Guidelines for Working with Creative Hopelessness

person standing between giant doors

This blog is an excerpt from Learning ACT, 2nd ed. by Steven C. Hayes, PhD, Robyn Walser, PhD, and Jason B. Luoma, PhD 

The idea in creative hopelessness work is to validate clients’ actual experience of control, not working to validate the emotions they’re experiencing, and to suggest that the social messages they’ve been given might be incorrect, rather than that clients are incorrect. So before the end of a session, be sure to establish that you’re suggesting that the agenda is hopeless, not that the client is hopeless.

Note that the “creative” piece in creative hopelessness refers to an openness that comes when clients finally abandon needless experiential control and turn their attention to living a life that aligns with their chosen values. After all, the goal is not to create a feeling of hopelessness or belief in hopelessness; in fact, this process often creates a hopeful feeling. The goal is simply to speed the process of abandoning what isn’t working (Hayes et al., 2012).

When clients fully contact the unworkability of old control agendas, they may feel lost or confused because the path they’ve been on no longer seems viable. This isn’t a negative sign; it’s a sign that old control behaviors are beginning to fall away. Occasionally, clients might feel upset or angry at this point, with a sense that they’ve been tricked by life or by the clinician.

If so, you might validate this saying something like, “It makes sense that you’d feel upset after putting so much effort into something with so little payoff.”

In order to forestall potential self-blame, you might say, “It isn’t your fault that you fell into this hole. These were the tools you were given by society. But what if it’s the case that much of what we’re taught to do with our painful emotions and thoughts can actually make things worse? What if it’s the case that the things your mind tells you to do might actually get you more stuck?”

Other common reactions, which may not require a specific response, include clients slowing down or being more thoughtful, periods of silence, a sense of lightness in the room, laughter, and a start-and-stop quality to clients’ speech, as if they’re catching habitual patterns of thinking.

Because creative hopelessness is such an important piece of both the up-front and the ongoing work in acceptance and commitment therapy (ACT), and because it typically begins early in therapy, we have additional key guidelines to share.

A common mistake on the part of therapists is trying to convince clients that avoidance isn’t working or that they must give up their agenda of experiential control.

Another is that therapists may try to push clients further than they’re currently ready to go. It’s essential that the client’s experience be the absolute arbiter.

Creative hopelessness will only function as it should if the confrontation is between the client’s system of experiential control (the mind) and the client’s actual experience, not between the therapist and the client. The therapist is simply there to guide the process of helping clients examine their own experience and determine whether the solutions their minds have been putting forward have actually worked as they were supposed to, or whether their experience has shown otherwise.

Another common therapist misstep at this point is getting caught up in the content of what clients say. For example, therapists may assume that a seemingly logical or healthy solution should be supported, without exploring its actual function. In this case, a therapist might encourage a depressed client to exercise more (a seemingly healthy behavior in depression) without knowing whether exercise functions primarily as avoidance for that client. So remember that the target of acceptance is undermining behaviors that serve as experiential avoidance, which is defined based on function, not form.

See also: How Avoiding Emotions Keeps Them at High Intensity

In the example of exercise, a psychologically flexible route forward might involve either more exercise or less—more if this behavior is linked to values, and less if it’s linked to avoidance.

Responding based on content is especially tempting if strategies the client has tried are similar—in form—to ACT methods (e.g., mindfulness meditation). However, the purpose is not to endorse formally correct methods; it is to explore the functional impact of any and all solutions and let go of anything that isn’t working. Typically, what isn’t working is clients’ cognitive entanglement with their mind and the resulting control agenda, which may not be easily seen or logical.

Clients’ experience is the biggest ally in determining the function of their behavior.

Finally, we want to be clear that creative hopelessness isn’t about a one-time, all-or-nothing shift in behavior; it’s about establishing the possibility of an approach other than control—in this moment, the next moment, and then the next moment. It’s about helping clients see that each moment of existence offers an opportunity to say yes to their experience, feeding the vitality of a values-based life, rather than continuing down the path of experiential avoidance.