Acceptance and Commitment Therapy -- and a shrink's view on meds for addiction

[suneelca]

Hi, everyone. As part of my journey, I have started seeing a therapist here in San Francisco whose therapeutic approach is called 'Acceptance and Commitment Therapy' (ACT). Short story -- it's about accepting one's feelings and getting to a place where one can manage them as opposed to trying to get rid of them. It has a lot of elements of Zen Buddhism. It would be instantly recognizable to anyone who's done EST or the Landmark Forum.

Acceptance and commitment therapy - Wikipedia, the free encyclopedia

Today, he went through an explanation of how the brain manages anxiety, and of course zeroed in on the amygdala. I was in a state of Baclofen-induced somnolence so I won't represent this comprehensively. The upshot is that he talked about how the goal of ACT is to improve the frontal lobes' ability to regulate the amygdala. He indicated he was glad that I am tapering off a benzodiazepene so that I could learn how to improve the functioning of my frontal lobes in an unfettered way -- acknowledging that I might experience more anxiety during the process. No pain, no gain, I guess. He doesn't know much about Baclofen, and wasn't wanting to terminate my experiment with it. But he did vocalize the concern that ACT is all about developing better coping mechanisms through being able to feel one's feelings fully. This is also intended not only to deal with anxiety, but with resulting issues such as drug and alcohol abuse.

Any thoughts / reactions to this? For anyone who has undergone or is currently undergoing talk therapy, what have your therapists had to say about using Baclofen or one of the other pharmacological approaches?

[Greg]

Acceptance and Commitment Therapy -- and a shrink's view on meds for addiction

Although I failed to benefit from types of CBT I have tried, I'm still in favour of people trying things that may be of benefit to them. Buddhism has always been of interest to me too.

I am impressed that this guy actually knows about parts of the brain like the amygdala and frontal lobes, and some of their functions. I'm even more impressed that he understands that there is a difference between these two parts. I have usually just imagined it in terms of my thinking/rational/logical side versus my emotional/impulsive/addicted side, as I am not an expert in brain structure.

So many counsellors I have been to have never been able to "get" that there can be a difference and a struggle between two fundamental parts of the mind, or that the addicted part that is emotionally desperate for its "fix" can and does over-ride all logic and determination sometimes (far too many times, with addicted people). One or two I have talked to were able to fully relate to this inner struggle, and they were (not surprisingly) the ones who had been addicts/alcoholics themselves. Unfortunately, they were not trained in brain structure in great detail however.

If the amygdala or other impulsive/craving parts of the brain can be "tamed" with therapy, then that's an ideal solution. If someone finds this too hard to do, then using baclofen or another chemical agent that is generally stabilizing towards that part of the brain seems the best extra help we know about right now. I imagine this is how acamprosate (Campral) was intended to work, and in theory it sounds great too, but not many seem to have spectacular results with it. Some mention things like gabapentin too.

Many do say that benzodiazepines cause too much mental fog, and while I have only found this at medium-high doses, if you can function without benzos then it would seem a good idea. Just be careful not to taper them down too quickly, since some people get very unpleasant symptoms when trying to hurry it up!

Good luck, I hope you get good results from the therapy.

[GingerDust]

Acceptance and Commitment Therapy -- and a shrink's view on meds for addiction

I can't comment on how baclofen affects it but the therapy sounds pretty neat.

[suneelca]

Acceptance and Commitment Therapy -- and a shrink's view on meds for addiction

Thanks for your posts! I've thought a bit about what my shrink said. The issue about why this doesn't happen with benzodiazepenes notwithstanding, is it possible that Baclofen creates a space where one can learn new behaviors, to in fact be more amenable to the therapy? For those of you in therapy who are also using Bac, has something like this worked for / happened to you?

For those of you who are interested in this kind of therapy, or who are interested but don't have the dough to do sustained therapy, you can get a flavor of it by (again) doing the Landmark Forum. I did it, but my newly minted girlfriend at the time, now my wife, wasn't into my continuing to the 'Advanced Course' because she thought that it smacked of being a cult, and it can take on that flavor because they essentially do multi-level marketing. In any case, here's the link:

Landmark Education: The Landmark Forum, Landmark Education seminars, courses, and programs for Landmark Forum graduates