Why People Relapse

by Nathan Chua

Seeing a client again after a while evokes mixed feelings for me.  Part of me says, I am happy to meet an old friend again and someone with whom I had deep, important, and meaningful conversations.  But another part of me tells me that I might have not done the best job that was possible within the means that I knew.  The pendulum swings to the negative even more, if I hear a loved one of a former client inform me of a relapse.  What is wrong with my approach?  Why do people (myself included) relapse?

I have two things that can explain this.  One is, it is quite normal for us to have relapses.  In fact, before 2019, I often tell my clients that they are welcome to come back on an as-needed basis rather than our usual weekly or bi-weekly meetings.  Now that they have improved in handling their difficult emotions, I fully expect them to have relapses every now and then.  I am relieved though that even as some clients do come back for the sporadic follow-up sessions, they do manage to rekindle some of what they had learned from our previous work more quickly than they would otherwise.

The second reason I believe relapses happen, is the focus on symptom-alleviation in the approaches that I had available to me.  In 2019, I learned about Acceptance and Commitment Therapy or ACT.  Since then I have begun to understand that not all of these relapses are to be counted off as expected realities.  

Helping clients manage their symptoms has its weak points because recovery is based largely on their level of distress.  In this case, the client’s attention is focused on whether the depression, anxiety, etc, are still around or not!  It’s like regularly watching your back to see if the symptoms have gone or are kept to a minimum.

The reality though is life can often hand us challenges that can go beyond what we believe is our capacity to manage these symptoms.  The randomness of life can give us something that can overwhelm our capacities to suppress these painful feelings.  Running away or keeping these feelings underwater like a giant beach ball has its limits.

I love the way Dr. Russ Harris uses the metaphor of the two donkeys to illustrate this.  Let’s say we have two options to make two donkeys move in a certain direction.  One donkey was made to move with the experience and the threat of being hit by a stick, while the other was prodded by a carrot in front of it.  Which donkey do we think will last longer?  I presume most of us would say that it would be the second donkey with the carrot.  Secondly, which donkey do we think would be happier as it moves in the direction we want?  It’s quite a natural choice for us to say that it will still be the second one.

I used to call myself eclectic in my approach simply because I had to use different techniques and frameworks to address different problems.  However, there is one underlying presumption in these approaches that I had adopted for the first 10 years of my work, that counseling was all about alleviating symptoms or suffering, so people can go on living their “normal” lives.  

Under these approaches though, clients would tend to measure their progress by the absence or suppression of their symptoms.  For example, if my depression or anxiety is kept to a minimum tolerable level, only then can I move on with the tasks of living.  The end result becomes achieving a life absent those overwhelming feelings again.  Clients end up thinking that feeling good is what makes them “normal.”  This is what in behavioral terms is called living life under aversive control.  It is just like the donkey that is motivated by the avoidance of the stick.

In ACT, an alternative way of motivating people to live the kind of lives they want for themselves.  I learned what it means to be the donkey motivated by the carrot ahead of it.  Wouldn’t life be so much more fun if we had the carrot that we follow until the very last breath we take?  In behavioral terms, this is life lived under appetitive control.  It is not looking behind our shoulders every now and then, and reminding ourselves that we have BPD or OCD or MDD, etc. that is just waiting for us with open mouths to swallow us again.

This is about looking at ourselves as a whole human being and not just parts of ourselves.  We are whole.  We are not broken.  These painful experiences, emotions, thoughts, and physical sensations are part of our makeup as human beings.  We are not machines to be taken apart and having to remove parts of ourselves that we think are causing the depression, the anxiety, or the obsessive thoughts, or whatnot.

Being human means we chase after our carrots in life with the pain that comes along in that chase.  That’s when we know that we exist with a purpose.  Maybe with this in mind, a relapse only signals a need for a refresher on what is important to my clients, and not just being reminded of the ways to run away from pain.  What a difference ACT in 2019 made to my practice!

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Are some emotions toxic?

by Nathan Chua

How was your day?  Toxic!  How often have you and I heard this from a partner, friend, co-worker, or even ourselves?  It may be unsaid, but in our subconscious, that normally means we had a day with really “bad” emotions.  The mantra seems to be, we have to be feeling good at least most of our day to make it a day worth our while.  The toxic day becomes nothing more than one that’s wasted, forgotten, and thrown into the garbage bin, a part of the many insignificant moments of our personal history.

This is often thrown around in media and online circles as positive thinking.  The undisclosed rule here is, we need to have positive feelings in order to move forward with whatever it is we want to do with our relationships, careers, etc.  We flip it around and we come up with the opposite rule, negative feelings equals a negative life or a life that is spent dwelling in negative thoughts.  Simply stated, negative feelings mean you can’t do much that’s productive.  These unwanted feelings cause us to do bad stuff or become unproductive.  

Much of this comes from what we learn as kids from our parents.  The ultimate babysitter rule is don’t be angry cause anger causes you to act badly towards your siblings.  What’s so bad about learning that, you might ask?  One way to answer this is with a question.  Why do you think there are some men out there who believe that anger causes them to lose control of their actions?  It’s because these men were trained to think that the emotion of anger is the invisible thing that causes them to become violent.  But nobody ever got into trouble with anger.  It is what we do with our anger that does that. 

Another problem that this rule about avoiding negative feelings can create, is that we can believe that we should remain positive even in situations that would normally cause us to feel sad or anxious.  This way we become insensitive to context.  We pretty much saw this in certain events when the Covid 19 pandemic struck.  Some people remained optimistic that the virus was going to just go away and threw caution to the wind.  Positive thinking in this context works rather poorly in saving lives.

Emotions are there to give us messages that there may be something here that is important to us.  In what ways, you may ask.  

Here are some ways our negative emotions can be helpful to our well-being:

  • When our kid crosses the street:  Without the fear that our child could get badly hurt in a car accident, we would not grab the child out of danger when they attempt to put one foot out on the street.  The so-called “negative” emotion can be just the thing to keep us breathing.
  • When we visit the grieving:  Without sadness, we will not be able to be present with the people who had suffered a loss.  I mean, wouldn’t you think the grieving would feel more comforted when they know that they are not alone in their sadness, guilt, fear, and whatnot?
  • When we date:  Without having a clear sense of our feelings while we are on a date, we could end up with multiple relationships that are abusive.  For instance, if you do not sense that this person makes you feel unimportant because they only want to talk about themselves, then you might be in for a rude awakening some day.  You miss an opportunity to say no to your date and find another one who may make you have a sense that your evening, your ideas, and your feelings matter as much to them as they do to you.
  • When we want to discover who we want to be:  The most difficult feelings we have usually tell us about what truly matters to us.  If we care about friendships, then we would naturally feel anxiety when we are in a situation where friendships can be made.  If we care about being accepted, then the possibility of rejection is something that would mortify us.  Behind the anxiety and the fear of rejection we often miss the idea that being sociable and being accepting matter to us dearly.  If they didn’t matter, they wouldn’t hurt!  Are being sociable and accepting qualities we would want to run away from?  If we do (primarily because we don’t want the pain that comes with these qualities of being), we lose chances of discovering who we want to be.  And time can go by really fast without us noticing that we have been so busy pursuing relief from the pain but not really being the sociable and accepting person we want to be.

As you see, we have feelings for good reasons.  That’s just how we were built in order for us to survive and succeed in cooperative groups; for we did evolve successfully in groups.  We are not the solitary type of species.  

Furthermore, not wanting to feel bad means we can’t be happy either!  How does this happen?  Think about that trip you made to Boracay.  If you are the type who does not want to feel disappointed, then you would not want to feel too bad when your vacation ends.  We end up living a flat life with very little adventure since full-on enjoyment reminds us of full-on disappointment.  To paraphrase a renowned psychologist, your mind is like your hand, it cannot choose what it can feel.  Your hand will feel both the rough and the smooth surfaces.  We can’t tell our hands to only feel the good stuff. 

On a final note, I want you to notice the difference between making a presentation with the goal of getting it over and done with, and how you’d feel if you made the presentation regardless of how hard it was emotionally, simply because it was important for you to do it for an audience that you cared about.  The former will probably be more about a sense of relief, while the latter would most likely give you an experience of accomplishment and satisfaction.  Now, which side would you like to be on? 

Remember, both situations have anxiety in common.  One though wants to run away from it, while the other knows anxiety is just part of the deal of pursuing meaningful ends.  Neither of them want anxiety, but one of them accepts it for a cause greater than what they feel.  So the question you would want to ask yourself is, “Would you be willing to have something you don’t like, to gain something that you do want?”  In other words, would you prefer living a life pursuing relief or a life pursuing satisfaction, meaning, and purpose, because as I often like to remind you, my audience, we all have One Life Only!

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Why some good advice may be bad for your relationship

by Nathan Chua

These words of wisdom can range from the general to the specific.  How often have you and I heard some talk show hosts and even some clergy, tell us what to do in our relationships, only to find out that these seem to backfire or only give short term results but eventually fail us when we most need them in our most distressing moments.

Here are some examples that hopefully covers the general and the specific advice: 

  • Love your spouse.
  • Do something to satisfy your partner’s love language everyday.
  • Don’t let the sun go down on your anger.
  • Don’t be stingy with your apologies.  Apologize as soon as you can whenever conflict ensues.

If these types of advice did work for the majority of us, then we would see a lot less marital discords and separations in our midst.  Last I heard, the “divorce” rate in our country doesn’t veer away much from the averages in more economically-developed countries.  Last I heard also, the divorce rates among therapists are even higher than the average in a developed country like the United States.

For example, let’s use the advice that one should immediately seek reconciliation with a partner to avoid drifting apart.  One way to do that is to make an apology as soon as the conflict starts.  This could end up with the couple not just fighting about what they fought about, but also fighting about how the apology was done!  Double whammy!  And then the couple goes off on a tangent with even more issues about the past or future worries about how the relationship will unfold. 

Context Matters:

The types of advice we hear from talk shows and read about online are well-meant.  I mean who could argue that you should make an apology or that you should address your partner’s love language.  The reason this doesn’t qualify as the silver bullet for change in your relationship, is that we are all different based on our own histories, and also that not all situations are the same.  

Going back to the earlier mentioned example, a highly conflict-avoidant partner may use quick apologies to appease situations.  The offended party though has a history of ranting and in his or her view, being hit immediately by an apology doesn’t offer a chance to release some of that inner tension or start any kind of meaningful talk.  

So for instance, they fight about one not being responsible enough to take out the garbage,  Partner A is angry because this has become a constant irritant between them while Partner B uses his quick apology once again to keep the peace.  A now becomes more annoyed because this was not the first time B has used his apology to avert a discussion.  For A, this does not allow for them to have a constructive conversation or a moment when they are both open to arriving at a compromise.  And there they go!  A gets into a fit that B does this, and B retorts that A should be more receptive to his or her apologies.  So the fight goes from a simple household chore, to their differences in the way they handle conflict.  Sound familiar?

As you can see from this example, no advice however sensical they may sound, will be done in a vacuum.  In other words, the solution becomes the problem so that the original problem remains while they fight about the solution that didn’t work because one did not live up to the expectation that the solution is supposed to provide!

So next time be mindful of the advice that you hear in popular media and psychology.  Understand that your partner and you are unique and your situations, likewise.  Try other ways to address these situations that have remained a concern for you for many months or years.  Be aware of these situations as you see them coming.  Look back and see how the situation unfolded, and understand why your relationship is vulnerable to such conflicts.  In other words, be mindful of the context before you apply the advice.    

Finally, remember that you love this person for so many reasons that make your life so much more meaningful.  One of your vows you made rings a bit like the idea that you accept this person for who he or she is.  As Christensen, Jacobson, and Doss have written, “Approach change in the context of acceptance [for] change is the brother of acceptance, but it is the younger brother.”

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What is One Life Only Counseling about?

Hi everybody! We have recently updated our definition of what One Life Counseling is all about. In our zeal and dedication to provide you with the best possible results in your quest to change your lives for the better, we began our new journey towards a process-based approach to our work. This applies to all our clients including couples and families.

We will never be satisfied unless we find the best possible and most effective approaches that empower you and help direct you to a path of growth and personal satisfaction in living the kind of life you have long wanted for yourself and your loved ones!

We have put the updates in italics.

Here’s what you can expect from One Life Only Counseling:

You can be assured that your information with be kept completely confidential.

You will be respected regardless of your religion, gender preference, ethnicity, economic status, and even your personal lifestyle and values.

Your counselor will not impose his or her values and beliefs on you.

We use brief, scientific, and evidence-based approaches to address your concerns. These approaches are known to produce the best results that require only a handful to about a dozen sessions for you to experience life-changing results, as against years of seeing a therapist which can, at its worst, foster dependency.

Since 2019, we have adopted new therapy approaches that do not categorize people into sets of symptoms. They are process-based approaches to therapy that are now gaining appreciation from thousands of experts in the field who have found the current symptom-reduction, syndromal approaches less than adequate in addressing the human condition. The process-based approach has been found to be effective in many areas of concern ranging from common mental health concerns like depression and anxiety to even work and sports performance.

Since 2019, we have been very excited to offer this type of a radically different approach to therapy that is not just about relieving symptoms, but rather helping people towards creating lives imbued with meaning and purpose.

This is content is the subject of our first podcast in our One Life Only Counseling Spotify Channel! If you wish to hear this on Spotify, click here!

What happens when we biomedicalize mental health?

by Nathan Chua

If we were trained to look at the ads we see everywhere from our mobile devices to the busy highways we go through in our regular commute, we can pretty much sum up what they’re selling us in one word.  Would you like to venture a guess?  That new car, that shimmering bottle of beer (that in reality is rather bitter and awful-tasting), that outfit, or even that loan that you have to pay off in a matter of a month to 20 years, are invariably supposed to make us feel good!  So what in one word are they selling us?  Happiness!

Having this in mind, the helping-people business has not been above the culture of the times.  It is understandable that for about a century now, the field of psychology has devolved into an endeavor of classifying us into a set of symptoms or syndromes.  The goal then becomes removing or lessening the four out of seven or the five out of nine signs that you are, for example, a borderline personality.  This is what experts have called symptom-reduction therapies.  Let’s remove your anxiety and depression so you can start moving on with your life, at least to the level of “normality.”  To borrow from one of the pioneers of Acceptance and Commitment Therapy, it’s sort of like looking at how a fountain works by trying to figure out the different colors and patterns, and seeing how these can be explained.  

Unfortunately, such endeavors have only left places where people have been almost literally drugged out of existence.  It turns out that removing these “negative” emotions has a costly side effect: not feeling at all!  There has been no science to determine that there is a germ or microbe or gene that causes mental problems.  The drugs only serve to numb us–something that dead people can do better than we who are alive.  

Too much anxiety?  Well, here’s a drug to keep you relaxed.  Too much depression, well here’s something to perk you up.  It can go so bad as to make those who take these medications dependent on them.  As another expert has said, it’s become so prevalent that in their country, the chemicals that are used in these antidepressants are now found in their water.  Moreover, there are now drugs to treat the very side effects that such medications can create.  And with trained eyes, you can sum up what these drugs are selling in one and the same word again–Happiness!  The objective is to remove those feelings and thoughts first before you can start living a worthwhile life.  

Fortunately, the group of people that Dr. Steven Hayes has assembled, have come up with something called process-based therapy.  Dr. Kirk Strosahl who likened the way symptom reduction therapies work to explaining or addressing the phenomenon of a water fountain by the numerous colors and patterns that it makes, explains it this way:  That if we were engineers studying how this fountain works, we will see that underneath it, is a simple combination of processes that a few tubes combine to do, to make it look intricate.

I have seen it in the people I have met in my work, where they come in with glassy eyes, looking enervated and lifeless.  It breaks my heart to see this.  In my work, I would love to see the exact opposite happening to my clients.  I would love to see them bubbling with energy and enthusiasm for what life has to offer.

The culture nowadays provides for an environment where people (and that includes me) are unintentionally tricked into believing that life is about feeling good.  The meaningful life has become about having the right kind of car, job, or even partner.  Got this or that and you and I will be happy all the time.  Well, first of all, that goal is impossible.  Secondly, some of the most meaningful parts of life revolve around something we did that was hard and anxiety-causing.  

I often use the following vignette to give my clients a new perspective towards life and what it is that we come to therapy for:

“If you look back at a graduation ceremony of a child, or a wedding, or any of these momentous occasions, don’t you at some point want to shed a tear?  Why?  Is it because raising a child and putting them through school was always happy and joyful?  Is culminating a long-term relationship during a wedding all just about having fun?  Or was it more like, you went through a lot of hardship and trials and somehow made it through together?  The most meaningful and purposeful moments were hard, full of ups and downs, and of unpredictable and anxiety-causing moments!  The tears would mean you somehow pulled through and made it!  You did the hard thing, the brave thing!  That’s why you come to me for counseling.  Not just to be happy but always pursuing that which gives you purpose and meaning, until you breathe your last!  And that’s how that wiser part of you says you were meant to live.” 

Goals of Counseling: What is it all about anyway?

by Nathan Chua

I remember a person who shared with me that she had been with her therapist for several years.  She felt it helped her in terms of managing her anxieties and anger issues.  She went on to share that she needed her weekly sessions to get some relief from all the emotional struggles that go on during the week.  This type of counseling is called supportive counseling which certainly has its place in the field.  In my graduate studies, I can certainly attest to the fact that I used to do this type of work in dealing with my test cases to begin my training in listening or counseling skills.  With this person who shared her experience though, the weekly sessions have become a psychological crutch, just like taking a break from her cares for at least an hour a week. *

Counseling work is more than just being supportive.  The goal is more about having clients learn, as experientially as possible, skills that can be brought to their everyday lives.  The counseling room becomes the lab where these skills are introduced and tested.           

I don’t really mean to be simplistic here but I thought the title can help us focus on knowing what goes on inside the work I do and its ultimate goals.  If we come up with something that would make it simpler and more understandable, then we would have done a better job in assisting people in appreciating what all these working sessions are for.  

If you wish to change the way things are in your relationship with your partner, then you need to try different things.  In ACT or Acceptance and Commitment Therapy linggo, we call that expanding behavioral repertoire.  It is also referred to as flexibility skills.  If you start a conversation with your spouse with a criticism or a “You” statement every time, you are more than likely to get defensiveness in return.  And so on and on you go with the circular arguments that often lead you to ultimately just avoid each other or get into a massive shouting match.  

Unfortunately, we are the creatures who think that we can do the same things over and over again and come up with the results we want, even if the evidence clearly shows the contrary.  We like to follow rules and rule-following becomes the dominant reinforcer of our behaviors, and not the actual contingencies that show up.  We can see this if we break down the process of how people get hooked to the slot machine or some form of gambling addiction.  Although it is true that there is a one in a billion chance that you might hit pay dirt, the addicted person is not aware of the consequences happening as they continue this obsessive behavior.

Taken in these terms, we in this helping profession are after you getting out of your comfort zones.  Comfort zones are places where we want to end up that give us the short term feel-good moments.  Being able to analyze your spouse and find out what’s wrong with them, can give you that sense of accomplishment that you know something they don’t.  Getting that high in front of a slot machine when you win a small pot can be intensely rewarding at the moment.  However, the long term consequences eventually show up.  You no longer become the spouse you want to be.  The more you criticize your partner, the more they snap back.  Slowly eating away at the relationship you once thought will go smoothly through the years.  The more you gamble, the more you end up piling up debts and spending countless hours unable to do anything else that could have otherwise been spent more productively and meaningfully. 

I’d like to borrow a phrase from a book to help you, my readers, understand how counseling works.  The work is about being comfortable with the uncomfortable.  Maybe it’s time you tried another approach to your spouse, even if it feels embarrassing or extremely “so not you.”  Maybe you need to sit with those urges to gamble and find out what really is behind the pull towards the addiction so that you can find alternatives to spend all that energy on.  To paraphrase a well-known ACT therapist, Kirk Strosahl, maybe there’s something more important here than what you feel. 

If you are like the person I discussed in the first paragraph of this post, then be wary.  That’s because the counseling work is making you feel comfortable!  If you start to do things that are uncomfortable with the help of your counselor, then you might be on the road to being comfortable with being uncomfortable.  That’s also when you know that your work with your counselor is worth all that time and energy.  Maybe you’re on to trying something different that moves you towards what I regularly use in my discussions with my clients: being the person you want to be, and living the life you want to live.

*The example here is an amalgam of different cases that do not refer to any person in reality.

Running Towards the Vaccine: Overcoming Vaccine Hesitancy Revised Version

by Nathan Chua

I recently came upon an article on my newsfeed that someone had a really bad reaction to the vaccine.  I can’t remember if she had either died or gone through some really frightful and horrific struggle to survive.  Asked whether she regretted taking the vaccine, she had an interesting response.  No.  

Now I am not here to talk about every single reason as to why some people are either hesitant or completely opposed to having the shot, but I am here to share with you some way that those of us who are willing to take the vaccine can encourage those who have yet to decide.  

First, there is really little use to argue about how safe the vaccine is.  We all have that confirmation bias in which we tend to believe what we want to believe.  Secondly, it is true that one could die not because of the virus but the vaccine, just as the lady I talked about in the beginning of this blogpost.

So how can we encourage a friend who’s afraid of needles, even more so a needle with a newly-developed drug, to go out there and take something that we can’t really guarantee to be 100 percent safe and effective?  What can our knowledge of the human mind tell us about what motivates people to do some things and not others?  Well, we can start with knowing how our minds can trick us into believing that some things, like taking a risk to get vaccinated, are beyond our capacity to do.  Ever woke up one day with your mind telling you that you’re too tired to get up?  Stay a few more minutes, don’t worry you’ll wake up with no time lost for work.  Well, you know what comes after.  There’s a good chance that you’d end up being late for work or just waking up with just enough time to call in sick.

However, what if we were to say that this urge to stay in bed happened while your bed had just caught fire?  Wouldn’t you jump out of it faster than a rabbit being chased by a cat?  Or if I were to say that you should get up at exactly six o’clock this morning otherwise I would kidnap your loved one and you’d never see him or her again, would you still follow the rule your mind is giving you that you’re too tired to get up?  So if it were important enough, we can certainly break such rules for the sake of saving our own life as well as a loved one.  

So what other things can someone tell a vaccine hesitant friend about why it is beneficial to them that they take it?  If you look at the example above, it tells you that you and I are capable of doing things out of the ordinary when faced with something that connects us with our values.  

Guess what the girl in the article said when asked why she didn’t regret taking the vaccine?  She said she was willing to do her part to end the pandemic that cost the lives and livelihoods of billions of people around the world, including her loved ones.  As human beings, we are capable of doing things beyond what logic can explain.  We are the most successful species on the planet because we cooperate to a degree that not even the ants and bees can match.  The more we do things that may not be good for ourselves but good for this and future generations, the more we thrive and extend our existence on this finite planet.  It’s part of our evolutionary DNA.  They’ve done studies that have found that societies where people are more cooperative end up becoming more successful in promoting social well-being.  

Is it true that the vaccine can have lethal side effects?  Yes, of course!  But it is also true that we are unique in our ability to do things as crazy as sacrificing our own safety to save another human being, our pets, and our planet.  

So if you have a friend who is still hesitant to take the vaccine, ask them if deep inside they see that in their own small way, they can be part of a story that ended the pandemic and brought us back to what life used to be regardless of the end results.

You can also ask your friend, “If you had a dear friend or loved one who lived in another country and was very ill, wouldn’t you take the next plane out to have just a few moments with them even if it would cost you some? And by doing so, is there a likelihood, albeit slim, that your plane may crash and you’d die in the process of wanting to say a few last words to this person?” If the answer is, “Yes, you’d go,” then what’s stopping you from getting the shot!

In action movies (and we love them, don’t we?), we’d see the hero fighting the enemy in that one last fateful battle.  We’d see the hero lose their weapons one by one and sometimes even get severely wounded by a lethal strike from the enemy, and yet keep fighting on with whatever is left in their arsenal.  

The science is still imperfect, but it’s all we have left to fight this pandemic.  You and I can ask our hesitant friends, “Like that hero we pay to see in those movies, would you be willing to join in the fight with whatever is left in our arsenal?” 

What is in your “born-again experience” and how can you make your newfound spirituality last?

by Nathan Chua

Growing up exposed to faith traditions, I remember always looking forward to spiritual retreats.  Not only do I get to have time off from school or work for free or at a discounted rate, I also get to meet new people or have more bonding opportunities with friends or schoolmates.  However, it is often a big question among retreat-goers as regards how long the effects of such a religious experience will last into their mundane lives.  Of course, being in a situation where everybody is smiling and having a break from the usual busyness of life, provides an idyllic setting that makes it easier to be kinder and more loving.  No doubt there are doubts if there is an actual spiritual side to any one of us.  Maybe we are just ordinary folks not really destined to consummate lives that are anything close to the clergy who facilitate these events.

Well, what my fellow retreat-goers and I couldn’t figure out in those days, I think some good ol’ science has posed an answer to.  In most other approaches I have encountered in my more than a decade’s long journey into counseling, I think ACT or Acceptance and Commitment Therapy stands out as unique in its inclusion of values into what I thought was supposed to be a valueless undertaking.  Before 2019, I used to think that my job was confined to helping people find a way out of their mental miseries and the rest was up to them.  In ACT though, there is that very powerful component of pursuing a values-based life.

So how do spiritual retreats work?  Why do they have such an impact on us?  How do we keep that spiritual revival going in real world settings?  To answer the first two, these retreats function as a way to help us get back in touch with our values.  These values are chosen patterns of behaving that are consistent with our deepest aspirations for ourselves.  These values never actually leave us, they just become obscured when life as we know it, gives us the challenges of work and the important but difficult relationships we have.  

Our minds have evolved into an evaluative, problem-solving tool that takes over when challenges to these values are present.  Your kid starts to act nastily towards you.  Your boss makes a comment that you found offensive.  Your spouse forgets your birthday.  How are we supposed to still be kind and loving in these situations?  

Dr. Steven Hayes mentioned in one of his talks, that the problem-solving mode of mind can be described as analytical and predictive.  In other words, it wants to find out how we got into such a situation and how we can get out of it quickly and painlessly.  And these modes of mind are focused on the past and the future; unable to recognize what’s going on in the present.  Our minds pretty much work in a way that suggests we take the fastest way out of troublesome thoughts and feelings that come along at work and in relationships.  For example, the recalcitrant child is making us feel angry and frustrated.  The problem-solving mode of mind figures out how we got to this point by thinking that the child has been spoiled, and then suggests the quickest way to solve the spoiled child and get out of our frustrated feelings is to just try to control the child by yelling and screaming at them.  Goodbye sweet, kind, and loving us that came out of the retreat!  It is easy to see how these spiritual revivals are only as good as the few days or the few weeks after.  Simply said, it is more likely that we live out or become aware of our values or what is truly meaningful and important to us, when the situation is well-protected from the challenges of life outside these exclusive retreat enclaves.

And how do we keep the spiritual fire burning when like all good things, the retreat must come to an end?  In ACT, I have learned quite a few ways to do it.  The first step however is to get out of the mindset that all good things are about good feelings.  A good way to challenge this “good feelings equals good life” idea is to notice the not-so-good feelings that come with living our values.  Anything important to us usually comes with a price.  If it were easy then we wouldn’t really care about it.  We hurt because we care.  Our sadness from a loss is because we loved.  We get angry because something has violated our sense of justice.  We experience anxiety because there’s something worth our trouble that we want to accomplish.     

As we keep our final destinations in sight, committing to something also involves taking small steps towards them.  After having been able to return to these values, we can take action no matter how small in that direction we go.  Make it a point today to call a friend you haven’t reached out to in a while.  Go buy ice cream for your kid just because.  Stand up for yourself and don’t take a sip of alcohol in your weekly gathering with your alcoholic friends.  Small steps to break your patterns can put you back in touch with those values you cherish and also understand that situations, thoughts, and feelings have no control over you, but you do.  Start doing the uncomfortable stuff and then take time to savor the results as a reward.  It will likely be worth all the struggle! 

Every so often I do get some calls inquiring about whether I do a faith-based approach in my practice or not.  I welcome anyone and everyone from all faith traditions to come see me.  I’d rather spread the word that I am inclusive, not exclusive.  Why?  Because while we may be subject to different rules of faith, we are all subject to the same rules of science.  For me, there is no conflict.  In fact, what I am learning now from ACT as an evidence-based approach to therapy, just showed me how much traditional faith-based practices have been affirmed by the science behind ACT, albeit thousands of years late.

I always feel a sense of sadness when people turn away from what ACT science can do for them, without first investigating if it is in sync with their faith.  I hope, if you’re one who is looking for a faith-based approach to therapy reading this post, that you give me and this science I use, a chance to help you because it has tremendously helped me.  Call or better yet, text me.  I’d love to go on a journey with you towards a more meaningful and purposeful life you may have yet to experience!

A Life Worthy of Your Suffering

by Nathan Chua

“There is only one thing that I dread: not to be worthy of my sufferings.”

Fyodor Dostoevsky

I recently heard a podcast interview of Kelly Wilson, one of the developers of ACT or Acceptance and Commitment Therapy.  He had a well-known quote that the interviewer eagerly mentioned at the beginning of the program, which went something like this, “Values and vulnerabilities are poured from the same vessel.”

One thing that really drew me to ACT is it’s probably the only type of therapy I know of that blends values into a practice which used to be for me, more about symptom-reduction.  Much of my work before ACT was focused on this.  Getting clients to get over their problems or to understand the roots of their symptoms for them to finally start moving forward.  For example, my goals were more about helping an angry person be less angry, or a depressed person become more engaged and alive, or a shy person to be more assertive.  It was more of that feel-good about one’s self type of approach.

ACT however, therapy does not have such goals of symptom-relief.  In fact, one of the best ways to start ACT in my experience, is to have people get back in touch with their values, or qualities of being that were and are still within them, and they still aspire to demonstrate in their daily living, but have long neglected due to this overemphasis of having positive thoughts and feelings, not just most of the time but at times even all the time!  We often assume that our values leave us.  The reality however is that they often get relegated to the background and are far from our consciously pursuing them.  

So what you may ask has vulnerability got to do with our values?  It is in our values that we find the scariest parts of ourselves.  As the old ACT expression goes, we care where we hurt and we hurt where we care.  If one of our deepest aspirations for ourselves is being honest, it will be very scary to be honest.  Loving someone means getting in touch with that part of us that’s most vulnerable or hurtable.  Aiming for success means feeling those anxious moments as we pursue uncertain ends.  As one of the developers of ACT once expressed, it is about learning how to feel good rather than feel good.  

We can choose our suffering.  We can suffer because of all the efforts we make to eradicate our difficult thoughts and emotions.  Kelly Wilson has a name for this that really struck me and served as my inspiration for this piece.  He calls it valueless suffering.  Put in other words, we can ask ourselves, “Do we really want a life dedicated to feeling better or getting rid of depression or anxiety or what not?”  Now how is that going to look on top of our tombstones?  Here lies Nathan, he worked really hard to feel good about himself!  

The other option is that we suffer for what we believe in and what truly matters to us when we leave nothing but our memories behind.  This is when we suffer because we choose justice over injustice, love over fear, freedom over safety, etc., in other words, our values over shortcuts.  

Let me leave you with this quote from Viktor Frankl:

“Dostoevski said once, “There is only one thing that I dread: not to be worthy of my sufferings.” These words frequently came to my mind after I became acquainted with those martyrs whose behavior in the camp, whose suffering and death, bore witness to the fact that the last inner freedom cannot be lost. It can be said that they were worthy of their sufferings; the way they bore their suffering was a genuine inner achievement. It is this spiritual freedom — which cannot be taken away — that makes life meaningful and purposeful.” Viktor Frankl

Living our values is going to be hard, and we are bound to fail at times.  But one thing I can guarantee, it will be rewarding unlike any other thing we may have experienced, and I can guarantee it will be rewarding…up to that very last breath we take

How to be OK even when everything else is not

by Nathan Chua

Multiple deadlines, challenges at home and at work, you’re about to lose your job, someone in the family has a serious ailment, pressure is coming from all sides…life happens and is coming at you like a savage beast hungry for a fight to the death!  These are the times when people come to see me.  The world has turned against my clients and there seems to be nothing they can do that has succeeded in changing anything.  In fact, the more they try the worse the outcomes become!

It is also during these moments that our minds go on overdrive, drilling judgmental thought after judgmental thought into our consciousness.  The key here is to reach a level of awareness of what is within or outside our control.  If you ever wondered what it is that makes us feel that we are living ineffectual lives, it is our misdirected efforts to control that which is not subject to control.  

Just be the human being that we had become through billions of years of evolution!  We have an assortment of wonderful tools inside our nervous system.  Turning against these evolved functions, is like working against gravity.

Ultimately, what happens to us in life is not within our control, but our responses are.  The goal of psychology as a field of scientific study is to bring to bear what it is that makes us live ineffectually and then find ways to change or interrupt that process to get us moving towards a different, more effectual, and more life-enhancing direction.  So it really does not matter as much what happens to us, as how we face them.  How we handle ourselves in those moments is where we can bridge the gap between what we are and what we aspire to be.

The question we could keep in mind is, “Did we handle it well?”  Here’s a paraphrase of Dr. Darin Cairns words reminding us that we can be okay even when everything around us tells us we’re not.   

“I can’t promise you everyone’s going to like you.

I can’t promise you that people will always know you exist.

I can promise you this, if you like you at that time, if you liked how you lived it, then you’ll like that you were true to what you believed in.

That you liked how you handled yourself in terms of whatever you value, then you’re always ok.

You’re ok when you’re popular, you’re ok when you’re alone, you’re ok after a breakup, you’re ok when you’re scared to death, and you’re ok when you’re hurting. 

You don’t have to stand tall but you do have to stand up.  You don’t have to think that you’re better than anyone, you don’t have to have anyone praise you, but you do have to be willing to exist for you.”

So to you my friend, I can say that no matter how dire your circumstances are at this moment, take a look at yourself ahead of you by a year or so, and ask yourself, “Would your future you like how you, the present you, handled the situation?”  I hope that brings you back in touch with what truly matters for you in each and every moment that comes.  No matter how not okay these moments can get, you can be okay knowing you stood up for you! 

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