Defusion procedures should be offered whenever you suspect that fusion is operating to hold the client back from the kind of life he or she really wants or action consistent with his or her values.
Identifying fusion is an important precursor and prompt for initiating defusion techniques. Harris (2009; p99-100) describes six ways of talking that point to fusion [see Note H3i].
Rules – Does the client have any rigid rules about how life, work, relationships etc should operate? Most concerning are rules about how someone needs to feel before she can take action. Watch out for words like should, must, ought to, right, wrong, can’t, don’t. Take note of phrases like ‘I shouldn’t have to’, ‘If I feel X, then I can’t do Y’, ‘If I do A, then you should do B’.
Reasons – What reasons does the client give for why change is impossible, undesirable, or impractical? ‘All my family are alcoholics’, ‘All my friends use drugs and they’re okay’, ‘I don’t want to lose my old friends’. If we fuse with these thoughts and take them as facts they hold us back from making changes.
Judgements – If we hold onto judgements like ‘I’m bad’, ‘You’re unfair’, ‘He’s too selfish’, ‘Life sucks’, and believe that they are literally true, this suggests fusion that is holding us back.
Past – Fusion is present if your client spends a lot of time ruminating on old hurts, failures, mistakes, missed opportunities.
Future – Worrying about the future, fantasising about dramatic improvements that could come in the future, or constantly thinking about things that need doing in the future are indicative of fusion.
Self – What sort of self-description is your client fusing with? Some common ones for young people include: ‘I am weak/useless/unlovable’, ‘I will never amount to anything’, ‘I’ve never finished anything in my life and never will’, ‘I am just a ball of useless anger’, ‘I don’t need help’, ‘I just need to sort it out for myself now’.
When introducing defusion techniques for the first time it can be useful, but not essential, to start with some psychoeducation about the two parts of the mind – the thinking self and the observing self. The thinking self is the “part of you that chatters away inside your head, never shuts up and always has something to say”. Harris also suggests offering an explanation of how the thinking mind evolved to think negatively in order to protect primitive human beings from the many dangers facing us in the natural world. For some useful text see Harris (2009; p100-101) <Setting the Mood>.
The next step is to review or revisit some of the clients most problematic thoughts, clarify the downside of getting entangled or pushed around by these thoughts and then invite him or her to learn new ways of handling these thoughts. Harris (2009; p101-102) offers some text to illustrate how this might be done <Introducing Defusion Part 1> [see Note H3ii].
There are several techniques or ways of talking that the ACT therapist uses when inviting or encouraging the client to learn new ways of handling problematic thoughts. These techniques are illustrated in Harris’s text that can be located using the link above.
Normalising and allowing thoughts – When we talk about the client’s thoughts we describe them as normal and natural, typical or common and make no attempt to judge them
Treating the mind as an entity – Talking about your thinking mind as an entity that is separate from you and autonomous helps us to separate from the thoughts it generates. We might ask questions like “What is your mind saying about that?”, “Who’s talking here, you or your mind?”. We can also talk about the mind as having its own personality and as taking autonomous action. For example we say that your mind is “beating you up”, “calling you names”, or “acting like a bully”. [see Note H3iii]
Listening to the mind – We talk about listening to the mind, hearing what it is saying, tuning in to what it sounds like.
Writing thoughts down – Writing thoughts down helps you to take a step back and see them for what they are - a string of words.
Thoughts as stories – ACT practitioners often talk about thoughts as stories, and the thinking mind as a story teller.
After we have focused on and clarified the content of the problematic thoughts that are bothering the client, and placed their source within the thinking mind, it is useful to revisit the experience of fusion. Harris (2009; p104-108) uses a very simple metaphor that dramatizes this experience powerfully when it is acted out. He suggests that the practitioner write the thought or thoughts down on a piece of cardboard and invite the client to follow these instructions.
Note H3ii An exercise for practitioners learning to use defusion is to draft a few scripts for yourself using imaginary conversations with one or more of your own clients. Focus on the kinds of problematic thoughts that are quite common for your clients and imagine their responses if you began talking to them about fusion and defusion.