Sunday, December 27, 2009

The Mindfulness and Acceptance Workbook for Depression

I began reading this book with the cynical expectation of being brainwashed by ACT (acceptance and commitment therapy). I relaxed some when in the middle of the book I read, “The type of acceptance we encourage you to practice is best thought of as a voluntary, intentional stance of nonjudgmental awareness of thoughts, feelings, memories, and sensations in the context of a triggering event.” By the end of the review, I absolutely loved the book. But I am quite certain I wasn’t brainwashed. Instead, I think it was the large focus on mindfulness with lots of engaging exercises that won me over.

The authors use a comprehensive definition of health that includes physical, psychological, and social aspects. The text itself is interesting in that it contains elements of ignorance, intelligence, poetry, insightfulness, creativity, superiority, and flaky triviality.

In the foreword the authors claim that, “Depression is not just a feeling. Depression is an action.” I would argue that depression is much more than either or both of those things. However, depression does affect action and action can likewise affect depression so both need to be ‘treated’ (by treating actions I mean learning healthy new behaviours and coping strategies).

There is a lot of talk of avoidance (presumably in order to contrast acceptance) of issues as being a root problem for depression. It is not uncommon for people with depression to avoid certain problems, but it is also common for depressed persons to be actively seeking solutions, only their illness clouds effectiveness. People with depression do try.

The ideas, at least in the first half of the book, are quite dichotomous. The book only has two options for thinking processes – wise mind and reactive mind – whereas I am more familiar with the three option approach – emotional mind, reasonable mind, and wise mind, which is a combination of the former two. There was actually a sentence at the end of a chapter implying that if the reader wasn’t ready to commit to change, they shouldn’t read any further until they are. I encourage readers to continue regardless as there are some beneficial exercises.

Many of the exercises in the book were insightful. I particularly liked the one where you get to write your own epitaph – “I should have separated the whites.” This type of individual engagement with understanding problems and solutions is likely to be more effective than simple fill-in-the-chart exercises.

It’s refreshing to see CBT ideas translated with a different vocabulary. An example of this is the ‘phishing’ metaphor used to help the reader identify problematic thinking. In CBT these same thinking types are recognised as ‘mind reading,’ ‘all or nothing thinking,’ etc. Plus, bonus points for using a computer metaphor leaning on the geeky side.

Final Rating: Very good.

1 comment:

  1. I had the same reaction the first time I was exposed to ACT, and although I don't practice it in the "ACT is the new black" kind of way, there are some nice contributions. My clients seem to raelly like the acceptance part, and I think that specifically has real value.