Values Verbal Relations and Compassion Can We Do
Values, Verbal Relations and Compassion: Can We Do a Better Job of Facing Global Challenges Steven C. Hayes University of Nevada
The World is Facing a Series of Behavioral Challenges • “…. knowing is not enough; action is needed. Why should it occur? That is perhaps the most terrifying question in the history of the human species” (Skinner, 1982)
Terrifying Because (from Paul Chance) • Immediate consequences outweigh delayed consequences. People want to live in a world with clean air, but also want to drive Hummers. • Some chemicals are destructively reinforcing. The reinforcing power of sugar, salt, or drugs threaten our health.
The List • Consequences for the individual outweigh consequences for others. We often fail to make sacrifices for the common good. • In the absence of counter-control, the use of aversives tends to be very reinforcing to those who use them. For example, Abu Ghraib
The List • Coincidental events often strengthen ineffective behavior. Superstition often wins out over rationality. • Simple, familiar wrong ideas are preferred over complex, alien but correct ideas. For example, evolution is rejected by 75% of the US population
The List • Susceptibility to social reinforcement can incline us toward extreme views. For example, 9 -11 was perpetrated by mostly well-educated, middle-class people with families but who spent a lot of time interacting with others who shared extreme beliefs
The List • Strong aversives presented abruptly prompt appropriate action, but strong aversives following a long string of aversives that gradually increase in strength often do not. This suggests that so long as conditions worsen gradually, we will tolerate bad air, foul water, loud noise, psychological and physical abuse, and crime that would once have been considered intolerable.
The Processes • Weak delayed consequences for positive behaviors or powerful short term ones of negative behaviors • Weak social concern or cooperation or using aversives on others • Impulse and superstition rather than scientific data and reason • Entanglement with socially supported deviant beliefs • Lack of attention to gradual aversives
The Problems • • Obesity and health Drugs Over-population Lack of self-control Poverty Violence Pollution and global warming
Reformulating the Questions • Not why are we controlled by short term consequences – it is why we ever fail to be. • Not why do we show low concern for others – it is why we ever cooperate or show compassion for others • Not why aren’t we controlled by scientific data – it is how is it that science ever makes a difference • Can a psychological flexibility model help? Is it relevant? • I will share data only from the last three years
Inflexible Attention to Past and Future Experiential Avoidance Psychological Inflexibility Lack of Values Clarity Inaction, Impulsivity, Avoidant Persistence Cognitive Fusion Conceptual Self / Weak Perspective Taking
The Present Moment “Be Here Now” Values “Know What Matters” Acceptance “Opening Up” Psychological Flexibility “Be Present, Show Up, and Do What Matters” Committed Action “Do What Works” Defusion “Watch Your Thinking” Self as Context Perspective Taking
Not Why are We Controlled by Short term Consequences Rather, How Do We Ever Fail to Be? 9/25/2020
Within a Psychological Flexibility Model Acceptance and Defusion Increase Willingness to Experience Discomfort of Foregoing Short Term Reinforcers; Use Values or Motivative Augmentals to Increase Psychological Presence of Chosen Long Term Consequences Social Processes that Support Both
Weight Maintenance Lillis et al. , 2009 • 87 participants who had completed at least 6 months of organized weight loss intervention (on average their 37 th try) • Randomized to 1 day ACT workshop (n = 43) or TAU Control (n = 44)
Acceptance, Defusion from Self-Stigma and Values • Focused on values and patterns of avoidance toward weight-related thoughts, feelings, and bodily sensations • No diet, physical activity, self-monitoring, or weight education components
Process Results Cohen’s d Improvement 1. 4 1. 2 1. 0. 8. 6. 4. 2 0 -. 2 Effect Sizes: ACT Large Medium Small Control -. 4 AAQW Breath Holding
Pre to Follow-Up Weight Change 3 month follow-up % gaining 5+ lbs p <. 001 ACT Control 35 30 25 20 15 10 5 0 % losing 5+ lbs d = 1. 21
ACT for Diabetes Management Gregg, Callaghan, Hayes, & Glenn-Lawson, 2007, JCCP • Randomized controlled trial with poor, mostly minority clients • 40 / group: ACT plus diabetes education (one sixhour workshop) or diabetes education (also a six hour workshop) • Only 3 hours were different content
Pre to Follow up Change AAQ (Diabetes) % in Diabetic Control Self. Management 10 50% 5 25% 0 0% 0% Ed’n ACT AAQD and Self-Management mediated blood glucose outcomes
Pediatric Chronic Pain Wicksell, Melin, Lekander, & Olsson, Pain, 2010 • 32 children w/ longstanding pediatric pain • Average of 32 mo pain duration • Randomly assigned to ACT or multidiscipinary Rx & medication (MDT). • ACT = 12 session; MDT = 23
Pain Interference (1 -10) Pain Interference 6 4 2 Pre Post 3. 5 mo 6. 5 mo
Effect of Writing About Your Values Cohen, Garcia, Purdie-Vaughns, Apfel, & Brzustoski (2009), Science, 234, 400 -403. • 385 middle school children followed through 7 th and 8 th grade • Randomly assigned to a series of short (15 minute) writing assignments at the beginning of 7 th grade on their values in various specific domains and the importance of these values
Impact on GPA Thru Middle School 3. 5 European Americans or High Achieving African-Americans Both Conditions and Ethnic Groups Are Identical 3. 0 2. 5 Low Achieving African-Americans Values 2. 0 1. 5 Control 1. 0 Pre 1 2 3 Year 1 4 1 2 3 Year 2 4
Motivating Physical Exercise Jackson et al. , in preparation • 46 female students in a spinning class • Identify fitness motivation via IRAP • Prompt during class – compare to form based prompts or IRAP identified low motivators
Percentage of Instructor’s Heart Rate Bsln Prompts Bsln 105 95 95 85 85 1 3 5 7 9 105 Baseline Positive Goals Forms 105 95 95 85 85 1 3 5 7 9 Prompts 1 3 5 7 9 Exercise Sessions
Average Difference from Baseline Green = Positive Implicit Goals Blue = Instruction About Form
Average Difference from Baseline DIFFERENCE IN % OF INSTRUCTORS AVERAGE HEART RATE 10 8 Green = Non-Preferred “Positive” Implicit Goals 6 4 2 18 0 17 18 -2 -4 -6 -8 -10 Blue = Instruction About Form
Randomized Trial: ACT vs. TAU Tapper et al. , 2009 • 62 overweight women (BMI = 31. 6) • All participants already in weight loss programs • 4 two-hour sessions. 26 attended at least one; 31 left in existing diet • Short ACT protocol • Pre / Post / 6 month follow up
BMI . 5 Overall -. 5 -1 - “Never apply”
Change in Weekly Exercise 3 2 1 0 -1 Overall - “Never apply”
Physical Fitness Butryn, Forman, Hoffman, Shaw, and Juarascio, under submission • 46 female students assigned to two 2 -hour workshops (two weeks apart) on ACT or education about fitness. • “Post” at week four; follow up at week seven • Primary measure: use of exercise facilities at the University Athletic Center (these were automatically recorded from the swipe cards, resulting in a high integrity measure with no drop outs)
Weekly Number of Exercise Sessions 2. 2 ACT Visits to the Athletic Center 1. 8 1. 4 1. 0. 6 Fitness Education . 2 Pre Post Follow Up
The Question Is Not Why Aren’t We Controlled by Scientific Data Instead of Impulses It Is How Can We Increase the Impact of Scientific Data 9/25/2020
Within the PF Model: Link Science Knowledge to Values; Use Acceptance and Defusion to Deal with the Discomfort of Newness and the Interference of Alternative Beliefs 9/25/2020
Adopting ESTs Varra, Hayes, Roget, & Fisher, JCCP, 2008 • 59 drug and alcohol counselors randomly assigned to – One day ACT workshop focused on the psychological barriers to learning – Control condition: One day workshop on EAP policies – Both groups then do a one day educational workshop on the science behind the use of agonists and antagonists
Frequency of Perceived Barriers to Using Empirically Supported Treatments Mean Score 75 ACT plus Education 70 Control plus Education 65 Pre Post Phase
Believability of Perceived Barriers to Using Empirically Supported Treatments Mean Score 70 Control plus Education 65 60 ACT plus Education Pre Post Phase
Mean Score on 1 -5 Scale Willingness to Use Pharmacotherapy 3. 5 3. 25 ACT plus Education 3 2. 75 Control plus Education 2. 5 2. 25 2 Pre Post Phase
Subsequent Use of Pharmacotherapy 3. 5 3. 25 ACT plus Education 3 2. 75 Control plus Education 2. 5 2. 25 2 Pre 3 month Follow - up Phase
The Question Is Not Why Do We Show Low Concern For Others It Is How Can We Promote Cooperation, Compassion and Concern for Others 9/25/2020
Within the PF Model Promote a Social/Perspective Taking Sense of Self Link Self-Acceptance and Compassion Link Values and Compassion 9/25/2020
Experiential Avoidance and MH Stigma Masuda et al. , 2007 • RCT comparing education focused on prevalence and costs of stigma toward mental health problems, and accurate information about them • ACT focused on defusion from and mindfulness of prejudicial thoughts, acceptance of difficult prejudicial feelings, and values
Average MH Stigma Score ACT for Mental Health Stigma -25 Education Hi EA -30 Lo EA ACT -35 -40 Pre Post F-Up
Racial Prejudice Lillis & Hayes, 2007 • Replicated with ACT versus Education for racial bias in a college student population • Within subject test (16 with A/B/A/C/A and 16 with A/C/A/B/A) • 32 participants in a two racial differences classes • 90 minute class period • “follow up” = next class period
Assessment Items • Bias Awareness – I feel that I am aware of my own biases • Bias Does Not Affect Me – I feel that my prejudicial thoughts are a significant barrier to me being culturally sensitive – My biases and prejudices affect how I interact with people from different racial and ethnic backgrounds.
Assessment Items • Acceptance – It is OK to have prejudiced thoughts or racial stereotypes – I try not to think negative thoughts I have about people from different racial or ethnic backgrounds. • Defusion and Action – When I evaluate someone negatively, I am able to recognize that this is just a reaction, not an objective fact. – It’s ok to have friends that I have prejudicial thoughts about from time to time.
Assessment Items • Positive Action – I would attend a social event where I was the only person of my race/ ethnic background. – I believe that I am able to transcend racial boundaries with my actions. – I plan to actively seek out experiences that could expose me to people who have a different cultural, racial, or ethnic background than me. – I am likely to join a campus organization or participate in a campus event that is focused on cultural diversity.
RFT Take on the Formation of Self and Perspective Taking YOU HERE NOW I THEN THERE
The I-Here-Nowness of Awareness is the Foundation of Perspective Taking Self-as-context
But If “From Hereness” is Relational • It says something very profound: I don’t get to show up as a conscious human being until you show up as a conscious human being • One of the way we measure perspective taking are “Theory of Mind” assessments • Are deictic relations and Theory of Mind performances related?
At Least Broadly, They Are For general direction of the relationship only. These data are from 2 unpublished studies, one by another author, so details could change
Why This Matters • A perspective taking sense of self is social • Which is why your pain can pain me • I need to accept my own pain in order to care about yours in a healthy way • Gives a personal motivation beyond values and evolution for empathy and caring for others
Experiential Avoidance, Shame, and Stigma Toward Others 164 persons dealing with weight (Lillis et al) Weight Self Stigma Experiential Avoidance. 76** Negative Attitudes Toward Others with Weight Problems. 33**
And Guess What? Weight Self Stigma Weight Problems. 40** Mental Health Problems. 42** Quality of Life -. 68**
What That Says • Compassion toward others is related to some degree to self-compassion and to liberation from entanglement with judgments • Those processes have tangible positive effects on the person, giving some possible motivation to deal with a judgmental lack of compassion
Roger Vilardaga, Ana Estévez, Michael E. Levin and Steven C. Hayes Caring About Being With Others Perspective Taking Joy Now/Then I/You Here/There Experiential Avoidance Empathy - Sadness -- Repertoire Narrowing + Social Anhedonia
R 2 Step 1 Gender Age Step 2 Gender Age Deictic ability Step 3 Gender Age Deictic ability Empathic concern Step 4 Gender Age Deictic ability Empathic concern Experiential Avoidance Social Anhedonia ∆F β . 036 1. 87 . 10* 6. 91 . 15* 5. 17 . 26** 14. 60 -. 17 -. 09 -. 13 -. 10 -. 26* -. 06 -. 04 -. 23* -. 02. 05 -. 18† -. 26*. 35**
The Question Is Not Why Do We Become Entangled With Deviant Beliefs It is How Do We Disentangle Ourselves from Them 9/25/2020
Within the PF Model Defusion and Mindfulness Skills; Cost in Valued Behavior 9/25/2020
ACT for Self-Stigma / Shame Luoma, Kohlenberg, et al. , under review 134 participants in a 28 day in-patient drug program Randomly assigned to 6 -hour ACT group focused particularly on self-judgment and shame
Shame Outcomes: Better for TAU ACT Average Score 110 105 100 95 90 TAU 85 Pre Post
Quality of Life Outcomes: Better for TAU Average Score 80 78 76 74 TAU 72 ACT 70 Pre Post
Days / Month Using Drugs or Alcohol Group ACT for Shame: Substance Use Outcomes 6 5 TAU 4 3 2 1 ACT 0 1 Month Follow Up
Days / Month Using Drugs or Alcohol Group ACT for Shame: Substance Use Outcomes 6 5 TAU 4 3 2 1 ACT 0 1 Month 2 Month Follow Up d = 1. 21 3 Month
Shame Outcomes Average Score 110 ACT 105 r with use at follow up = ns 100 95 90 r with use at follow up = -. 51 (p <. 01) TAU 85 Pre Post 3 Mo F-Up
Quality of Life Outcomes Average Score 80 ACT 78 76 74 TAU 72 70 Pre Post 3 Mo F-Up
Where We Are § Good start but it is not enough § There are some sour notes at the level of technology § Social trends are not good – if psychological flexibility is key § Enormous increase in exposure to horror and chatter
What is Missing § Content wise: no studies on global warming and energy consumption; violent conflict; prevention; creating values-based groups. § We need to think about our work in a broader social context § We have natural allies § Could we scale the model?
Weak Data / Inflexible Attention Suppress Difficult Material Lack of Values Clarity and Group Choice Organizational Inflexibility Judgmental & Rigid Practices Delinked to Workability Conceptual Organizatn Weak Perspective Taking Inaction, Impulsivity, Avoidant Persistence
Good Monitoring / Flexible Attending Clear Values and Goals / Chosen by Group Openness to Distress, Problems, Conflict Organizational Flexibility Active Steps Linked to Values and Goals Multiple Views, Filtered by Workability Aware of Perspective/ Context and that of Others
Can We Extend It? § Projects are underway that will test these ideas § But we can take heart in the connection with evolutionist thinking and data
Elinor Ostrom 2009 Nobel Prize in Economics
Elinor Ostrom’s Eight Steps 1) Clearly Defined Boundaries. The identity of the group and its rights to the common resource must be clearly delineated. 2) Proportional equivalence between benefits and costs. Members of the group must negotiate a system that rewards members for their contributions. High status and other disproportionate benefits must be earned. 3) Collective-choice arrangements. Group members must be able to create their own rules and make their own decisions by consensus. People hate being told what to do but will work hard for group goals that they have agreed upon. 4) Monitoring. Managing a commons is inherently vulnerable to free-riding and active exploitation. Unless these locally advantageous strategies can be detected at relatively low cost, the tragedy of the commons will occur.
Elinor Ostrom’s Eight Steps 5) Graduated sanctions. Transgressions need not require heavy-handed punishment, at least initially. Often gossip or a gentle reminder is sufficient, but more severe forms of punishment must also be waiting in the wings for use when necessary. 6) Conflict resolution mechanisms. It must be possible to resolve conflicts quickly and in ways that are perceived as fair by members of the group. 7) Some recognition of rights to organize. Groups must have the authority to manage their own affairs. Externally imposed rules are unlikely to be adapted to local circumstances and violate ingredient 3. 8) For groups that are part of larger social systems, there must be nested enterprises. The previous ingredients work best in relatively small groups. Society at a larger scale must be multicellular, with groups interacting with groups, often in multiple layers.
Effective monitoring by monitors who are part of or accountable to the The selfappropriators; determination of the community is Good recognized by higher. Monitoring level authorities; Mechanisms of / Flexible Collective-choice conflict Attending arrangements allow resolution are most resource Clear Values Openness to cheap and to appropriators to and Goals / Distress, easy access; participate in the Problems, Chosen by decision-making Conflict Group process; Rules regarding the appropriation and provision of common resources are adapted to local conditions; Multiple Views, Filtered by Workability Organizational Flexibility Meets Elinor Ostrom In the case of larger common-pool resources: organization in the form of multiple layers of nested enterprises, with small local CPRs at the base level. Aware of Perspective/ Context and that of Others There is a scale of graduated sanctions for Active Steps resource Linked to appropriators Values and who violate Goals community rules;
The World is Facing a Series of Behavioral Challenges • We cannot rely on the politicians and soldiers to solve this problem for us • The CBS community needs to consider the implications of its work for the health and well being of human beings and the global challenges they face
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