Willingness is a very important part of doing acceptance work with clients. We can ask our clients to hold discomfort – but if they are not willing, due to fear, we can easily get stuck and progress will be minimal. As such, we may need to work with our client’s willingness to hold discomfort to make therapeutic gains.
There is a model we can use to explore this with our clients. We look at two dimensions: intensity and time. We want to support our clients to increase their capacity to hold greater levels of discomfort and to hold this discomfort for longer periods of time. In doing so, we may need to help our clients connect their values with a willingness to hold discomfort – such as discomfort relating to fear of rejection in the service of meeting a romantic partner. We can use this to explore with our clients their expectations when placing themselves in an environment that is likely to bring discomfort. The aim is to promote a willingness to hold discomfort.
The ‘snake in the room’ example helps here. We want to illustrate how our emotional arousal levels change over time. If we were to notice a snake in the room, we would quickly become highly aroused – that is, fearful. In the event we could not escape and the snake lay there in the corner, not moving for 15 minutes, we are likely to begin feeling slightly more comfortable. If we then noticed a second snake in the room, the same level of arousal/fear is likely to occur initially, but this time not last as long. Over time, the level of arousal/fear, too, is likely to decrease. It is similar to systematic desensitisation.
In acceptance work, the goal is not to systematically desensitise to fear/discomfort, but rather change our relationship with the fear, whereby we do not need to remove it, avoid it, or try and get rid of it. Acceptance work allows us to hold discomfort in the service of values to provide a richer more vibrant life – while possibly still experiencing the original discomfort.
If we are looking at our client’s willingness to experience the kind of discomfort that can occur as they take action towards a value, we might find resistance. The clue is to find a point that provides the client with a challenging level of discomfort (that is manageable for them) and linking this with a value worth working towards.
Kaito was depressed. He said he wanted to be able to talk to young women in social situations but found it awkward and embarrassing. Kaito was willing to take action that he knew would be uncomfortable, so that eventually he would be able to talk more openly with his peers in social environments and possibly meet a girl.
Working with Kaito’s willingness to endure discomfort in the service of connecting with others, we began by having him say ‘hi’ to a young female checkout operator at his local supermarket. After doing this several times, he felt comfortable enough to move on to the next challenge – to say ‘hi, how are you?’. Within weeks he was engaging in light-hearted small talk – although still feeling a level of discomfort, Kaito felt comfortable enough to repeat the performance in a social situation. Kaito was aware he would continue to feel uncomfortable but was willing to hold that discomfort in the service of connecting with his peers and being able to pursue a romantic relationship in the future.
In the above example you can see that we can create a ‘hierarchy of discomfort’ in collaboration with our clients and assist them with holding this discomfort in the service of a value. Over time we ask our clients to hold greater levels of discomfort (in a flexible manner, making room for them) and gently increase the intensity. We don’t want to ask our clients to do too much too soon, because they may avoid the experience. Avoiding the experience reinforces the idea that pain is to be removed or banished.
On the other hand, challenges that are too easy do not present the level of discomfort that produce benefit and don’t reinforce that some discomfort can be managed in pursuit of a value.
Over continued practice, and if necessary in increasingly challenging situations, clients learn to hold their discomfort without it causing so much distress. Discomfort is likely to still cause some angst but because our clients have had experience holding discomfort lightly, it does not cause the same level of angst as previously. They also have confidence in their capacity to deal with the discomfort as they pursue what is important to them.
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