ACT - a bridge which translates Epicurean philosophy into life goals

A psychotherapy answer compatible with Epicurean philosophy

In think Acceptance & Commitment Therapy (ACT) – unlike most therapies – is fully compatible with Epicurean philosophy, especially regarding its attitude, and I think it is very helpful in solving the problem you've described here. It is also not a therapy which inherently requires a group or a therapist, which makes it accessible to anyone, at any time – much like having a philosophy

I understand psychotherapy as consisting of: exercises, models, approaches, attitudes, and therapies. Exercises are practical hands-on (social/physical/cognitive/emotional) tasks aimed at improving a skill (eg the skill of perceiving emotions before they become overwhelming). Models are maps, schematic assumptions of how the mind is built/works (eg the dialogical self). Approaches are a combination of a model and exercises to reach a goal (analogous to climbing routes). Attitude is the "philosophy" (colloquial sense of the word) underlying the therapy. A therapy is a combination of attitude, approach, model and exercises (similar to a style in traditional martial arts).

Summary:

1. ACT posits that suppressing thoughts and feelings is futile and counter-productive. ("Please try not to think about pink elephants for two minutes", "Just calm down!" – these things don't work.)
2. In practicing «defusion» the "I" is separated from thoughts and feelings: "I should have bought oranges." → "I notice the thought that I should have bought oranges." → The self is once-removed from the thought; the self is no longer identical to the thoughts and feelings, it became their observer. I am not my thoughts and feelings, I am the context of my thoughts and feelings. (Many other words exist for «defusion»; this is simply the ACT jargon for it.)
3. Next, thoughts and feelings are accepted: like feedback from our friends can sometimes be hard to hear, our own thoughts and feelings can be hard to accept, too. Because the self is a separate thing, it can fall into the trap of rejecting the arising thoughts and feelings; however, because it is separate, it can also accept them without agreeing with them – same as feedback from our friends. This allows me to hold both: "I notice the thought that I should have bought oranges, and I sense the sadness about not having any now. I appreciate being made aware of this thought and feeling, I agree it is valid on its own, but I continue to uphold my choice for prudent budget reasons."
4. This ability of holding both leads to two more traps: 1. rejecting reality ("I drink ten bottles each day but because I have a job and only drink with friends it is not a problem"), 2. rejecting/neglecting one's values
5. Values in ACT are understood as qualities of goals, but they are not virtues. Goals are specific tasks. Metaphor/Analogy: "Fly to Seattle" is a goal in support of the value to "Go West". When I've reached Seattle, my goal will be fulfilled, but the value will continue to exist – next stop: Honolulu! So the value of "Fitness" can be achieved by continually setting the goal to eat healthy and move my body. There are countless values, for example Love, Romance, Intimacy, Sexuality: This illustrates how fine-grained the values are. (Another value is Pleasure: ACT-Pleasure is defined as "give pleasure to oneself or others", which is more immediate/Cyrenaic than the Epicurean Guide-To-Life-Pleasure, which prudently considers Choice & Avoidance as part of Hedonic Calculus.)
6. Values are primary (true value) or secondary (false value): Each value which has another underlying value is a false value. For example, my value to Go West is only a false value, because it has an underlying value of Freedom. When I recognise this, I can conclude that I do should not Go West forever: I might end up in North Korea (which is further west, but less free). A true values is found when only Epicurean Pleasure can be named as its underlying motivation.
7. Whenever I act against my true values, that causes pain. I don't like pain, and since I myself am not my feelings (#2 above) and I can hold both (#3), I can fall into the trap of mental gymnastics (#4): I can rationalise my actions ("It had to be done!"), finding excuses ("Other people do that, too!"), minimise ("I don't do it often!"), and bargaining with myself ("There are many times I didn't do that!"). All of these mental gymnastics serve one purpose: To not have to accept and agree with the feeling and felt sense of having messed up. The thoughts and feelings which imply "I just betrayed my true values" are kept at a distance from the I, from my Self.
8. This psychological defence (#7) is a very slippery slope. For example, Power is a value in ACT. However, power is an unnatural desire. If I pursue power, I will soon need a lot of mental gymnastics, because I will have to act against my values of humility, honest, friendliness, trustworthiness, …. The longer I do this, the harder it will be to stop, because psychological defences are habit-forming and it is much harder to admit "I did wrong for ten years" than to accept "I made a mistake this once."
9. Now that the Acceptance is covered, it is time for Commitment: Once I have determined and prioritised my true values, it is time to commit to them. Counterexample: Power is a (false) value of mine, I accept that, but also I know it is an unnatural desire and it would undermine most of my other values, thus it only gets such a low priority as to be invisible in actual practice. Example: Responsibility/Accountability is a true value of mine. I know that making excuses doesn't get me anywhere, I don't like unreliable/flaky people, and I don't want to be one of them! So I commit to that value.
10. After committing to my true values, I select and plan specific goals which will bring their qualities into my life. (In ACT, goals which take a lifetime to achieve are called missions.) Because my plans serve my goals, my goals serve my values and my values serve Epicurean pleasure, I have no reason to diverge, and whenever I am tempted to diverge from my plans, I remember how painful it is to act against my values. The memory of that pain spoils the temptation, and the (greater) pleasure I get in following through with my plan is my reward. Every once in a while, one's values and the goals planned because of them should be reviewed – however, this should be done consciously, and not as an excuse to give in to unwise pleasures (#7, #8).

High-level (Epicurean): The ultimate goal of my nature is pleasure. It is what happiness is made of. I pursue pleasure through Choice and Avoidance guided by the virtues. Mid-level (ACT): Under the Epicurean umbrella, my commitment to my true values allows me to deduce my goals (and possibly a mission). Low-level (eclectic self-management): Under the ACT umbrella, I organise my smart-compliant goals according to an Eisenhower matrix – and once all this preparation is done, all that's left is to just do it. (A new book is published about this low-level category every day, but the truth is that almost always do I already know what to do and how to do it – and if I don't know how, I know who to ask or what to learn – and if I wouldn't know what to do, a fancy new way of writing my to-do lists wouldn't change that.) The mid-level is the glue, the bridge that connects philosophy to everyday life and vice versa.

This is a spontaneous summary of how I perceive ACT to relate to this thread, and while I'm certainly not an ACT expert, but I am quite an expert at being lost in life so when I suggest having a look at Acceptance & Commitment Therapy, I do that because its attitude, approach, model, and exercises were very helpful to me, because reading the thoughts behind it and doing the exercises can be done on one's own, and also because I think it is a recipe which favourably complements our Epicurean main course.

Julia I see that ACT is compared to Cognitive Behavior Therapy (perhaps as a self-help version of it?)

On the Wikipedia CBT page I think the "criticisms" section used to be longer, but this part is still there:

Quote

Philosophical concerns with CBT methods

The methods employed in CBT research have not been the only criticisms; some individuals have called its theory and therapy into question.^[256]

Slife and Williams write that one of the hidden assumptions in CBT is that of determinism, or the absence of free will. They argue that CBT holds that external stimuli from the environment enter the mind, causing different thoughts that cause emotional states: nowhere in CBT theory is agency, or free will, accounted for.^[246]

Another criticism of CBT theory, especially as applied to major depressive disorder (MDD), is that it confounds the symptoms of the disorder with its causes.^[249]

I seem to recall that the older criticism was longer (I made the same comment two years ago...) and I believe that the extended criticism was to the effect that CBT does not start with a model of "healthy" behavior and thus has no identifiable target for what it seeks to produce.

Would ACT be subject to similar criticisms of determinism or lack of identification of the proper goal?

UPDATE: I found a 2015 revision of the page with a much longer "Criticism" section. Here is the statement I remember: "However, the research methods employed in CBT research have not been the only criticisms identified. Others have called CBT theory and therapy into question. For example, Fancher^[159] writes the CBT has failed to provide a framework for clear and correct thinking. He states that it is strange for CBT theorists to develop a framework for determining distorted thinking without ever developing a framework for "cognitive clarity" or what would count as "healthy, normal thinking." Additionally, he writes that irrational thinking cannot be a source of mental and emotional distress when there is no evidence of rational thinking causing psychological well-being. Or, that social psychology has proven the normal cognitive processes of the average person to be irrational, even those who are psychologically well. Fancher also says that the theory of CBT is inconsistent with basic principles and research of rationality, and even ignores many rules of logic. He argues that CBT makes something of thinking that is far less exciting and true than thinking probably is. Among his other arguments are the maintaining of the status quo promoted in CBT, the self-deception encouraged within clients and patients engaged in CBT, how poorly the research is conducted, and some of its basic tenets and norms: "The basic norm of cognitive therapy is this: except for how the patient thinks, everything is ok".^[163]

Quote

Criticisms

The research conducted for CBT has been a topic of sustained controversy. While some researchers write that CBT is more effective than other treatments,^[155] many other researchers^{[7][156][157]} and practitioners^[158][159] have questioned the validity of such claims. For example, one study^[155] determined CBT to be superior to other treatments in treating anxiety and depression. However, researchers^[7] responding directly to that study conducted a re-analysis and found no evidence of CBT being superior to other bona fide treatments, and conducted an analysis of thirteen other CBT clinical trials and determined that they failed to provide evidence of CBT superiority.

Additionally, a recent meta-analysis revealed that the positive effects of CBT on depression have been declining since 1977. The overall results showed two different declines in effect sizes: 1) an overall decline between 1977 and 2014, and 2) a steeper decline between 1995 and 2014. Additional sub-analysis revealed that CBT studies where therapists in the test group were instructed to adhere to the Beck CBT manual had a steeper decline in effect sizes since 1977 than studies where therapists in the test group were instructed to use CBT without a manual. The authors reported that they were unsure why the effects were declining but did list inadequate therapist training, failure to adhere to a manual, lack of therapist experience, and patients' hope and faith in its efficacy waning as potential reasons. The authors did mention that the current study was limited to depression disorders only.^[160]

Furthermore, other researchers^[156] write that CBT studies have high drop-out rates compared to other treatments. At times, the CBT drop-out rates can be more than five times higher than other treatments groups. For example, the researchers provided statistics of 28 participants in a group receiving CBT therapy dropping out, compared to 5 participants in a group receiving problem-solving therapy dropping out, or 11 participants in a group receiving psychodynamic therapy dropping out.^[156] This high drop-out rate is also evident in the treatment of several disorders particularly anorexia nervosa, an eating disorder commonly treated by CBT. People with anorexia nervosa who are treated with CBT have a high percent chance of dropping out of therapy before completion and reverting to their aneroxia behaviors.^[161]

Other researchers^[157] conducting an analysis of treatments for youth who self-injure found similar drop-out rates in CBT and DBT groups. In this study, the researchers analyzed several clinical trials that measured the efficacy of CBT administered to youth who self-injure. The researchers concluded that none of them were found to be efficacious. These conclusions^[157] were made using the APA Division 12 Task Force on the Promotion and Dissemination of Psychological Procedures to determine intervention potency.^[162]

However, the research methods employed in CBT research have not been the only criticisms identified. Others have called CBT theory and therapy into question. For example, Fancher^[159] writes the CBT has failed to provide a framework for clear and correct thinking. He states that it is strange for CBT theorists to develop a framework for determining distorted thinking without ever developing a framework for "cognitive clarity" or what would count as "healthy, normal thinking." Additionally, he writes that irrational thinking cannot be a source of mental and emotional distress when there is no evidence of rational thinking causing psychological well-being. Or, that social psychology has proven the normal cognitive processes of the average person to be irrational, even those who are psychologically well. Fancher also says that the theory of CBT is inconsistent with basic principles and research of rationality, and even ignores many rules of logic. He argues that CBT makes something of thinking that is far less exciting and true than thinking probably is. Among his other arguments are the maintaining of the status quo promoted in CBT, the self-deception encouraged within clients and patients engaged in CBT, how poorly the research is conducted, and some of its basic tenets and norms: "The basic norm of cognitive therapy is this: except for how the patient thinks, everything is ok".^[163]

Meanwhile, Slife and Williams^[158] write that one of the hidden assumptions in CBT is that of determinism, or the absence of free will. They argue that CBT invokes a type of cause-and-effect relationship with cognition. They state that CBT holds that external stimuli from the environment enter the mind, causing different thoughts that cause emotional states. Nowhere in CBT theory is agency, or free will, accounted for. At its most basic foundational assumptions, CBT holds that human beings have no free will and are just determined by the cognitive processes invoked by external stimuli.

Another criticism of CBT theory, especially as applied to Major Depressive Disorder (MDD), is that it confounds the symptoms of the disorder with its causes.^[164]

A major criticism has been that clinical studies of CBT efficacy (or any psychotherapy) are not double-blind (i.e., neither subjects nor therapists in psychotherapy studies are blind to the type of treatment). They may be single-blinded, i.e. the rater may not know the treatment the patient received, but neither the patients nor the therapists are blinded to the type of therapy given (two out of three of the persons involved in the trial, i.e., all of the persons involved in the treatment, are unblinded). The patient is an active participant in correcting negative distorted thoughts, thus quite aware of the treatment group they are in.^[164]

The importance of double-blinding was shown in a meta-analysis that examined the effectiveness of CBT when placebo control and blindedness were factored in.^[165] Pooled data from published trials of CBT in schizophrenia, MDD, and bipolar disorder that used controls for non-specific effects of intervention were analyzed. This study concluded that CBT is no better than non-specific control interventions in the treatment of schizophrenia and does not reduce relapse rates, treatment effects are small in treatment studies of MDD, and it is not an effective treatment strategy for prevention of relapse in bipolar disorder. For MDD, the authors note that the pooled effect size was very low. Nevertheless, the methodological processes used to select the studies in the previously mentioned meta-analysis and the worth of its findings have been called into question.^{[166][167][168]}

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Sorry for the lack of organization of this post but the question I would ask to either ACT or "nonviolence" would be:

Would ACT (or NVC) be subject to similar criticisms of deterministic assumptions or lack of identification of what constitutes healthy thinking?

Quote from Kalosyni

I spent some time studying a system of self-help and mediation called Nonviolent Communication

I'm familiar with NVC, but I see it as more of a communication style, a technique; it can be used as part of pretty much anything, especially couples therapy and mediation. However, I don't see how it would help in "Clarifying Your Philosophical Goal Through Your Individual Definition of Pleasure", which is specifically what I sat down to write my post for.

Quote from Kalosyni

I found this method called WOOP

I've had never heard of "WOOP" before, but the website you linked to says it equals Mental Contrasting with Implementation Intentions (MCII). MCII is not a therapy; it is an exercise / technique / specific task. As such, MCII is implicitly a part of what I tried to outline above. On its own, however, I don't think it would be sufficient for glueing the high (abstract) level of Epicurean philosophy well to the low (concrete) level of self-management, because it stays very close to the latter.

ACT is much broader than this. To quote one of the original ACT books: "If theory is necessary, is philosophy also? It is. […] This book is based on a particular philosophy and a set of theoretical concepts that differ notably from those within the psychological mainstream. If the core philosophies of ACT are understood, many techniques can be added to it and it will still be ACT. ACT is an approach, based on a theory and set firmly within a philosophical tradition. It is to that tradition that we now turn." (Quotation source: Part 1, Chapter 2 of Acceptance and Commitment Therapy: An Experiential Approach to Behavior Change, by Hayes, Strosahl & Wilson, 1999) It has begun 40ish years ago, has garnered large research interest, is widely used clinically all over the world, and as a self-help tool is endorsed and offered by world-class universities for struggling students as well as by WHO for refugees. So it's kind of a thing.

Quote from Kalosyni

Here I mean "goal" in a philosophical sense, not in getting a good career or marriage and family (these could be thought of as a means but not an end). The goal we hold in our mind becomes a kind of "canon" for how we make decisions.

I think of that goal-in-the-philosophical-sense as my values-in-the-ACT-sense. It was not my intention to argue for or against the compatibility of one or another therapy or self-help guide with Epicurean philosophy (but of course I would not suggest one which I consider incompatible). For me, ACT is the bridge which translates Epicurean philosophy into life goals and actionable plans (which will make me happy), and this is what I understood your other post (linked above) to be about – maybe I misunderstood?

Quote from Cassius

Julia I see that ACT is compared to Cognitive Behavior Therapy (perhaps as a self-help version of it?)

CBT is a class of therapies which developed in waves. I suppose ACT can be put in that box, but if I had to write a classification of therapies, I probably wouldn't place it there; among other reasons, because it does not share this "basic norm":

Quote from Cassius

"The basic norm of cognitive therapy is this: except for how the patient thinks, everything is ok"

Quote from Cassius

(perhaps as a self-help version of it?)

It is not primarily designed as a self-help tool, but it can be used as such with reasonable ease, and some off-the-shelf variants exist for that purpose.

Quote from Cassius

Would ACT be subject to similar criticisms of determinism or lack of identification of the proper goal?

I would reject both of these claims.

To reject determinism, I combed through the same book I already quoted above (because it has the distinction of being the first one published in a little series by the group which made ACT really gel together, and also because it has a focus on theory, laying out what I called attitude and approach): "Most clients have little appreciation for how random social conditioning actually is. Instead of approaching the issue from the perspective of random and accidental learning, the client may […]" → By seeing learning as random and accidental, determinism is implicitly rejected. Furthermore, they quote research showing that humans can be trained in producing statistically random sequences – which isn't quite compatible with determinism, is it? And finally, "free choice" is a common theme in ACT, and while the authors acknowledge that behaviour is not, in fact, entirely free, they also do not argue for determinism: "That does not mean [the behaviour] is random or literally free. From a scientific perspective, such contingency-shaped behavior occurs because of certain historical conditions, and thus choices are sensible, coherent, and historical. […] From the point of view of the client, the closest we can get to peaking about such situations honestly is that choices are “free.”"

I am confident to reject the "lack of identification of a proper goal", because there are various passages which stress actual experiences (as opposed to numbness/nirvana or living-in-your-head) alongside a focus on "happiness" and an absence of "pain". To me, this is quite close to Epicurean philosophy (and I perceive it as close to that in other ways, too). What is more, they are well-aware that normal/average ways of thinking are far from ideal, and the entire dance is not about making the client normal but about making them well; what is well isn't arbitrarily magicked out of thin air, but is carefully reasoned about and is, by now, tried and tested in practice for decades; to quote: "Happiness for a dog or a cat is straightforward. If pets are given shelter, food and drink, warmth, stimulation, play, and physical health they are contented. […] But many humans have all the things a nonverbal organism would need to be happy, and yet they are not. […] Literally nothing external that you can name […] [is] enough to ensure that a human will not suffer terribly. […] [And despite all evidence to the contrary, in mental health] there is the assumption of healthy normality."

ACT values are not prescriptive, but descriptive. They are also not considered absolute (like Stoic/Platonic virtues), and they are not considered ultimate (like Epicurean pleasure). They're simply a method of figuring out what brings pleasure and to remember that. If you don't need an intermediate step between Pleasure/Pain and specific, individual actions, that's fine. For me and countless others, however, knowing what type of actions/objects/behaviours/… consistently result in a net-gain of pleasure is very helpful. And that, among many other problems, can be solved by using ACT.

Quote from Kalosyni

it appears there is a kind of "language of abstractions" at work

This is both incorrect and correct. It is correct, because the ACT value of "Order" is more abstract than "put the trash in the trash bag"; it is incorrect, because "order" is less abstract than Pleasure. And also: ACT values are explicitly not virtues (and they're also only one of many things ACT entails). Values are simply types of things/behaviours/… you value, as in which bring long-term net pleasure. The types of or categories of things/behaviours/… which bring pleasure aren't obvious just like that to everybody. When you've been raised by wolves, how would you know that chocolate is fun? And once you've figured that out, why would you conclude from it that there is an entire category called "candy", that there's an entire type of things which are fun in a similar way to chocolate? Just because I know I like my trash in the trashbag doesn't mean I recognise I might also like a clean sink. And once I know I like trashbags and clean sinks, how do I know which is more important to me and how they compete against each other and against eating candy? Not everyone is already conscious of the category of things which they appreciate, can conceive of all relevant categories on their own, can easily figure out how important they to them – or how important they would be, had they known them. You cannot hold a value firmly in your mind until you've experienced it, and unless you want to wait until your mind, on its own, comes up with all that's good and available, you need to learn about it from somewhere. Then, once you know it exists, how to think about it? Which patterns of thought are useful, when it comes to values? There's nothing wrong with using a flexible and non-prescriptive framework to help oneself think, and there's nothing wrong with bootstrapping it all by using a descriptive list of categories of things many people find pleasurable as a basis for inspiration.

I never claimed ACT was a replacement for Epicurean philosophy and I never claimed it was a replacement for to-do lists, because it isn't. I simply say is that it fits neatly in the middle and connects the two. This implies that people who have no trouble in making that connection stand nothing to gain in that respect. They might still benefit from other ACT aspects (because, as I said, it is much more than that), but I imagine those aspects should better be discussed at TherapistsCorner, than at EpicureanFriends