An Interview with Jonathan Bricker

The following is an interview between Steve Hayes and Jonathan Bricker on the occasion of Jonathan’s TEDx talk passing the 1 million view mark

STEVE: A million views. That’s by far the most exposure of any video presenting Acceptance and Commitment Therapy (ACT). How does it feel to be reaching that benchmark?

JONATHAN: Exhilarating. It’s great for all of us. I never imagined it would touch so many people. It’s been a big surprise.

STEVE: What you were the challenges of making the talk effective?

JONATHAN:I saw three main challenges. The first was telling a story about my Fred Hutch research team’s clinical trials research program. The second was telling a story of a behavioral therapy based on the principles of a theory of language. And the third was to talk about smoking and obesity as public health problems. In short, research, clinical intervention, and public health problems are hard to make fun and educational to a broad audience. Yet, I firmly believe that is an obligation of scientists. We need to be able to tell our story to broad audiences, show the value of science for all.

STEVE: Probably a lot of people reading know about Acceptance and Commitment Therapy, or psychological flexibility, but not as much about your work as such. Could you explain in a short paragraph what the core message was in your talk?

JONATHAN: Smoking and, to some extent obesity, are the most preventable causes of premature death and human suffering. There are huge worldwide problems. Mainstream behavior change programs will teach you to avoid your cravings to smoke or eat. Science shows that is usually not helpful in the long run. My Fred Hutch research team has shown that the ACT model is very promising for smoking cessation and we have a new study in the works for weight loss.  The takeaway is that if you try willingness, it just might help you quit smoking or lose weight. Next time you have a craving, say aloud: “I am noticing I am having the thought that I have a craving to smoke right now.” I wanted viewers to give it try and see if it helps.

STEVE: You sang “Turn it Off” from Book of Mormon. Why did you sing a song and why that one? Did it feel risky?

JONATHAN: Yep, that was a risky move. I’d never sang in front a large audience before, have no formal voice training, and I didn’t know how the audience would react. Not even my wife knew I was going to sing.

But songs are a powerful medium for communicating ideas and concepts, making them memorable and understandable. ACT can be dense and mystifying so I thought a song would quickly cut through to the main point.

The backstory behind that song is that I had seen The Book of Mormon a few months before and loved the show. When the character Elder Price sang the song as his naive but well-intended message for the Ugandans to turn off their suffering, I immediately saw the connection to ACT and the late Harvard psychologist Dan Wegner’s research on paradoxical intention. Wegner had done some elegantly designed studies on intentionally avoiding smoking cravings which showed that they predicted more smoking and higher risk of relapse over time. Basically, it’s what happens when you tell people not to think of a white bear.

STEVE: Some viewers who don’t know much about ACT will likely say the talk is entirely about mindfulness. What else are they not noticing that is in there?

JONATHAN: It makes perfect sense for someone who knows about mindfulness to see the connection to the talk. And if they haven’t read about ACT, I can see how they would immediately say “oh, this is mindfulness.” I think this is a basic cognitive phenomenon that when we see something for the first time, we immediately look for connections to what we know. That’s how we seek to understand. In the end, I think it’s great making the comparisons because it gets people to see the overall value of psychology (in whatever form it takes) for alleviating human suffering.  And that ultimately is the point.

Now, there are certainly fundamental differences between ACT and mindfulness. ACT is about being willing to have one’s thoughts, emotions, and sensations for the sake of pursuing what matters in your life—your values. In parallel, Jon Kabat-Zinn defines mindfulness as paying attention on purpose, in the present moment, and non-judgmentally. So there are certainly similarities here and the key thing to see here is that in ACT, mindfulness is merely one of many roads a person can take to pursue their life purpose. There are a myriad routes to willingness. One that I demonstrated in the talk was defusion, which is unhooking from or getting distance from your thoughts. “I am having the thought” was one defusion exercise, and of course another common one in ACT is the Tichener method of repeating a word aloud for 60 seconds or until it becomes a meaningless jumble of sounds. Quite powerful.

STEVE: The talk has been viewed by a million people around the world. That’s an amazing success, even in this era of YouTube. What qualities of the talk do you think made it effective?

JONATHAN: TED talks are volunteer efforts, labors of love to serve a broad audience. I thought about how the talk would serve the listeners. So what did I want to offer the listeners? What I concluded was that I wanted to give them a story about my Fred Hutch research team’s behavioral science that would touch their hearts. Show them our passion for this research. That vision guided me to weave between facts about an important public health problem to stories about my life and back again to describing the science and then back to stories about people we have helped. Basically, what worked was to move from the head to the heart and back again.

As for the channels of communication, I used multiple forms of voice and body language. You could do an entire analysis of the latter with the sound turned off. Finally, I paid close attention to the words I chose, as I do in all my talks. I love the meanings and sounds of words. When I was 16, my dad gave me a book called “Choose the Right Word.” Using it had a profound influence on my writing and public speaking, teaching me to appreciate the nuances of language. Well-placed words can richly texture our ideas.

STEVE: When you put a talk like the one you gave out into the world and it touches many lives and people sometimes then reach out to you and they touch your life. Can you tell us a story or two of how and why people who have been moved by the talk have entered into your life?

JONATHAN: I get emails almost daily from people around the world and make a point to respond to each one of them. They are so many touching stories of people wanting to improve their lives, stop a habit, and finding hope in the message of the talk.

There are two correspondences that I re-read for inspiration. One was from a woman in Ghana, which is a country on the west coast of Africa. She wrote that where she lives she has no exposure to ideas from psychology. Resources are so scarce that “when the power goes off in a hospital, doctors have to operate on patients using the light from their mobile phones.” She said that she applied several of the techniques from the video, including imagining a tug of war with a monster and “having the thought.” She said that they helped her control her soft drink habit as she was concerned about developing diabetes. We’ve corresponded several times about other methods she can practice to respond to food cravings and stay focused on what matters to her. I have delighted in being able to assist her, in a remote part of the world in need, and offer the latest clinical wisdom that we have gleaned from our research.

The other was from a well-known guitarist who I agreed not to publicly name. He wrote me this beautiful story about his life with smoking.  He started smoking with other musicians at age 18, to feel belonging, and it slowly became a part of this identity and public image. By his early 30s, he had managed to stop for a while…until a time he was performing in Ireland and later had a few drinks with friends. “I’ll have a few tonight and that be it,” he told himself and then “I was smoking again, just like before.” To stop completely, he realized he had to “analyze himself.” He realized that smoking was serving several functions: “self-image” and “chemistry, the nicotine itself.” The hardest part of quitting wasn’t the nicotine. It was changing his self-image because, for him, who would he be without smoking: “What do I do with my fingers?” or “Can I write a song without smoking?”  To find out, he had to experience urges as “going to a place where there was an absence….And the absence was where I could redefine myself, one day at a time, one minute at a time.”

His story hit me on so many levels. It eloquently illustrates the trajectory of so many people who smoke: the starting to fit in, the sense of identity, the slippery slope of thoughts like “I’ll have a few” and then has “smoking again.”  I appreciated that he stopped to look within to understand himself. He did his own version of a functional analysis. And the best part was that he was breaking what ACT would call his his self-as-concept, that narrow story we have in our minds about who we are. He makes it clear that it was the smoker self-as-concept which was the key barrier to quitting smoking, which I think is a key aspect of addiction so rarely talked about. He breaks that self-as-concept by staying in the present moment, changing “one minute at a time.” I love it when I get a gem like this that speaks so deeply to the talk by simply telling a personal story in one’s own words.

STEVE: You pay tribute to your mom at the start of the talk. I know she passed away a year after you gave it. Did she get a chance to see it and if she did can you tell us what she thought of it?

JONATHAN: My mom saw it a few times, the last being when she was in the hospital just days before she passed.  She was touched by it and by the tribute to her. She was a private and self-deprecating person. Never one to take compliments or heap praise, she simply said to me: “Well, that was very nice” in her typical New England manner.

STEVE: How has her passing changed the meaning of the talk for you?

JONATHAN: The talk was my dedication to her (and to my dad, who does appreciate it as well). Her passing has made that dedication even more meaningful for me. It’s a permanent record of how I feel about her, how inspiring she was, and how I admired her so much. The talk is like a reminder for me to live the spirit of her legacy in my work and life.

STEVE: The Association for Contextual Behavioral Science (ACBS) fosters the development of ACT and related methods. Your talk is one of concrete example of things in the ACBS community that have made an enormous public impact. What impact do you see that the talk has had on the ACBS community worldwide?

 

JONATHAN: I think overall the talk has spread these core principles of the ACBS community: (1) flexibly responding to our urges, emotions, and thoughts with willingness and openness, (2) showing compassion to ourselves and others, (3) applying these principles to important problems in human suffering, and (4) placing a high value on scientific method and rigorous testing of these principles.

The talk has provided worldwide exposure to these ACBS principles, both inside and outside the psychology. North America, Europe, Asia, Australia, Africa. People from everywhere, all walks of life. I often refer to them to the ACBS website, to the ACT For The Public listserv. My go-to book recommendations, written by ACBS community members, have been:

General Self-Help Books on ACT

The Happiness Trap by Russ Harris

Get out of Your Mind and Into Your Life by Steve Hayes

Substance Use Self-Help Books on ACT

The Wisdom to Know the Difference by Kelly Wilson

Weight Loss Self-Help Books on ACT

The Diet Trap by Jason Lillis

The Weight Escape by Anne Bailey and colleagues

I get emails from ACBS therapists who say they assign the talk to their clients as a way to help them learn about the ACT model or to help them understand how it is applied to changing habits.

And I get emails from professionals who want to learn more about ACT for their clinical work or their scientific research. To them, I often recommend attending the ACBS Conference, upcoming workshops in their area, or books like Acceptance and Commitment Therapy 2014 edition. By the way, the 1999 edition is the one I referred to in the talk. The talk has impacted ACBS membership, workshop and conference attendance, and overall engagement in our community.

So the overall impact of the talk on the ACBS community I would say its quite broad.

STEVE: What about your home base? Tell us about the Fred Hutch and what impact it has had there.

JONATHAN: The Fred Hutch is shorthand for the Fred Hutchinson Cancer Research Center, an independent nonprofit research institute in Seattle, Washington. Home to three Nobel prize winners, the mission is to end cancer as a cause of human suffering and death. We are funded by highly competitive grants from the National Institutes of Health and private donations. My research team is part of the largest and oldest cancer prevention research program in the world. The talk is raising awareness of the power of Fred Hutch behavioral science for preventing cancer through habit change interventions like quitting smoking and losing weight.

STEVE: Thank for the time, and again, congratulations on your TEDx.

JONATHAN: Thanks. I hope it has made a difference.

ACT and Beyond

Lessons Learned, Hopes for the Future and Advice for Young Therapists

“Expert Talks” is a series of interviews with eminent psychotherapy teachers and researchers.
Created by Alexandre Vaz, sponsored by ANEP (Portugal’s National Association of Psychology Students) and Clínica ISPA.

Psychological flexibility | TEDxUniversityofNevada

How love turns pain into purpose

What can we do to prosper when facing pain and suffering in our lives? More than a thousand studies suggest that a major part of the answer is learning psychological flexibility. Steven C. Hayes is one of the researchers who first identified that process and put it into action in the form of a popular acceptance and mindfulness method called Acceptance and Commitment Therapy. In this emotional talk, Hayes distills the essence of psychological flexibility down into a few easy to understand sentences. He takes viewers through a harrowing journey into his own panic disorder, to the very moment in his life when he made this life changing choice: I will not run from me. Hayes shows how making that choice allows us to connect with our own deep sense of meaning and purpose, arguing that taking a loving stance to your own pain allows you to bring love and contribution into the world.