Abstract
We all must confront existential crises such as sickness, death of loved ones, loss of job, mistreatment from others, and relationship breakdown. These crises can shatter our sense of meaning. How can we face that moment with honesty and courage, embrace the distress, and create new meaning? This chapter provides a theory of how language and self-awareness can lead us into existential crisis and loss of meaning. It then provides an evidence-based account of how the DNA-V model of Acceptance and Commitment Therapy (ACT) can help people to answer “Yes” to Camus’ most important philosophical question, “Is life worth living?”. ACT can help people recreate coherence after a coherence-shattering event, overcome alienation from the body, overcome inertia, overcome a sense of self that is self-destroying or feels “empty,” and bridge the gulf between self and others and create genuine connection.
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References
Adler, P. S., & Kwon, S.-W. (2002). Social capital: Prospects for a new concept. AMRO, 27(1), 17–40.
A-Tjak, J. G. L., Davis, M. L., Morina, N., Powers, M. B., Smits, J. A. J., & Emmelkamp, P. M. G. (2015). A meta-analysis of the efficacy of acceptance and commitment therapy for clinically relevant mental and physical health problems. Psychotherapy and Psychosomatics, 84(1), 30–36.
Atkins, P. W. B., Ciarrochi, J., Gaudiano, B. A., Bricker, J. B., Donald, J., Rovner, G., Smout, M., Livheim, F., Lundgren, T., & Hayes, S. C. (2017). Departing from the essential features of a high quality systematic review of psychotherapy: A response to Öst (2014) and recommendations for improvement [Review of Departing from the essential features of a high quality systematic review of psychotherapy: A response to Öst (2014) and recommendations for improvement]. Behaviour Research and Therapy, 97, 259–272.
Bai, Z., Luo, S., Zhang, L., Wu, S., & Chi, I. (2020). Acceptance and Commitment Therapy (ACT) to reduce depression: A systematic review and meta-analysis. Journal of Affective Disorders, 260, 728–737.
Bancroft, A., Bratter, J., & Rowley, K. (2017). Affirmation effects on math scores: The importance of high school track. Social Science Research, 64, 319–333.
Barnes-Holmes, D., & Barnes-Holmes, Y. (2000). Explaining complex behavior: Two perspectives on the concept of generalized operant classes. The Psychological Record, 50(2), 251–265.
Barnes-Holmes, D., & Barnes-Holmes, Y. (2020). Updating RFT (more field than frame) and its implications for process-based therapy. The Psychological Record. https://link.springer.com/content/pdf/10.1007/s40732-019-00372-3.pdf
Barnes-Holmes, D., Hayes, S. C., & Dymond, S. (2001). Self and self-directed rules. In S. C. Hayes & D. Barnes-Holmes, et al. (Eds.), Relational frame theory: A post-Skinnerian account of human language and cognition (pp. 119–139, xvii, 285pp).
Barnes-Holmes, Y., Barnes-Holmes, D., McHugh, L., & Hayes, S. C. (2004). Relational frame theory: Some implications for understanding and treating human psychopathology. International Journal of Psychology and Psychological Therapy, 4, 355–375.
Bennett-Levy, J., Westbrook, D., Fennell, M., Cooper, M., Rouf, K., & Hackmann, A. (2004). Behavioural experiments: historical and conceptual underpinnings. In Oxford guide to behavioural experiments in cognitive therapy. Oxford University Press.
Biglan, A. (2015). The nurture effect: How the science of human behavior can improve our lives and our world. New Harbinger.
Bluett, E. J., Homan, K. J., Morrison, K. L., Levin, M. E., & Twohig, M. P. (2014). Acceptance and commitment therapy for anxiety and OCD spectrum disorders: An empirical review. Journal of Anxiety Disorders, 28(6), 612–624.
Burnette, J. L., Knouse, L. E., Vavra, D. T., O’Boyle, E., & Brooks, M. A. (2020). Growth mindsets and psychological distress: A meta-analysis. Clinical Psychology Review, 77, 101816.
Camus, A. (2013). The myth of Sisyphus. Penguin.
Cartwright-Hatton, S., & Wells, A. (1997). Beliefs about worry and intrusions: The Meta-Cognitions Questionnaire and its correlates. Journal of Anxiety Disorders, 11(3), 279–296.
Chen, B., Vansteenkiste, M., Beyers, W., Boone, L., Deci, E. L., Van der Kaap-Deeder, J., Duriez, B., Lens, W., Matos, L., Mouratidis, A., Ryan, R. M., Sheldon, K. M., Soenens, B., Van Petegem, S., & Verstuyf, J. (2015). Basic psychological need satisfaction, need frustration, and need strength across four cultures. Motivation and Emotion, 39(2), 216–236.
Ciarrochi, J., & Bailey, A. (2008). A CBT-practitioner’s guide to ACT: How to bridge the gap between cognitive behavioral therapy and acceptance and commitment therapy. New Harbinger.
Ciarrochi, J., & West, M. (2004). Relationships between dysfunctional beliefs and positive and negative indices of well-being: A critical evaluation of the common beliefs survey-III. Journal of Rational-Emotive & Cognitive Behavior Therapy, 22(3), 171–188.
Ciarrochi, J., Heaven, P., & Supavadeeprasit, S. (2008). The link between emotion identification skills and socio-emotional functioning in early adolescence: A 1-year longitudinal study. Journal of Adolescence, 31(5), 565–582.
Ciarrochi, J., Morin, A. J. S., Sahdra, B. K., Litalien, D., & Parker, P. D. (2017). A longitudinal person-centered perspective on youth social support: Relations with psychological wellbeing. Developmental Psychology, 53(6), 1154–1169.
Ciarrochi, J., Sahdra, B. K., Hawley, P. H., & Devine, E. K. (2019). The upsides and downsides of the dark side: A longitudinal study into the role of prosocial and antisocial strategies in close friendship formation. Frontiers in Psychology, 10(Feb), 114.
Ciarrochi, J., Sahdra, B. K., Yap, K., & Dicke, T. (2020). The role of nonattachment in the development of adolescent mental health: A three-year longitudinal study. Mindfulness. https://doi.org/10.1007/s12671-020-01421-7
Cohen, G. L., & Sherman, D. K. (2014). The Psychology of Change: Self-Affirmation and Social Psychological Intervention. Annual Review of Psychology, 65, 333–371.
Cohn, M. A., & Fredrickson, B. L. (2010). In search of durable positive psychology interventions: Predictors and consequences of long-term positive behavior change. The Journal of Positive Psychology, 5(5), 355–366.
ContextualScience. (n.d.). State of Act Evidence. Contextualscience.org. Retrieved July 7, 2020, from https://contextualscience.org/state_of_the_act_evidence
Cooper, D., Yap, K., & Batalha, L. (2018). Mindfulness-based interventions and their effects on emotional clarity: A systematic review and meta-analysis. Journal of Affective Disorders, 235, 265–276.
Dal Bó, P., & Fréchette, G. R. (2019). Strategy choice in the infinitely repeated prisoner’s dilemma. The American Economic Review, 109(11), 3929–3952.
Dimidjian, S., Hollon, S. D., Dobson, K. S., Schmaling, K. B., Kohlenberg, R. J., Addis, M. E., Gallop, R., Mcglinchey, J. B., Markley, D. K., Gollan, J. K., Atkins, D. C., Dunner, D. L., & Jacobson, N. S. (2006). Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. Journal of Consulting and Clinical Psychology, 74(4), 658–670.
Dostoyevsky, F. (2017). Crime and punishment. Oxford University Press.
Dweck, C. S. (2008). Current directions in psychological science can personality be changed? The role of beliefs in personality and change. https://doi.org/10.1111/j.1467-8721.2008.00612.x
Dymond, S., May, R. J., Munnelly, A., & Hoon, A. E. (2010). Evaluating the evidence base for relational frame theory: A citation analysis. The Behavior Analyst/MABA, 33(1), 97–117.
Ellis, A., & Harper, R. A. (1961). A guide to rational living (p. 195). https://psycnet.apa.org/fulltext/1962-03323-000.pdf
Ferrari, M., Hunt, C., Harrysunker, A., Abbott, M. J., Beath, A. P., & Einstein, D. A. (2019). Self-compassion interventions and psychosocial outcomes: A meta-analysis of RCTs. Mindfulness, 10, 1455–1473.
Feske, U., & Chambless, D. L. (1995). Cognitive behavioral versus exposure only treatment for social phobia: A meta-analysis. Behavior Therapy, 26(4), 695–720.
Foody, M., Barnes-Holmes, Y., Barnes-Holmes, D., & Luciano, C. (2013). An empirical investigation of hierarchical versus distinction relations in a self-based ACT exercise. International Journal of Psychology and Psychological Therapy, 13(3), 373–388.
Grant, A. M. (2013). Give and take: A revolutionary approach to success. Penguin.
Greenberg, L. S., & Pascual-Leone, A. (2006). Emotion in psychotherapy: A practice-friendly research review. Journal of Clinical Psychology, 62(5), 611–630.
Gu, J., Strauss, C., Bond, R., & Cavanagh, K. (2015). How do mindfulness-based cognitive therapy and mindfulness-based stress reduction improve mental health and wellbeing? A systematic review and meta-analysis of mediation studies. Clinical Psychology Review, 37, 1–12.
Hacker, T., Stone, P., & MacBeth, A. (2016). Acceptance and commitment therapy – Do we know enough? Cumulative and sequential meta-analyses of randomized controlled trials. Journal of Affective Disorders, 190, 551–565.
Hawkley, L. C., & Cacioppo, J. T. (2010). Loneliness matters: A theoretical and empirical review of consequences and mechanisms. Annals of Behavioral Medicine, 40(2), 218–227.
Hayes, S. (2019). A liberated mind: The essential guide to ACT. Random House.
Hayes, L. L., & Ciarrochi, J. V. (2015). The thriving adolescent: Using acceptance and commitment therapy and positive psychology to help teens manage emotions, achieve goals, and build connection. New Harbinger.
Hayes, S. C., Wilson, K. G., Gifford, E. V., Follette, V. M., & Strosahl, K. (1996). Experiential avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment. Journal of Consulting and Clinical Psychology, 64(6), 1152–1168.
Hayes, S. C., Strosahl, K., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. The Guilford Press.
Hayes, S. C., Barnes-Holmes, D., & Roche, B. (2001). Relational frame theory: A Post-Skinnerian account of human language and cognition. Springer.
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and commitment therapy, second edition: The process and practice of mindful change (2nd ed.). Guilford Publications.
Heinrich, L. M., & Gullone, E. (2006). The clinical significance of loneliness: A literature review. Clinical Psychology Review, 26, 695–718.
Hughes, L. S., Clark, J., Colclough, J. A., Dale, E., & McMillan, D. (2017). Acceptance and commitment therapy (ACT) for chronic pain: A systematic review and meta-analyses. The Clinical Journal of Pain, 33(6), 552–568.
Hurl, K., Wightman, J., Haynes, S. N., & Virues-Ortega, J. (2016). Does a pre-intervention functional assessment increase intervention effectiveness? A meta-analysis of within-subject interrupted time-series studies. Clinical Psychology Review, 47, 71–84.
Jiménez, F. J. R. (2012). Acceptance and commitment therapy versus traditional cognitive behavioral therapy: A systematic review and meta-analysis of current empirical evidence. International Journal of Psychology and Psychological Therapy, 12(3), 333–358.
Kabat-Zinn, J. (2013). Full catastrophe living (revised edition): Using the wisdom of your body and mind to face stress, pain, and illness. Random House Publishing Group.
Kissi, A., Hughes, S., Mertens, G., Barnes-Holmes, D., De Houwer, J., & Crombez, G. (2017). A systematic review of Pliance, tracking, and augmenting. Behavior Modification, 41(5), 683–707.
Lee, E. B., An, W., Levin, M. E., & Twohig, M. P. (2015). An initial meta-analysis of acceptance and commitment therapy for treating substance use disorders. Drug and Alcohol Dependence, 155, 1–7.
Lindsay, J., & Ciarrochi, J. (2009). Substance abusers report being more alexithymic than others but do not show emotional processing deficits on a performance measure of alexithymia. Addiction Research & Theory, 17(3), 315–321.
Miller, D. I. (2019). When do growth mindset interventions work? [Review of when do growth mindset interventions work?]. Trends in Cognitive Sciences, 23(11), 910–912.
Montoya-Rodríguez, M. M., Molina, F. J., & McHugh, L. (2017). A review of relational frame theory research into deictic relational responding. The Psychological Record, 67(4), 569–579.
Pinker, S. (2012). The better angels of our nature: Why violence has declined. Penguin Group.
Pinto, R. A., Kienhuis, M., Slevison, M., Chester, A., Sloss, A., & Yap, K. (2017). The effectiveness of an outpatient acceptance and commitment therapy group program for a transdiagnostic population. Clinical Psychologist, 21, 33–43.
Polk, K. L., & Schoendorff, B. (2014). The ACT matrix: A new approach to building psychological flexibility across settings and populations. New Harbinger.
Rowsell, H. C., Ciarrochi, J., Deane, F. P., & Heaven, P. C. L. (2016). Emotion identification skill and social support during adolescence: A three-year longitudinal study. Journal of Research on Adolescence, 26(1), 115–125.
Ryan, R. M., & Deci, E. L. (2017). Self-determination theory: Basic psychological needs in motivation, development, and wellness. Guilford Publications.
Sahdra, B. K., Shaver, P. R., & Brown, K. W. (2010). A scale to measure nonattachment: A Buddhist complement to Western research on attachment and adaptive functioning. Journal of Personality Assessment, 92(2), 116–127.
Sahdra, B., Ciarrochi, J., Parker, P. D., Marshall, S., & Heaven, P. (2015). Empathy and nonattachment independently predict peer nominations of prosocial behavior of adolescents. Frontiers in Psychology, 6(March), 263.
Sartre, J.-P. (1967). Essays in existentialism. Citadel Press.
Sartre, J.-P. (2000). The emotions: Outline of a theory. Citadel Press.
Sartre, J.-P. (2013). Nausea. New Directions Publishing.
Törneke, N., Luciano, C., & Salas, S. V. (2008). Rule-governed behavior and psychological problems. International Journal of Psychology and Psychological Therapy, 8(2), 141–156.
Walder, N, Levin, M., Twohig, M., Karekla, M., Gloster, A. (2019, October). The meta-analytic evidence of acceptance and commitment therapy: A review. In 2019 ACBS world conference, Dublin, Ireland. https://contextualscience.org/files/51.%20The%20Meta-Analytic%20Evidence%20of%20Acceptance%20and%20Commitment%20Therapy%20-%20A%20Review_0.pdf
Wells, A. (2006). The metacognitive model of worry and generalised anxiety disorder. In Worry and its psychological disorders: Theory, assessment and treatment (pp. 179–199).
Wiebe, S. A., & Johnson, S. M. (2016). A review of the research in emotionally focused therapy for couples. Family Process, 55(3), 390–407.
Wilson, A. C., Mackintosh, K., Power, K., & Chan, S. W. Y. (2019). Effectiveness of self-compassion related therapies: A systematic review and meta-analysis. Mindfulness, 10(6), 979–995.
Yalom, I. D. (2008). Staring at the sun: Overcoming the dread of death. Scribe Publications.
Yeager, D. S., Hanselman, P., Walton, G. M., Murray, J. S., Crosnoe, R., Muller, C., Tipton, E., Schneider, B., Hulleman, C. S., Hinojosa, C. P., Paunesku, D., Romero, C., Flint, K., Roberts, A., Trott, J., Iachan, R., Buontempo, J., Yang, S. M., Carvalho, C. M., … Dweck, C. S. (2019). A national experiment reveals where a growth mindset improves achievement. Nature, 573(7774), 364–369.
Yu, L., Norton, S., & McCracken, L. M. (2017). Change in “self-as-context” (“perspective-taking”) occurs in acceptance and commitment therapy for people with chronic pain and is associated with improved functioning. The Journal of Pain: Official Journal of the American Pain Society, 18(6), 664–672.
Zettle, R. D., Gird, S. R., & Webster, B. K. (2018). The self-as-context scale: Development and preliminary psychometric properties. Journal of Contextual. https://www.sciencedirect.com/science/article/pii/S2212144718300851?casa_token=4SovPwnbp2kAAAAA:pXA2nGRcPFXDYn0iZEC3zfaq9FHdqtOmoKTcfIhEVDFYUZIyI236A8Y44ZZF9eWRquDOouHBRSs
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Ciarrochi, J., Hayes, L., Quinlen, G., Sahdra, B., Ferrari, M., Yap, K. (2022). Letting Go, Creating Meaning: The Role of Acceptance and Commitment Therapy in Helping People Confront Existential Concerns and Lead a Vital Life. In: Menzies, R.G., Menzies, R.E., Dingle, G.A. (eds) Existential Concerns and Cognitive-Behavioral Procedures. Springer, Cham. https://doi.org/10.1007/978-3-031-06932-1_17
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