Unexpected Results

Sometimes ACT interventions backfire – fail miserably or have the opposite

results to those intended. (Of course, this happens in every model of
therapy – nothing unique about ACT there!)
In ACT, this is probably most common with defusion techniques; although
they often work as intended, sometimes they cause fusion instead.
Same goes for acceptance exercises; sometimes they backfire and the client
struggles even more with his pain than before.
Luckily, this doesn’t often happen – but sooner or later it will. So how do we
respond when this happens?
Well the answer is … it depends.
It depends on who the client is, what the issue is, how many sessions you’ve
had, what stage of ACT you’re at, whether they understand the rationale
and purpose of defusion, and so on.
What follows is some general advice, some useful tips; adapt it to your
situation.
(copyright) Russ Harris 2015 www.ImlearningACT.com
 Experiments
Remember, unexpected results are always easier to
handle if you’ve been liberally using the language of
‘experiments’ in your sessions.
Ideally, we will repeatedly come back to the notion that
we can never know for sure what the outcome will be of
any intervention or exercise or technique or practise.
Ideally the therapist repeats the message, in her own
words, that she recommends trying these things
because she hopes it will be helpful – but there’s no way
to know for sure what will happen, it’s always an
experiment.

(copyright) Russ Harris 2015 www.ImlearningACT.com

 Stay Calm
Some general advice: when anything in a therapy session
(not just defusion) fails, goes wrong, or backfires (in any
model of therapy, not just ACT) – stay calm!
You won’t feel calm, of course. You may feel anxious, sad,
frustrated, guilty, fearful, angry; you may have all sorts of
unhelpful thoughts about yourself, the client, the exercise,
the model; but even with all those thoughts and feelings
present, you can still act calmly.
In other words, you can use ACT on yourself: defuse, accept,
drop anchor; and even though you don’t feel calm, you can
model the quality of calmness through your voice, your
words, your body posture, and your actions
(copyright) Russ Harris 2015 www.ImlearningACT.com
 Drop Anchor
Of course, not only do we drop anchor for ourselves, we also
help our clients to do the same.
If the client is upset or fused or struggling in any way - sad,
angry, frightened, shaken, disappointed, frustrated,
dissociated, overwhelmed etc. – then our first step is usually
to help her drop anchor, using the methods we’ve previously
practiced in session (e.g. breathing, stretching, pressing feet
into the floor, sitting up straight, noticing and naming any
difficult thoughts and feelings, expanding awareness, etc).
If you haven’t yet taken the client experientially through
dropping anchor, or some other mindfulness-based
grounding/centering exercise, then now is the time to do so.
(copyright) Russ Harris 2015 www.ImlearningACT.com
 Openness & Curiosity
Having grounded & centered the client (and yourself) model
openness and curiosity, as you explore what just happened.
Useful questions could include:
What happened just then?
What thoughts and feelings and memories showed up?
What did your mind hook you with?
What feelings are showing up for you now?
What’s your mind saying now?
(Can you think of other good questions to ask, ways to
explore? Please share them on the forum.)
(copyright) Russ Harris 2015 www.ImlearningACT.com
 Rationale & Apology
Is an apology warranted? If so, be quick and genuine. For
example:
“I’m sorry. I didn’t expect that to happen. I can see that
you’re upset. I hope this hasn’t put you off working this
way.”
It’s generally useful to remind the client of the rationale for
the exercise or intervention (which ideally you gave clearly
before doing the exercise or intervention). For example:
“I was hoping that exercise would help you unhook from
difficult thoughts – but it looks like you actually ended up
more hooked than before.”
“I was hoping that exercise would help you stop struggling
with difficult feelings – but it looks like you actually ended
up struggling even more than before.”
(copyright) Russ Harris 2015 www.ImlearningACT.com
 Learning Opportunity
Having dropped anchor/grounded the client, apologised,
clarified the rationale, find your own way of saying
something like:
“I didn’t want or expect this to happen, but given it has
happened, can we look at this as a learning opportunity?”
Amongst other things we can learn:
More of the many different ways your mind can hook you
More of the many different ways you can get pulled into a
struggle with thoughts and feelings
How our minds easily make life difficult for us – can interfere
with anything we try to do
(Can you think of other possible learning opportunities?
Please share them on the forum.)
(copyright) Russ Harris 2015 www.ImlearningACT.com
 Try Something Different
At times, the best thing to do, having run through most
or all of the above, is to say something like:
“I’d hate to give up on this important part of our work
here. Can we try something different, that hopefully will
work better for you?”
Then – again emphasising that it’s an experiment, and
again clarifying the rationale for doing it – try something
different.
This might just be a variation on the same
exercise/intervention/technique, or it might be a
radically different exercise that serves the same purpose.
(copyright) Russ Harris 2015 www.ImlearningACT.com
 Come Back To What You Were Working On?
At times, rather than do something different, it’s a good idea to come back to
where you were before the exercise backfired.
For example, suppose you’ve been using ‘noticing and naming’ for defusion,
but on this occasion it backfired and the client got more fused. Then you
might say:
“So notice, now your mind has hooked you with something fresh. So this is a
good challenge – let’s see if you can unhook from this new stuff. See if you can
step back and notice what these new thoughts are; notice how they’re
hooking you, pulling you in. Can I get you to try naming these thoughts?”
Then we can guide the client through naming, e.g. “I’m having thoughts that
this doesn’t work” or “Here’s my mind finding new ways to beat me up.” (If
this still doesn’t work, we can go back to dropping anchor, grounding,
expansive awareness etc.).
If we were working on values or goal-setting, prior to the unexpected reaction,
we might say, “Well, your mind kind of hooked us there, pulled us off-track. Is
it okay if we get back to where we were?”
(copyright) Russ Harris 2015 www.ImlearningACT.com
 The Part That Notices

If you’ve introduced ‘the part that notices’ (or the ‘observing

self’, or whatever you choose to call it), you can use this to help
with any or all of the aforementioned responses. For example,
we can ask the client to “use that part of you that notices” to…
- Drop an anchor (contacting the present: grounding &
centering; a useful first step in defusion or acceptance)
- Bring up the lights on the stage show (contacting the
present; often a useful first step in acceptance)
- Step back and notice the thoughts that just hooked you
(often a useful first step in defusion)
- Step back and notice the feelings you’re struggling with
(often a useful first step in acceptance)
(copyright) Russ Harris 2015 www.ImlearningACT.com