Comment on "Getting Beyond the Way of the Guru and Other Scientific Deadends" - ACT as an assault on the culture
Some very unscientific comments about "Getting Beyond the Way of the Guru and Other Scientific Deadends":
As a member of the public who's benefited from ACT (and therefore from RFT), I would naturally like to see ACT/RFT thrive rather than merely survive. From a purely non-professional perspective, however, I have my own concerns about whether this will happen.
The guru thing right now is asserted by some to be a problem, but that may just be because it's easy to gossip about. Some have said that Al Ellis's personality was the reason REBT never became as widespread as CBT - but to my mind, it may simply have been that REBT was more threatening & radical in its attack on the culture than CBT. As a former client of many sorts of talk therapies, I believe it's true that many of these therapies do as much to quell clients' dissatisfactions with the culture as they do to help us function better. This makes sense if the agenda is to make the client feel "better" - more comfortable - rather than "feel" better - whoops, possibly uncomfortable!
And that's one of the things I wonder about with ACT/RFT: Although it may be helpful therapeutically, and therefore popular in the public among people who've directly benefited, it can also be seen as an assault on hegemony. I find it interesting that in his response to the Salon article, Steven remarks that "when folks who are more reactionary are shown sessions of ACT and traditional CBT, they prefer CBT. More activist folks prefer ACT." This can't help but be a major barrier in a country as divided and in some ways backwards as the U.S. I suppose that leaves open the possibility that ACT/RFT will spread among some demographics and not others - but without evidence, I don't know. It would be interesting to see how disciplines such as yoga have fared in penetrating different populations: in its unadulterated form, yoga aspires to an activist spiritual awakening; in its tame form it is merely an exercise routine. Even mindfulness, divorced from religious or spiritual roots, can and probably is frequently reduced to a palliative. Over the ages, real spirituality has been as welcome in most communities as a virus; why should ACT be any different? There was a reason the TIME magazine journalist (who did an OK job for the most part) chose to mock Steven's quote about the Mideast conflict as a "grandiose prediction."
On another front, I wonder in my considerable ignorance whether ACT/RFT's roots in behavioral analysis will prove a barrier as well. I am curious (but have done no investigation yet) as to where behaviorism in general stands in this country & in the profession of psychology. Behavioral analysis is powerful but not very romantic - my sense is that we in the public don't want to hear about it except when it's presented in very small doses & in very limited contexts. Cure my smoking addiction or panic attacks, yes - but stay out of my life otherwise. We see mechanistic exploration of the brain as scary but legitimate science, behaviorism as an ideology. Can ACT/RFT succeed in being accepted where behavioral analysis has not?
But since all of this is speculation on my part, I'd be interested to hear where my assumptions are off.
Comment on comment on "Getting Beyond the Way of the Guru.."
Randy, thank you for your insightful comments on Steven's post. I am an Australian psychologist who's relatively new to ACT but have had the benefit of attending a fabulous conference in Oz recently in which I became part of the community, in addition I have benefited from ACT processes personally (although I didn't really think of them as ACT at the time!)
I definitely take your point and Steven's as well on the whole guru thing - it impressed and gratified me at the recent Australian conference how much the community seems to try to "degurify" itself (although Steven wasn't there Kelly and Kirk and Robyn and some others who people might want to classify as ACT gurus were, but they clearly distanced themselves from this, and are all quite real worldly which undermines guru stereotypes. Although I have to say Kelly IS a bit guruish in his demeanour 'cos he's so intense and present!).
It wouldn't surprise me if people who are more conservative would go for the structured rigidity of hard-nosed conventional CBT over ACT, but that people who are more anti-establishment or "anarchistic" if you will would go for ACT - because ACT in my view is anti-establishment whilst still a community - it isn't trying to position itself as a dogma or therapeutic religion (like some other therapies seem to have ended up either deliberately or inadvertently) but as a science of functionality.
To be honest though, one of the things that most drew me to ACT, and what I think draws a lot of other clients and therapists to it is its consistency with spiritual beliefs and practices that promote self-awareness, presence, and interconnectedness. While I don't think ACT really attempts to provide a spiritual path as a focus it is certainly consistent with mine, and therefore the most appealing therapeutic modality I have ever come across. Of course, the spiritual and new age tradition has been frought with gurus too. These days whenever some guru character even suggests they've got it all figured out or seem to be putting themselves up on a pedestal they lose me immediately, because there is no having it all figured out at any point in time and it's completely beside the point. I agree that real or personal or non-institutionally bound spirituality is still unpallatable to many, but I think a change is happening and ACT will be deeply embedded in the new therapeutic and spiritual paradigm shift. Right now it still threatens the status quo but that will change eventually, there's nothing like results and a strong and compassionate community to help forge ourselves ahead.
As far as behavior analysis goes I must admit when I hear the term I immediately think of Skinner, rats, Pavlov and drooling dogs, even though its been put in context within an ACT/RFT framework by some of my ACT colleagues. While I agree and really see the value I think it will still take some time for my undergrad psych associations to weaken (!). In this sense I think its good that ACT, RFT and behavior analysis are spoken about separately but frequently linked together, within time the meanings within this discourse will evolve too and the terms may seem more naturally interchangeable.
All the best,
Jon.
Beware of dogma
One of the things I intensely dislike about my field is that theories, whose real function is to provide one with working hypotheses for research or clinical work, so often tend to become rigid belief systems among those who adhere to these theories. My undergraduate university was strongly S-R behaviorist, and so anything from any other perspective was considered unscientific nonsense. Therefore, my fascination with Jung at the time was regarded by the faculty as a sort of personal defect. At my first graduate school, the prevailing perspective was Gestalt therapy, and so my then-keen interest in cognitive behavior therapy was laughed off as pointless mental masturbation. Suffice it to say that I was similarly out of synch in my second graduate program, which accounts in part for the fact that although I invested five years of my life and a lot of money in a Ph.D. program, I do not have those initials after my name. Theories or school of thought in psychology function much like religious denominations or political parties; if you think differently, you're not one of us.
I agree that the association between behavior analysis and ACT will, no doubt, cause it to be rejected out of hand by some of the dogmatists who reject anything "behavioral." Its sympathetic stance towards spirituality will also cause it to be rejected by those dogmatists who reject anything that smacks of "religion." But I think these problems are just the tip of a much bigger iceburg of a problem in psychology, which is that strong tendency towards dogmatism that pervades in a field which should encourage divergent thinking. I am not sure what can or even should be done to remedy this problem. The only step I have taken is to work to avoid dogmatic thinking myself, and when I teach or mentor to encourage others to break free from the same strictures.
It has been my experience that "behaviorism" does negative connotations in some circles in the US as well, especially in regard to developmental disabilities. Part of that is that there was some misapplication of such strategies; partly, it is also the dogmatism I just commented on.
John W. Balchunas, MS
Licensed Psychologist (WV)
Licensed Psychological Associate (KY)
Politics of Thinking
Unfortunately, in every arena I have looked at in any depth, my impression is that the various schools of thought are often chosen due to political efficacy rather than intellectual agreement. You can tell when you find one of these folks, because they snarl really loud when they think you might be a member of an opposing camp.
Which leads to situations that have been mentioned above where certain models in psychology circles hold much in common with models touted in family therapy circles. But the words must be altered somewhat, and distincitions must be emphasized over the similarities in order to avoid appearing to have fallen in with the wrong camp.
Of course family therapists could learn much from functional analysis, and functional analysis could learn much from the pragmatic methods of Minuchin, Haley, Fisch, O'Hanlon and other Systemic people from MRI origins. A relative lack of "empirical" data from these sorts arbitrarily makes them off limits to many who could benefit from their thinking.
One of the refreshing aspects of ACBS is the willingness to admit areas where common ground exists, the willingness to be open to comment from anyone, the willingness to share "ownership" of this developing wave of thinking.
How will the masses react? Those with vested interests in promoting the importance of other modes of thought will dismiss, combat, appropriate, assimilate, or capitulate as they will. I've seen examples of all those things within a few months.
What do the reactions of large numbers of people inside or outside of whatever might be perceived as the mainstream psychological community have to do with the real importance and value of what ACT/RFT and other related areas of thought have to contribute?
Absolutely nothing.
Just another example of an inappropriate use of quantitative thinking.
The status of behaviorism in general
Just to react to one of the questions you pose in your post, Randy, as someone who has been "in the field" of psychology as a student, instructor, and clinician for 35 years now, my perception is that the status of behaviorism, as I knew it years ago in terms of the strict stimulus-response, ignore-what's-inside philosophy, a la B.F. Skinner, is dead as a doornail. I haven't run into a dyed-in-the-wool strict behaviorist in at least fifteen years. In fact, as someone who has, at times, had a primary job responsibility of developing behavior management strategies, the "buzz" in behaviorally oriented journals and research in recent years has been all about "functional analysis," which is, in essence, looking to figure out why a behavior is occurring on the basis of its function, which is very closely akin to its context. This, obviously, is in the same area of the spectrum as ACT/RFT inhabits.
John W. Balchunas, MS
Licensed Psychologist (WV)
Licensed Psychological Associate (KY)
Re: The status of behaviorism in general
I guess what I meant wasn't necessarily Skinnerism - but behavioral analysis as it lives and breathes today. So to rephrase, what is the relationship between today's behavioral science community and those presumably allied professional communities interested in psychotherapy, clinical pysch, cognitive science, etc.?
E.g. the practicing therapist I saw last summer (pre-ACT, for me) was trained in "schema"-style CBT, meaning a blend of psychodynamic and CBT approaches. She's reasonably well-read, teaches at a small college, etc. Abstracting her into a hypothetical individual, what might be her attitude towards hard-core functional analysis? Would she have reason to be aware of it? If there were tensions, what might they be, and why?
I can rephrase in yet another way: If functional analysis (as the new frontier of behavioral analysis) were more popular, surely I would have heard more about it as such; surely it would be more a part of the larger therapeutic culture; surely it would be getting written up in TIME magazine as a scientific movement in and of itself - never mind this strange ACT thing.
Or are there manifestations here and there that I'm missing, for example if some of this work were to go by another name?
the status of behaviourism
the posts above do raise some interesting points. the first thing that showed up for me reading the above was that in my experience, the link between ACT and behavioural analysis does put some people off. When I talk about it in general terms, some colleagues do seem interested, particularly with the mindfulness components. I sometimes get responses along the lines of "wow, that sounds a bit fuzzy for you Aidan, I thought you were a behaviourist", or "Ah, so you are finally giving up on that cold, mechanistic behaviourism you used to love..great stuff!".
However, when I get into the philosophical and empirical roots of ACT, some people change their tune, it somehow seems less appealing to them. The same is true if I talk about "this new radical behavioural approach" first. It puts some people right off.
In the UK clinical psychology, there is in my experience a very anti-behavioural stance, although how wide spread, I am not sure. Many older psychologists have had bad experiences of its mis-application in the past and in particular the use of punishment schedules in challenging behaviour services for learning disabilities (1970s/1980s). Others, who should know better, are content to portray behavioural analysis as cold, mechanistic, stimulus response with nothing inside. This is despite the fact that an undergraduate reading of radical behavioural theory should inform a reader that radical behaviourism and Skinner in particular stood for none of these things.
I come across this a lot. Sometimes from people using what I would see as 'behavioural' non-behavioural therapies such as systemic family therapy (easily understood in operant or functional analysis terms), who object to a functional analysis of systemic therapy, yet can not explain what the mechanism of change actually is, on what empirical roots the intervention stands.
So I don’t know about the state of behaviourism in the U.S, but in the UK, I fear that ACTs explicit connections will hold it back from gaining support among psychologists who prefer CBT, CAT, BSFT. I know of some behavioural psychotherapists attempting to build ACT services as a second line treatment (i.e. where something else has been tried first).
In the U.K at least, the hostility toward and mis-representation of all things behavioural is alive and well it seems and perhaps we will have so sell the approach in an audience friendly manner. However, I think and hope that the approach will stand strong and tall on the outcome data
Very interesting and
Very interesting and provocative comments, Randy. At this point I'm going to let your contentions rattle around in my mind for a while and see what comes up.
John W. Balchunas, MS
Licensed Psychologist (WV)
Licensed Psychological Associate (KY)
The Future of ACT
The current problems with the image of Behaviorism stem from people throwing too much money at the budding discipline. The US congress did so after WWII because, unlike most psychological disciplines, behaviorism could provide hard numbers they could sink their teeth into. However, time heals all wounds.
How much time is another issue altogether. In any contest it tends to be the loosers that have the longest memories of the event. In this case, it is largely the academic community that is keeping the memory alive. What may be required is for ACT or some related therapy to prove itself unconditionally to a large segment of the academic community.
In the meantime, the research continues thanks again in no small part to RFT's strength in hard numbers.
Another promising avenue is the integration of substance abuse programs into conventional psychatric practices. At least eighty percent of all mentally ill have substance abuse problems, and many therapists are now being cross trained. These patients are literally self-medicating and a more holistic approach is being taken towards their treatment. Often this cross training involves RET and other behaviorally based therapies as alternatives and adjuncts to the already well established 12 step programs.
In general, I would say RFT, ACT, and several of the more modern therapies tend to resemble Buddhist and Zen philosophy. It is their relativistic and dramatic approach that cause this similarity. Although Buddhism is not particularly popular where it originated, it has proven itself to be remarkably flexible and adaptable to vertually any widely accepted system of thought anywhere in the world. Of all the asian schools of thought, it seems to make the first footholds in western societies.
ACT in a humanistic/existential context
From my perspective, I view ACT as a fascinating interplay of behavioristic psychology in a humanistic/existential psychology context. Steve Hayes has a joint chapter in Journal Of Humanistsic Psychology editor Kirk Schneider's recent book: "Existential-Integrative Psychotherapy" that convincingly describes ACT in a way that fits in very well with existential/humanistic psychotherapy. Of-course the mindfulness part of ACT and its Buddhist associations can be construed in a transpersonal psychology context as well. But the hard science and behavioral component of ACT is simply forceful and powerful to me in an irresistable way. However, for me I am quite comfortable in viewing ACT as essentially an experiential spiritual psychology, complete with a concrete scientifically based behavioral component to take active steps to make changes in your life according to your deepest values.
ACT in a humanistic/existential context
That is interesting, but does not address the topic of this thread, which concerns ACT as an assault on western culture. Please, expand upon your post and/or feel free to start a new thread.
By definition, any psychotherapy deals with issues of mental health and illness. The assumption people tend to make from the start is that the "doctor" knows more about what is good for you than you do and, when the philosophy behind the psychotherapy deviates dramatically from the norm for a culture, people can begin to view the "doctor" as a Guru.
This can also occur when ACT is interpreted as a simple pragmatic philosophical practice rather than a psychotherapy. A way to make ourselves happier, more productive, etc. rather than a means of curing what ails you. There are so-called philosophical Buddhists as well as spiritual ones and their world view can be described as existentialist.
Spirituality is a particularly muddled term that has only gained prominence outside of religious circles in the last century. Today it can mean something as simple as "team spirit", indicating our affect or attitude. Among the Chinese such distinctions have not been a problem; historically they do not distinguish between philosophy, religion, spirituality, and lifestyle.
ACT and possible cult/guru dangers
Hello Wu,
I will briefly expand upon my post, as I have studied and experienced a number of spiritual/philosophical organizationos with varying degrees of cult and guru dangers, and have written a number of articles about this--most recently concerning Ken Wilber and his Integral Institute. From what I have thus far learned from my preliminary experience in the ACT world, I see very little dangers of anything resembling a cult or following a guru. Steve Hayes is certainly a tremendously impressive creative and scholarly individual, in my opinion, but from my workshop with him I also view him as having an amazing degree of humiity and modesty for someone who has such a respected worldwide reputation. I am still too new to the whole ACT world to say much about its possible cult dangers, except that from what I have experienced it feels to me to be refreshingly open to new input and new ideas in a non-authoritarian way--which is very much the opposite of an organization with cult dangers.
The emphasis in ACT appears to me to be very much against the main thrusts of Western culture, offsetting our culture's dominant values of speed and money and "feeling good." However, once again I do see this as being in the same context as humanistic and existential psychology, as I mentioned in my last post. Perhaps if you get the chance you might take a look at the new forum topic I started, entitled "ACT & Sex" as I would be interested in your perceptions of ACT in this context.
Thank you for your reponses to my posts on both this topic and my post about fathers and sons.
Elliot
ACT and possible cult/guru dangers
I agree that currently ACT is in little danger of creating any serious Guru figures or becoming some kind anti-mainstream cult. However Randy, the original author of this thread, mentioned that it seems to attract pro-active and progressive people more than the conservative mainstream and that this marginalizes its usefulness.
My own suggestion was that it could make more of a foothold into the mainstream by dealing with alcohol and drug addiction in conjunction with mental illness. I have little doubt that this will require more time than was required for CBT to gain a foothold in the culture, but that is the price you pay for anything worthwhile. However, if people really wish to speed up the process it would be a simple matter to accentuate the Zen Buddhist aspects of ACT.
Zen is a yin and yang mixture of Buddhism and Taoism, and has sometimes been called "Taoism in wolf's clothing". Taoism has a tradition of gradual enlightenment and simple but subtle practices. On the other hand, Zen has a tradition of instant enlightenment, challenging disciplines, and high drama. It is precisely this melodramatic approach that the mainstream can identify with imho.
That is one of the reasons why Zen first became popular in the US in the 1950s and Taoism is only now beginning to become popular. Subtlety requires more time, but also tends to defeat any would be Gurus.
The Twelve Step programs present an interesting example of such mixtures of the dramatic and subtle. In my opinion, Alcoholics Anonymous appeals to a much more conservative audience while Narcotics Anonymous appeals to a much more progressive audience. The difference is that NA deliberately incorporated more of a Taoistic viewpoint into their written texts.
By deliberately splitting RFT into two distinctive viewpoints like these it would become easier for alternative therapies to be developed that would be more appealing to the mainstream.
Just a thought. :?)
ACT and substance abuse
Actually ACT has already been quite involved in the alcohol and substance abuse therapy scene. There is a chapter describing this in the 2004 book "A Practical Guide to Acceptance and Committment Therapy" (Chapter 7). It would make sense to me that ACT attracts more of the progressive pro-active population than the conservative mainstream, and once again this is certainly the same phenomenon that occurs in the humanistic and existential psychology realm. But I must say that I believe this is a good thing, as I think that the way progress in life happens, inclusive of artistic, scientific, and ethical domains, is initially thru this pro-active progressive population and not initially thru the conservative mainstream. I think that eventually the mainstream may follow suit after enough time passes and word catches on to enough of an extent. In this way I would identify myself with the creativity ideas in the novels of Ayn Rand, minus her questionable ethics and extreme praise of capitalism. But yes--ACT is a moving force in society as I see it, and I for one am very glad to see this being embraced by the pro-active progressive element initially. But I also think that ACT has a much stronger foothold on the potential to reach the mainstream than say the humanistic psychology movement has, because of the solid academic and professional research basis of its behavioristic psychology roots--and of-course Steve Hayes'impressive and well respected career as a mainstream psychologist--before he took his voyage into these other realms.
ACT and substance abuse
Because of Contextualism's relativistic perspective it is not terribly compatible with humanism per se, which is clearly not relativistic. However, I can see why many humanists might be attracted to the philosophy because of its scientific connections.
I too have nothing against ACT attracting a progressive crowd but, again, the issue in this thread is how to make it more popular with the mainstream.
ACT and Behavior Analysis
I think Behavior Analysis can easily dismiss ACT because several of the phenomena addressed (acceptance, defusing, values etc.) are covert. The phenomenal success of Behavior Analysis has been due in no small part to avoiding the invisible explanatory fictions that plague most other psychological disciplines. ACT, it seems to me, doesn't bother with Behavior Analysis in its clincial application because it has been successful so far without it. Eventually, the activities of an effective (inductive) science and treatment will meet when treatments don't work. That is, when the next question must be asked. When this happens, and if the two disciplines have not ignored each other to the extent that they no longer understand what the other is doing, I think there will be productive work in explaining the processes of RFT/ACT in terms of automatic (self-provided) reinforcement processes. RFT largely involved in what is considered automatic positive reinforcement processes and ACT largely involved in what is considered automatic negative reinforcement processes. Of course, this is just my opinion.
Martin Ivancic
ACT and Behavior Analysis
Actually in 30+ years going to ABAs I've never directly encountered the idea that we need to avoid discussion of private events (I have encountered that odd idea from "behaviorists" in print ... but it is 100% off the traditional Skinnerian line, which showed the flaw in Watson's thinking on this point). They are not invisible -- you can see your own. There are even some methods we have developed (Silent Dog method for example) that at times can tell you in a functional sense what others are thinking.
Private events can readily be EXPLANATORY fictions because it is so easy to see private actions as other than actions. I agree that BA has been successful in part because it avoids treating thoughts and feelings as causes. ACT too. But that is not an issue of privacy -- no actions public or private are causes within BA of other actions within the same individual. Context is always the "cause" -- for pragmatic, non-dogmatic, but not ontological, reasons.
ABA gave me an award for this work last year -- its not like BA in general doesn't like it.
I get why folks think that the BA link to ACT is odd -- but literally no one who goes to ABA regularly would think it odd. The "behaviorism" that folks are talking about is the behaviorism in books, not the tradition that is alive and well and growing. (ABA conventions are larger than CBT conventions in the US).
The mainstream does not know it is alive ... but that's due in part to the problems RFT and ACT help solve. ACT and RFT are taking BA toward the mainstream. If the Time Mag article showed anything it showed that.
BUT
The whole point is to tear down needless fences between people. Behaviorism is a foundation to stand on, not a wall to hide behind. I relish writing chapters like that one Elliot mentions; and we subtitled the 1999 ACT book "an experiential approach" for the same reason. It is to make legitimate, honest connections across artificial boundaries. There are real differences between things, but they generally aren't the ancient categories and schools we suffer with (humanistic, behavioral, cognitive, etc etc). Contextualism / mechanism is vastly more impactful -- and that's one you can't evaluate, only describe, so the division itself is nothing to fight about.
I'll respond to some other posts on here a bit later -- gotta grant to get out
- S
Steven C. Hayes, University of Nevada
ACT and blending
I appreciate Steve Hayes' viewpoint that he has offered in this thread. As I have mentioned, I am new to both ACT therapy and the ACT organization, and I am in the process of learning about both. I have never been to a behaviorist conference, and quite frankly this is about the last thing I had ever envisioned myself doing. But I am willing to be open to Steve's point of view here, and it is making me curious to some day experience a behaviorist conference. In the meantime, I will try my best to be more open to the humanistic possibilities that exist in behaviorism.
a different viewpoint regarding ACT and anything automatic
Well, I must say that I do not agree that ACT would embrace anything such as an automatic self process when it comes to its focus upon mindfulness and values. As I understand the ACT philosophy, these are in the spiritual experiential realm, which is where I very much believe they belong. I do agree that ACT is in a completely different realm from behavioral analysis, in spite of how hard Steve Hayes tries to resolve ACT with behaviorism and his allusions to the third wave of behaviorism. The experiential emphasis of ACT is in a whole different world from any kind of behavorism--cognitive included. For me, I do see ACT fitting in a humanistic/existential context, though it is true what Wu said about the contextual emphasis of ACT not being consistent with the dominant features of humanistic psychology. But the emphasis upon the individual finding his/her own precious values and the therapist being totally supportive does have quite a strong resemblance to the humanistic psychology of Carl Rogers. Well, I suppose ACT truly is in its own world.
Humanistic psychology is a
Humanistic psychology is a reductionist approach, while RFT is a holistic approach. Holistic viewpoints always have room for reductionist ones such as Carl Rodgers', but the opposite is not true. Since the advent of quantum mechanics and relativity a century ago, each of the sciences has steadily adopted their own holistic theories because, by definition, holistic theories describe more than reductionist ones.
The drawback with holistic theories is that their foundations are so broad that they are difficult to formalize, while reductionist theories are limited in scope. Carl Rodgers, in my opinion, overcame these hurdles by trusting his instincts for a more holistic approach, while formalizing his work using a reductionist model. However, the last forty years have seen a dramatic increase in holistic theories in philosophy and psychology.
Today it is no longer enough to deal with people outside of the context of their complete environment. The food we eat, the toxins we absorb, the genes we inherit, and the messages we hear all increasingly impact our well being. What is needed is an objective philosophy that is firmly grounded in the sciences and does not place humanity on a pedestal as separate and distinct from its environment. This is what RFT accomplishes so well, bridging not only the cognitive and behavioral sciences, but also the medical and environmental. Again, unfortunately, such a broad foundation will require time to formalize.
ACT and Behavior Analysis
Interesting post Elliot. As you are indicating, these issues are only "resolvable" from the context you view them. I was just trying to view ACT from a behavioral context. In doing that I see a couple things. One is that the idea of mindfulness could represent an experience where fusion cannot be supported (ba's call that extinction). And two, thinking in this context might give a therapist tools when treatment doesn't work. That is, if mindfulness is not helping defusion, it could be more work on the how fusion is reinforcing the problem response (automatic negative reinforcement process) is necessary and not that mindfulness doesn't work. I thought it might be a neat way for clinicians to think about their treatments when they were not working, but I was certainly not saying all clinicians should be behavior analysts. As long as treatments work, there is no reason to challenge what you are doing. In any case, it was fun hearing your view on it too.