively trying to control their anxiety sensations (Feldner et al. 2003).

Among people who habitually pull out their own hair, experiential avoidance predicts more frequent and intense urges to pull, less ability to control urges, and more hair pulling–related distress than among people who are not experientially avoidant (Begotka, Woods, and Wetterneck 2004). People with generalized anxiety disorder are more likely to have high levels of emotional avoidance (Mennin et al. 2002), and both the amount of worry and degree of impairment they suffer correlates with experiential avoidance (Roemer et al. 2005). Even a very small amount of training in acceptance can be helpful, however. For example, just ten minutes of acceptance training made panic-disordered persons more able to face anxiety; training in distraction and suppression was not helpful (Levitt et al. 2004). Similarly, for anxious people, teaching them a simple ACT acceptance metaphor, the Chinese finger trap , reduced avoidance, anxiety symptoms, and anxious thoughts more successfully than did breathing retraining (Eifert and Heffner 2003).

Childhood abuse and trauma. Childhood abuse predicts current distress to some degree, but the practice of willingness mediates that relationship (Marx and Sloan, forthcoming [b]). In other words, if you are unwilling to experience the memories, thoughts, and feelings that childhood abuse produces, you get stuck with chronic distress as an adult. However, if you are willing to experience those thoughts, memories, and feelings again, the same abuse history is significantly less destructive to your life. When people with initially equal levels of post-traumatic stress have been compared over time, research has shown that those who are willing to have these private experiences have less post-traumatic stress over time (Marx and Sloan, forthcoming [a]).

Job performance. People who are more emotionally willing to experience negative emotional experiences enjoy better mental health and do better at work over time. The effect is significantly greater than the effects of job satisfaction or emotional intelligence (Bond and Bunce 2003; Donaldson and Bond 2004).

Substance abuse. Substance abuse is typically motivated by an attempt to avoid negative private experiences (Shoal and Giancola 2001). The more substance abusers believe that drugs or alcohol reduce their negative emotions, the more likely they are to relapse (Litman et al. 1984).

Depression. Up to half of the variations in the symptoms of depression can be accounted for by a lack of acceptance and willingness (Hayes, Strosahl, et al. 2004).

This review could go on for many more pages, and deal with many more areas, but perhaps these examples are enough to make the point. The scientific literature is filled with evidence that the person’s willingness to experience whatever emotion is present is of central importance to many areas of human psychological functioning.

So, why is willingness so important? Perhaps some first person accounts of the importance of willingness will be more convincing than our capsule review of the literature. Read the following statements and see if they hold true for you, too.

• Why willingness? Because when I am struggling against my painful experiences, the struggle seems to make them all the more painful.
• Why willingness? Because when I move away from the pain that I meet when I’m pursuing what I value most, I also move away from the richness of life that those valued actions bring to me.
• Why willingness? Because when I try to close myself off from the painful parts of my past, I also close myself off from the helpful things I’ve learned from my past.
• Why willingness? Because I experience a loss of vitality when I am not willing.
• Why willingness? Because my experience tells me that being unwilling just doesn’t work.
• Why willingness? Because it is a normal human process to feel pain, and it is inhumane and unloving to try to hold myself to a different standard.
• Why willingness? Because “living in my experience,” that is, living in the moment, seems potentially more rewarding than “living in my mind.”
• Why willingness? Because I absolutely know how my pain works when I am unwilling, and I’m sick and tired of it. It’s time to change my whole agenda, not just the moves I make inside a control and avoidance agenda.
• Why willingness? Because I have suffered enough.