Section 3: ACT intervention to reduce stigma of mental illness

Activity 2.4.2. Label exercise

ACT Processes:

  • Defusion
  • Self-as-Context

Objectives:

  • To promote increased understanding on the effects of words and language on our sense of being;
  • To support participants in recognizing that detachment from words and language is possible;
  • To support participants in realizing that our personal fears and self-criticism may be similar to others; and
  • To provide an opportunity for participants to experience some freedom of action despite their previous or current reservations related to a sense of shame, guilt, anxiety, and self-stigmatizing thoughts.

Participation Format:

  • Participants sit in a large horseshoe; co-facilitators sit across from each other at the open end of the horseshoe.
  • Participants work independently in this activity

Number of Facilitators:

  • 2

Time Required:

  • 35 mins
    • Part A – 15 minutes for instructions and guided activity; participants carry out this activity during lunch break (40 minutes).
    • Part B – 20 minutes for large group debriefing after lunch.

Materials Required:

  • Small notepads or paper, and pens
  • Adhesive labels (1 per participant) and several markers shared by participants

Activities & Instructions


Setup
  • Arrange all the chairs in a large circle.
  • Co-facilitators sit apart from each other to enhance integration with participants.
Instructions for participants

Part A

  • Facilitators give each participant an adhesive label.
  • Facilitator #2: “During lunch time, we are going to do an activity called the label exercise.”
  • Facilitator #2 continues, “As we have talked about in previous activities, words are very powerful in keeping us stuck in believing and behaving in certain ways that do not promote our wellbeing; for example, judging ourselves and others harshly, avoiding certain actions or interactions with others, etc. But what is important for us to know is that we can break free from the restrictions imposed on us by words or our thoughts no matter how powerful these words may come across. So in this exercise, you have an opportunity to challenge yourself to face some of these words.”
  • Facilitator #2 continues, “We now invite you to think of 3 words to describe what you do not like about yourself, and write them down on your notepad. For the first word, write down one negative adjective that you feel quite comfortable to share with others. For example, you may share this easily as your weakness on a job interview and you feel quite ok to share it with everyone here. For the second word, write down one adjective that is more stigmatizing and more difficult to share with others. It is something that you may or may not share with others. For example, you may have a 50-50 chance of talking about it with others today. For the third word, write down one adjective that you feel is most stigmatizing and impossible to share with others. You are probably never going to talk about it with anyone here. We will not ask you to hand in your sheet of paper, and if you are worried that others may peek, you can even write these words in tiny hard-to-read hand-writing and scribbles.
  • Facilitator # 2 continues after participants are done, “We have given each one of you a label. Choose one of your 3 words, write it on the label with a thick marker we are passing around, and stick it to the front of your chest right underneath your nametag. You will be wearing this label throughout lunch time. Here is an opportunity for you to challenge one of these words. See if you can write down one of the more difficult words – if you are willing to do so. Gauge for yourself which one will be right for you to share at this moment.”
  • Facilitator #2 continues, “During lunch time, each one of us is free to look at others’ labels, but we will not make any comment on others’ labels. You cannot ask others about what the word means or why they chose that word. You also do not need to reassure others. Do not make any comment on our own label either. There is no need to explain why you wrote your chosen word down. Just wear the label and go about having lunch, talking with each other, but without commenting on any of the labels.”
  • Facilitators check to see if participants have any questions about the label exercise. Participants put their labels on and then take part in lunch. The facilitators need to also do the same – having a negative adjective on a label on their own chest.

 

Part B

  • After lunch, participants return to sitting in a large circle.
  • Facilitator #1 debriefs the exercise by asking participants to share their experience in doing the label exercise:
    • How easy or difficult was it for you to find the three adjectives to describe yourself?
    • What helped you to decide which label you will wear on your chest?
    • After putting the label on, what was it like for you? How did it change over time?
    • What was it like for you when you looked at others’ labels, or when others looked at your label?
    • Do you feel that you identify with some of the words that are on others’ chests?
  • Facilitator #1 concludes the sharing and debriefing by highlighting that “We all struggle with our own words and labels, and in fact, we may even share in struggling against some of the same terrorizing words. Words or labels may appear to be powerful in making us feel stigmatized, embarrassed, ashamed, anxious, or guilty if we take these labels seriously. We may feel that we need to hide this from ourselves or others, or we may need to work so hard at changing them, as if we are not acceptable to ourselves or others. However, if we recognize them for what they are – just labels and words, then we have the opportunity to get unstuck from these internal rules and thoughts and not let them bully us or scare us. We can cultivate more acceptance of ourselves and others. We are not our labels.”

References & Sources

  • Adapted and modified from: ACT Experiential Workshop with Steven Hayes, Philadelphia, 2005

License

Icon for the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License

Acceptance and Commitment Training (ACT) for Mental Health Promotion Copyright © 2024 by Kenneth Po-Lun Fung, Josephine Pui-Hing Wong is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, except where otherwise noted.

Share This Book