Cognitive Defusion in Mindfulness Psychotherapy
A well-meaning therapist might ask: What is cognitive defusion. Well this practice, as used in Acceptance and Commitment Therapy, is beyond cognitive restructuring of cognitive distortions and automatic negative thoughts ( I call “Red Ants”). The practice concretely de-literalizes the personal truth and meaning of unhelpful, repetitive thoughts and words. As The Buddha warned: We probably should NOT believe the distinctions of thoughts in our heads. Our strong thoughts may be our best friends or our worst enemies. In neuroscience the fact that more negative than positive thoughts occur in humans implies we are more attached to limbic reactivity and fear than to 
positive thoughts and emotions. When we get stuck in negative cycles of thinking, feeling and doing our right brain and limbic area dominate. A very old mindfulness belief is that you are not your thoughts, your emotions, or your behaviors; these parts of you are simply associated with your life experiences. When a client learns to defuse a though it means they have changed its linguistic structure and removed it from being cemented into their CABs, or cognition-affect-behavior cycles. In all good therapies, especially Cognitive-Behavioral Therapy and various mindfulness therapies (MBCR, DBT, MBCT, MBRP, ACT), helpers often work on truth-analysis of unhelpful, repetitive, negative thoughts patterns – especially those embedded into CABs cycles of ineffective experiences. Self-medication, isolation, and avoidance are commonly associated with these realities. Sometimes this work includes meta-cognitive analysis regarding your thoughts about your thoughts or the patterns of your thoughts. The clear logic is that the words we often tell ourselves in times of stress or fear are NOT often true. Of course, if indeed you are seriously endangered best to allow your limbic brain area to save your life. The list below will note various approaches used to defuse thoughts from our experience of being, our CABs cycles.
- Stay the thoughts out loud and mindfully notice the sensations, images, emotions, and associated CABs cycles that arise. Now say the words over and over again for at least half a minute. Note any changes that follow.
- Use scrambling of the phrase to change it grammatical brain-connections. Your brain should react a different way to the “scrambled” message. It is like changing the code of the phrase. For example: try saying “am person a bad” or “person I a bad am” instead of “I am a bad person.” Notice what your brain-mind does now.
- Speed up and then slow down the rate of inner and outer speech. Try all four options; notice any relief you have obtained.
- Reduce then intensify your energy level when saying the phrase. Notice, again.
- Elongate the sounds of the key words in your phrase. Keep elongating and notice what happens. Elongate and slow as far as you can.
- I like this approach. Change the most important one or two words in your phrase. Now say the phrase out loud with one or two slightly less harsh words. You will need to repeat this technique for effects. For
example: “I am so worthless” helps solidify your brain plasticity about personal meanings and images. Try this: “Sometimes I feel worthless” or “When really bad things happen, I can feel worthless” or “My unpleasant feeling can relate to feeling less worthwhile.” - Change the language code of your key word/s. For example: change “I am a terrible person” to “I am a spanty person.” Spanty being Czech for terrible or bad. Notice how the brain/mind/body responds to this simple change.
- You could also sing your statement, or say it in a foolish voice tone.
- I have used defusion and added body movements to the process. Here are four examples.
A) Find a spot on the floor where you try to project all your bad feelings about your repetitive phrase. You are consciously projecting the bad feeling into the spot on the floor. Now stand in it and notice how your mind body reacts. Slowly, but with some bodily energetic force, step out of the spot on the floor. Notice the effects.
B) Stand in the same spot, and pretend you are taking off a pair of pants – BUT when you are out of the imaginary pants, immediately step aside. Notice.
C) Find a pleasant place to go for a brief walk. Enjoy the environment, but say your statement to yourself. Split your attention in two: attention to the beauty of the walk (and watch your step), and attention to repeating your phrase. Notice any changes and shifts that occur.
D) This one is out-there but fun. Energize yourself (if healthy enough) into a rapid skipping movement. At the same time say your phrase, and pay attention to where you are skipping. Your body will respond by contrasting the negative statement against the body-memory of good-old skipping. For most adults, skipping was a fun thing to do. Notice the effects.
For more information refer to: Blackledge, J. T. (2015). Cognitive Defusion in Practice: A Clinician’s Guide… Oakland, CA: Context Press/New Harbinger, pp. 3-42, 87-109, 159-162.
Anthony R. Quintiliani, PhD., LADC
From the Eleanor R. Liebman Center for Secular Meditation in Monkton, Vermont
Author of Mindful Happiness
more impulsively to escape from the painful feeling tone or to quickly improve it. We tell ourselves stories about “how bad it is” as we immediately work to reduce the psychic suffering. This is where so many common human problems are born; this is where we may begin habitual behaviors around eating, consuming, angering, isolating, acting out, acting in, using mind-altering substances, and greediness, etc. There are ways to reduce this kind of mindbody stuckness and misery.
increase personal freedom with the skill of pausing between stimulus and reaction. Become more liberated by practicing your PAUSE, then label in a neutral manner – just wait it out. No need to avoid or to self-medicate the unpleasant feeling. This is our best HOPE to master choiceless awareness, especially when it leads to unpleasant feeling tones. Simply pause and label: “I am feeling unpleasantness in my body.” This too will pass. Try NOT to be more specific, since doing so may lead to stories and avoidance behaviors (negative reinforcement). Negative reinforcement by way of quick relief from suffering WILL cause unhealthy habits to form. The more you avoid or self-medicate painful feelings, the stronger the habit will become. This is a path to powerlessness NOT liberation. Just pause and label “I am feeling unpleasantness.” WAIT! Get stronger is your tolerance. Become a more satisfied and happier person. Just keep labeling without actions.
will guide you through a longer meditation dealing with your perceptions and experiences with impermanence. It is hoped that by being more direct in the guided practice, you may benefit prematurely. Although there is no substitute for regular daily meditation practice, especially when vipassana is concerned. Let’s begin. Do your best to remain on focus and deep.
especially trauma and substance misuse, initiating, developing, and sustaining a hopeful future-view is highly important in client motivation and faith in beneficial change. In the client’s personal world of hopelessness (possibly helplessness), pain and suffering, a common expectation is that this “hell realm” will not end. Therefore, to enhance hope in the intersubjective space of psychotherapy, therapists need to implement certain on-going hope-based strategic interventions. Here is a list to consider. Do you routinely do these things in your sessions?
