“Peace, Love, Life”
I am periodically asked about career influences. Here are the ones that occur to me most forcefully as I sit here revising this list in January 2008. I will rough them out in chronological order. Then I will present some additional information on my academic lineage
1960-1966 (High school)
I grew up in southern California in the 1960’s, attending high school in San Diego (University High, which was affiliated with a Catholic college, the University of San Diego). I was interested in psychology because I wanted a field that combined science and humanities. In high school I acted, was a creative writer, sang, played music, and was good in math and science. I did not want to let go of either side. Psychology seemed to fit the bill – though in truth I knew little about it.
My earliest substantive interest in psychology was Abraham Maslow and others interested in human growth. I think I was attracted by the sense of new possibilities that he described and by the idea that psychology could change how we think about how humans should live.
1966-1970 (Undergraduate work at Loyola Marymount)
I went to Loyola Marymount University in Los Angeles in 1966. LMU is a Jesuit university but by then I was no longer a Catholic.
I was exposed in my freshman year to behavior therapy by Irving Kessler, a psychology professor and my mentor at Loyola-Marymount. Dr. Kessler had recently become a faculty member after doing a dissertation on eye blink conditioning at the University of Southern California. He was a kind and intelligent man who gave behavioral psychology a human face, as well as teaching me something about basic research, clinical practice, and their connection. One of the early behavior therapists in the area, when I was just a freshman or sophomore he let me sit in on clinical sessions with real clients while he was doing desensitization (who would do such a thing today with a young undergraduate?!) I was fascinated by flooding and implosive therapy and wrote my first undergraduate psychology paper in my sophomore year on applying exposure methods to emotions, not just situations (if you know ACT you now how prescient that was).
I was part of the counter culture, increasingly so during my four years there. I was especially attracted to the utopian ideals of the time and to the importance of spiritual exploration. Like most hippies I was heavily influenced by eastern thinking in college, particularly the writings of D. T. Suzuki (Zen Flesh, Zen Bones) and Alan Watts. I loved seeing the paradox of language as revealed in eastern thought. From the outside I looked like a crazed hippie but from within I was not that interested in intoxication or dropping out. I was interested in transformation — of myself and of the world. I was interested as well in things like T-groups, Esalen, and Gestalt Therapy.
The interest in spirituality, the arts, and science came together for me in the work of B. F. Skinner. I was amazed by Walden Two which I think I read in my junior year as part of the honor program. Here at last I saw a technology that might help accomplish the kind of world altering possibilities that were so tangible in the late 1960’s. I was attracted to the idea of communal living and Skinner’s book electrified me.
I read more and more Skinner. His book Science and Human Behavior was a kind of zen exercise and led me to conclude that I should seek out graduate training in behavioral psychology. I thought Skinner was at once iconoclastic and brilliant, and yet practical and technological. I interpreted him contextually, pragmatically, and functionally, not mechanistically–and I still do. I saw no fundamental contradiction between the influences of eastern thought or Maslow or Perls and Skinner (and still don’t). I became increasingly behaviorally oriented. Under Dr. Kessler’s supervision, I created a rat lab at LMU, built the cages myself, and completed an honor’s thesis comparing response prevention, shaping, and observation in the reduction of avoidance behavior in rats.
Getting into graduate school proved to be unexpectedly difficult. I found out later that it was due to a poor letter from a faculty member who objected to my hippie appearance, thought I must be a drug addict, and said so in the letter.
After undergraduate work and before graduate school I was heavily influenced by my time in an eastern religious commune (Ananda Farm, in Grass Valley, CA, run by Swami Kriyananda). It deepen my interest in utopian thinking and in mindfulness and eastern thought. I was also heavily influenced and by the work of a political activist named Ed Koupal, who taught me to “go for it.” He appointed me chair of the San Diego county People’s Lobby, which had put a citizen’s environmental initiative on the ballot, and in that role I debated Pete Wilson (San Diego mayor at the time) during city council meetings, disrupted Chamber of Commerce meetings, and generally did things I did not know I could do. I’ve been disrupting the political calm ever since, especially in psychology. I also married Angel Butcher, my high school sweetheart. Camille Rose Hayes (my first daughter) was three when we married in 1972.
1972-1976 (doctoral training)
After two years of failure I discovered the problem of the bad letter, solved it, and was accepted into the doctoral program in clinical psychology at West Virginia University (WVU). WVU’s psychology department was (and remains to this day) one of the strongholds for Behavior Analysis. The faculty I worked with who were behavior analysts or cognitive behavior therapists including John Cone, Rob Hawkins, Andy Lattal, Norm Cavior, John Krapfl, and Hayne Reese.
I immersed myself in behavior analysis and published both human and animal work.. Jon Krapfl, who taught me to value philosophy and to understand radical behaviorism; John Cone (later editor of the journal Behavioral Assessment) who taught me the value of applied research, behavioral assessment, and of precise writing; Rob Hawkins and Andy Lattal were good models within applied and basic behavior analysis. Norm Cavior gave me exposure to CBT and REBT and Hayne Reese was gentle intellectual giant with a love of ideas.
Skinner’s 1945 Psychological Bulletin paper on the operational analysis of psychological terms was a hugely important article for me. The writings of the late University of Nevada psychologist Willard Day, founder of the journal Behaviorism, were extremely influential, because he drew the specific links between Skinner and existentialism, humanism, hermeneutics, and latter day Wittgenstein. He confirmed my early connection between radical behaviorism and pragmatism, Dewey, James, and the like. Willard also, in a charismatic colloquium he gave at WVU while I was a graduate student, challenged us to “understand human language as it actually functions.” I’ve spent most of my professional life trying to live up to that challenge. It is ironic that years later Willard brought me to the University of Nevada.
I did my masters and dissertation on environmental problems (also the topic of my first book, written with John Cone).
1976-1977 (internship at Brown University)
On internship I was most heavily influenced by David Barlow, who taught me how to do clinical work and clinical research (I had little training of that kind at WVU). He also taught me more about single-case designs and deepened my appreciation of behavioral assessment. He also taught me how to move in national circles, and to think of how to move the field. My fellow interns also had an impact: Kelly Brownell (now a professor at Yale), Peter Monti (now a professor at Brown), Toy Caldwell-Colbert (now Provost at Central State University), and Carol Landau (at Brown as well). Personally, playing music with Kelly Brownell and Tom Wadden (now at Penn) in various bars was a hoot. I played banjo (Tom was on bass; Kelly played the guitar).
1977-1986 (faculty member at the University of North Carolina at Greensboro)
As a faculty member at the University of North Carolina at Greensboro I was heavily influenced by Werner Erhart and his est training, and by the human potential movement more generally. My colleague Rosemery Nelson (now Nelson-Gray) taught me to be obsessive, careful, and hard-working in research, and my basic behavior analytic colleague Aaron Brownstein, perhaps the most brilliant behavior analysts I ever knew, taught me how to refine research ideas to get the most out of questions you were asking.
On the personal front, I was divorced early in my years at UNC-G. UNC-G quickly became a very divided department. The fighting was especially strong between behavioral faculty and information processing oriented cognitive faculty. I developed a robust anxiety disorder which gradually made life unlivable. ACT was in part my answer to that anxiety problem.
I spent an inspiring sabbatical year with A. Charles Catania in 1985-86 at the University of Maryland – Baltimore County learning more about his approach to rule-governed behavior. When Aaron Brownstein suddenly died I figured I had to get out of UNC-G and I accepted a position as Director of Clinical Training at the University of Nevada.
Research at UNC-G that seems particularly important in hindsight:
We first conducted a series of empirical pieces on cognitive methods, finding that they do indeed work, but only in particular social and verbal contexts. Eight such studies were published from my research team between 1983 and 1985. For example, we found that coping statements work, but only if the client knows the therapist knows the statement (e.g., Rosenfarb & Hayes, 1984). We found in a component analysis of cognitive therapy that distancing was a key feature, but as we suspected it did not work though cognitive change but rather through the behavioral process of helping patients “make more effective contact with the natural consequences surrounding pleasant activities” (Zettle & Hayes, 1987, p. 951). We constructed methods to see what would happen if we focused on changing the social and verbal contexts that we believed linked thoughts and feelings to overt action, and then to integrate behavioral methods into that new context. ACT was initially called comprehensive distancing to reflect that focus, but a review of early ACT protocols (e.g., Zettle, 1984) shows that a wide variety of acceptance, defusion, and mindfulness methods were employed that went far beyond Beck’s (1976) specific approach to distancing.
In addition to an open trial with anxiety disorders (Hayes, 1987), we conducted three very small studies comparing ACT to some of the best available CBT protocols of the day, in the areas of depression (Beck, Rush, Shaw, & Emery, 1979), pain (Turk, 1978) and weight control (Brownell, Heckerman, Westlake, Hayes, & Monti, 1978). All three studies showed different processes of change as predicted, and two showed better outcomes. Having convinced ourselves that our broadly relevant alternative model might succeed, we described it (Hayes, 1984; 1987), and promptly stopped doing outcome research altogether. While the depression study was published quickly (Zettle & Hayes, 1986), the pain study was published only 16 years later, after our development work was finished (Hayes, Bissett et al., 1999). The weight protocol was never published but instead was revised and data regarding it is currently under review (Lillis, Hayes, Bunting, & Masuda, under submission).
My students in this era (and their first major job) were:
Robert D. Zettle, Wichita State University
Jeanne M. Devany, Auburn University
Arlinza E. “Sonny” Turner, Albert Einstein School of Medicine
Irwin Rosenfarb, Auburn University
Edelgard Wulfert, State University of New York at Albany
David Steele, Greensboro Area Health Education Center
1986-1999 (faculty member at the University of Nevada)
From 1986 to 1999 I worked on ACT and RFT in relative intellectual obscurity. That ended in 1999 with the first ACT book, which is why I end this era in 1999.
Early in my Reno years I married Linda Hayes (nee Linda Parrott), who was one of the last students of J. R. Kantor. She strengthened my contextualistic leanings and helped me weed out implicit mechanistic ideas. The philosopher Stephen C. Pepper and his 1940’s book World Hypotheses (which had been recommended to me by Hayne Reese) further solidified those distinctions.
I was very active politically within psychology. I proposed the formation of the American Psychological Society (APS), and chaired its organizing committee. The originating society (called the Assembly for Scientific and Applied Psychology) was literally housed in my lab for a year. I served as the first editor of the APS Observer and as the first secretary-treasurer of APS. After I was suddenly maneuvered out of any role within APS (long story that), with Logan Wright, Bonnie Strickland, and others I helped start the American Association for Applied and Preventive Psychology, and later served as AAAPP President. AAAPP later collapsed.
I came away from that experience feeling somewhat wounded – the vision of applied and scientific psychology I had was difficult to translate into broad organizations and both APS and AAAPP were personal disappointments.
Intellectually, we spend 15 years attending to the development of a strategy to create long term scientific progress on the issues we were working on at UNC-G.
This section below describes what we did. It is modified from a paper that is out or soon to be:
Hayes, S. C. (in press). Climbing our hills: A beginning conversation on the comparison of ACT and traditional CBT. Clinical Psychology: Science and Practice.
The development strategy we pursued is an elaboration of the inductive, functional approach that characterizes behavior analysis. We term it a “contextual behavioral science” approach, since it deviates in some ways from traditional behavior analysis.
Explication of philosophical assumptions. ACT is integrated with a radically pragmatic, monistic set of scientific assumptions known as functional contextualism (Hayes, 1993; Hayes & Brownstein, 1986; Hayes, Hayes, & Reese, 1988; Biglan & Hayes, 1996). Being philosophically clear allowed ACT researchers and practitioners to identify and take responsibility for their assumptions and to integrate their core concepts with them, without the theoretical confusion that eventually arises from skipping this step. Much of what is unique about ACT can be traced back to these philosophical assumptions, which are more similar to constructivist approaches such as feminist psychology, hermeneutics, dramaturgy, or social constructivism than to the realistic and at times mechanistic assumptions of the psychological and CBT mainstream, but with a different goal than most other contextualistic approaches (Hayes, Hayes, Reese, & Sarbin, 1993). Functional contextualists view truth as the incremental achievement of prediction-and-influence with precision, scope, and depth, and they assess any act of partitioning the one (“real”) world against that criterion (Hayes, 1993). As a result, all ACT concepts need to be linked to context, defined both historically and situationally, since only contextual variables can be directly manipulated and lead directly to both prediction and influence (Hayes & Brownstein, 1986). The ACT rejection of cognitive and emotional causality, the clinical emphasis on values, de-emphasis of an interest in literal truth, and the emphasis on workability all flow from the radical pragmatism of its underlying philosophy. CBT researchers who cannot quite understand what ACT is up to are usually coming to their work with quite different philosophical assumptions, but often without having owned and explicated them, precisely because the culture of dominant paradigms tend not to be self-reflective.
Create a basic account that continuously informs treatment and vice versa. ACT is part of modern behavior analysis, and as befits that inductive tradition every hard-won and well-established behavioral principle is part of its theoretical armamentarium. Because no empirically adequate behavior analytic account existed of human language and cognition, however, one had to be created to extend behavioral principles to that level. Years were spent on the effort and Relational Frame Theory (Hayes et al., 2001) was the result. Over the last decade RFT is the most active area of basic human research in behavior analysis, and its findings have implications that go far beyond ACT. Indeed, if a CBT researcher were interested in producing cognitive change, RFT suggests some interesting ways to do it (see Hayes et al., 2001, pp. 228-230), since RFT is meant to be a progressive empirical account of cognition, not a handmaiden to ACT as such. The ACT emphasis on acceptance, defusion, contact with the present moment, and self in the sense of perspective taking can all be readily derived from RFT.
Create a model of psychopathology and intervention linked to these principles. A set of abstractive theoretical terms (acceptance, defusion, a transcendent sense of self, experiential avoidance, values, psychological flexibility, and so on) were created and systematized into a formal model of psychopathology and treatment (e.g., Hayes, Bond, Luoma, Masuda, & Lillis, 2006). For the readers of this journal an explication of this model would be relevant, but there are now myriad books and articles on ACT that accomplish that purpose (e.g., Luoma, Hayes, & Walser, 2007) and the focus of this reply is at a strategic level. These middle-level concepts stand on the technical language of RFT and behavioral principles, much as a user friendly operating system is in turn based on programming languages and machine code.2 Concepts such as acceptance and defusion make it possible for ACT clinicians to apply much of the analysis without being expert in the arcane world of basic contextual behavioral science. Comparisons to CBT have so far focused on this level of theoretical discourse. But when these concepts are compared across traditions, it is important not to lose track of the differences. “Acceptance” and “defusion” are not the same kind of concepts as, say, self-esteem or irrational beliefs, because they are linked to basic contextualistic behavioral processes which are studied in the basic RFT laboratories.
Measure processes of change. Measures of ACT-related processes have received attention from the very beginning. For example, a measure of cognitive defusion was used in the first ACT study (Zettle & Hayes, 1986). A recent summary of ACT related process measures identified over 26 such measures that have been developed and used (Ciarrochi & Bilich, 2007) from ratings of in session interactions, to general and specific measure of acceptance and action or psychological flexibility, to values assessment. A great deal remains to be done, but this area has been a focus.
Test components linked to processes. A practical theory needs to tell clinicians which components are likely to manipulate specific processes. Instead of the traditional strategy of dismantling studies that are so expensive and delayed that they occur long after mistakes are well ingrained (e.g., Dimidjian et al., 2006; Jacobson et al., 1996), ACT components and processes have been tested in experimental psychopathology studies from the earliest stages of empirical development. This literature is now large, encompassing dozens of component studies on acceptance (e.g., Hayes, Bissett et al., 1999), defusion (e.g., Masuda, Hayes, Sackett, & Twohig, 2004), values (Paez-Blarrinaa et al., in press), self as context (Williams, 2007) and other ACT elements (Levin et al., 2007). So far, all of the published studies of which I am aware have shown that the individual methods and processes in ACT are psychologically active, and work in ways that comport with ACT theory.
Show that dissemination and training works. Viewed through the radical pragmatism of functional contextualism, it is critical to show that concepts and methods are broadly useful since that is a key measure of “truth” within this perspective. One of the best ways to test this is through effectiveness studies, and ACT already has several. All show that ACT training creates positive outcomes. Two of them shown that ACT outcomes are either as good as (Forman, Herbert, Moitra, Yeomans, & Geller, 2007) or better than CBT methods (Lappalainen et al., 2007) and work through different processes of change. Parenthetically, many of the clients in the Lappalainen et al study were anxious and unlike Forman et al it included a follow-up so it is not clear why the target article left it out of their review.
Care about mediation and moderation as much or more than outcome. The target article is correct in emphasizing the importance of mediation and moderation, and ACT researchers have embraced this goal from the beginning as will be shown below.
Broad outcomes. As the seven features above show, ACT / RFT researchers adopted the view that controlled outcome studies alone cannot create a progressive discipline. This is why the first book on ACT (Hayes et al., 1999) and the first on RFT (Hayes et al., 2001) appeared 15 to 20 years after ACT and RFT themselves were created. Dozens of controlled outcome studies have followed in the few years since the appearance of these volumes.
I was very much supported in this era by the work of Irish psychologist Dermot Barnes who understood my work in RFT long before others and extended it way beyond me while remaining true to its essence. I was also heavily influenced by Kirk Strosahl, who helped me to focus on getting my ideas focused in such a way that they could influence clinicians.
I was also influenced heavily by my students in this era (listed with their first major job):
Joseph R. Haas, Children’s Behavioral Services
Susan Melancon McCurry, University of Washington School of Medicine
Durriyah Khorakiwala, Keiser Permanente Hospital
Regina Lipkens, University College of North Wales
Christoph Leonhard, Harvard Medical School
Barbara S. Kohlenberg, Veteran’s Administration Medical Center, Reno
Niloofar Afari, University of Washington School of Medicine
Jacqueline Pistorello, University of Nevada, Reno
Robyn Walser, Weber State University
Kelly G. Wilson, University of Mississippi
David M. Sayrs, Pierce College
My son Charlie was born in 1988 and my daughter Esther in 1991. I was divorced from Linda in 2001.
2000 – present (faculty member at the University of Nevada)
This era has been characterized by an explosion of interest in ACT / RFT, by grants and randomized trials, by the development of ACBS, by the creation of an international community of scholars and clinicians interested in the work, and by the publication of popular books and national media attention.
What is striking about this era, and one of the most obvious empirical indications that ACT / RFT is a coherent but also distinct model, is the breadth of the ACT and RFT work. Successful ACT outcome studies range from psychosis to smoking; from diabetes management to professional burn-out; from prejudice to being more able to learn empirically-supported treatments. Applied RFT studies are also now appearing (e.g., Berens & Hayes, 2007), expanding the overall research program.
The other thing that is striking is the strength of the community that supports the work.
My students in this era have included:
Winifred C. T. Ju, Center for the Disabled, Cohoes, NY
Adam M. Grundt, Dartmouth College
Patricia Bach, University of Chicago
Richard T. Bissett, University of Nevada, Reno
Elizabeth V. Gifford, Palo Alto Veteran’s Administration and Stanford University
Dosheen Cook, Rural Clinics
Jennifer Gregg, San Jose State University
John T. Blackledge, University of Wollongong
Akihiko Masuda, Georgia State University
Alethea Varra, Seattle VA
Tim Weil, University of South Florida
Michael Twohig, Utah State University
Jason Lillis, Palo Alto VA
There is a LOT to say about this era, from how ACBS was formed; to the role of 9/11, Ned Carter and Psychology Partners in the first WorldCon in Sweden in 2003; to the craziness of the 2006 Time Magazine publicity. But it is too close to write about such things now (January 2008).
Personally, I married Jacque Pistorello in 2005 and Little Stevie was born several months later. Jacque is a DBT expert in addition to ACT and Stevie is a little zen master. You will note that Jacque is a former student – we first began dating several years after she received her degree so no fair busting me for that.
My academic lineage
I trace my lineage primarily through John D. Cone (my dissertation advisor) and David H. Barlow (my internship advisor).
John founded the journal Behavioral Assessment and studied under the psychometrician Allen Edwards, who studied under A. R. Gilliland, who completed his degree at the University of Chicago while it was still heavily influenced by the functionalist and contextualistic thinking of such faculty members as James Rowland Angell, J. R. Kantor, and John Dewey. Gilliland was a well known psychometrician and educational researcher (and founder of the Midwestern Psychological Association), but published early well-developed work on the law of effect in the 1930’s. Thus this primary academic lineage was a mix of the functional contextual behavioral wing of psychology, and practical applications in assessment and learning.
David Barlow studied under Harold Leitenberg who studied under basic behavior analyst James Dinsmoor who studied under William Nathan (“Nate”) Schoenfeld. Schoenfeld, along with Fred S. Keller (a roommate, fellow graduate student, and close friend of B.F. Skinner at Harvard), coauthored the first major textbook in behavior analysis in 1950. Thus, this aspect of my lineage is through the functional contextual wing of behavior analysis, both applied and basic.
And as you can from what I wrote earlier most of my other major influences can also be traced back to a functional, contextual behavioral tradition. Thus, it is not surprising that this has been a major theme, all the way up to the name of the society that is currently involved in developing ACT and RFT.