A Lot in Common
What do TEAM-CBT, ACT, David Burns and Steven Hayes have in common? The obvious answer for the initiated is: cognitive and behavioral based therapy. For those of us not initiated I’ll elaborate a bit, and by doing this maybe we’ll learn a bit about how our thinking style effects our communication. With this awareness we may just be able to impact our relationships in a positive way.
Setting the Stage
Dr. David Burns is a pioneer in the development of CBT (Cognitive Behavioral Therapy) a “second-wave” behavioral therapy that threw cognition (thinking) into the mix. He wrote Feeling Good, a best seller that has been translated into twelve languages and brought CBT to the attention of the layman. Dr. Burns created TEAM-CBT in order to address some of the short-comings of CBT.
Dr. Steven Hayes is the creator of ACT, which stands for Acceptance and Commitment Therapy (pronounced like the one word “act” and not referred to by its initials). Unlike CBT, the goal of ACT is not to change thoughts thereby changing feelings, but to accept, hold, and unhook from difficult thoughts and feelings in order to stay engaged and take action towards ones values and live a meaningful life.
Oil and Water
The common ground is very broad as both focus on cognitions and managing inner and outer behavior in order to bring relief to clients. But the differences stand out like a sore thumb: between the personalities of the creators, and the personalities of the therapies.
Recently members of a workgroup I participate, a group intent on integrating ACT and TEAM, presented a workshop “ACT for the TEAM Therapist,” led by the awesome psychiatrist Heather Clauge, M.D., and the awesome therapists Danielle Seybold, MFT; and Kayley Saunders, LPC. They presented the case for and against integrating ACT and TEAM, and on the list of reasons against was: The podcast with Burns and Hayes – Oil and Water. ( 220: An Interview with Dr. Steven Hayes – Feeling Good The Feeling Good podcast is an amazing free resource from the generosity of Dr. Burns. There is a tremendous wealth of free information about TEAM and a variety of tops. I say “You could actually learn TEAM from listening to the podcasts.” Only a slight exaggeration.) As a member of the TEAM/ACT work group said “They have very different communication styles – I don’t think they could agree on where to go out for dinner…”.
Meyers-Briggs, Looking to the Right (Brain) and to the (Left) – Bridging the Gap?
I would postulate that a major contribution to the effect described (besides threatened male alpha male egos?) has to do with dominant forms of thinking styles ie. “right brain,” vs. “left brain.”
What does that mean? Well, after studying people with brain damage on either the right or left hemisphere of the brain (pre MRI), scientists noticed that a lot of language and linear thinking processes (math, etc..) seemed to be located on the left hemisphere, whereas more abstract reasoning seemed to be in the right hemisphere.
Since then, the theory has been disproved – basically because either thinking process is dependent on the other, and because there’s nothing that’s ever simple and clear cut about the brain, the most complex object in the universe. But the expression “right-brained” or “left-brained” has still lived on to describe a person’s dominant thinking process. One can still ask if a person prefers to think in terms of concrete facts, things, and principles and conclusions carefully derived after analyzing the details – or does a person focus more on the abstract , focusing on the concepts behind the facts on the ground, and deriving details from those principles.
This dichotomy is described another way in the Meyer’s Briggs personality system – a system that divides people into personality types based on four personality variables. The one I’m focusing on is the second dichotomy in the system: “Sensing vs. Intuitive.” Is the focus of a person on things that can be experienced with the senses – i.e. raw data – or is the focus on things that are “intuited” – the pattern behind the information? The description of these categories basically lines up with the right brain/left brain idea – sensing correlating with the left brain concept, and intuitive matches up with “right brained.”
(Those of you who are familiar with the ancient Jewish tradition of Kabbalah, or with Chassidus, the less ancient application of Kabbalistic thought, would name these cognitive modalities Chochmah and Binah, with the integration of the two referred to as Daas.)
David and Steven – Right or Left, ACT or CBT
So I would propose that the underlying communication issue (or one of them) between David and Steven come from their dominant thinking approaches.
David to the Left
David focuses on what the data says. He’ll often say “We don’t know what the cause of depression is – there’s no clear data.” Or, “There is no correlation between addiction, personality disorders, and childhood experiences. That’s not what the data we have indicates.” He won’t treat people who don’t do homework, because it’s the only thing that has a proven casual effect on depression.
TEAM-CBT, the therapy Dr. Burns created, is organized into clear-cut steps and methods, and the T. for testing is done with his own statistically proven questionnaires. David has even done the amazing job of systemizing empathy with five elements called the 5 secrets – five skills that when mastered allow a person to feel truly understood. I can not imagine something more left-brained than that – quantifying something as abstract as empathy into distinct measurable elements! (It’s really amazing. You can learn all about it on his podcast.)
And Steven to the Right
One could say that is ACT more “right brained.” It’s organized into the six processes of psychological flexibility – but the number six is where it stops being so tangible. Most of the processes are abstract concepts, and many analogies are used to convey the ideas to clients (an therapists). Committed action – ok, I get it. But being present, cognitive diffusion, self as context – those take a bit more thought to explain. And mindfulness itself – it’s very hard to quantify that.
Steven has done the amazing job of developing a whole behavioral learning theory called relational frame theory (RFT, and wrote a famous paper that bridges the gap between mindfulness and behaviorism in his famous article – Making Sense of Spirituality – sort of “quantifying” mindfulness. (I love that article!!) So he’s worked a lot on taking the abstract and spiritual, and distilling them into processes, gathering data supporting the theories and producing a myriad of studies etc.. So he’s not lacking in left brained skills – but the focus, and the way he communicates especially, is definitely right brained.
Example: Dr. Burns says something like, “I could never understand – what are these 6 processes exactly?” So Dr. Hayes answers with an experiential exercise and says something like… “Imagine you’re with someone in your life that was really there for you… How was he showing up for you? Was he present? Did he see you seeing him seeing you?” So yeah, this didn’t really seem to work for David. It did lead to a bit more common ground.. I think. (I’m more right brained, and I actually loved the exercise – it really gives you a “feel” for the hexaflex. If a person likes concepts like the right/left brain dichotomy… he might just be right-brained. The exercise is somewhere about half way into the podcast.)
Who cares? What Does this Do For My Life?
There are different ways of approaching everything, even how we approach things. It makes sense to be cognizant (pun retroactively intended) of people’s different thinking styles when we communicate with others.
Maybe a right brained researcher communicating with her left-brained colleague can start the conversation about hertheory with the facts and data that led herto develop it, before launching into her description of the beauty of the theory and how the theory integrates and envelopes the something or other. And maybe a left-brained person can start the discussion by describing a principle that lies behind his theory before getting into the nitty gritty.
Perhaps more practically, maybe a wife who is more interested in “stuff” could appreciate her husband’s interests and make room to hear his ideas, and the husband could look for ideas and patterns that come out of his wife’s interests.
Coming from the right, we could try to make things more concrete and appreciate the abstract, and coming from the left, we could try to communicate the principles behind the process and appreciate what’s happening on a deeper level. As a right brained person, I could try to come up with better examples that better illustrate the abstract nature of what I’m saying (I’m really trying hard here!). And as a left brained person, I could try to summarize what I’m saying in a way that conveys the main idea of what I’m saying or doing, and find a way that it could apply to other arenas.
ACTing along CBT lines
And along those lines, we can separate ourselves from our thoughts and realize that we are not our thoughts (ACT), and we can choose to think differently (CBT approach). And if we can’t or won’t change our thoughts, we can choose to take them much less seriously, “diffuse” from them, engage in the present moment (ACT), and continue to live a meaningful life.
We can even separate from how we think, and choose to think in different ways that can bring us towards our goals guided by our values and become happier people, suffering less and engaging with life more.
I think both an “ACT brained person” and a “CBT brained person” would agree with that.
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