Learning Objectives:

• To weaken the literal meaning of stories and rules among participants
• To weaken the perceived barriers to more effective action among participants; and
• To encourage greater flexibility towards action among participants

Materials: Scrap paper and pens, a mindfulness bell, a watch/clock for timing, Handout 1.8.1 – Cognitive Defusion Techniques

Time Required: 45 minutes

Activities & Instructions

Setup:

• Participants work in pairs. Participants move their chairs around to get into pairs, facing each other directly.
• Co-facilitators walk around to observe the interactions in different pairs.

Instructions To Participants

1. Attentive Listening in Paired Sharing

Facilitator says,

• “The next activity we are going to do is sharing stories. As we talked earlier, thoughts, feelings and labels can have a powerful hold on us when we are fused with them. We invite you to take a moment to think about one thing that you dislike about yourself, or a difficult area or experience in your life. Write a few words about this thought on a piece of paper.” (Pause for a minute to let participants write down their thoughts)
• “We would like you to get into pairs. You can move your chairs around, so each pair has some space to engage in sharing. We invite you to sit face to face as close to each other as you feel comfortable.” (Pause until each pair has settled in their space.)
• “I will explain the activity first and then we will do it. In each pair, one of you will be the storyteller and the other person will be the listener. The storyteller will speak for 2 minutes while the listener listens. Then you will hear a bell. We will take a one-minute break, and we will then ask you to switch roles, so that the listener will become the storyteller and speak for 2 minutes while the other listens. Decide who will be the storyteller first. Storytellers, raise your hands so that we know that each pair is clear on who is going first.”
• “When it is your turn to speak, we invite you to tell your partner a story about something you do not like about yourself, or a difficult area or experience in your life. Share with him/her/them the suffering you have experienced. Share what you have written down about yourself. When you are the listener, your role is to listen without making any comment, gesture, or response, no verbal or non-verbal responses. You do not need to provide counselling or advice. Just maintain eye contact and listen attentively and compassionately.”
• “To guide you along, I will be ringing the bell to prompt you about what to do next, so you do not need to remember all these steps. Any questions before we begin?”
• Facilitator rings the bell to start one-minute of silence by saying, “Let’s begin the exercise with a minute of silence. See if you can just connect with your partner in front of you with your gentle gaze… Look at each other with compassion and appreciation, but do not make any comment, gesture or response. No nodding, no “hi ha”, etc.” (Designate the co-facilitator to help with keeping time.)
• Facilitator rings the bell to begin a two-minute of sharing by saying, “The first person to share can now tell your story to your partner – what you don’t like about yourself, how you struggle to change it, and how it affects you or other people.”
• Facilitator rings the bell to begin another minute of silence by saying, “Now let’s have another minute of silence and reconnect with each other. One of you just shared something personal. Let’s look at each other mindfully and honour each other with appreciation and compassion.”
• Facilitator rings the bell to begin a two-minute of sharing by saying, “Now we will switch roles. The second person to share can now tell your story to your partner – what you don’t like about yourself, how you struggle to change it, and how it affects you or other people.”
• Facilitator rings the bell to mark the final minute of silence by saying ,“Now let’s have a final minute of silence and reconnect with each other. Both of you just shared something personal. Let’s look at each other mindfully and honour each other with appreciation and compassion.”

2. Paired Singing:

Facilitator says,

• “We are now ready for the second part of the exercise! We will be doing something very similar to what you have just done. In the exact same sequence as before, we will ask you to connect with each other for a minute, followed by 2 minutes of sharing by the first person, then a minute of reconnection, switch roles for the other person to share for 2 minutes, and end with a final minute of reconnection. You will use the same story and even pretty much the same words. The only difference is that in sharing your story, we would invite you not to speak the story but to sing it. ‘You – can – sing – it – to – any – tune – you – like’ (facilitator role models by singing this sentence). You can pick any song or tune you like. You can even use the most common songs, e.g., children songs, birthday song, national anthem, etc. You may also rap. This is not a singing contest, but simply try sharing your story in a different way — a way that you would seldom use. We would encourage you to try singing it or rapping it! If you are really really stuck, you can also try retelling the story in an altered voice, e.g., imaginary cartoon character’s high-pitch voice … or recite this story like an epic and ancient poem… or like a news anchor on TV, telling the story in the third-person… Any questions about this? ….Ready? Let’s start.”
• Facilitator rings the bell to start one-minute of silence by saying, “Let’s begin the exercise with a minute of silence. See if you can just connect with your partner in front of you with gentle gaze… Look at each other with compassion and appreciation…”
• Facilitator rings the bell to begin a two-minute of singing by saying, “The first person to share can now sing your story to your partner!”
• Facilitator rings the bell to begin another minute of silence by saying, “Now let’s have another minute of silence and reconnect with each other. Let’s look at each other mindfully and honour each other with appreciation and compassion.”
• Facilitator rings the bell to begin a two-minute of singing by saying, “Now we will switch roles. The second person to share can now sing your story to your partner!”
• Facilitator rings the bell to mark the final minute of silence by saying, “Now let’s have this final minute of silence and reconnect with each other. Let’s look at each other mindfully and honour each other with appreciation and compassion. As this is the final step of this exercise, and this may be your only chance to have this opportunity to connect with your partner in this particular way in this particular moment, see if you can really treasure this final minute of connection with one another.”
• Facilitator closes the exercise for debriefing by saying, “Now please thank your partner. Let us get back into the large group for debriefing.”

Debriefing Questions

Facilitator asks the participants after they regrouped into the large group:

• “What was this experience like for you?”
• “Did you feel any difference between telling your story and singing your story?”
• “How did singing your story change the experience of telling the story for you?”
• “Did singing your story change the way you felt about the negative thought or experience you were sharing from when you were talking about it?”

Key Summary Points

• Internalized rules and stories that are about HIV or other stigma, or those that are about who we are, what is wrong with us or others, etc. can be powerful ideas and thoughts that influence our behaviour, especially when we are unaware of their influence and take them for granted as the reality or as unbreakable rules that we have to follow. (Fusion)
• We can free ourselves from fusing with these arbitrary rules by treating them as what they are – words and thoughts and stories – and use different ways such as singing to loosen their grip on us. We sometimes call this ‘defusion’ – which means getting unstuck from our thoughts. We do not have to take our thoughts so seriously. It is the opposite of ‘fusion’ – or getting stuck with our thoughts – even when it is harmful to us or others.
• Today we explored singing to each other about our stories. There are many other ways we can practice “defusion” – seeing our thoughts as thoughts, no matter how “true” they seem. (Take-Away Activities 1.8.1.) It would be great if you can try out some of these other methods at home too.
• We can learn to see and appreciate ourselves for who we are as human beings and not our labels or stories, just as we can learn to look at others compassionately as fellow human beings, and not as their labels or stories we hear.

Sources:

• Fung, K. P., & Zurowski, M. (2011). ACT protocols for CHAMP Study. Toronto, ON: Community Alliance for Accessible Treatment.
• Inspired by the idea, Create A Song, in , S. C., & Smith, S. (2005). Get out of your mind and into your life (pp.80). Oakland, CA: New Harbinger Publication, Inc.

Handout 1.8.1 – Cognitive Defusion Techniques

These are some techniques to help us “defuse” from our thoughts – to see thoughts as just thoughts – nothing more and nothing less – rather than being trapped and dictated by our thoughts.

1. The Mind: Treat “the mind” as an external event, almost as a separate person, e.g., “Well, there goes my mind again” or “My mind is worrying again”.
2. Thought Labelling: Label your thoughts as thoughts, e.g., “I am having a thought that I will not be able to champion any change”) or label the type of thought, e.g., “I am having a judgment that my illness is too terrible to have,” or “I am having a prediction that people will not listen to me”, etc.
3. Get off your “But”!: Replace “but” with “and”, e.g., “I would like to speak out on stigma, but I may get nervous” becomes “I would like to speak out on stigma, and I may get nervous”.
4. Use a variety of vocalizations: Say the thought very slowly, say it in a different voice, sing it, etc.
5. Thank your mind: Thank your mind when you notice it butting in with worries and judgments, e.g., “Thank you mind. You’re doing a great job of scaring me today”. This is not sarcasm…after all, the mind is doing exactly what it was designed to do all of those thousands of years ago- “problem solve” and avoid danger.
6. Say the thought out loud quickly and repeat it until it loses its meaning: e.g., I’m useless, I’m useless, I’m useless, I’m useless, I’m useless, I’m useless, I’m useless, I’m useless, I’m useless, I’m useless, I’m useless,……
7. Imagine that thoughts are like Internet pop-up ads:

• A ringing cell phone you can’t turn off, e.g., “Hello. This is your mind speaking. Don’t do too much because you are going to regret it”, etc.).
• Clouds floating across the sky.
• Leaves floating down a stream. You don’t have to dive in. You can watch from a bridge.
• A waterfall. You’re standing behind it, not under it.
• Guests entering a hotel. You can be like the doorman: you greet the guests, but you don’t follow them to their rooms.
• Actors on a stage. You can watch the play; you don’t need to get on stage and perform.
• A passing parade. You can watch the floats pass by. You don’t have to climb on board.
• Suitcases dropping onto a conveyor belt at the airport. You can watch them pass by, without having to pick them up.

8. Buying thoughts:
   Distinguish between thoughts that just occur and the thoughts that are believed – that you “buy into”, e.g., “I guess I’m “buying” the thought that I’m hopeless”).
9. And how has that worked for me? When you are buying a thought, back up for a moment and ask yourself, “How has that worked for me?” and if it hasn’t worked ask, “Which should I be guided by, my mind or my experience?”
10. Create your own defusion strategy!