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4: ACT therapy for teenagers (Part 2)

ACT therapy, or Acceptance Commitment Therapy, provides valuable skills for everyone. Skills to help you to live a life of meaning despite emotional turmoil and hardship. Dr Louise Hayes has made these skills more widely accessible through her model: DNA-V (© DNA-V, L. Hayes & J. Ciarrochi, This model is easy to understand, and relatable, for children, teenagers, and adults. In the previous episode Louise introduced the DNA-V model, and provided an overview of the four core skills. In this episode Louise discusses how self-view and social-view apply to each area of the model, and we explore the developmental context around the development of the DNA-V model.

ACT Therapy for Teens 2

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Introduction: Hello, welcome back! This is the second half of my interview with Dr Louise Hayes. If you missed the first interview, and are new to the DNA-V model, I would recommend you start there. In Episode 3 Louise outlines the DNA-V model, and we explored those four processes. Your Discoverer – which is your ability to learn through trial and error, to try things out and observe what happens. Your Noticer, the part of you that senses your internal and external world, and allows you to live in the moment. Your Advisor, the part that gives you advice, tells you what to do and how to act. And your Value or Vitality, what you need and care about, what energises you.

In this episode Louise helps us to put these processes in perspective by understanding the self-view and social-view, which provide context to all four processes. We also discusses the broader evolutionary, and developmental context to the DNA-V model.

Let’s get to the interview! 

Interviewer: You mentioned self and other approaches could you talk a bit more about those?

Louise Hayes: Sure, well so we consider DNA-V as four basic behaviours if you want. Ways that we can think and act and feel. And those ways are influenced by different perspectives such as our view of our self, self-as-context as it is sometimes called or self-view. And what we mean by that is that we are not a fixed thing, that our Self is created from all of our actions, and so by the time you become a teenager a very formative part of being a teenager is discovering this Self, who I am.

And our task with young people is to help them know that your Self is actually constantly changing, and your Self is not a thing, it's a product of what you do, it's an outcome of your memories and your history and your thinking and your feeling and everything, and that that is no not a thing, but a behaviour. So when I say to myself ‘I am stupid’, I am Selfing I'm doing Selfing behaviour, and that behaviour in itself then influences how I then go and think and act and feel. But if I said ‘I had a thought that I am stupid’, then we can change how we do that. Or ‘my Advisor is telling me…’ or ‘I have an experience sometimes that I'm not as smart as other people’ then that's all behaviour that we can say ‘do we need to attend to that? Can we put it in our back pocket and do what we care about? Or study your math test even when you've got the thoughts that you're really not smart’.

So that's the self-view and the interesting thing is that the more we engage in this behaviour of ‘I am’, ‘I am popular’ ‘I am smart’ ‘I am clever’ ‘I am stupid’ the more we engage in that, the stickier it becomes. And the more we live our lives by it. You know I have worked with adults, who are in their 40’s and will have labels like I am dumb and they will remember acquiring that label in Grade 3, you know, when they were the last one in their grade to get their pen-licence as we called it back in the day. And sometimes we just start acquiring these things and we don't test them out and we follow them as if they were rigid rules that must be followed. So if you have a label I am dumb, you must follow that, and you can't step aside from that, and you can't take it with you into something hard.

Interviewer: And can you have similar issues if that label is a positive label?

Louise Hayes: Absolutely, absolutely, it can be just as difficult to get stuck on a positive label as a negative label for want of a better word. For example, the research by Dweck shows that kids who get stuck on self-concepts like I am clever or I am smart will actually not try as hard, because they don't want to risk losing that label. So we can get stuck on any words, any words at all, or any thoughts at all and so understanding ho w we use that self-view, and that we can influence our behaviour by being loose around it can be really helpful.

And it doesn't actually matter whether those thoughts are true or not true. Some of them will be true, some of them won't be. What matters is understanding that that's a part of me but it's not all of me and I can take my label ‘I am stupid’ or ‘I am not as good as other people’. I can take that thought or that experience that I have and the feelings that come with it, and I can still do the thing that I really care about, even if it's difficult. So self-view influences the way in which we give ourself advice, the way in which we notice our self and others, and the way in which we are willing to try new things and fail.

Interviewer: So turning around that ‘I am’ changing it into ‘I'm having the thought that’ or ‘I behaved in this way’ or that sort of thing…

Louise Hayes: Yeah separating, creating a bit of distance, so we can just see that we make our Self. Our Self is not actually fixed thing but a collection of experiences and behaviours and thoughts and that that is constantly changing. And we accept that our body is constantly… well, we don't always accept it, but we know that our body is constantly changing. And we understand that the body we had when we were a teenager is not the same as a child or when you're middle aged is not the same as when you're a teenager. And we can see that part of our Self is constantly changing, we kind of accept that without question, and so we want to apply that same awareness to how cognitive experience of ourselves, that that is constantly changing too. There is so much hope and possibility inside our minds and thoughts and feelings if we actually do that. And we make our Self with what we do.

So the next part you asked me about the social-view if you want me to talk about that?

Interviewer: Yes please.

Louise Hayes: So, social view or social-as-context or the social perspective is quite similar to Self, except what we do is we turn that lens to a different place and say the ways in which other people behave around us influences our Discoverer our Noticer our Advisor and what we value, or out thoughts and feelings our actions and what we do and this begins from birth. So we begin from an evolutionary place with an understanding that our attachments, our closest carers, are the people who influence us and how we grow. So my ability as a Discoverer, to try and fail, to make errors, and stand up, and fall down, is influenced by the people around me and how they shaped that behaviour. Not only them but that’s an important influence. My ability to feel love and cared for will influence every part of me and that begins from birth, so other people influence us, and that continues from birth until death. We are a social species and we are influenced by other people and we influence other people too. They influence us, we influence them. So how I give myself advice, how I think and talk to myself, is influenced by what you think of me and how you talk to me and everybody else around me. Social transmission is really important to think about.

Interviewer: OK so when we bring onboard this social-view and begin to understand the various social influences around our behaviour and thoughts and everything that's going on for us, how does that, how is that helpful?

Louise Hayes: Well it can be helpful in lots of different ways. Firstly can be helpful to understand that there is no separation. We are deeply connected to other people and other people are deeply connected to us and that we need those relationships. So in some ways that some of the collectivist cultures is a way to think about this where there is no separation between themselves and their family and so I think in some ways we've lost some of that that awareness that we need to work as a group.

And we draw a lot on the work of David Sloan Wilson, one of the world's leading evolutionary scientists, who looks at what they call multi-level selection and that is the idea that our evolution and adaptation occurs at multiple levels. We all know about the genetic level so I put that aside, but there’s genetics, and then we go all the way out to cultural evolution and the way in which our culture adapts and evolves over time. And so evolution is a multi-level process. Genetics, epigenetics, behavioural, symbolic, cultural, and along the way when you look at all those levels what you see is groups, all the way. Cells operating groups and all the way out to humans and culture which is groups so we need those groups of other people and other people need us.

When we start to think about that it really influences some of the ways in which we can grow in the world. And sometimes of course our minds get us stuck, we spend so much time evaluating ourselves, we forget that. And I'm not necessarily saying we need to be running out being the most social of people, that's not what that's about it's just about understanding that together we are much stronger. And once again if you look around houses and cars don't happen because one person created them it takes a group to make anything really happen and inside that group is power.

Interviewer: OK so the social piece is sort of around understanding where you fit within the social sphere. How interconnected you are in a way and therefore how other people are helping you and you're helping others. So by understanding that piece a bit better it can help people to interpret their own thoughts within that context?

Louise Hayes: Absolutely. And it can even get as simple as this, when you and I are sitting here and my self-talk or my advisor as we call it might be having a little dialogue as I talk to you saying ‘Am I being entertaining enough? ‘Is this podcast interesting enough?’ ‘Maybe Nicole doesn't like what I'm saying’ and that, and I can also, my social-view is to also know that you're sitting there with an advisor saying the same thing or something along those lines, that you could be equally sitting there nodding and looking smiling, but inside you've got a voice saying ‘am I asking good questions?’ you know, so we can make it really simple and human. You've got critical stuff going on too, and so do I. So we don't need to hide away when we have negative thoughts like that, or critical thoughts like that, we could just look at other people and say well she's probably got that going on too. And as soon as we do that, we are closer to each other.

Interviewer: OK, yeah, absolutely, and that's so important for adolescence when fitting in is so important. When you see other people's facial expressions and interpret them immediately as ‘she doesn't like me’ or ‘she just ignored me’ or… once you realise that the same things are going on inside their mind they may have just not seen you because they were so distracted by something else or…

Louise Hayes: Exactly, exactly, that's when we talk about the advisor or your self-talk but the other part that's really interesting to think about here is your Noticer and the way in which we notice together, and how sensitive that is. You know we've all had the experience of going into work and looking at someone's face and going ‘Oh’ and instantly your stomach drops and you think, ‘what's going on there?’ and you suddenly just got this exchange without any words, and how we can respond to that. You know sitting in a presentation and looking at someone's face in the room and thinking ‘they hate this presentation’ and in fact what you're seeing is their thinking face.

So but then we change our presentation because we see that one person in the audience. And so we are so sensitive, you know someone stands too close, or sits too close, or it's the slightest raising an eyebrow. Especially if you're the parent with a teenager you'll know exactly this. You know the slightest raise of an eyebrow and they might say ‘you're judging me’ or ‘you disapprove’ and so it's just really sensitive exchange going on. And then there can be a cascade, we can then respond to that eyebrow, you know or we can respond to them saying you're judging me, and we get a whole cascade of events, and sometimes at the end you look at it and you thing ‘Oh, how did that happen?’.

Interviewer: So in some ways if we can catch those assumptions earlier we can change that cascade events, sort of like the difference in how you'd react if you went into work and saw that colleagues face and interpreted it as ‘I've done something wrong, they’re angry at me, it's personal’ how you might react then versus if it you didn't feel threatened by it you saw this as ‘they are having a bad day’ or ‘something's going on for them’ you might be a lot more compassionate towards them in that instance.

Louise Hayes: Yeah and you might check it out, you might say ‘Oh they have something going on, it might be me but it might be other things too because they've got stuff going on inside they've got an advisor bossing them around, they've got stronger feelings, they've got actions that they're worried about, and so you might check it out. I mean it could be you but it might not be. So the tricky thing is one part of our evolutionary heritage is mind reading. We have evolved and adapted to… We need to know whether other people are happy with us or unhappy with us, because that's part of survival.

You know the biggest risk for humans is that actually the biggest risk to humans is other humans especially when in our evolutionary heritage. And so you want to know whether you fit in, whether you belong. And being loose around that understanding can be really helpful, as in knowing that everyone is doing the same thing, and knowing that your mind and body is set out to read other people and you are doing that all the time, and you need to check it out, because you could be wrong. That person who looks disinterested in your presentation or in the class might just be thinking about something else.

Interviewer: And I guess there's an evolutionary bias in terms of how we mind read, is there? Like we'd be more likely to pick up the negative.

Louise Hayes: The risk, yeah, we're always looking for risk yeah yeah.

Interviewer: So we are more likely to interpret anger…

Louise Hayes: Well I don't know that research. I don't know if we'd be more likely to interpret anger or happiness for example. But I do know that we're always looking out for risk, and a huge risk to humans is ‘do you love me?’ and ‘will you be there for me?

Interviewer: Awesome this has been so helpful, and I think this is going to be interesting, despite what your Advisor said.

Louise Hayes: [Laughs] yeah, it's just going to be a podcast between yours and my Advisor.

Interviewer: Yeah absolutely. And, what's the back-story to the DNA-V model. How did it come about?

Louise Hayes: Well, my colleague Joseph Ciarrochi and I, we have been working on using ACT for young people for, we've been doing it for about 10 years I guess, and we wrote a book called “Get out of your mind and into your life for teenagers” and then we really wanted to do a deep dive, because we could see that there were some issues with taking something that was essentially made for adults, and trying to apply it for young people.

And so we did a deep dive into developmental aspects of what it means to grow and develop as a human, starting from birth, and how we acquire language functions, and how we acquire emotional awareness, and emotional understanding, and how we learn to behave, and move about in the world, and take actions and develop agency. And we ended up writing a book called “Thriving adolescent”, which was our developmental model but kind of addressed some of the issues that we worried about, you know things like working with a young person for example and making an assumption that they know what they value what they care about, those kind of things. And so that whole process took us 10 years.

Interviewer: Yeah, I've read through a lot of your books and there's a lot of research that went into that. I'd like to hear more about the developmental aspects. So given that adolescents are still forming what they care about, how do you then have to approach it differently?

Louise Hayes: Well, there are some key tasks in each of our developmental aspects, well in our development across life really. It's a really important thing that we talk about is to stop thinking that development finishes when you become an adult, because actually we develop all throughout our lives. And if you think about it, you know, I'm sure you can think Nicole of different life phases that you've been through, and different developmental things that happen, such as becoming a parent, wow, that’s a developmental phase, becoming middle aged all of those things. And so what we tried to do is look at, we began by looking at some of the developmental tasks that were specific to adolescence.

Adolescence is a time of developing autonomy, it's a time of no longer seeing yourself as part of just, you know like your nuclear family and the people who are really close to you. It's an outward time, it's a time when our brain and our body develops biologically and we begin to develop and change psychologically and socially as well, and we change from, if we talk psychologically it's a good way to think about it, we change from psychologically looking at our parents and our family as our primary sources of information and we start to look out in the world and think about who do I want to be and how do I want to be in the world? And that includes developing new relationships and trying out new behaviours in order to see what it's actually like to be an adult.

If you think about it there are some enormous tasks that we do in this developmental period and interestingly in my workshops Nicole, I often used to ask for a show of hands amongst health professionals, for a show of hands around who wants to go back to their adolescence and no-one does. And there's some evidence to suggest that some of the memory formations that we have in adolescence are very profound and they stay with us for our lifetime because they’re profound new experiences, sexual relationships, independence, all of those things, as well as rejection, all of those things.

Interviewer: So it feels from what you've said that it's a very important stage your life for, in a way, learning how you interact with the world.

Louise Hayes: Yes and that's the primary task, is to discover how to become autonomous outside in the world, and autonomous doesn't necessarily mean independent I'm using autonomous as more like a term for an adult, as opposed to a child who will look to their parents for the answers. Autonomous as in being able to think and make decisions and problem solve, whether you are part of a more collectivist culture or more individual culture, still those tasks are really important to do.

Interviewer: Yeah very interesting and so, you found that the ACT model didn't quite fit in that in that period of development as it was based on the adult model, what other things needed to change? So it was the values as a more formative thing rather than a ‘you know your values’ kind of assumption, what else?

Louise Hayes: Well, we changed a lot actually, it's not just that. Values tends to be a sticky place that people remember but we changed quite a lot. So if you think about what ACT is, ACT is a model that's based on psychological flexibility, which is the ability to, in a nutshell, the ability to do what you care about even when your thoughts and feelings make it really hard, or say this will be really difficult. So if you think about that, firstly we have to know what you care about. And when we say what you care about, we don't mean right in this moment, that's part of it, but we also mean what kind of person you care about being, how you want to move around in the world, what you want to make, what actions you want take to make your life meaningful to you and to develop purpose.

And so that whole piece is developmental and I know, and I'm sure you can think of it too Nicole, what you cared about when you were 14 was not what you cared about or the kind of person you want to be when you're 16 or 17 or 21. And so there's quite a lot of changes that happen through that phase in terms of exploration and thinking about “how do I want to be in the world”? And often what adolescents do is they try and they push the boundaries so far and try out things and go “No, actually, I don't want to be like that. That's not the kind of person I want to be” and that's the point of it. We need to allow for that pushing at the plastic, you know pushing at the boundaries and then coming back again, and finding out all those different things. Not in terms of making mistakes.

So that's the first part is that there is a whole lot of trial and error that in itself is a value in adolescence. And so the other part of it is that adolescents tend to focus on an immediacy. There's a piece in childhood and adolescents about living for the moment, and so we broadened out values which is often used in adult ACT to also consider vitality. So valid vitality we define as that sense of engagement of being in life being in the present if you like but it's not just present moment it's actually engaging in vital experiences, which is very much what that young period is meant to be about. And that in itself is really important. So we had those two aspects.

And then the other part of the adult ACT model is trying to work with that ‘doing what you care about even when your thoughts and feelings say this will be difficult’. Well in adolescence we felt that there was a slightly different emphasis that we could take. It's not that adult ACT was wrong for young people, it can be used quite well, but we just felt that there were some things that were really important developmentally to consider, such as how you developed language, and how you grow. So rather than looking at a say a middle-aged adult and saying you know in what ways do they get stuck with their cognitions (thoughts), we want to look at a young person and say how do we help them develop cognitions that are flexible from the beginning? Can we do that?

And emotions of course are a really important part of adolescence. Emotions are like a rollercoaster, but we know, from the neuroscience research, that there's lots going on there. So we wanted to say, well, ‘how do we actually help a person grow, in a way that allows them to have the full range of emotions and experiences?’ And to understand what to do with that. And so everywhere we looked there were lots of different ways that we could look at it from a different angle through a developmental lens and just get a bit sharper in our focus.

Interviewer: That's really helpful and so how would you say the DNA-V model then relates the ACT model?

Louise Hayes: Yeah, well, I mean DNA-V is ACT. So many people when they learn Acceptance and Commitment Therapy learn a certain model that we often called the hexaflex or the hexagon, and that's actually not all of ACT, but many people learn that and they assume that those things that they see is all of ACT. But act as a bit broader than that and that hexiflex or hexagon is one way of learning what ACT is. And so this DNA-V the processes in DNA-V, they look a little different, they sound a little different, but they work quite well together but they're different because they consider things like not just diffusion for example, in the adult model we would focus on something like diffusion, which is if your thoughts are stuck and they are sticking to you like glue, like they welded onto you, then we try to help a person separate from them. But when we look at language and thoughts or cognitions we want to look at helping a young person develop them in a way that's flexible in the beginning.

So how do you use rules? Can we help you understand what rules are? Can we help you create flexible rules? How do you know if you're thinking is helpful or unhelpful? And that in itself is a fascinating topic because most of us don't even really separate from our thinking enough to even consider those things. We tend to treat our thoughts as bricks that are as hard as a brick that must be carried around. Instead of really conceiving them as things that come and go, in the same way that out itchy foot comes and goes, or our hunger comes and goes, and thoughts are a process that come and go too. And so if we could help young people to see them as passing events, and to know that not every thought needs to be treated like it was a brick but instead could be treated for example like it was a cloud that comes and goes then they might be in a much better place to understand what thinking is about.

Interviewer: I like those analogies. It's helpful to make things more tangible. Given that so much has been tailored to the developmental stage of adolescence, does that make DNA-V inappropriate for adults? Or can it be used with adults as well?

Louise Hayes: Well yes, it can be used with adults, because it's easier to tweak it up, than to tweak it down. And so Joseph Ciarrochi and I, my co-author, are in the process of writing a DNA-V book for adults that we're really excited about because it's a way of helping adults think about development, about their own development, and think about growth. Which ACT does in this traditional form but it's just a different tweak and more variation is a great thing, not less.

Interviewer: I agree, that's awesome because it also gives a common language to adults and and young people which is great for parents who are working with their adolescents, for example.

Louise Hayes: Oh absolutely, absolutely, and you know a lot of people around the world tell us that they use it without adults anyway and that kind of makes sense because the language is simple and one of the things about working with young people and children is that you are forced to make concepts, difficult concepts, simple. There's no place for complicated language, not because they're not intelligent, but because they need the concepts presented in a way that's clear. (Not) surprising, adults benefits from having concepts presented in a way that is clear too.

Outro: A big thank you to Louise Hayes for this interview. I hope you found it as interesting as I did. I would highly recommend Louise’s books and training. I’ve included links in the show-notes (above). We have also developed an online resilience course for adults based on the DNA-V model, this provides practical exercises to strengthen your resilience that can be practiced alone, or with your family. We also run resilience workshops for kids and adolescents at Personal  Strength. Our adolescent resilience workshops include a copy of Jo and Louise’s new book, “Your life, your way”.

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