Resiliency In The Face Of Trauma And Chronic Pain: Using Acceptance And Commitment Therapy In Building A Values-Based Life With Robyn Walser, Ph.D.

Welcome back to the Healing Pain Podcast with Robyn Walser, Ph.D.

The month of September is Pain Awareness Month. In years past, I’ve done lots of different things for Pain Awareness Month. I’ve held online summits, which hosted 30 plus experts. I’ve done courses for professionals and people with pain. In 2021, I was trying to figure out, “What are we not talking about in the chronic pain space that we need to bring more awareness around? What should we be talking about? What can we bring some more disruption around to disrupt our pain care world out there that isn’t always as effective for people with chronic pain?”

As I started to reflect on my practice and the patients I’ve seen over many years I’ve been treating patients looking at research, I said, “We need to talk more about the link between trauma and chronic pain.” This September, I’ve done a couple of different things to raise awareness around the trauma-pain connection. The first is I’ve done lots of different posts on my Instagram handle. If you can head on over to Instagram and find me, my handle is easy. It’s @DrJoeTatta. You can find me on Instagram. Like and follow me. I have lots of great posts and sliders that are perfect for you if you’re a practitioner or someone with chronic pain and you want to learn more about the trauma-pain connection.

The second is I partnered with a physical therapist this September. His name is Dr. Jeremy Fletcher. He is teaching our first Trauma-Informed Pain Care Course. You can find that by going to IntegrativePainScienceInstitute.com. Head on over to the Courses tab and scroll down and you’ll find the Trauma-Informed Pain Care course. That’s open now and you can register. It’s available for CEs as well as CEUs for physical therapists and other licensed health professionals. It’s about seven hours long and has lots of great content.

Jeremy is a physical therapy educator. He works for a company called Veterans Recovery Resources, which is a not-for-profit organization, which helps veterans with both their physical well as mental health needs. He is a dad, coach and also a survivor of trauma himself. He is a veteran of the Afghanistan War. He brings lots of professional as well as personal input to this topic. I’ve learned so much from Jeremy. He and I lectured in 2020 at Combined Sections at the APTA National Conference. I’m going to lecture again in 2021 at the national conference, which is in February. You can meet both of us there if you’re around.

Finally, I’ve reached out and partnered with people like our guest, Dr. Robyn Walser, who is an ACT-trained clinical psychologist. She is one of the world’s leading experts in treating trauma and PTSD. She is the Director of TL Psychological and Consultation Services. She is also an Assistant Professor at the University of California, Berkeley and works with the National Center for PTSD. As a licensed clinical psychologist, she maintains international training, consulting as well as therapy practice.

Robyn is well-known as an expert in Acceptance and Commitment Therapy, specifically for the treatment of trauma and PTSD. She has co-authored seven books, including a book on Learning ACT. Robyn’s work spans traumatic stress, depression, substance use and chronic pain. She has written research articles, chapters and books on these topics. She has been doing ACT training and workshops since 1998.

Robyn is incredible. I’ve seen her in action at a couple of national conferences through ACBS. I’ve also read a couple of her books. They’re great. Head on over to Amazon and make sure you check out all of her books. Dive into this episode, read the topics that she and I are talking about around chronic pain and trauma, see if it resonates with you and think to yourself, “How much do I understand about trauma, PTSD, adverse childhood experiences and the social-political contextual aspects of trauma?” All these are important factors when it comes to treating people with chronic pain. Let’s begin this episode and meet Dr. Robyn Walser.

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Resiliency In The Face Of Trauma And Chronic Pain: Using Acceptance And Commitment Therapy In Building A Values-Based Life With Robyn Walser, Ph.D.

Robyn, welcome to this episode of the show. It’s great to have you here.

Joe, thank you for inviting me.

I’ve been wanting to chat with you for a while. I had an opportunity to sit on training with you at an ACBS Conference. That was very impactful. It helped me with my ACT skills. ACT, chronic pain and trauma have so many overlaps. I’m looking forward to this conversation. I know your history as an ACT trainer but I don’t know your history as a professional or person who has become interested in trauma. How did that journey begin for you?

I’m looking forward to the conversation as well. I got interested in trauma long before I knew about ACT. That’s where my roots started. My Master’s degree was on trauma with sexually abused women as compared to non-abused and psychotherapy, looking at things like their level of knowledge, birth control, guilt and a number of different things.

I had gone to the University of Nevada, Reno to work with Victoria Follette who was interested and she is still interested in trauma at that time I wanted to continue my work in that area. I got up to Reno and attended a Steven Hayes ACT workshop in 1991. If you can believe it, it was a long time ago. It was my first workshop and it blew me away. I had this complete shift. I was already on the trajectory of not liking the idea of cognitions being illogical, irrational and dysfunctional.

When I attended that workshop, I totally came into this place where acceptance made sense and perspective-taking. Self-as-context was like, “This is amazing.” I continued to work on trauma but I started going to Steven Hayes’ lab and basically grew up in Steven Hayes’ research lab at UNR. The rest is history from there. I’ve been doing Acceptance and Commitment Therapy work and training since 1991 with my first workshop delivered in 1997. I have been on that path ever since.

It’s great because so many people are hearing about ACT now especially in the chronic pain world. I’m happy that you’re going to talk about how long it has been around and some of the research and effectiveness for trauma, chronic pain and everything in between. You have a PhD in Clinical Psychology, I guess at that point you were still in a Master’s program it sounds like?

I got my Master’s at the University of Nevada, Las Vegas. I went there first and then decided to continue on. I went on and got my PhD. The Master’s at UNLV is interesting because, as an undergraduate, I was in this place where we were interested in cognition and looking at how cognition plays a role in our human maladies and much more in the Cognitive behavioral camp. When I went to UNLV and started working on my Master’s degree, there was a lot more behavioral orientation there so I could start to feel that shift there, too. UNR is all behavioral all the time or at least it was when I went there. It has been a long time. I’m not sure if they still have that intense of a focus at UNR.

I’m going to weave in and out of some of these concepts. When you say little-c, big-B, some of the mental health providers who are reading get that right away. Others might not quite understand what that means. Can you tell us what you’re talking about when you say that?

One thing for people that knows Acceptance and Commitment Therapy, it comes under the broad umbrella of Cognitive Behavioral Therapy. It fits in that category. The second-wave intervention that we were seeing during the ’70s through the early ’90s was a Cognitive behavioral intervention. What I mean by that is that the focus on interventions was cognition.

What you wanted to do is go in and manipulate or restructure cognitions in such a way that it would change emotion and thus behavior. When it first started, it was a very linear process, “Change the thought, emotion and behavior.” As time went on and the third wave of cognitive behavioral therapies started to emerge, that focus shift in that little-c, big-B. The focus tuned into behavior and what we can do with an individual’s behavior.

When you think about what ACT is doing, we don’t have to feel good in order to behave consistently with our values. The target is that behavior here and now versus feeling good or thinking differently before you can begin to live your life well. That’s that shift. It used to be, “Feel good, think good then live.” Now it’s, “Let’s get right after it, get in there, work on living well a values-based life in the here and now and be with your emotional and thought experience.” It’s a very mindful quality to it. That’s what the shift was in the big-C, little-b, big-B, little-c process was.

I want everyone to put that on a Post-it note in their mind because I’m going to connect that in a couple of moments with some other things. First, tell us what your definition is of trauma or PTSD so we can give some background as we move into some of these topics.

It’s an interesting question because as you may know, there’s the DSM-5 criterion, which includes that there must be an event that demarcates the diagnosis. You have to have some kind of a traumatic event where you felt helpless or your life or someone else’s life was in danger or you learned of traumatic death. There has to be an orienting event in order to receive a diagnosis of PTSD.

HPP 246 | Acceptance And Commitment Therapy
Acceptance and commitment therapy comes under the broad umbrella of cognitive behavioral therapy.

 

To get that diagnosis, you would have intrusive images and thoughts, hyperarousal, more anxious, alert and aware. You would be avoiding anything that reminds you of the experience. You would have alterations in mood and cognition, like maybe feeling guilt or thinking that something is wrong with you or bad about you because of the fallout of the trauma. That’s the standard, technical, straightforward definition but if you work in the field of trauma, what you learn pretty quickly is that it’s not that straightforward.

There’s complex trauma, which is trauma that occurs over a long period of time where there’s no defining event and maybe your life wasn’t in danger. Your safety is threatened. That might be something like long-standing childhood physical or sexual abuse. The impact is such that it’s not just that you have those four areas of symptoms that I talked about with PTSD. You also have lots of relationship struggles and alerting history that contributes to other challenges aside from just what you might see inside of PTSD.

There are two more terms that I’ll mention briefly that I’ll talk about is Trauma and trauma. The Trauma is of the PTSD sort. The trauma is more like, “I had a friend who committed suicide or I had a critical parent who berated me constantly. I could never get a break from it. I never felt safe under those circumstances.” The friend who committed suicide could be a big one, depending on how you learn the information but it could also be a smaller-t like, “I’m grieving over the loss of this individual. It wasn’t shocking. I knew they were depressed. They had been talking about taking their life for a long time. I’m having a lot of grief around it and struggling with it.”

There are lots of different ways that you can think about trauma but I tend to be clear about it when I’m doing an intervention. Often, when I’m working with clinicians, I remind them to be a little bit more specific when they’re talking about which trauma because sometimes people label everything trauma. Like you have something that’s emotionally overwhelming and the clinician says, “That’s a trauma.” That’s not trauma. We all have times in our lives when we feel emotionally overwhelmed by things and that doesn’t make it to be a trauma. Being specific about what you’re talking about can be useful in terms of how we communicate and define these things.

There are so many good points in there. I want to let those settle in. There are so many questions involved in all of that. The first thing that comes up for me is, as you’re talking and as many clinicians too, what kind of textbook first. We’re going back to what we learned in school and for lack of a better word, how systems dictate how we treat patients and their influence there. A lot of the criteria that you’re describing from the DSM fits well with chronic pain and what might be termed somatoform disorder depending on how someone is diagnosing it.

The other thing when you’re talking about big-T, little-t and making sure we’re clear in our language, as professionals, we model behavior for our patients, family and friends. There’s a difference between let’s say maybe persistent or toxic stress in trauma. Helping call it what it is might help frame someone’s journey to recovery better.

There can be intense stress where you and I are going through school and we had to take a test or something like that. We’re studying and it feels hard. You know you’re going to be evaluated but it’s time-limited. There’s chronic stress. Let’s say you’re in a job that’s highly demanding and you have a family life. After work, you have to go home and take care of the kids. You’re under constant, intense calls for you to be on your game and then there’s basically a no-stress.

You can categorize trauma. There are some trauma that equal that chronic high-intensity and some that are more momentary and then no trauma at all. People can mix those in ways that are problematic. In clearly defining it, we can target our intervention a little bit better. Is it a lifestyle change or a coping skill that you can use at the moment when you’re under time-limited stress or something like that?

You mentioned the DSM. Technically, trauma is a psychiatric diagnosis. That puts it in the realm of Psychology. Traditionally, whenever we put anything in the realm of Psychology, we think maladaptive thoughts, problematic thinking, rumination, problems dealing with feelings, problems with memory, traumatic images, etc. All of that is vitally important. How do we bring the brain and the body together with trauma and help raise awareness around the idea that trauma is not just a brain-based condition but that it’s a whole-body condition?

I do want to say that chronic pain and trauma are highly correlated. People can have chronic pain as a result of trauma or we also know that people with trauma are more likely to have chronic pain. The relationship is pretty strong. I work at the VA and many of the veterans that I work with have both subclinical PTSD and chronic pain. These issues are very important. I have a longer answer about DSM. Feel free to interact with me around this so that I don’t get off on a crazy tangent here.

PTSD, in some ways, is one of the few diagnoses that have an etiological origin, which depending on what kind of trauma you’re talking about, is what the DSM was supposed to be but never became. We had, a long time ago, the medicalization of human experience. Let’s focus on cognition. All of our pain is about what we think. We separated mind and body in a way that was probably not very useful.

That was due to medicalization like humans are machines. You’ve got to break everything down into its parts like a machine and then look at what’s broken and fix it, just like you might do if somebody has a broken bone. The problem with that is that emotions and thoughts are not broken. In my opinion, they’re not dysfunctional and irrational. They’re simply thoughts. If you have a thought that that’s a dysfunctional thought, that’s thought about a thought. You still have to do the analysis of the second thought that it’s a dysfunctional thought.

There’s more work to do in that area. ACT nicely does it with its understanding of human languaging but the piece about separating mind and body creates a problem. When you look at what’s happening with trauma, it’s impacting the entire person and that somatic experiences are very important. I’ll give you an example. I had a client who came to me who had all the symptoms to meet the criteria for PTSD. She was a Manager of a bank. She had two hostile takeover bank robberies in a two-week period. It was close in time. In both of them, weapons were involved.

The first one created a lot of anxiety but the second one was particularly bad. She had a gun pressed up to the back of her neck. When she came to see me, the main thing that she was distressed by wasn’t the thoughts of the bank robbers or the entire experience. That was distressing but she kept feeling the gun at the back of her neck. Somatically, she kept experiencing that pressure back there.

Clearly, that’s an example of how this is not just about what’s happening in your head. It’s about what’s happening with your body. Our whole body responds to trauma. The adrenaline doesn’t just go to the brain. It’s released in our whole system. It’s activated and we need to look at a whole perspective when we’re treating and not just what’s going on in the mind.

HPP 246 | Acceptance And Commitment Therapy
Sometimes people label everything trauma. We all have times in our lives when we feel emotionally overwhelmed by things, but that doesn’t make it a trauma. And so being very specific around what you’re talking about can be useful in terms of how we communicate and define these things.

 

I want everyone to grab that sticky note I posted for everyone before because of that big-C, little-b, big-B, little-c. Traditional trauma treatment started with traditional Cognitive Behavioral Therapy, which typically has a big-C component to it. You’ve nicely articulated somatic experiences interoception. All those are body-based symptoms and respond well to body-based treatments. A lot of trauma, in fact, responds well to body-based treatments.

As a professional, should we start thinking about a little bit more of a B and maybe a little smaller-b when working with people with trauma? Is it a case-by-case basis? I know it’s hard from an ACT perspective because ACT looks at thoughts as a behavior, which is not typical in traditional Cognitive Behavioral Therapy. I love the synchronicity between trauma and chronic pain because they both embody the experiences that people are struggling with.

When I’m thinking about treating trauma, I see thinking as a behavior because that’s the perspective that I’m coming from but I want to treat the whole person. For instance, if I’m looking at the system of anxiety that’s on high alert, hearts are beating fast. There’s a feeling of tension. Maybe they experience something heavy in the gut. Whatever is happening for the individual, I want to do exposure and willingness work in such a way that they are more interested in some ways in the bodily experience of it than what’s happening in their head.

I’m going to look at that too but I want to get them fully present to all of the experiences that they’re having in their body, becoming aware of them, changing the perspective on it so they can see it as an experience that they’re having, watching its rise and fall, noticing its intensity, quality and how it shifts as they continue to observe it. Essentially, we’re creating new learning here. They learn that these experiences are not dangerous. They’re safe even if those experiences arise. They can be with and hold these experiences without the need to avoid and move away from things that they care about in their lives.

We do look at thoughts but we’re seeing them for what they are. We’re having people take perspective on thinking, seeing the mind as learning like a critter that doesn’t unlearn. We can’t unlearn. It just learns and adds to learning. What I’m hoping that people will be able to see is that they can observe the ongoing process of thinking. They don’t have to get all entangled in what their mind is saying about them as a result of the trauma, just like I would if I’m working with someone with chronic pain.

Your mind is going to say things like, “I can’t do it. This is impossible. How can I go on like this?” It’s pulling people away as with trauma from what they care about and what matters to them in meaning in life. Diffusing from disentangling people from their minds in ways that help them to step forward in meaningful, values-based engagement in the service of vitality rather than in the service of happiness. Some people might think that’s an odd thing to say like, “Don’t you want people to be happy?” I do but we don’t walk around happy. Happiness isn’t a permanent state.

There’s even research that shows that if you’re trying to suppress pain, you’re trying to eliminate and get rid of emotional pain. We’re not very good at targeting that single emotion and saying, “I just want that one to go away so I can have all the others.” Indeed, if you try to push one down, you push them all down. If you’re not willing to have emotional pain, you’re also not going to have joy. You cut joy off as well. If you open yourself up to experiencing, you’re available at the moment for pain or joy, whichever one is there.

There are vitality and vulnerability in those instances, which is great. As you’re talking, you’re mentioning learning. You’ve mentioned it a number of times now. I love the simple concept of looking at the human organism as an organism that learns. All day long we’re learning. That’s what we’re doing in many different ways.

Through our therapy techniques and exposure, there’s new learning that happens there. We can layer on all these different new layers on top of our old learning instead of looking at the nervous system or the human body, in essence, as something that you turn on and off, delete things from or have the ability to extinguish. There are so many different words that are used in all different research. It’s a different perspective of approaching someone. The ACT model, with the exposure base that it has, is so important for people with chronic pain and those with trauma PTSD.

If we’re able to learn and see our whole selves as experiencing beings, which is not typically how it works. We grow up in a cultural system. This happens this way a lot around the world where you lose contact with the experiential way of learning and instead you’re just focused on verbal learning or mind. People get up into their minds. They forget that they have a whole system here that’s learning and interacting with the world.

Part of this new learning is to see the whole system again and get people back in touch with experiential ways of knowing the world. Emotions rise and fall. Thoughts come and go. We’re beings in motion. It’s another way to say it. We’re not holding still very much. Even if we’re holding still, there are tons of motion going on inside of us, including emotion as well. We need to get back in touch with that whole process of constant movement and change. When we can see that, we’re going to be less threatened by certain thoughts or feelings because they’re going to change and move.

With chronic pain or what we might call chronic PTSD, people say, “I have this all the time.” That’s the standard response. It’s always there. I would be interested to know your thoughts on this too. If you mindfully watch your experience, even chronic pain or the experiences that come along with trauma, you’ll see those shifts. You’ll see that it changes in quality or disappears. The thought arises and then it falls. The experience in your body grows and then it contracts. If you’re watching, there are lots of different things going on.

Sometimes patients will tell you that right away. When you’re taking a history and you ask, “Where’s your pain?” They’ll say, “Most of the time, it’s in my lower back but sometimes it’s down in my right or left leg. Sometimes it shoots up to my neck.” Our patients are dropping the crumbs for us to follow. There are seeds there for us that we can pick up and start to work with.

It’s interesting when we think about pain and put our focus on that, we tend to have more of that. It becomes more intense. As we start to pull apart all those pieces of pain and instead of seeing it as just a sensation, picking it apart and then seeing it more of an experience then that experience starts to change. There’s room for that experience to change.

HPP 246 | Acceptance And Commitment Therapy
Separating mind and body creates a problem. And really when you look at what’s happening with trauma, it’s impacting the whole entire person and that semantic experiences are very important.

 

One of the places I know you do a lot of workarounds is training professionals. You have a book out called The Heart of ACT and you’ve done some papers on it. When I’ve watched your training and I’ve watched you work with some patients and professionals who are struggling with their own stuff, you’re able to adopt an ACT stance. If people are familiar with the ACT Core Competency Form, they can go through there. You displayed that beautifully. I know it takes time to cultivate that.

As I’ve trained PTs especially where they come from a background of, “Pain means technically that something is broken and we have to fix it,” they start to approach their patient care like that. When they come to ACT, PTs specifically are completely confused. They’re blown out of the water and can’t get enough of it. They’re trying to figure out, “Where do the fixing end and the nurturing begin?” I’m going to have you talk about the importance of the ACT processes and the ACT stance in a professional skillset.

This is what The Heart of ACT is about too. If you’re learning ACT and going to do it well, you need to be applying it to yourself that you’re practicing and living more fully in the moment. You’re conscious of your experience. You’re making choices that are based on values and engaging in a behavior in that fashion that’s lined up with those values. The other thing that is important for clinicians to know as they’re learning ACT is that there’s no done and arrival. That’s one that I’m aware of.

I’ve been doing ACT for many years. I’m still learning, gaining information and practicing my own mindfulness and awareness processes. One of the things that I would say is that there’s not a place that you’re going to get to where you go, “That’s it. Now, I’m done. ACT is the answer and I have fixed it.” It’s more of, “I’m going to be working on accepting for the rest of my life and valuing.”

We can translate that to our clients as well that acceptance is an ongoing process and probably should be turned into a verb instead of a noun, accepting versus acceptance. It’s always there to be done and practiced. Valuing is always there to be lived. That can help with some of these ideas about, “Where do we get to the part where we move from fixed to nurturing?” It’s nurturing from the start and all the way through. The fixing is in changing the behavior, not in changing the internal experience.

It’s not necessarily in changing someone’s pain whether that’s physical pain or emotional pain. It’s how to restart to modify or change your behaviors based on what your values are. It’s not mine or anyone else’s but figuring out what your values are.

What’s meaningful to you? When you come to the end when you look back, what legacy will you have hoped to leave? You got to start living that legacy now if you want to create it. I know with chronic pain, people feel frozen by their pain. As with trauma, they feel frozen by their trauma. They can’t step forward. What we want to convey here is we wanted to do it thoughtfully.

Some people, when they get active, their pain flares up. Some people with trauma, when they visit their family, they get triggered. We want to think about it thoughtfully. Being present, open and willing to engage, those things are going to be different than, “This pain has to go away. My trauma has to go away before I can live.” Life is short and it will unfold very quickly in avoidance and non-connection if you’re waiting to have these things disappear.

People come to professionals like us because they’re looking for a change. We start to steer them. It’s not necessarily that pain relief is never going to happen because oftentimes it does but the change that you’re looking for exists in the valuing, not necessarily the pain-relieving efforts.

How will your behavior change versus how will your thoughts, sensations and emotions change? They’re going to change regardless. What will you do with your behavior? They’ll come and go. They’ll rise and fall. I want to be careful when I say change. You’ll keep learning. We add and keep learning, both experientially and verbally. We might learn, “Pain is part of my experience but it doesn’t have to mean that I can’t live meaningfully.”

If you had to give us a top tip, three strategies or your biggest frustration around the treatment of trauma as we exist here in the United States where we are, what would they be?

Let me do tips and then I’ll do frustrations. If I think of tips, if you’re treating trauma, you got to expose to the traumatic material. What’s happening in the body, memory and those things, you need to expose to those things. Secondly, getting people to behave according to their values early on is important so they can get that experience of building a meaningful life right away.

Third and this is important to me in my understanding of Acceptance and Commitment Therapy. Helping people recognize self-as-context perspective-taking is incredibly valuable. Once people can connect to this felt sense and experience of, “I am more than my trauma and pain,” there’s freedom inside of that and I wanted to get to that freedom as quickly as possible. Those are the three tips that I would think about when working with trauma and pain for that matter.

Frustrations sometimes have to do with what’s going on in the field of Psychology and this notion that feeling good is the only way to feel. I don’t know if that’s the kind of frustration you’re talking about but certainly, I keep getting the message that feeling good is what you have to do in order to have a meaningful life. I would use small examples here to show that that’s not the case.

The meaning might be found, for instance, in being present to a family member passing away. That doesn’t feel good by any means but it might be incredibly meaningful. You want to ask yourself, “Is this pain that I’m going to feel is what I would want to do in the service of being there for my family member?” I know for myself that answer would be yes and I’ve done that.

HPP 246 | Acceptance And Commitment Therapy
Getting people to behave according to their values early on is really important so they can get that experience of building a meaningful life right away.

 

I get frustrated when this idea is held out that feeling good and thinking positive thoughts all the time is the way to be. If I were in charge of Psychology, I would get rid of this idea of negative and positive emotion and thought. It’s just thought and emotion. That’s one frustration. Is that the kind of frustration you were thinking about or looking for?

Whatever frustration you have is fine for me but that’s a pretty good one in the pain world. The labeling of good feelings and bad feelings can be a slippery slope for some people.

What it does is it takes human experience and turns it into a problem. In the emotional experience of pain, that there’s a problem and we’re hell-bent on fixing problems. Our minds are very task-oriented. They want to get those things done. What if you have chronic pain? How do you fix that problem if I want to ask, “How do you live well if you have chronic pain versus how do I get rid of it?”

The reversal process is different. Instead of approaching that reversal of pain from, “First, we have to get rid of what’s bad then we can focus on what’s good,” in a lot of ways, it’s the opposite.

Let’s focus on what you care about upfront and start that process now. I don’t have too many other frustrations with clients or people who have trauma and chronic pain. That’s what’s happening for them. I want to be there, present and compassionate. I’m working with them in a way that is helping them move forward in life. My frustrations arrive with clinicians who get sucked into this idea that there’s only one way to be in life and that’s happy. I should say too I’m a fan of happiness. I like it and I want to invite as much of it into my world as I possibly can but I’m not going to do it by not tasting other parts of life.

That’s also why those ACT Core Competency skills are important because if you’re working with exposure effectively, you have to be able to be present with that in yourself, your client and that space between you and the client that’s constantly shifting as well. Ive been speaking with Robyn Walser. She is a licensed clinical psychologist and ACT trainer. She has incredible books. Is it 7 or 8 books? How many books do you have on the ACT?

I’m working on an eighth. We’re close to eight.

Can you give us any insight into the eighth, a little sneak-peek?

The one that’s coming out, the seventh is The ACT Workbook for Anger, which can be useful for people who have chronic pain and trauma. It’s a self-help book coming out with New Harbinger. Manuela O’Connell and I are writing a book for APA on The Straightforward Skills in ACT, like literally, “Do this process with this skill.” That won’t be coming out. We’ve still got time to write it. We’ve got the contract signed and we’re starting to develop the outline but we still got a lot to go.

Everyone can find those books on Amazon. If you go to Amazon and look up Robyn Walser ACT, those will all pop up. Robyn, let people know how they can follow you and learn more about your work.

I have a Facebook page called The Heart of ACT so people can go there. I also have a website, TLConsultation Services, if people want to contact me, ask questions or see some of the other work that I’m doing. I’ve opened a Twitter account @RobynWalser. I’m not very good at social media. I have to work at it. I’m going to start tweeting here pretty soon. Is tweeting still popular?

It’s still out there.

The problem is that I want to get away from these devices as much as I can when I’m not working. I don’t hang out at these places very often but they’re there and I do welcome people to come and visit.

If you want to give Robyn a little help, share this, tag her on Twitter and say, “Thanks so much for the interview, Robyn. It was great to learn about ACT, trauma and the convergence of chronic pain.” Robyn Walser, you can find her. All her books are on Amazon. Her website is TLConsultationServices.com. Make sure to share this episode with your friends, family and colleagues on social media, in a Facebook group, on Twitter or wherever you’re following the show. We’ll see you in the next episode.

Thank you.

Important Links:

About Robyn Walser, Ph.D.

HPP 246 | Acceptance And Commitment TherapyRobyn D. Walser, Ph.D. is Director of TL Psychological and Consultation Services, Assistant Professor at the University of California, Berkeley, and works at the National Center for PTSD.

As a licensed psychologist, she maintains an international training, consulting and therapy practice. Dr. Walser is an expert in Acceptance and Commitment Therapy (ACT) and has co-authored 6 books on ACT, including a book on learning ACT. She has most recently written a book entitled: The Heart of ACT.

Dr. Walser has expertise in traumatic stress, depression and substance abuse and has authored a number of articles, chapters, and books on these topics. She has been doing ACT workshops since 1998, training in multiple formats and for various client problems. She is a past president and fellow of the Association for Contextual Behavioral Science (ACBS).

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