Chapter 3.The Practice of Functional Psychiatry

In Part I, we described some of the core benefits of adopting the ACT approach in psychiatric practice and presented a broad overview of the ACT framework. We examined the basic science foundations of the ACT model and presented a transdiagnostic clinical theory of both psychopathology and human resilience. This theory holds that two highly toxic forms of behavior have been empirically linked to psychopathology and behavior dysfunction: emotional and behavioral avoidance. We also examined an underlying, potentially destructive feature of language that enables unworkable patterns of avoidance: the unwitting tendency of people to follow socially conditioned self-instructional rules that encourage the use of emotional and behavior avoidance strategies. The tendency to follow mental rules is heightened in the presence of low levels of self-reflective awareness and a reduced ability to take perspective on the consequences of one’s own actions. We introduced a set of basic clinical intervention principles that, when applied in practice, promote three core psychological processes that foster engagement with values-consistent behaviors and collectively offset the tendency to engage in rule-following and avoidance: 1) openness to and acceptance of distressing inner experiences; 2) awareness and perspective-taking that lead to better objective assessment of the workability of behaviors; and 3) strengthening the connection between personal values and action tendencies in the world.