This week I was asked, “What common ground is there between Acceptance and Commitment Therapy and ‘the unconscious’? And if there is any common ground, how can it apply to addiction counseling and addiction recovery?”
To me, the common ground is cognitive dissonance.
In my opinion, that was an interesting question. Here’s why. Acceptance and Commitment Therapy is from the cognitive-behavioral therapy (CBT) tradition. And “the unconscious” as this person meant it is from the psychodynamic or psychoanalytic tradition. Some people might see those two traditions, and those two models of understanding people, as inherently unrelated – and having no common ground.
I gave my reply when I was asked, and wanted to share my reply here on Recovery Review.
I’ll start with a disclaimer. I’m not an expert in ACT, in spite of being academically educated in radical behaviorism, and clinically trained in behavior therapy, cognitive therapy, and CBT. And I’m only a novice at reading the psychoanalytic literature.
With that disclaimer out of the way I’ll give my answer.
Here’s how I broke it down.
In psychology we learn that a particular kind of discomfort occurs when our behavior contradicts our internalized values. That discomfort we experience is called cognitive dissonance.
Meanwhile, pertaining to the unconscious, many of our internalized values are outside of our immediate awareness; we don’t go around thinking about them all day every day. In this sense, “values” includes things like deep cultural assumptions, social mores, and frameworks of expectations that we internalize from our society and family system. Many times, those deep assumptions stay in the background, outside of our awareness, and function there without us explicitly realizing they are there. They typically reside in the unconscious.
Let’s now consider these together.
When our behavior produces a felt sense of cognitive dissonance, that experience can help us get in touch (e.g. consider, identify, clarify) with our deeply held assumptions. And then, when we move our behavior back in alignment with our values, the cognitive dissonance diminishes or is eliminated. Across our lifetime these functions and processes can be adaptive for us and serve as a protective factor.
The ACT model shows us that many times when our behavior is not in alignment with our values we experience dissonance, and then tend to turn inward and struggle against ourselves. It shows us that a common result of behaving in contradiction to or in violation of our values, is to then be self-critical. We start to struggle against the behaviors we did. And talk to ourselves in a way that is critical, corrective, and harsh.
This critical voice and content can be a source of judgment. We might have adopted and internalized these messages from our family system without much thought. In analytic terms, this is the classic “harsh super-ego”. Interestingly, all of this can seem to function by itself, on auto-pilot, without any help or even awareness from us – emanating from the unconscious.
ACT offers a preferred alternative: simply re-align with our values, orient toward the valued direction, and move toward it. ACT emphasizes pivoting toward our values and moving with intentionality in our behavior – in the valued direction. This reduces cognitive dissonance, diminishes the harsh super-ego, and helps us exit our auto-pilot system of well-engrained problem solving behaviors that don’t work so well.
Aside from all of that material in the background, there is another kind of unconscious content that is appreciated in radical behaviorism: procedural learning. This is any well-rehearsed behavior that the person has so ingrained they literally don’t need to think about it to do it well. Examples include playing a piano (for a pianist), driving a car, or even something as simple as our morning routine. Procedural learning can serve us very well, especially when it’s so ingrained it can work efficiently and effectively, on auto-pilot, and outside our conscious effort. For example, learning to drive a car eventually lays that procedural learning so deep within us we don’t have to think about driving in order to drive.
Any well-rehearsed behavioral repertoire is unconscious.
Here, the ACT model serves again. Behavioral deviations away from our valued direction, and into our old and automatic routines, will serve to trigger cognitive dissonance. We can use the experience of cognitive dissonance as a signal to re-orient and make intentional movement in the valued direction.
In this way, the over-lap of our (1) behaviors and our (2) values, helps to make us consciously aware of some things we need to accept. And aware of the values and actions to which we need to commit, and re-commit through our behavior. This is a non-tense holding environment of self, and self-support, rather than an internal environment of self-criticism.
To summarize, our unconscious holds old behavioral routines that work very well for us. It also holds assumptions and values from our family of origin and culture that we’re so familiar with we often don’t even realize they’re there. Harsh and corrective messages are also at the ready, yet generally out of access.
During SUD progression and chronic addiction illness, our earlier values are out of access and less-healthy behavioral routines develop and predominate. For patients in addiction counseling, addiction treatment, or early recovery, all of this material can get in the way at times.
How so?
During treatment or early recovery our values from earlier life are re-awakened, and new values are introduced. And during the change process our less healthy and well-rehearsed problem-solving methods sometimes emerge. This can result in us doing old behaviors that might lead to an internal eruption of unconscious material that’s not very helpful.
But we can use that as a reminder to re-orient toward our values and move in our valued direction. Over time, we eventually make our new way of living nearly automatic. We can become more natural at using this discomfort as a signal to do the next right thing, while being a friend to ourselves, and allowing ourselves to be supported. During the journey we can learn to intentionally support ourselves in our personal growth process. And make giving and getting support rather automatic, while noticing deviations away from our healthy values as a reminder to accept and re-commit.
Suggested Resources
Coon, B. The Change Process. September 8, 2020.
Coon, B. Coast Guard Search and Rescue: Lessons and Inspiration. January 23, 2022.
Coon, B. Technique vs. Empathy. June 6, 2022.
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