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Wise Choices Handouts

This document provides materials for a 10-session "Wise Choices" group program focused on acceptance and commitment therapy. It includes: 1. An outline of the session topics for each of the 10 meetings. 2. Handouts on concepts like ACT, mindfulness, values, and avoidance loops. 3. Forms like group norms and an evaluation form. The materials are meant to guide participants through exercises and discussions on acceptance, values, and committed action to support behavior change.

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mario ruiz
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0% found this document useful (0 votes)
259 views71 pages

Wise Choices Handouts

This document provides materials for a 10-session "Wise Choices" group program focused on acceptance and commitment therapy. It includes: 1. An outline of the session topics for each of the 10 meetings. 2. Handouts on concepts like ACT, mindfulness, values, and avoidance loops. 3. Forms like group norms and an evaluation form. The materials are meant to guide participants through exercises and discussions on acceptance, values, and committed action to support behavior change.

Uploaded by

mario ruiz
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
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Part E

Handouts for
Series 1, 2 and 3 groups
Wise
Choices
Session 1: Date:
Introduction to Wise Choices

Session 2: Date:
Avoidance and values

Session 3: Date:
Willingness and acceptance

Session 4: Date:
Awareness of thoughts

Session 5: Date:
Mindfulness of pleasure

Session 6: Date:
Awareness of emotions, sensations and urges

Session 7: Date:
Responding to emotions, sensations and urges

Session 8: Date:
Acting on values

Session 9: Date:
Obstacles and choice points

Session 10: Date:


Review and celebration

182 Handout: 1.1 - Wise Choices


Wise Choices group norms
Confidentiality:
• what group members say and do in the group is not talked about outside the group.

Treating each other with respect:


• listening to each other and sharing the time
• phrasing feedback and suggestions as positive requests rather than criticism
• focusing on ourselves rather than trying to change other group members
• focusing on moving forward, not on past injustices and hurts
• not discussing the details of self-harm (e.g. methods) or suicide urges in ways that
might be distressing for others
• not discussing the details of past trauma in ways that might be distressing for others
• mobile phones switched off.

Taking a break:
• taking time-out for a
short period rather
than saying or doing
something destructive
• letting us know you will
return in a few minutes.

Attending on time:
• missing no more than three
sessions per series.

Attending sober and not drug affected.

Other agreed or amended norms:

Handout: 1.2 - Wise Choices group norms 183


184
Acceptance and Commitment Therapy

Accept your feelings and thoughts and be present


Choose action that is in line with your values
Take action

Handout: 1.3 - Acceptance and Commitment Therapy


Remember, it’s what you do that counts!
Wise Choices
Change the things

Handout: 1.4 - Wise Choices


you can change

Accept the things


you can’t change

Practise being
fully present so
you gradually
learn to know
the difference

185
186
What is mindfulness?
Bringing your awareness to your here-and-now
experience with openness, gentleness and curiosity.

How to practise mindfulness


Step 1: Bring your full attention to something
in the here and now.
Observe curiously, as though you have never
come across something like this before.

Step 2: When your attention naturally wanders,


gently and patiently bring it back.
When you find yourself judging, categorising
or comparing, bring your awareness back to
the thing as it is, in this moment.

Step 3: P
 ractise!
Practise!
Practise!

Handout: 1.5 - What is mindfulness?


Passengers on the bus
Imagine you’ve been driving a bus called ‘My Life’ and the road you’ve decided to take
is towards a full, rich and meaningful life. As you drive along, you pick up passengers –
memories, emotions, thoughts and so on. Some of the passengers you like – friendly
ones, funny ones and supportive ones. You hope they will sit up the front, near you.
Some passengers you don’t like at all. If only these passengers had taken another bus!

Sometimes difficult passengers come up the front of the bus and start trying to get you
to go a different way:

‘You’ve got to turn left!’


‘You’ve got to turn right!’
‘That way is too hard, go this way’

If you do what they say and turn the bus in the direction they want to go, they quieten down
and you might feel better for a while. However, giving in to them means you are driving your
‘life bus’ in a direction you don’t really want to go. You can end up focusing on how to keep
these difficult passengers quiet and completely lose your way. After a while, you are likely
to feel worse.

Naturally, you would really like the difficult passengers to get off the bus, but because they
are your thoughts, feelings and memories, there is no way to get rid of them. Even turning
around to argue with them distracts you from driving where you want to go. In the end, to
have the life you want, you will need to find ways to take all the passengers — the likeable
and difficult ones – along for the ride. You will need to find a way to stop making deals with
them, which turn control of the bus over to them.

Can you find a way to drive your bus in a direction that makes your heart glad?

Handout: 1.6 - Passengers on the bus 187


Evaluation form
Overall how would I rate today’s session?
1 2 3 4 5 6 7 8 9 10

not useful ok really good

What I liked...

Suggestions for improvement...


Hmmm?

Other comments or suggestions

188 Handout: 1.7 - Evaluation form


Try observing your thoughts and
feelings and the outside world like
a gentle, curious scientist

Handout: 1.8 - A gentle, curious scientist 189


190
Caught in an avoidance loop?
Who is in charge of your bus – My values: Being a good friend – reliable,
you or your difficult passengers? caring, open to giving and receiving affection

It is a relief to stay home.


Drinking cheers me up for a while.
Choice point
Typical triggers:
Going out to see Feel better for a while
my friends …
Difficult thoughts:
‘What if I have a Avoidance loop
panic attack?’ Stay home, withdraw,
‘They will drink alcohol
laugh at you.’
‘They don’t like you.’
Difficult feelings:
Heart racing, sweating, ... then f
eel worse
panicking
Skills available:
‘Just noticing’ I miss my friends. Each time I don’t go, it’s harder the next

Handout: 1.9 - Caught in an avoidance loop?


time. I get depressed. Sometimes I self-harm if I drink a lot.
My avoidance loop
My values:

Handout: 1.10 - My avoidance loop


Choice point
Typical triggers:
Feel better for a while

Difficult thoughts:
Avoidance loop
What do I do to try to control or avoid my
difficult passengers (impulsive action,
withdrawal, self-harm, substance use)?
Difficult feelings:

... then f
eel worse
Skills available:

191
What do I want my
life to be about?
Deep down inside, what is important to me?
What do I want my life to stand for?
What sort of qualities do I want to grow
as a person?
How do I want to be in my relationships?

Some values that are important to me are:

• Preserving the environment, • Working hard, finishing what I start,


living non-materialistically persevering
• Contributing to a better world • Working as a team, being loyal
• Creativity, originality • Sharing, generosity
• Love of learning • Curiosity and interest in the world
• Zest, enthusiasm and energy • Honesty, genuineness
• Bravery, courage • Capacity to love and be loved
• Fairness, social justice • Appreciating beauty or skill
• Forgiveness, mercy • Sense of higher purpose, spirituality
• Leading, organising, encouraging • Being modest, humble
• Understanding and supporting others • Kindness
• Compassion • Humour, playfulness
• Open-mindedness, not jumping to • Making wise choices even when
conclusions, flexible perspective emotions are strong
• Gratitude, not taking things • Seeing the best in others, not speaking
for granted badly of others

Some examples of how I currently act on my values:

A value that I’d like to act on more (or in new ways) this week:

192 Handout: 1.11 - What do I want my life to be about?


What do I value in others?
Sometimes it’s difficult to think about big questions like ‘What do I want my life to be about?’
Brainstorming what we value (or don’t value) in others can be a great way to get started.

Think of someone you admire and someone you don’t approve of (no need to write down
their names). Quickly write down as much detail as you can about the qualities they have
that makes you admire them (or not approve of them).

Description of someone
I like or admire:

Description of someone
I don’t like or approve of:

What do these descriptions tell you about what you would like
your life to be about?

Handout: 1.12 - What do I value in others? 193


Obstacles to identifying my values
Difficult thoughts I noticed as I worked on identifying my values:

Difficult feelings or urges:

Obstacles to living my values


Difficult thoughts I noticed as I worked on how I live my values,
or small steps:

Difficult feelings or urges:

194 Handout: 1.13 - Obstacles


What are values?
Values are our heart’s deepest desires for the way we want
to interact with and relate to the world, other people and
ourselves. They can guide us and motivate us as we move

Handout: 1.14 - What are values?


through life. Values put into action make our hearts glad.

Are values and goals the same?


Values are not the same as goals. Values are directions we
keep moving in, whereas goals are the small steps we want
to achieve along the way. Goals can be achieved or ‘crossed
off’, whereas values are directions we travel in for our
whole lives and can live in small ways every day.

Are values like shoulds?


As we grow up, we collect a lot of ‘shoulds’ from others that
can feel like a pressure or a burden. Acting on these doesn’t
make our hearts glad in the same way acting on our own
values does. ‘Shoulds’ are about what others think of us.
Ask yourself, ‘Would I feel good about doing this even if
no-one else ever knew?’

195
196
Mindfully focus on ... just one thing!
One important part of
mindfulness is focusing your
full attention on just one thing
in the present moment.

Our minds, however, are not


used to focusing on just one
thing. They tend to be like
puppies – easily distracted
and happily chasing
after everything.

Practising mindfulness is a
lot like training a puppy to sit.
When you become aware
your attention is wandering,
see if you can bring your
awareness back as gently
and patiently as if you were

Handout: 1.15 - Mindfully focus on ... just one thing!


training a puppy.
Pain is inevitable; suffering is optional
There is no avoiding pain – life serves it up to all of us in one way or another. However, when we try to
fight with pain or push it away, our discomfort levels tend to decrease for a bit and then they increase
again. Our fear of pain, anger at pain, or efforts to deaden pain, all tend to create MORE pain.

This can be called ‘suffering’.


Although pain is inevitable, Feel guilty for hurting self

suffering is not.

Handout: 1.16 - Pain is inevitable; suffering is optional


Act on urge to lash out

Criticise and blame self

Feeling of
distress when
you lose your
wallet
PAIN: SUFFERING:
Our response to difficult The extra burden we
events themselves. ‘You’re so stupid!’ add by trying to fight
Some amount of pain is with, reduce or avoid
unavoidable. Hit a wall and hurt your hand
our original pain.
Unlike pain, this
can be eliminated.
‘You’ll never get it right’

197
Caught in a tug-of-war

Just drop the rope!


with a monster?

198 Handout: 1.17 - Caught in a tug-of-war with a monster?


What is willingness?
Willingness is being prepared to have your own experience – whatever it is!
You don’t have to like it. You don’t have to want it. You don’t have to approve of it.

Handout: 1.18 - What is willingness?


Willingness is making the choice to:
• give it permission to be where it already is
• let go of struggling with it
• make peace with it, let it be
• make room for it
• soften up around it
• breathe into it
• stop wasting your energy pushing it away,
fighting with it, denying it or trying to change it

Hold it lightly, as you might hold a butterfly that has


just landed on your finger.

199
Metaphors for willingness
Struggling against difficult thoughts and feelings often just makes them stronger.
Sometimes trying to change other people just makes them more determined not to
change. At these times, an alternative to struggle is willingness or acceptance.

These metaphors illustrate the difference between struggling against


what is there and willingness.

Lie back in quicksand


What happens if you fall in quicksand and
struggle? You sink. In fact, if someone falls
into quicksand, struggling is the worst thing
they can do.
What works? Lying back, spreading your
arms and being as still as possible, floating
on the surface.

Got an itch? Stop scratching!


What do you do when you have an itch? You
scratch it. Sometimes this works so well
you don’t even think about it. Suppose one
day you developed a bad itch and after you
scratched, it just kept coming back, worse
and worse.
The best advice is to stop scratching!

Play the hand of cards life deals you


It makes no difference to a good card player
what cards they get, they play whatever hand
they get as well as possible. One hand is
played, another is dealt.
Be mindful of the current hand of cards life
has dealt you. Play it as skilfully as possible
and then be willing to let go and focus on
the next hand.

200 Handout: 1.19a - Metaphors for willingness


Learn to love those dandelions
If you had a beautiful lawn, but dandelions
kept appearing, what would you do? You
could try pulling them out. You could try
poisoning them. You could even try planting
different grasses. What if no matter what you
tried, the dandelions came back?
Maybe it would be time to learn to love those
dandelions.

Work with the horse


Even if the horse is very spirited or going too
fast for you, fighting with it may cause it to
fight back.
Be one with the horse, communicate with
it, get to know it – work with it rather than
against it.

Take a swing at each of life’s


tennis balls
Life is like hitting tennis balls shooting from
a ball machine. Our job is to do our best to
hit each ball as it comes. Refusing to accept
a ball is coming doesn’t make the machine
stop shooting the balls out – they just keep
coming one after another.
We can stand in the way of a ball and get
hit. We can do nothing and let the ball go by.
Or we can take a swing at each ball and be
willing to see what happens.

Hold your heavy bag close


Try holding your heavy bag out as far away
from you as possible.
Then try holding it in close. Which is easier?

Handout: 1.19b - Metaphors for willingness 201


202
Questions to ponder
• Am I going to trust my mind or my experience?

Hmmm? • Is this thought an old story? Have I heard this story before?
• What would I get for hooking into this thought?
• Is this thought in any way useful or helpful to me?
• Does giving a lot of my attention to this thought help me
make the most of this moment?
• Does giving a lot of my attention to this thought help me
build the kind of relationships I value?
• Does giving a lot of my attention to this thought help me
be the person I want to be?
• Does giving a lot of my attention to this thought help me
take wise action?
• Is fighting with, struggling with or avoiding this thought
increasing my suffering?
• Who’s driving my bus (my life)? My passengers (my thoughts)
or me?

Handout: 1.20 - Questions to ponder


‘Hooked’ and ‘unhooked’

Handout: 1.21 - Hooked and unhooked


Hooked Awareness of thoughts Totally
(unhooking) unhooked

203
Different ways to
relate to thoughts
If an unhelpful thought comes into your mind (for example ‘I’m
useless’), you could:

‘Hook in’ to the thought


Think back through your life and choose to
focus on memories that make this thought
seem really, really true. Like a film director
editing a film.

Argue with the thought


Think of lots of reasons it’s not true. You’re
not agreeing with the thought, but are you
still hooked in?

Try ‘just noticing’


Try thinking ‘I’m having the thought that …’.
Then try ‘I’m just noticing I’m having the
thought that …’

‘Thank you, mind’


No need to pay attention to everything your
mind says and no need to be rude either!
Your mind is just doing its job. Try saying
‘Thank you, mind’ with a touch of humour,
and not too much sarcasm.

How do the words sound?


Say the words over and over to yourself quite
fast and notice the sounds of the letters like
in the ‘Milk, milk, milk’ exercise. Are they
soft? Sharp? Or silly sounds? Are the words
running together?

204 Handout: 1.22a - Different ways of relating to thoughts


Sing the words
Sing the words to the tune of ‘Happy
birthday’, or ‘Mary had a little lamb’,
or any other song you know well.

Silly voice
Try saying the thought using the voice of one
of your favourite cartoon characters such as
Homer Simpson or Bugs Bunny. Try saying it
in a funny accent or really fast or super
s-l-o-w.

Write the words over and over I’m useless I’m useless
How do they look in different sizes? I’m useless I’m useless
Different fonts? Different styles?
I’m useless I’m useless
Different colours?
I’m useless I’m useless

Leaves on a stream
Imagine yourself on the bank of a stream.
Put ‘I’m useless’ on a leaf and watch it float
down stream. Wait on the bank of your
imaginary stream for other thoughts, images,
sensations or thoughts to come, and put each
on a leaf and let them go too.

Clouds and sky


Imagine ‘I’m useless’ and other thoughts
are like clouds passing by. Perhaps you
are the sky, not the clouds.

Handout: 1.22b - Different ways of relating to thoughts 205


Bad News Radio
… playing all the bad news, all day, every day!

Blah, blah, blah … That’s bad. You’re


bad. It’s a disaster! No one will like
you. You’ll fail!

Let ‘Bad News Radio’ play on in the background without


trying to ignore it or fight with it …

… and get on with your life!

206 Handout: 1.23 - Bad News Radio


Watching your thoughts
Choose a metaphor and remind yourself of it when you notice yourself getting hooked
by a difficult thought.

Handout: 1.24 - Watching your thoughts


Birds flying across A waterfall. You stand Suitcases on a
the sky. behind it, not under it. conveyor belt.

Guests entering a Waves washing in Kids running across


hotel. You greet them, and out. You watch a playground. You stay
you don’t follow them from the shore, still and watch while
to their rooms. without being they run around.
swept away.

Trains coming and Fish swimming Bubbles rising in a


going. You stand in a pond. glass. They rise and
watching from the disappear.
platform.

207
Five things to bring and share
for Session 5
Next week we’re going to practise mindfully experiencing pleasure and
a gentle and compassionate stance toward ourselves. Please bring along
things that are pleasing to each of your senses to share with the group.

Vision
One thing I like to look at (e.g. photos, picture books, letters).

Smell
One thing I like to smell (e.g. incense, perfume, flowers, tea, gum leaf).

Taste
One thing I like to taste (e.g. grapes, piece of chocolate, cheese).

Sound
One thing I like to listen to (e.g. chimes, music or mindfulness CD).

Touch
One thing I like to touch (e.g. silky material, velvet, teddy, hand cream).

208 Handout: 1.25 - Five things to bring and share for Session 5
Ideas for a ‘Wise Choices’ box
Pleasure – using five senses
Things I like to look at
Things I like to taste
Things I like to smell
Things I like to touch
Things I like to hear

Handout: 1.26 - Ideas for a ‘Wise Choices’ box


Reminders of values, goals and inspirations
Compassionate message to myself when in crisis
Messages from people I love or admire
Pictures, stories, videos of people who inspire me
Pros and cons – reminders of long-term suffering from avoidance
Wise, inspiring sayings

Resources for awareness, serenity and reflection


Mindfulness tapes and exercises
Writing and art material
Positive memories

Reminders of good times and favourite people


Photos or postcards
Letters, notes, emails from a friend
Theatre or concert tickets

209
How emotions can help us live
a full, rich and meaningful life
Emotions feed into intuition
Sometimes a ‘gut feeling’ of fear can warn us of
danger. Feelings can help us work out who to trust
and who not to trust.

Emotions motivate us to act on


our values
Anger can help us fight for justice. Fear can
energise us to run from danger. Love can move
us to reach out to others.

Emotions help us know what we like


and what is important to us
Without emotions, how would we be able to choose
which jar of peanut butter to buy?

Emotions link us to others


Facial expressions communicate faster than words.
We connect with others via our tendency to ‘catch’
emotions from each other. This is the basis of
empathy and the prompt for compassion

Pleasure is part of a full and


meaningful life
Experiencing pleasure via all our senses – seeing,
hearing, smelling, touching and tasting – is an
important part of a life worth living. Also important
is the deep feeling of satisfaction and pride that
comes from living our values each day.

Living in full colour


It’s tempting to try to hold on to pleasure and avoid
pain. Unfortunately, if we try not to feel pain and
sadness, then we tend to lose our capacity for
happiness and love too.

It’s a package deal – a life in shades of grey, or the


full, rich tapestry of life in a palette of bright, dark
and pale colours.

210 Handout: 1.27 - How emotions can help us live a full, rich and meaningful life
Emotions pass like a wave ...

Handout: 1.28 - Emotions pass like a wave


… unless I get hooked by difficult thoughts

Thought Thought Thought Thought

… or act on urges against my values

Unwise action Regrets, negative consequences More unwise action More regrets, negative consequences

211
212
The anatomy of anger

Feeling:

Bodily sensations:




Trigger •

Urges for action:



• Choice
• Action
point

Thoughts:




Handout: 1.29 - The anatomy of anger


The anatomy of joy

Feeling:

Bodily sensations:

Handout: 1.30 - The anatomy of joy






Trigger •

Urges for action:



• Choice
• Action
point

Thoughts:




213
214
The anatomy of emotion

Feeling:

Bodily sensations:




Trigger •

Urges for action:



• Choice
• Action
point

Thoughts:




Handout: 1.31 - The anatomy of emotion


Be like water …
When a big stone is thrown into water
there are big ripples.

Handout: 1.32 - Be like water


When a small stone is thrown into
water there are small ripples.

Between stones, the water returns to


a state of stillness.

It doesn’t tense up waiting for the


next stone.

215
216
Pros and cons of an unwise choice
We don’t usually keep making the same unwise choice over and
over for no reason – it usually gives us some short-term relief
and the cost is only apparent in the long term. Sometimes Choice point
exploring the pros and cons of a choice helps us see more clearly What are the pros
why we are tempted to act in ways that are against our values. and cons?

An unwise choice I repeatedly make (e.g. self harm, drugs).


Short-term pros Short-term cons

What are the situations which trigger a strong urge to act against
my values in this way (e.g. feeling sad, frightening memories)?

What are the difficult thoughts, feelings and urges I notice in


these situations?
Long-term pros Long-term cons

What is an action I could take that would be in the direction


of my values?

Handout: 1.33 - Pros and cons of an unwise choice


Mindfulness and acceptance
strategies for emotions,
sensations and urges
Use mindfulness
Bring your attention to your inner experiences (not to the person or situation that has
triggered your reaction). Approach them like a curious scientist. Cultivate courage and
gentleness with yourself.
• ‘What I feel like doing is …’
• ‘I am having a feeling of (anger/sadness etc.) …’
• ‘The sensations I am noticing in my body are …’
• ‘The urges to act I am noticing in my body are …’

Use imagery
Notice the emotion, sensation or urge as you feel it in your body, or imagine it as an object in
front of you (and later welcome it back).
• If it had a size, what size would it be?
• If it had a shape, what shape would it be?
• If it had a colour, what colour would it be?
• If it had a texture, what texture would it be?

Use acceptance/willingness
• ‘Make room for’ these inner experiences. You don’t have to like them or want them; try
allowing them to be there without doing anything to change them or push them away.
• If you notice yourself tightening up around emotions, urges or sensations, imagine
bringing your breath down into that part of your body to help you open up around it.
• Survey your body for other sensations. Notice how you continue to function even with
these intense inner experiences.
• As the urge to take action gets stronger, remember you don’t have to act on it, you can
stay with it.
• Remember strong emotions and strong sensations are part of a full, rich and
meaningful life – see if you can shift from fighting them to choosing to embrace them.

Choose action in line with your values – no matter how strong your
emotions, sensations or action urges are.

Handout: 1.34 - More strategies for emotions, urges and sensations 217
Experimenting with
holding my breath
This is an experiment in using mindfulness and
acceptance strategies to increase your ability to stay
with strong thoughts, emotions, sensations and urges
without acting on them.

Time 1: How long I held my breath


Are you willing to make a commitment to hold your breath for as long as you can?
If so, choose some strategies from the session you are willing to try.
While holding your breath notice the thoughts, emotions, sensations and urges you
have. Take note of the ones occurring right before you choose to breathe.

Thoughts I noticed Emotions I noticed

Bodily sensations I noticed Urges I noticed

What I noticed just before I took a breath

Strategies that helped

Time 2: How long I held my breath using mindfulness and acceptance

218 Handout: 1.35 - Experimenting with holding my breath


Dare to dream!
Write down all your ideas (no matter how unrealistic) about what a full, rich and meaningful life would look like for you.
If fears, doubts or other unhelpful thoughts come to mind, write them on another sheet of paper and then keep
on daring to dream.

Handout: 1.36 - Dare to dream!


Connecting with others Contributing

Pleasure/ Fun Personal Meaning/ Spirituality

Health/ Fitness/ Energy Other

219
220
My values in action
What is a small step I can choose to take to act on my values this week?

What difficult thoughts, feelings or sensations might I experience?

Which of these am I willing to experience to act in line with my values?

Handout: 1.37 - My values in action


Values are like lighthouses in the distance …

Handout: 1.38 - Values are like a lighthouse in the distance …


… they guide us through emotional storms.

221
222
Clarifying values
If nobody knew, what you would choose to pursue in
your life? If there were no internal barriers, such as or
fear or lack of confidence, what would you really want
your life to stand for?

Did I identify this value because:


• it is a value I was raised with and my parents, or other people important to me, would be upset if I didn’t value this?
• if I didn’t value this, I would feel embarrassed, guilty, anxious or ashamed?
• only a bad or evil person would not value this?

… or did I identify this value because:


• it feels important to me from deep inside and even if nobody knew that I valued this, it would still matter to me?
• I experience peace and joy within myself when I behave according to this value?

Handout: 1.39 - Clarifying values


• this gives meaning and vitality to my life?
Choice points for action

Change what you


can change:

Handout: 1.40 - Choice points for action


Use the energy of the action
urge to take action in line with
your values. Do something to
make the situation better.

Feel better for a while



Accept what you
can’t change: Unwise action:
Act on the urge, even though it
Don’t take any action on the goes against your values.
urge – there may be nothing
that can be done right now,
or ever, to help. If this is
the case, you can practise ... then f
eel worse
acceptance and mindfulness
skills or use emergency time-
out measures.

223
224
Hovering at the choice point
Think of a choice point you repeatedly come to in your life where it is difficult to make the choice that
is in line with your values.

What is the choice?

Hover at the choice point in your imagination (or in real life) and notice as much as you can about your
thoughts and feelings. See if you can be willing to do this from a gentle, curious perspective without
getting caught up in judging or criticising your experience.

What did you notice?

In your imagination (or in real life) make the choice that is in


line with your values. Once again, notice as much as you can
about your thoughts and feelings.

What did you notice?

Handout: 1.41 - Hovering at the choice point


Wise
Choices
Session 1: Date:
Introduction to Wise Choices in Relationships

Session 2: Date:
Values in relationships

Session 3: Date:
Listening mindfully

Session 4: Date:
Practising courage to share ourselves

Session 5: Date:
Brainstorming alternative perspectives

Session 6: Date:
Assertively making requests

Session 7: Date:
In the other person’s shoes

Session 8: Date:
Giving and receiving positives

Session 9: Date:
Negotiation

Session 10: Date:


Review and celebration

Handout: 2.1 - Series 2 sessions 225


226
Five attitudes to bring
to mindfulness
Focus on … just one thing!
It could be a flower, your own breath, a sound, a piece
chocolate.

Be fully present
Let go of thoughts about the past and the future and come
right into the present moment.

Approach with openness and curiosity


Approach the flower, or chocolate, or whatever is the focus
of your mindfulness practice as though you have never,
ever come across one of these before.

Let go of judging and comparing


If you are looking at a flower, try to look at it and accept it
just as it is rather than comparing it with other flowers or
focusing on whether or not you like it.

It is as it is
Mindfulness is not about relaxing, distracting ourselves
or having pleasant experiences. We can also practise
mindfulness with a taste or body sensation we don’t like.

Handout: 2.2 - Five attitudes to bring to mindfulness


Relationships Where do you want to go?
What qualities do you want to bring to your relationships? What
kind of relationships do you want to build? What’s most important
to you in your relationships? What kind of relationships would
make your heart glad?

Where are you?


Inside skills: Outside skills: What do your relationships look like? How do you go starting
Unhooking from I-statements them? Maintaining them? Ending them? Are they mostly close?
thoughts Mostly distant? Is there a balance between giving and taking?
Mindful
Getting present listening

Handout: 2.3 - Relationship avoidance loop – overview


Leaning into Conversation
feelings skills
Feel better for a while
Making space Expressing
for feelings affection …
Brainstorming Expressing
alternative disagreement Avoidance loop
perspectives What do I do to try to control or avoid my
Negotiation
Willingness skills difficult passengers (impulsive action,
withdrawal, self-harm, substance use)?

What sends you off track?


What are the difficult passengers
... then f
eel worse
(thoughts, feelings, body
sensations, urges) that show up
for you in relationships?

227
228
Relationships

What sends me
off track? Where do I want to go in my relationships?
What qualities do I want to bring to my relationships?
What are the difficult
passengers that Where am I?
show up for me in What are my current relationships like?
relationships?
Thoughts:

Feel better for a while


Feelings: …

Avoidance loop
What do I do to try to control or avoid my
difficult passengers (impulsive action,
withdrawal, self-harm, substance use)?
Body sensations:

Action urges:
... then f
eel worse

Handout: 2.4 - Relationship avoidance loop – blank


Wise Choices in relationships – an overview of skills

Mindfulness, acceptance and values Values in action

Handout: 2.5 - Overview of skills


Becoming aware of my values. Setting limits and boundaries – saying no.

Being willing to act on my values rather than impulsively doing Sharing – giving my thoughts and feelings when others ask,
or saying something I might later regret. directly expressing my wants and needs to others.

Practising mindfulness – gently noticing my experience in the Actively listening – looking, showing interest, reflecting back
moment, including my nonverbal communication (how I stand, what the other person says, asking open questions.
sit, the expression on my face, etc.).
Expressing positives – reaching out, expressing affection,
Tuning in to others – being present and paying attention to gratitude and appreciation.
what others are saying and doing.
Accepting positives – accepting appreciation, compliments
Accepting there are things I cannot change about others. and affection.

Unhooking from unhelpful thoughts using defusion. Brainstorming options for action.

Making space for difficult feelings and bodily sensations. Respectfully negotiating – working to resolve differences by
means of creatively compromising.
Flexible perspective – imagining how things look from
others’ points of view - accepting people will experience the Accepting respectful disagreement or constructive criticism
same event differently. from others without withdrawing or attacking.

Finding compassion – noticing my harsh or critical thoughts; Repairing relationships – apologising, working to fix damage.
trying to see the situation, others or myself from a gentle place.

229
230
Wise choices
in relationships
Change … the things you can change
• focus mainly on changes you can make rather
than pushing the other person to change
• strengthen the relationship with listening,
sharing, giving positives
• address concerns with negotiation

Accept … the things you can’t change


• think ‘it is as it is’
• practise taking a compassionate perspective

Learn to notice the difference Wise choices in unsafe relationships


Take action!
• observe what works and what doesn’t • limit contact or have no contact at all
• look after yourself and get help if needed

Handout: 2.6 - Wise choices in relationships


• don’t try the same thing over and over
What do I want to bring to my relationships?
Deep down inside, what is important to me in my relationships?
What sort of qualities do I want to bring to my relationships?
What would I want to stand for in my relationships?

Seeing the best in others Compassion Encouraging


Showing love Assertiveness Honesty and loyalty
Gratefulness Thoughtfulness Fairness

Handout: 2.7 - What do I want to bring to my relationship?


Playfulness Showing affection Authenticity
Reliability Considering others’ views Forgiveness
Patience Accepting others Respectfulness
Generosity Understanding Openness to affection

How would I like to be as a member of this group? How would I like to be as a friend?

How would I like to be as a ............................? How would I like to be as ............................?

231
232
Using conversation to build closeness
Listening and showing interest
Looking and listening
With interested body language
Reflecting what you have heard
Asking open-ended follow-up questions

Giving ‘free information’


Sharing a bit extra when
answering a question
Using your answers to help guide
the conversation

Handout: 2.8 - Using conversation to build closeness


Practising courage
Lean into it! Bring it on!
If you try to make emotions and body sensations go away,
they will almost certainly get stronger. If you have fear of
fear, or anxiety about anxiety, the body sensations will
increase and the temptation to avoid important parts of life
will grow.
The aim is to make room for the sensations, and let them
be there in the background, without fighting them. Over
time they may get less, or they may not. The important
thing is that you are getting on with living the life you want
for yourself.

These are some experiments you could try in order to practise courage in the face of
difficult sensations. Tick any fears that are limiting your relationships.

Fear of being touched


• hand massage, head massage or shoulder massage
• applying moisturiser

Fear of looking at others in the face


• walk down the street choosing some pleasant-looking people to make eye contact with
• practise looking and smiling at someone serving you in a shop

Fear of vulnerability, fear of being looked at, fear of closeness


• sit close to someone, look into each other’s eyes allowing yourself to be ‘open’ to the
other person

Fear of blushing, fear of embarrassment


• deliberately go out with something odd about your clothing – maybe odd socks

Fear of dizziness
• put your head between your knees and suddenly sit upright.

Handout: 2.9 - Practising courage 233


234
Brainstorming
Our minds can get stuck in a groove with the same thoughts going round and round.
We can practise opening up to new ideas using ‘brainstorming’.

Have fun!
Welcome unusual or funny ideas. They are a sign you’re thinking
creatively.

No criticism
Our minds will keep on judging and criticising, same as usual. Let
any judgements that arise be there in the background. There is no
need to talk about them or engage with them. Keep bringing your
attention back to mindfully searching for new ideas.

As many ideas as possible


Aiming for quantity instead of quality can keep our minds so busy
that they don’t have time to criticise and judge.

Look for the positive


Pay attention to the ideas you (or others) have listed and look for
the positive. Build on them, combine them and use them as a

Handout: 2.10 - Brainstorming


fresh source of inspiration.
Shifting perspectives
Objective description of what the other person said or did:

Handout: 2.11 - Shifting perspectives


Harsh, suspicious or Kindly, curious, optimistic or Humourous, zany, musical, odd or
judgemental perspective – compassionate perspective – unusual perspective – view of an
‘thinking the worst’ ‘giving the benefit of the doubt’ artist, cartoonist, filmmaker, etc.

235
236
Using I-statements to ask for what I want I thought we
were going to
the park at 5?

1. Share your feelings


‘I feel worried …’

2. Give a neutral description of the situation


(without judging, criticising or blaming)
‘I feel worried when you are more than half an hour late …’

3. Express what it is that you would like from the other person
‘I feel worried when you are more than half an hour late.
I would like you to call if you are running late’

Your example
1. Share your feelings:

2. Give a neutral description of the situation:

3. Ask for what you would like from the other person:

Handout: 2.12 - I-statements


Tips for giving
respectful feedback
Giving constructive feedback will only work when you’re doing it out of a
desire to improve the relationship. When done to punish others, it is likely
to make you feel worse and the situation worse.

Before you start:


• Take time to reflect on your feelings and what triggered them.
• Notice any feelings of fear or anger and ‘make space’ for these.
There is no need to act on them by avoiding the issue or punishing
the other person.
• Take responsibility for your feelings. Remember – no-one can make
you feel something (although they can provoke you).
• Keep an open mind to the possibility you may have misunderstood or
misinterpreted the other person. Experiment with a compassionate
perspective on the other person’s actions.
• Check with someone else if you think you could be overreacting.
• Wait until the right time to raise your concerns (i.e. not in front of others,
when you both are reasonably calm, non-intoxicated and rested).

Remember:
Start from a soft, gentle place. Soft start-ups usually begin with something
positive, express gratitude and contain an I-statement.

I really enjoy it when


we spend time together
Fluffy, but when you drool
like that, I feel scared.

Handout: 2.13 - Tips for giving respectful feedback 237


238
Tips for receiving respectful feedback
• Look at the other person. Try to really listen and
understand the situation from their perspective.
Remember each person sees the world differently. So, what you are saying is that
• Notice any feelings of anger or fear, and ‘make space’ for when I pressed this button, all
these. Notice your action urges. There is no need to act on your files got deleted?
them by counter-attack or running away.
I’m sorry love. Can we fix it?
• Acknowledge it may have been difficult for the person to
raise the issue. Maybe say ‘Thank you for trusting me to
share your feelings’.
• Feedback what you have heard the person say to make
sure you understood correctly (i.e. ‘So, what you’re saying
is …’ or ‘What you mean is …’). Ask questions like a gentle,
curious scientist.
• Accept what is valid about the criticism and make repair
attempts if appropriate (i.e. apologise).
• Respectfully disagree with what you do not believe
is valid.
• Ask for ideas about how the situation could be improved.
Jointly brainstorm creative solutions that meet both
people’s needs.
• Expect to feel angry, upset and hurt. These feelings are
normal! Work to ‘make space’ for them and keep your

Handout: 2.14 - Tips for receiving respectful feedback


values in mind when taking action.
Perspectives of self and other
Objective description of the situation (gentle, curious scientist):

Handout: 2.15 - Perspectives of self and other


Compassionate guesses about what Ideas for actions in line
What is going on for me
is going on for the other person with my values

239
Expressing affection, gratitude
and appreciation
• Look and smile.
• Say or do something positive, however small, as long as it’s genuine.
• If the other person knocks your gesture back, there’s no need to take
it personally.

Receiving affection, gratitude


and appreciation
• Look and smile.
• Notice any difficult feelings or thoughts and ‘make space’ for these.
There’s no need to act on them by knocking back the gesture.
• Say ‘Thank you’. A positive gesture is like a gift, it’s the thought that
counts. You can always say thank you for the ‘gift’ even if you’re not sure
you agree.
• Reflect on the positive gesture. Keep an open mind. Even if what the other
person has said or done doesn’t fit with how you see yourself, it may be an
honest reflection of how they see you. Remember each person will have
their own perspective.

240 Handout: 2.16 - Expressing affection


Negotiation
* Start the discussion gently. Show respect, be polite.

Handout: 2.17 - Negotiation


Step 1 – Objectively describe the issue using neutral language
– not judging, criticising or blaming – and agree on a time to talk.

Step 2 – My perspective: Use I-statements to say how you feel.


State your perspective in the positive if possible – what you would
like or what you used to like, rather than what you don’t like.

Step 3 – The other person’s perspective: Ask for the other person’s
perspective using open-ended questions and by showing interest.
Keep going until the other person feels they have been heard.

Step 4 – Brainstorm possible compromises using creativity, * Don’t forget to:


patience and humour. • make repair attempts and acknowledge
repair attempts from the other person
• soothe yourself and the other person
• take a break before the level of tension
Step 5 – Choose the most promising ideas and take action! gets too high

241
242
ACT: Acceptance and Commitment Therapy

Present
Acceptance moment Values
awareness

Get
Get open centred Get living

Mindful Committed
Defusion
observing action

Handout: 3.1 - Get open, get centred, get living


Values target

Myself: body, mind,

Handout: 3.2 - Values target


People I am close to
spirituality (including
(eg family and friends):
connection to nature)

Valued directions: Valued directions:

Valued directions: Valued directions:

Other people:
Society, environment, (eg acquaintances,
‘the greater good’ colleagues, people I
find difficult)

243
Accept your feelings and thoughts and be present

Choose action that is in line with your values

Take action

Commitment styles:
• Attempt realistic challenges and follow through (willingness)
• Attempt unrealistic challenges and blame self for failing
• Face obstacles and ‘get back on the horse’ (keep going)
• Face obstacles and give up
• Forgetful / disorganised
• ‘Gunna’ (procrastination)
• Half-hearted or doing it under pressure from others
• Set tiny steps because of fear of failing (under-ambitious)
• Commitment phobic – afraid to commit

244 Handout: 3.3 - Commitment styles


Observing self exercise

Notice yourself having a thought. Just wait until one comes.


Are you the thought, or the person having the thought?

Now bring an image to mind. This could be any kind of image.


Are you the image, or the person having the image?

Next notice a sensation – could be the chair against your back or any other
sensation that you can notice right now.
Are you the sensation, or the person having the sensation?

So, there is a self who experiences thoughts and images and sensations but
isn’t the same as those thoughts and images and sensations.
Let’s call that the ‘observing self’.

Now, think about yourself when you were a child and had a completely different
body. Was that same observing self there then?
So your observing self isn’t the same as your physical self either.

You can take the perspective of observing self at any time and observe
thoughts, images, sensations or whatever from this place, noticing that whatever
it is that you observe is not the same as the self who is observing it.

If you have painful sensations or pleasurable sensations, it is the same self who
experiences them even though the sensations experienced are quite different.
This place from which you observe – this observing self – is not changed by
what you view.

From now on, do you think that you will have any difficulty getting to this
‘observing self’ place again?

If you are not sure you can find it, try some more examples.

Handout: 3.4 - Observing self exercise 245


246
Baby avoidance tiger …
If you keep feeding the baby avoidance tiger bits and pieces
of your life to keep him quiet ... he will just get bigger and
hungrier!

Handout: 3.5 - Baby avoidance tiger …


The Question
Given what’s important to me,

Handout: 3.6 - The Question


what am I willing to do, and
what am I willing to experience,
in order to move me in that
direction, in this moment?

247
Obstacles Strategies
Unhelpful thoughts
Judgements of self and others Mindfulness of thought processes
Unrealistic expectations Defusion
Stuck, repetitive thinking Brainstorming alternative
perspectives, including
compassionate perspective

Difficult feelings
Fear of sadness  ractise sitting with the difficult
P
Fear of fear/ panic emotion step by step
Fear of anger ‘Tin Can Monster’
Fear of pleasure ‘Leaning in’ to it, practising courage
Fear of embarrassment Mindfulness of pleasure

Not present
Busy mind, or zoning out, drugs, Present moment awareness
alcohol, sleeping, TV, etc. Plan action to address worries,
Worrying about past or future move forward

Not willing/ committed


Not making commitments Practice realistic commitments
Not remembering commitments Use reminders
Procrastination Talk about commitments to others

Remoteness from values


Not sure about values Clarify values
Forgetting values Think, write, draw about values
Not living values Make, buy reminders of values

248 Handout: 3.7 - Obstacle and strategies


Looking with soft eyes
In pairs:

Think of a memory associated with a feeling


of warmth and openness.

Handout: 3.8 - Looking with soft eyes


Sit facing each other, as close as is comfortable. Notice
any difficult thoughts and feelings that arise. Are you
willing to ‘make space for’ these difficult thoughts and
feelings and do the exercise anyway?

(1) One person connects with their memory as powerfully as possible and shares
it with the other person though their eyes and face. The other person is open and
receptive, with their eyes and face also, but without speaking.

(2) Swap roles. The other person connects with their memory and shares it without
speaking.

There is no need to share the memories you were connecting with unless you wish to.

249
250
Taking apart the Tin Can Monster

Thoughts
‘Oh no!!’ Use mindfulness techniques to move towards just noticing each thought, one at
a time.
These techniques include: ‘Leaves on a stream’, ‘I’m noticing that I’m having
the thought that…’, ‘Bad News Radio’, ‘Sing the thought’, ‘Write the thought’
and ‘Thank you, mind’.
Racing heart

Anger Sad Feeling sensations


‘You can’t Use body awareness techniques to move towards acceptance of each
cope’ sensation, one at a time.
These techniques include: physicalisation (‘If it had a colour, what colour
‘This would it be? Shape? Size? Texture?’), ‘Breathing with it’ (focusing on the
happened breath), ‘Breathing into it’ (focusing on the sensation), ‘Making space’
last (opening up around it).
time’

Images
Use image defusion techniques to move towards acceptance of each image,
one at a time.
These techniques include: ‘Changing the image’ (larger, smaller, colour, black
and white, etc.), ‘Making it into a movie’ (Bollywood, drama, etc.) and imagining

Urge to run
Muscles tight
the image is on a TV and you are walking around the TV.

Handout: 3.9 - Tin Can Monster


My values in action
What is the value I want to put into action this week?
Example: Standing up for myself, being assertive

What is a small step I can choose to take to act in


line with this value?
Example: Go to a shop and ask the shop assistant
for advice about a product before buying it.

What passengers (thoughts, emotions, bodily sensations, action urges, memories,


etc.) do I expect to notice?
Example: Thought ‘You’ll look stupid’, feeling of anxiety.

Take a moment to pause, imagine taking action on this


value, and notice your willingness to experience these
passengers … sensation of a flushed face, an urge to run

What I noticed (either inside me or outside me) when imagining attempting to put
this value into action?

Ideas or encouragement offered to me by the group.

Handout: 3.10 - My values in action 251

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