Cognitive Defusion

Acceptance and Commitment Therapy (ACT) is one of the so-called "Third Wave" cognitive-behavioral approaches. Unlike previous iterations, which focused on removing or correcting a thought, behavior, or emotional response, third wave approaches integrate mindfulness to increase acceptance of problematic thoughts and emotions while developing adaptive strategies for interacting with the world (DBT is another third wave approach).

One of the ideas from ACT that I find particularly interesting is "cognitive defusion." To understand it, it helps to begin with the opposite: "Cognitive fusion." Basically, cognitive fusion occurs when we see a thought as literal truth, rather than a thought produced by our mind. We're like fish swimming in water without realizing they're under wanter. We become so immersed in our thoughts that we aren't really aware of them being thoughts. Often, that means that our evaluations of events feel as real and unchangeable as the event itself.

Sometimes, perhaps even most of the time, cognitive fusion isn't actually problematic. Our thoughts are helpful, or at least not harmful, and we go about our lives fairly successfully, all while thinking our thoughts are "true." However, sometimes cognitive fusion is both problematic, and harmful. The types of thoughts most likely to cause such problems are evaluation, and self-conceptualization. For example, someone who is fused to the thought "I am a bad student" is likely to act as if he or she is a bad student, and end up with a self-fulfilling prophecy.

If we think about the kind of thoughts that clients bring into therapy, we're likely to find all kinds of examples where taking a thought as fact adds to clients' suffering. Even something as simple as thinking "I am depressed" is problematic if it causes us to identify ourselves with depression. Believing the thought "I can't deal with panic" is likely to make someone desperate to avoid panic - an avoidance that can give rise to agoraphobia.

Since trying not to have these kinds of thoughts paradoxically causes them to happen, we have to instead learn to have the thoughts while also recognizing that they are thoughts rather than facts or literal truths - we have to defuse from the thoughts. Cognitive defusion teaches us to notice the process of thinking, so that we don't get swept up in our thoughts and allow them to define our reality.

Cognitive defusion begins with observing our own inner experiences (mindfulness), and labeling thoughts as thoughts, emotions as emotions, sensations as sensations, memories as memories, and urges to act as urges to act. So, instead of "I am depressed," we would think "I am having the feeling that I'm depressed," and instead of "I can't deal with panic," we would think "I am having the thought that I can't deal with panic." It is also helpful to distinguish thoughts that are descriptive (my desk is wooden) from thoughts that are evaluative (my desk is ugly).

Once we are aware of these inner experiences, there are several strategies to further defuse from them: We can try to objectify them by imagining them as external objects or beings. We can remove the emotional impact of the thought by turning it into just words - for example, by saying the words over and over, or very slowly, or in a funny voice, or as a song. We might imagine the thoughts as a radio broadcast, or internet pop-up ads. The idea is to turn the words of the thought into something you notice, but don't have to believe or disbelieve.

What do you think about this idea of cognitive defusion. What ideas do you have about how to defuse?