Values verbal relations and compassion can we do a better job of facing global challenges
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Values, Verbal Relations and Compassion: Can We Do a Better Job of Facing Global Challenges. Steven C. Hayes University of Nevada. The World is Facing a Series of Behavioral Challenges.

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Values verbal relations and compassion can we do a better job of facing global challenges

Values, Verbal Relations and Compassion: Can We Do a Better Job of Facing Global Challenges

Steven C. Hayes

University of Nevada


The world is facing a series of behavioral challenges

The World is Facing a Series of Behavioral Challenges

  • “…. knowing is not enough; action is needed. Why should it occur? That is perhaps the most terrifying question in the history of the human species” (Skinner, 1982) 


Terrifying because from paul chance

Terrifying Because(from Paul Chance)

  • Immediate consequences outweigh delayed consequences. People want to live in a world with clean air, but also want to drive Hummers.

  • Some chemicals are destructively reinforcing. The reinforcing power of sugar, salt, or drugs threaten our health.


The list

The List

  • Consequences for the individual outweigh consequences for others. We often fail to make sacrifices for the common good.

  • In the absence of counter-control, the use of aversives tends to be very reinforcing to those who use them. For example, Abu Ghraib


The list1

The List

  • Coincidental events often strengthen ineffective behavior. Superstition often wins out over rationality.

  • Simple, familiar wrong ideas are preferred over complex, alien but correct ideas. For example, evolution is rejected by 75% of the US population


The list2

The List

  • Susceptibility to social reinforcement can incline us toward extreme views. For example, 9-11 was perpetrated by mostly well-educated, middle-class people with families but who spent a lot of time interacting with others who shared extreme beliefs


The list3

The List

  • Strong aversives presented abruptly prompt  appropriate action, but strong aversives following a long string of aversives that gradually increase in strength often do not. This suggests that so long as conditions worsen gradually, we will tolerate bad air, foul water, loud noise, psychological and physical abuse, and crime that would once have been considered intolerable.


The processes

The Processes

  • Weak delayed consequences for positive behaviors or powerful short term ones of negative behaviors

  • Weak social concern or cooperation or using aversives on others

  • Impulse and superstition rather than scientific data and reason

  • Entanglement with socially supported deviant beliefs

  • Lack of attention to gradual aversives


The problems

The Problems

  • Obesity and health

  • Drugs

  • Over-population

  • Lack of self-control

  • Poverty

  • Violence

  • Pollution and global warming


Reformulating the questions

Reformulating the Questions

  • Not why are we controlled by short term consequences – it is why we ever fail to be.

  • Not why do we show low concern for others – it is why we ever cooperate or show compassion for others

  • Not why aren’t we controlled by scientific data – it is how is it that science ever makes a difference

  • Can a psychological flexibility model help? Is it relevant?

  • I will share data only from the last three years


Not why are we controlled by short term consequences rather how do we ever fail to be

Not Why are We Controlled by Short term Consequences Rather, How Do We Ever Fail to Be?


Values verbal relations and compassion can we do a better job of facing global challenges

Within a Psychological Flexibility ModelAcceptance and Defusion Increase Willingness to Experience Discomfort of Foregoing Short Term Reinforcers; Use Values or Motivative Augmentals to Increase Psychological Presence of Chosen Long Term ConsequencesSocial Processes that Support Both


Weight maintenance lillis et al 2009

Weight MaintenanceLillis et al., 2009

  • 87 participants who had completed at least 6 months of organized weight loss intervention (on average their 37th try)

  • Randomized to 1 day ACT workshop (n = 43) or TAU Control (n = 44)


Acceptance defusion from self stigma and values

Acceptance, Defusion from Self-Stigma and Values

  • Focused on values and patterns of avoidance toward weight-related thoughts, feelings, and bodily sensations

  • No diet, physical activity, self-monitoring, or weight education components


Process results

ACT

Control

1.4

Effect Sizes:

1.2

Process Results

1.0

.8

Large

.6

Cohen’s d Improvement

Medium

.4

.2

Small

0

- .2

- .4

AAQ

AAQW

Breath Holding


Pre to follow up weight change

Pre to Follow-Up Weight Change

3 month follow-up

p < .001

d = 1.21

35

30

25

20

15

Control

10

ACT

5

0

% gaining 5+ lbs

% losing 5+ lbs


Act for diabetes management gregg callaghan hayes glenn lawson 2007 jccp

ACT for Diabetes Management Gregg, Callaghan, Hayes, & Glenn-Lawson, 2007, JCCP

  • Randomized controlled trial with poor, mostly minority clients

  • 40 / group: ACT plus diabetes education (one six-hour workshop) or diabetes education (also a six hour workshop)

  • Only 3 hours were different content


Pre to follow up change

Pre to Follow up Change

% in Diabetic Control

AAQ (Diabetes)

Self- Management

10

50%

50%

5

25%

25%

0

0%

0%

Ed’n

ACT

Ed’n

ACT

Ed’n

ACT

AAQD and Self-Management mediated blood glucose outcomes


Pediatric chronic pain wicksell melin lekander olsson pain 2010

Pediatric Chronic PainWicksell, Melin, Lekander, & Olsson, Pain, 2010

  • 32 children w/ longstanding pediatric pain

  • Average of 32 mo pain duration

  • Randomly assigned to ACT or multidiscipinary Rx & medication (MDT).

  • ACT = 12 session; MDT = 23


Pain interference

4

6

2

Pain Interference

Pain Interference (1-10)

Pre

Post

3.5 mo

6.5 mo


Values verbal relations and compassion can we do a better job of facing global challenges

Effect of Writing About Your ValuesCohen, Garcia, Purdie-Vaughns, Apfel, & Brzustoski (2009), Science, 234, 400-403.

  • 385 middle school children followed through 7th and 8th grade

  • Randomly assigned to a series of short (15 minute) writing assignments at the beginning of 7th grade on their values in various specific domains and the importance of these values


Impact on gpa thru middle school

Impact on GPA Thru Middle School

European Americans or High Achieving African-Americans Both Conditions and Ethnic Groups Are Identical

3.5

3.0

2.5

Low Achieving African-Americans

Values

2.0

1.5

Control

1.0

Pre

1

2

3

4

1

2

3

4

Year 1

Year 2


Motivating physical exercise jackson et al in preparation

Motivating Physical Exercise Jackson et al., in preparation

  • 46 female students in a spinning class

  • Identify fitness motivation via IRAP

  • Prompt during class – compare to form based prompts or IRAP identified low motivators


Values verbal relations and compassion can we do a better job of facing global challenges

Bsln

Prompts

Bsln

Prompts

105

105

Percentage of

Instructor’s Heart Rate

95

95

85

85

Baseline

Positive Goals

Forms

1

3

5

7

9

1

3

5

7

9

105

105

95

95

85

85

1

3

5

7

9

1

3

5

7

9

Exercise Sessions


Values verbal relations and compassion can we do a better job of facing global challenges

Average Difference from Baseline

Green = Positive Implicit Goals

Blue = Instruction About Form


Values verbal relations and compassion can we do a better job of facing global challenges

Average Difference from Baseline

10

Green = Non-Preferred

“Positive” Implicit Goals

8

6

4

2

HEART RATE

DIFFERENCE IN % OF INSTRUCTORS AVERAGE

18

0

17

18

-2

-4

-6

-8

Blue = Instruction About Form

-10


Randomized trial act vs tau tapper et al 2009

Randomized Trial: ACT vs. TAUTapper et al., 2009

  • 62 overweight women (BMI = 31.6)

  • All participants already in weight loss programs

  • 4 two-hour sessions. 26 attended at least one; 31 left in existing diet

  • Short ACT protocol

  • Pre / Post / 6 month follow up


Values verbal relations and compassion can we do a better job of facing global challenges

BMI

.5

Overall

- “Never apply”

-.5

-1


Change in weekly exercise

Change in Weekly Exercise

3

Overall

- “Never apply”

2

1

0

-1


Physical fitness butryn forman hoffman shaw and juarascio under submission

Physical FitnessButryn, Forman, Hoffman, Shaw, and Juarascio, under submission

  • 46 female students assigned to two 2-hour workshops (two weeks apart) on ACT or education about fitness.

  • “Post” at week four; follow up at week seven

  • Primary measure: use of exercise facilities at the University Athletic Center (these were automatically recorded from the swipe cards, resulting in a high integrity measure with no drop outs)


Weekly number of exercise sessions

Weekly Number of Exercise Sessions

2.2

ACT

1.8

1.4

1.0

Visits to the Athletic Center

Fitness Education

.6

.2

Pre

Post

Follow Up


Values verbal relations and compassion can we do a better job of facing global challenges

The Question Is Not Why Aren’t We Controlled by Scientific Data Instead of Impulses It Is How Can We Increase the Impact of Scientific Data


Values verbal relations and compassion can we do a better job of facing global challenges

Within the PF Model:Link Science Knowledge to Values;Use Acceptance and Defusion to Deal with the Discomfort of Newness and the Interference of Alternative Beliefs


Adopting ests varra hayes roget fisher jccp 2008

Adopting ESTsVarra, Hayes, Roget, & Fisher, JCCP, 2008

  • 59 drug and alcohol counselors randomly assigned to

    • One day ACT workshop focused on the psychological barriers to learning

    • Control condition: One day workshop on EAP policies

    • Both groups then do a one day educational workshop on the science behind the use of agonists and antagonists


Frequency of perceived barriers to using empirically supported treatments

ACT plus Education

Control plus Education

Frequency of Perceived Barriers to Using Empirically Supported Treatments

75

Mean Score

70

65

Pre

Post

Phase


Believability of perceived barriers to using empirically supported treatments

Control plus Education

ACT plus Education

Believability of Perceived Barriers to Using Empirically Supported Treatments

70

65

Mean Score

60

Pre

Post

Phase


Willingness to use pharmacotherapy

ACT plus Education

Control plus Education

Willingness to Use Pharmacotherapy

3.5

3.25

3

Mean Score on 1-5 Scale

2.75

2.5

2.25

2

Pre

Post

Phase


Subsequent use of pharmacotherapy

Subsequent Use of Pharmacotherapy

3.5

ACT plus Education

3.25

3

2.75

Control plus Education

2.5

2.25

2

Pre

3 month Follow - up

Phase


Values verbal relations and compassion can we do a better job of facing global challenges

The Question Is Not Why Do We Show Low Concern For OthersIt Is How Can We Promote Cooperation, Compassion and Concern for Others


Values verbal relations and compassion can we do a better job of facing global challenges

Within the PF ModelPromote a Social/Perspective Taking Sense of Self Link Self-Acceptance and CompassionLink Values and Compassion


Experiential avoidance and mh stigma masuda et al 2007

Experiential Avoidance and MH Stigma Masuda et al., 2007

  • RCT comparing education focused on prevalence and costs of stigma toward mental health problems, and accurate information about them

  • ACT focused on defusion from and mindfulness of prejudicial thoughts, acceptance of difficult prejudicial feelings, and values


Act for mental health stigma

Education

ACT

ACT for Mental Health Stigma

Hi EA

-25

Lo EA

-30

Average MH Stigma Score

-35

-40

Pre

Post

F-Up


Racial prejudice lillis hayes 2007

Racial PrejudiceLillis & Hayes, 2007

  • Replicated with ACT versus Education for racial bias in a college student population

  • Within subject test (16 with A/B/A/C/A and 16 with A/C/A/B/A)

  • 32 participants in a two racial differences classes

  • 90 minute class period

  • “follow up” = next class period


Assessment items

Assessment Items

  • Bias Awareness

    • I feel that I am aware of my own biases

  • Bias Does Not Affect Me

    • I feel that my prejudicial thoughts are a significant barrier to me being culturally sensitive

    • My biases and prejudices affect how I interact with people from different racial and ethnic backgrounds.


Assessment items1

Assessment Items

  • Acceptance

    • It is OK to have prejudiced thoughts or racial stereotypes

    • I try not to think negative thoughts I have about people from different racial or ethnic backgrounds.

  • Defusion and Action

    • When I evaluate someone negatively, I am able to recognize that this is just a reaction, not an objective fact.

    • It’s ok to have friends that I have prejudicial thoughts about from time to time.


Assessment items2

Assessment Items

  • Positive Action

    • I would attend a social event where I was the only person of my race/ ethnic background.

    • I believe that I am able to transcend racial boundaries with my actions.

    • I plan to actively seek out experiences that could expose me to people who have a different cultural, racial, or ethnic background than me.

    • I am likely to join a campus organization or participate in a campus event that is focused on cultural diversity.


Values verbal relations and compassion can we do a better job of facing global challenges

YOU

HERE

NOW

I

THEN

THERE

RFT Take on the Formation of

Self and Perspective Taking


The i here nowness of awareness is the foundation of perspective taking

The I-Here-Nowness of Awareness is the Foundation of Perspective Taking

Self-as-context


But if from hereness is relational

But If “From Hereness” is Relational

  • It says something very profound: I don’t get to show up as a conscious human being until you show up as a conscious human being

  • One of the way we measure perspective taking are “Theory of Mind” assessments

  • Are deictic relations and Theory of Mind performances related?


Values verbal relations and compassion can we do a better job of facing global challenges

At Least Broadly, They Are

For general direction of the relationship only. These data are from 2 unpublished studies, one by another author, so details could change


Why this matters

Why This Matters

  • A perspective taking sense of self is social

  • Which is why your pain can pain me

  • I need to accept my own pain in order to care about yours in a healthy way

  • Gives a personal motivation beyond values and evolution for empathy and caring for others


Experiential avoidance shame and stigma toward others

Experiential Avoidance, Shame, and Stigma Toward Others

164 persons dealing with weight (Lillis et al)


And guess what

And Guess What?


What that says

What That Says

  • Compassion toward others is related to some degree to self-compassion and to liberation from entanglement with judgments

  • Those processes have tangible positive effects on the person, giving some possible motivation to deal with a judgmental lack of compassion


Values verbal relations and compassion can we do a better job of facing global challenges

Roger Vilardaga, Ana Estévez, Michael E. Levin and Steven C. Hayes

Caring About Being With Others

Perspective

Taking

Experiential Avoidance

Empathy

Now/Then

Sadness

Joy

I/You

Here/There

Repertoire Narrowing

-

-

-

+

Social Anhedonia


Values verbal relations and compassion can we do a better job of facing global challenges

The Question Is Not Why Do We Become Entangled With Deviant BeliefsIt is How Do WeDisentangle Ourselves from Them


Within the pf model defusion and mindfulness skills cost in valued behavior

Within the PF ModelDefusion and Mindfulness Skills;Cost in Valued Behavior


Act for self stigma shame luoma kohlenberg et al under review

ACT for Self-Stigma / ShameLuoma, Kohlenberg, et al., under review

134 participants in a 28 day in-patient drug program

Randomly assigned to 6-hour ACT group focused particularly on self-judgment and shame


Shame outcomes better for tau

Shame Outcomes: Better for TAU

ACT

110

105

100

Average Score

95

TAU

90

85

Pre

Post


Quality of life outcomes better for tau

Quality of Life Outcomes: Better for TAU

80

78

76

TAU

Average Score

74

72

ACT

70

Pre

Post


Group act for shame substance use outcomes

Group ACT for Shame:Substance Use Outcomes

6

TAU

5

4

Days / Month Using Drugs or Alcohol

3

2

1

ACT

0

1 Month

Follow Up


Group act for shame substance use outcomes1

Group ACT for Shame:Substance Use Outcomes

d = 1.21

6

TAU

5

4

Days / Month Using Drugs or Alcohol

3

2

1

ACT

0

1 Month

2 Month

3 Month

Follow Up


Shame outcomes

Shame Outcomes

r with use

at follow up =

-.51 (p < .01)

r with use

at follow up = ns

110

ACT

105

100

Average Score

95

90

TAU

85

Pre

Post

3 Mo F-Up


Quality of life outcomes

Quality of Life Outcomes

80

ACT

78

76

TAU

Average Score

74

72

70

Pre

Post

3 Mo F-Up


Where we are

  • Good start but it is not enough

  • There are some sour notes at the level of technology

  • Social trends are not good – if psychological flexibility is key

  • Enormous increase in exposure to horror and chatter

Where We Are


What is missing

  • Content wise: no studies on global warming and energy consumption; violent conflict; prevention; creating values-based groups.

  • We need to think about our work in a broader social context

  • We have natural allies

  • Could we scale the model?

What is Missing


Can we extend it

  • Projects are underway that will test these ideas

  • But we can take heart in the connection with evolutionist thinking and data

Can We Extend It?


Elinor ostrom 2009 nobel prize in economics

Elinor Ostrom2009 Nobel Prize in Economics


Elinor ostrom s eight steps

Elinor Ostrom’s Eight Steps

  • Clearly Defined Boundaries. The identity of the group and its rights to the common resource must be clearly delineated.

  • 2) Proportional equivalence between benefits and costs. Members of the

  • group must negotiate a system that rewards members for their contributions.

  • High status and other disproportionate benefits must be earned.

  • 3) Collective-choice arrangements. Group members must be able to create their own rules and make their own decisions by consensus. People hate being told what to do but will work hard for group goals that they have agreed upon.

  • 4) Monitoring. Managing a commons is inherently vulnerable to free-riding and active exploitation. Unless these locally advantageous strategies can be detected at relatively low cost, the tragedy of the commons will occur.


Elinor ostrom s eight steps1

Elinor Ostrom’s Eight Steps

5) Graduated sanctions. Transgressions need not require heavy-handed

punishment, at least initially. Often gossip or a gentle reminder is sufficient,

but more severe forms of punishment must also be waiting in the wings for use when necessary.

6) Conflict resolution mechanisms. It must be possible to resolve conflicts quickly and in ways that are perceived as fair by members of the group.

7) Some recognition of rights to organize. Groups must have the authority to manage their own affairs. Externally imposed rules are unlikely to be adapted to local circumstances and violate ingredient 3.

8) For groups that are part of larger social systems, there must be nested enterprises. The previous ingredients work best in relatively small groups. Society at a larger scale must be multicellular, with groups interacting with groups, often in multiple layers.


Values verbal relations and compassion can we do a better job of facing global challenges

Effective monitoring by monitors who are part of or accountable to the appropriators;

The self-determination of the community is recognized by higher-level authorities;

Collective-choice arrangements allow most resource appropriators to participate in the decision-making process;

Mechanisms of conflict resolution are cheap and to easy access;

Rules regarding the appropriation and provision of common resources are adapted to local conditions;

There is a scale of graduated sanctions for resource appropriators who violate community rules;

In the case of larger common-pool resources: organization in the form of multiple layers of nested enterprises, with small local CPRs at the base level.


The world is facing a series of behavioral challenges1

The World is Facing a Series of Behavioral Challenges

  • We cannot rely on the politicians and soldiers to solve this problem for us

  • The CBS community needs to consider the implications of its work for the health and well being of human beings and the global challenges they face


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