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ACT For Insomnia

The document provides guidance for mental health practitioners on using Acceptance and Commitment Therapy (ACT) to help clients with insomnia. It discusses problems with traditional sleep hygiene programs, the importance of thorough assessment, highlighting the sleep control paradox clients get stuck in, and offering an alternative approach of accepting lack of sleep and using restful activities instead of control strategies.

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0% found this document useful (0 votes)
1K views27 pages

ACT For Insomnia

The document provides guidance for mental health practitioners on using Acceptance and Commitment Therapy (ACT) to help clients with insomnia. It discusses problems with traditional sleep hygiene programs, the importance of thorough assessment, highlighting the sleep control paradox clients get stuck in, and offering an alternative approach of accepting lack of sleep and using restful activities instead of control strategies.

Uploaded by

melissa.f.torres
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

ACT for Insomnia

By Russ Harris
Bestselling author of 'ACT Made Simple' and 'The Happiness Trap'

12 MIN READ APPROX.

ACT Tips and Insights for Mental Health Practitioners


Contents
Insomnia Matters 3

Problems with Traditional ‘Sleep Hygiene’ 4

Assessment 5

The Sleep Control Paradox 6

Validate the Client’s Experience 7

Highlight the Vicious Cycle 7

Offer an Alternative 8

Restful & Restorative Activities: Part 1 10

Restful & Restorative Activities: Part 2 12

What’s Next? 15

Undermine Experiential Avoidance 16

Defusion & ‘Worry Time’ 17

Acceptance & Self-Compassion 17

Contact with the Present Moment 19

Dropping Anchor 19

Values & Committed Action 20

Ten Useful Strategies for a Restful Night 21

Ups & Downs 25

How You Spend Your Days Affects Your Nights 25

[Link]/Harris 2
Insomnia Matters
Improving sleep has a huge positive impact on mental health and
wellbeing. We all know how hard it is to get through the day when
we haven’t slept well; and how refreshed we feel after a good night’s
sleep. No matter what the clinical issue may be, if insomnia is part of
the picture, it’s sure to make matters worse.

On the other hand, if sleep can be improved (and it usually can), that’s
likely to have significant positive effects and help clients cope better
with their other problems.

[Link]/Harris 3
Problems with Traditional ‘Sleep
Hygiene’ Programs
‘Sleep hygiene’ basically means doing things to improve our quality
and quantity of sleep, and reducing behaviours that interfere with it.
The problem with most traditional ‘sleep hygiene’ programs is they
tend to be extremely rigid and demanding. Typically, they have very
strict rules that must be obeyed to the letter, and many people feel
‘under pressure’ when trying to follow them.

This is especially so when it comes to commonly recommended rules


like these:

• Only go to bed when sleepy.

• Only use the bed for sex or sleeping.

• Do not nap during the day.

• If you’re not asleep within 15 minutes, get out of bed, go into


another room, and do something relaxing, like reading a book.

These are hard rules for most people to follow. And for highly anxious
clients, the idea of reducing the amount of time they spend in bed
may itself become a source of anxiety. (This of course makes them
even more anxious, thereby increasing their difficulty in sleeping).
So it’s perhaps not too surprising that adherence rates for traditional
sleep hygiene programs are low.

The good news is, ACT offers a much more practical and flexible
alternative to traditional sleep hygiene programs - with none of the
bullet-pointed rules above. The information that follows has been
influenced by the ‘ACT for Insomnia’ program (ACT-I), created

[Link]/Harris 4
by Guy Meadows. And if you’d like a deep dive into the topic of ACT for
insomnia, check out Guy’s popular self-help book: appropriately called
The Sleep Book. Meanwhile, for a quick overview of the topic, read on.

Assessment
It’s important to do a thorough assessment for insomnia, which
includes:

• Comorbidity (for example, depression, PTSD, or anxiety disorders)

• Lifestyle factors (such as diet, exercise, drugs and alcohol)

• Sleep routines and bedtime habits

• Medical conditions (a medical check-up is advisable)

• Major life events (for example, a new baby, bereavement,


relationship break up, work deadlines, any sort of major loss or
crisis)

• Prescription medications (many have insomnia as a side-effect)

• All previous strategies used to try and improve sleep

Sometimes, when we ask about previous strategies, a client reports


that they’ve tried ‘mindfulness’, and ‘it doesn’t work’ or ‘doesn’t
help’. Usually this means they’ve fundamentally misunderstood the
concept.

In such cases, here’s what you’ll need to do.

[Link]/Harris 5
The Sleep Control Paradox:
What Has the Client Already Tried?
Trying hard to control sleep usually interferes with it. And most
insomniac clients have already tried hard to control it, with little or no
success.

So as part of our assessment, we want to explore all the different


‘sleep control’ strategies the client has previously tried. This may
include relaxation techniques, herbal remedies, alcohol, marijuana,
prescription medication, staying up late until exhausted, positive
thinking, following strict rules from traditional sleep hygiene
programs, practicing wind-down rituals, and so on.

[Link]/Harris 6
Validate the Client’s Experience
Once we’ve identified all the client’s previous ‘sleep control’ strategies,
we want to validate their experience. With great compassion, we may
say something like this:

Therapist: It’s clear that you have tried hard to improve your
sleep. And most of the methods you’ve tried are
widely recommended by friends or family or health
professionals; in fact, just about everyone tries using at
least some of those methods, at times. Unfortunately,
even though some of these methods do work in the
short term … in the long term, they’re not giving you
the results you want.

Highlight the Vicious Cycle


Following validation, a useful next step is to highlight the vicious cycle
the client’s been caught in:

Therapist: And that sucks, right? Despite all that effort, you’re still
suffering from insomnia. And there’s a very good
reason why. And it’s not because you haven’t tried
hard enough. It’s actually the opposite. The problem is,
you’re trying too hard.

Client: What do you mean?

Therapist: Well, if I can use a bit of jargon, what’s going on here


is that you’re stuck in the vicious cycle of ‘sleep control’.
We call it a vicious cycle, because trying very hard to
control our sleep usually interferes with it; and the

[Link]/Harris 7
harder we try, typically the worse it gets. See, what
happens is, when we’re not getting much sleep, we
start to develop a ‘sleep control’ mindset. We go to
bed thinking ‘I have to get a good night’s sleep! If I
can’t sleep, I can’t function! I must get to sleep! I can’t
carry on like this!’ - and so on. Which is completely
understandable. But the problem is, that ‘sleep
control’ mindset creates stress, anxiety, pressure and
worry – all of which makes it harder for us to sleep. So
I’m wondering: would you be open to trying a very
different approach; something that’s radically different
to everything else you’ve tried?

Client: Sure. What is it?

Offer an Alternative
The next step is to offer the client an alternative approach. We
have to be very careful how we do this, as it’s easy for the client to
misunderstand.

Therapist: Well, it’s a very different way of approaching sleep,


and there’s a fair bit to it. There’s a lot to take in, so is it
okay if we go through it step-by-step?

Client: Sure.

Therapist: Okay, well the first step is hard to get your head
around, at least for most people. But here it is:
stop trying to control your sleep. (Pause).

Client: What d’you mean?

[Link]/Harris 8
Therapist: I mean, basically, the idea is to treat your time in bed
as an opportunity to rest and restore yourself –
whether you’re sleeping or not. So if you’re in bed,
but you’re not sleeping, the idea is to use that time
constructively: to do something that’s restful
and restorative.

Client: I told you, I’ve tried that. I’ve tried relaxation/


mindfulness/calming/self-soothing techniques;
they don’t work.

Therapist: That’s right. Because when you’re doing those things,


you’re trying hard to control your emotions, trying
hard to control how you feel, trying hard to get rid
of anxiety and stress and tension, trying hard to feel
more relaxed. And that’s hard work. Trying hard to
control how you feel is not restful or restorative. When
someone who’s a good sleeper goes to bed, do you
know what they try hard to do?

Client: Err, no.

Therapist: Nothing. They just treat bed as a place of comfort and


rest. They don’t try to make sleep happen and they
don’t try to control their thoughts and feelings. The
more we try to do those things, the harder it is to sleep;
it just keeps that vicious cycle going.

Client: So what am I supposed to do, if I can’t sleep?


Just lie there, tossing and turning?

Therapist: No, not at all. The idea is to use that time in bed to do
things that are restful and restorative. Can I take a
couple of minutes to explain …?

[Link]/Harris 9
Restful & Restorative Activities: Part 1
The next step is to outline what the client can do in bed, when
they’re not sleeping. Basically there are two kinds of activity they
can do in bed:

1 Mindfulness practices

2 Anything that’s basically restful, soothing, or calming.


For example: cuddling, sex, masturbation, reading a book,
listening to music (but nothing that’s likely to stimulate you, like
reading a thriller; and nothing that involves exposure to screens
and blue light, like watching TV or scrolling on your phone).

[Link]/Harris 10
Now at this point, a quick reminder: in ACT, the word ‘mindfulness’ is
an umbrella term for defusion, acceptance, contacting the present
moment, and self-as-context; it may refer to any one of those
processes, or any combination of them.

At times, it may be better to avoid the term ‘mindfulness’, because


there are so many common misconceptions about it. (For example,
many people mistakenly think it’s meditation, Buddhism, or a
relaxation technique.)

So instead of talking about ‘mindfulness’, you could use ACT terms


such as unhooking, opening up, noticing, refocusing and expanding
awareness. For example, you can use ‘unhooking skills’ as an umbrella
term for any or all of the defusion, acceptance, self-compassion, self-
as-context, or present moment ACT skills:

Therapist: Well, there are two main kinds of activity you can do
in bed. One is practising your ‘unhooking skills’. For
example …. (you now mention practices you’ve covered
in earlier sessions, for example, leaves on a stream,
listening in to thoughts, physicalising, body scans, kind
hands, ‘making room’ for emotions, naming the story,
noticing the breath, and so on).

If we leave addressing insomnia for later sessions, that usually makes


it easier to work with, because the client already has ACT skills to
draw upon.

If we choose to address insomnia in an early session before the client


has such ACT skills to draw upon, we’ll need to say something like, ‘To
improve your sleep, you’ll need to learn a few “unhooking skills”. These
are methods for unhooking from difficult thoughts and feelings, so

[Link]/Harris 11
they can’t keep jerking you around. Once you learn how to do this
throughout the day, you’ll then be able to do it at night, in bed. But it
will take a fair bit of daytime practice to get to that point.’

Restful & Restorative Activities: Part 2


After running through the above, we can continue:

Therapist: So that’s one type of activity to do in bed, when you’re


not sleeping. The other type of activity is anything
that’s basically restful or soothing, like reading a book
or listening to music. But nothing that exposes you
to blue light - like watching TV or using your phone
– because blue light exposure interferes with sleep.
And also nothing that’s likely to make you even more
awake, like reading a gripping thriller or listening to
music that revs you up. And also, nothing that’s likely
to tax your brain, like working or studying.

If the client now says something like, ‘But I’ve already tried all that. It
didn’t help!’, we may reply:

Therapist: Yes – yes, absolutely; you have! So, two things that are
really important for you to know: One, this is just one
small piece of the puzzle. There’s a whole lot more to it
– we’re just getting started. Two: it’s not surprising that
it didn’t help, because you were doing it with a ‘sleep
control’ mindset: ‘I have to get to sleep!’ And it’s that
very mindset that keeps you awake. And nothing we
do here will help if you cling to that mindset. So you
have to fundamentally shift it: make your bed a place

[Link]/Harris 12
for rest and comfort; a place to treat yourself with
kindness and caring – whether you’re awake or asleep.
So if you’re sleeping, great; but if you’re not sleeping,
you’re doing restful, restorative activities that are
going to give you many of the benefits of sleep. And if
you’re anything like most of my clients, you’re probably
thinking, ‘But lying awake isn’t restful. I keep tossing
and turning and worrying.’

Client: Yes! I was just about to say that!

Therapist: Of course. Because at the moment, when you’re


awake in bed, that’s what it’s like – tossing, turning,
stressing out. Not restful or restorative. So that’s
where these unhooking skills come in. There are
several specific unhooking skills that can help you to
dramatically change that – so that lying awake in bed
does become restful.

Client: But I don’t want to lie awake! I want to sleep.

Therapist: Of course you do. We all do! But … if you get caught
up in that ‘sleep control’ mindset … Well, you know
what happens, right? Vicious cycle: the more you try to
control your sleep, the worse it gets. So we’re talking
about doing something radically different.

At this point, it’s often useful to introduce the classic ‘struggling in


quicksand’ metaphor, to illustrate how doing what comes instinctively
in a difficult situation can make it a whole lot worse. This isn’t
essential, but it’s often helpful.

[Link]/Harris 13
Watch Russ Harris discuss how letting go of the struggle with your own thoughts
and feelings is similar to being stuck in quicksand.

Then the next step is:

Therapist: So the aim now is to make this radical shift. Instead of


making your bedroom ‘the place of sleep’ – you make
it ‘the place of rest’. So if you’re in bed, and you’re not
sleeping, the idea is to use that time effectively.
Instead of tossing and turning and stressing and
worrying, you do these other activities we’ve been
talking about, which will make your bed a restful and
restorative place.

And here’s the bonus: most of the time, when you do


these activities in bed, you will eventually fall asleep.
That’s not the aim of them – and if you start using
them to try to make yourself sleep, then you’re right
back into that vicious ‘sleep control’ cycle. But it does
often happen - and it’s a nice bonus you can enjoy
when it occurs. And of course, there will be nights
when that doesn’t happen, because this isn’t some
[Link]/Harris 14
miracle cure – but even on those nights when you’re
not sleeping, at least your time in bed will be a lot
more restful and restorative than it is now.

What’s Next?
What we do next will depend on:

a) the causes/factors underpinning the client’s insomnia,

b) the other issues the client is dealing with, and

c) what we’ve already covered in earlier sessions.

With clients who already have some (genuine) mindfulness skills


to draw upon (such as, from earlier ACT sessions, previous therapy,
personal growth, or spiritual pathways), we can now begin to explore
how they can practice these in bed when not sleeping.

However, with clients new to mindfulness, we need to quickly explain


what it is. And it’s soooo important that we keep our explanations
short, sweet and simple; if we’re not careful, it’s easy to waffle on and
bore, overwhelm, or confuse the client.

It’s best to select just one core mindfulness process – usually either
defusion or acceptance – and introduce it with a simple but powerful
metaphor like ‘hands as thoughts’ for defusion or ‘pushing away
paper’ for acceptance. For example:

Therapist: Okay, so there’s a bunch of different skills involved and


it’ll be confusing if I try to go through them all at once.
I think the most useful one to begin with is something
called ‘unhooking from thoughts’. Can I take you

[Link]/Harris 15
through a little exercise to give you a sense of what’s
involved? (Therapist takes client through the ‘hands as
thoughts’ exercise.)

Or:

Therapist: Okay, so there’s a bunch of different skills involved


and it’ll be confusing if I try to go through them all
at once. I think the most useful one to begin with is
something called ‘making room for feelings’. Can I
take you through a little exercise to give you a sense
of what’s involved? (Therapist takes client through the
‘pushing away paper’ exercise.)

And after that? Well, let’s take a look at the different options.

Undermine Experiential Avoidance


& Emotional Control
With any mindfulness practice – especially defusion and acceptance
techniques - we need to be crystal clear that the aim is not to make
unwanted thoughts and feelings go away, but to open up and make
room for them, and allow them to freely come, stay and go in their
own good time. It’s okay if they hang around; and it’s okay if they go
and then return. (Note how the final paragraph of the script for both
‘hands as thoughts’ and ‘pushing away paper’ makes this explicit.)

If a client is opposed to this, and just wants these thoughts and


feelings to go away, we bring in ‘creative hopelessness’ to undermine
experiential avoidance and the agenda of emotional control. (If you’ve
forgotten what ‘creative hopelessness’ involves, read this free eBook.)

[Link]/Harris 16
Defusion & ‘Worry Time’
Both in the run up to bedtime, and when in bed, we encourage clients
to utilise defusion techniques to handle sleep-interfering thoughts.
Before bed, this may include simple defusion techniques based on
noticing and naming: ‘I’m having the thought that ….,’ ‘Aha! Here’s the
‘no sleep’ story! I know this one!’ ‘Hello anxious thoughts; here you are
again’, ‘Here’s worrying’, ‘Thanks mind! I know you just want me to
sleep better - and it’s okay, I’ve got this handled.’

Once in bed, they can continue to use simple noticing and naming, or
switch to meditative defusion techniques, such as ‘leaves on a stream’.
(About 10% of the population find visualisation hard or impossible, so
a good non-visual alternative to ‘leaves on a stream’ is ‘listening in to
the mind’.)

If the client is doing a lot of worrying in bed, an ACT-congruent version


of the famous ‘Worry Time’ strategy can be very useful. Click here for
a client handout on the ACT-ified version of this method. (Obviously,
‘Worry Time’ should NOT be scheduled immediately before bed!)

Acceptance & Self-Compassion


We actively encourage clients to open up and make room for all
difficult private experiences that show up in bed: thoughts, feelings,
emotions, memories, urges and sensations. For unpleasant feelings
and sensations in the body, useful acceptance techniques include
‘physicalising’, ‘observe-breathe-expand-allow’, and ‘mindfulness
of emotions’.

[Link]/Harris 17
ACT for Grief & Loss course

Watch Russ Harris explain the four ‘A’s of acceptance: Acknowledging, Allowing
Accommodating and Appreciating.

Meditative self-compassion exercises, such as ‘kind hands’ or ‘bowl


of kindness’ or ‘loving kindness meditation’ are good additions or
alternatives.

ACT for Beginners course

Watch Russ Harris explain the importance of self-compassion and deconstruct this
into six elements that interconnect and overlap with each other.

[Link]/Harris 18
Contact with the Present Moment
When clients are in bed but not sleeping, we encourage them to do
restful, restorative mindfulness practices – such as a mindful body
scan or mindfulness of the breath. In Trauma-Focused ACT, a popular
practice is Progressive Muscle Mindfulness (PMM). It’s like Progressive
Muscle Relaxation (PMR), but with one massive difference. The
primary aim of PMR is to relax, but in PMM there is no emphasis on
relaxation, and never any mention of the word ‘relax.’ In PMM, the aim
is simply to notice the sensations in your body and allow them to be
as they are. (Here’s a PMM script.) This avoids problems that can occur
with PMR, when people are ‘trying to relax’ but find they can’t.

A good alternative to such exercises is to simply tune in mindfully to


the experience of being in bed, consciously appreciating the warmth
and comfort: the mattress supporting you; the warmth in your chest,
arms and legs; the softness of the pillow beneath your head; the
darkness behind your eyelids; the touch of the blankets on your chest;
your body resting; and so on.

Dropping Anchor: To Wake Up or


Wind Down
You can use dropping anchor exercises in bed for two different
purposes: to wake up or to wind down. If you want to use it to help
people wake up and get out of bed – especially when they find that’s
hard to do because they’re tired and sleepy following a restless night,
read this. The document describes how dropping anchor is used to
wake you up, make you as alert as possible – with lots of emphasis
on active physical movement in bed and connecting with the world

[Link]/Harris 19
around you. During the day, you can use similar versions of the
exercise to disrupt rumination and worrying.

However, if you’re in bed and you want to wind down into a restful and
restorative state, you need to significantly modify the way you drop
anchor. In the C (connect with your body) phase of an ACE cycle, you
don’t want to be actively moving and stretching; instead you lie still
and connect with the gentle movement of the breath, or the feeling
of your body pressing down into the mattress, the sense of your head
sinking into the pillow. In the E (engage in current activity) phase, the
aim is to tune into the warmth and comfort of the bed beneath you
and the bedclothes on top of you. This is a good antidote to worrying
and rumination.

Values & Committed Action


In the service of their values, we encourage clients to implement new
behaviours likely to improve their sleep quality. The key to success
here is, not surprisingly, flexibility. We want to encourage clients to
experiment with the suggestions we give them and bring an attitude
of openness and curiosity.

And don’t turn them into RULES THAT YOU MUST ALWAYS OBEY.
The idea is to experiment with them - adapt and modify them as
necessary - and notice what difference they make, over time. We may
say something like:

Therapist: I’m going to suggest a whole bunch of things for you


to play around with. And I’m expecting most of these
things to be helpful, but of course, nothing always
works for everyone. So please, treat everything I
suggest as an experiment - in the sense that we don’t

[Link]/Harris 20
know for sure what will happen. The idea is to carefully
observe what happens, and if the results aren’t as
intended, be open to trying something different. With
all of these strategies, treat them as the loosest of
guidelines. They’re not rules you have to obey. The idea
is to modify and adapt everything so that we can make
it work for you as well as possible.

What follows next are ten useful strategies we can encourage clients
to flexibly experiment with. If you want these in the form of a client
handout, click here.

Ten Useful Strategies for a Restful Night


Below you’ll find a number of recommendations for things you can
do that are likely to give you a more restful night and a better quality
of sleep. No single strategy works for everyone - but most people
find most of these strategies helpful. But be flexible with them: don’t
turn them into RULES THAT YOU MUST ALWAYS OBEY. Experiment
with them - adapt and modify them as necessary - and notice what
difference they make to your sleep quality over time.

1 Restrict stimulants before bed

• Avoid products containing caffeine (tea, coffee, chocolate)


for at least four hours before bedtime.

• Avoid nicotine (cigarettes, vaping, nicotine patches, and so on)


for at least one hour before bedtime, and when waking
during the night.

[Link]/Harris 21
2 Restrict alcohol and eating close to bedtime

• Don’t drink alcohol around bedtime, because although it


often promotes sleep at first, it can disrupt sleep later in
the night.

• Don’t eat large meals, especially those packed with fat


and protein, immediately before bed.

3 Avoid ‘blue light’ for one hour before bed

• Exposure to blue light - from phones, computers, TVs -


immediately before bedtime often impairs our ability to get off
to sleep. So ideally, avoid looking at these devices for at least
one hour before bedtime.

• Ideally, also avoid working or studying, for at least an hour;


otherwise, your brain is likely to keep going over it in bed.

4 Create a ‘wind-down ritual’

• Create your own ‘wind-down’ ritual to help prepare you for


sleep. This may involve listening to relaxing music, reading
a relaxing book, having a warm bath or shower, practicing
a mindfulness or relaxation technique, or doing any other
activity that helps you to ‘wind down’.

5 Maintain regular sleeping hours

• The more regular your hours for getting up and going to bed,
the better your sleep is likely to be. And the more irregular, the
worse your sleep is likely to be.

• Sleeping in, or staying in bed longer than you should, is


particularly disruptive to healthy sleep.

[Link]/Harris 22
• Do your best to get up at the same time every day, even if
you’ve had little or no sleep. In the short term, this means
you’ll have some difficult sleep-deprived days to get through.
But in the long term, your sleep will improve.

6 Exercise during the day

• Do regular physical exercise during the day. Even mild exercise


helps - and anything is better than nothing.

• Getting out into the sunlight during the day also helps sleep
at night.

• But don’t exercise vigorously (to the point of sweating) for at


least one hour before bed.

7 Make your bedroom favourable to sleep

• Make your bedroom as conducive to sleep as possible. Keep it


clean, tidy and well-aired (not stuffy), and choose a mattress,
sheets and pillows that are comfy. Block out light and noise in
the bedroom. Make sure your phone is on silent. If necessary,
wear an eyepatch or ear plugs in bed.

• Avoid extreme room temperatures. Most people sleep best in


room temperatures of approximately 65 degrees Fahrenheit
(or within the range of 60 - 67 F), or 18 degrees Celsius (or
within the range of 15.6 - 19.4 C).

8 Limit daytime naps to half an hour or less

• Many people find a short nap - up to half an hour, in the late


afternoon is helpful. But longer naps than that usually impair
sleep quality at night.

[Link]/Harris 23
9 Limit Activities in Bed to Sleep, Sex, Relaxation
or Practising Your Unhooking/Noticing/Making
Room Skills

• When in bed, limit your activities as much as possible to sex


or sleeping. You can also do something relaxing, such as
reading a book or listening to peaceful music. You can also
practice unhooking/noticing/making room exercises (also
known as ‘mindfulness skills’) or self-compassion exercises.

• Alternatively, you can gently tune in to the warmth and


comfort of your bed: notice the mattress supporting you; the
warmth in your chest, arms and legs; the softness of the pillow
beneath your head; the darkness behind your eyelids; the
touch of the blankets on your chest; your body resting; and
so on.

• But don’t do things in bed that expose you to blue light (for
example, watching TV, using your phone), or wake you up
(such as reading a gripping thriller), or tax your brain (like
working or studying).

• You also want the bedroom itself to be strongly associated


with rest and sleep. So avoid doing other forms of activity in
the bedroom such as watching TV, working, eating, doing
yoga, lifting weights, and so on.

10 Don’t Try To Force Sleep

• If you’re in bed, and you’re not sleeping, trying to make


yourself sleep is a recipe for failure. So instead, the idea is
to use that time effectively. Instead of tossing, turning and
worrying, practice your unhooking/noticing/making room
skills, and/or self-compassion skills. That way, although you’re

[Link]/Harris 24
not sleeping, you’re resting. And, as a bonus, you’re developing
useful skills which can help you with many other problems.

The good news is, unhooking/noticing/making room practices and


self-compassion practices are usually restful and restorative - and a
much better alternative to tossing, turning, stressing, worrying, and so
on. Plus, often when you do these practices in bed, you will eventually
fall asleep. That’s not the aim of them, but it is a nice bonus. So enjoy
this bonus when it happens - and when it doesn’t happen, at least
you’ll get the benefits of a comfortable rest.

Ups and Downs


It’s important to emphasise, this isn’t a quick fix, but we do expect to
see significant improvements over time – often within the space of a
few weeks, and sometimes straight away. And of course, there will be
ups and downs: days (or weeks) where sleep and rest is much better,
and other days (or weeks) where it’s not so good. So it’s important to
be patient; to ramp up self-compassion during rough patches, and
come back to values, over and over again, to sustain motivation.

How You Spend Your Days Affects


Your Nights
It’s also important to explore how what we do during the day
affects our nights. If we’re spending our days living by our values and
focusing on/engaging in what we do, that’s going to be much more
conducive to a restful night than a day full of fusion and avoidance.
So as therapy progresses, and the client makes values-based lifestyle
changes, improves their relationships, lives mindfully, practices self-

[Link]/Harris 25
compassion, and so on, we expect all of that to contribute to
better sleep.

Wrapping Up
Well, here’s hoping you found something useful within these pages.
We’re all going to have disrupted sleep at times – so these strategies
apply to us just as much as they do to our clients. (Just like everything
else in ACT.) As usual, please freely share this document and the
resources linked within it – and modify and adapt everything to suit
your way of working and the clients you work with.

Good luck with it all,

Cheers, Russ Harris

[Link]/Harris 26
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