Magic Act: Transforming Pain into Purpose
In this session, Lou Lasprugato, MFT, and Phillip Cha, MFT, delve into the MAGIC ACT approach for transforming pain into purpose. They explore relationally framed questions, altering contexts of private events, and therapeutic pivots using RFT-based interventions. The session highlights contextual behavioral approaches and strategies for changing symbolic functions to enhance well-being.
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Lou Lasprugato, MFT Phillip Cha, MFT MAGIC ACT MAGIC ACT TRANSFORMING PAIN INTO PURPOSE WITH CLINICAL RFT
DISCLOSURES DISCLOSURES Lou Lasprugato Institute for Health and Healing; provides training events for Praxis Continuing Education; and maintains a private practice in Davis, California Phillip Cha outpatient clinic providing intensive case management services for people living with severe mental illness in San Francisco, California. He also maintains a private practice. No other financial relationships with commercial interests All photos and images used with permission Lou Lasprugato works at Sutter Medical Foundation s Phillip Cha works at UCSF Citywide Case Management, an
MAGIC ACT OBJECTIVES MAGIC ACT OBJECTIVES 1. Delineate the various types of relationally framed questions for evoking a transformation of function in painful private events. 2. Describe how to alter the context of painful private events, in an experientially pragmatic manner, by approaching them with open curiosity. 3. Demonstrate how to therapeutically pivot from pain to purpose through timely RFT-based interventions.
CONTEXTUAL BEHAVIORAL APPROACH CONTEXTUAL BEHAVIORAL APPROACH Experiential Orienting toward, relating to, and deriving from experience Experiential E Pragmatic Responding to what is useful, practical, and/or purposeful Pragmatic P Integrative Approaching language in a cumulative and coherent manner Integrative I Contextual Altering the context to transform symbolic function Contextual C C Adapted from Villatte, M., Villatte, J. L., & Hayes, S. C. (2015). Mastering the clinical conversation: Language as intervention. Guilford Publications.
ALTERING THE CONTEXT TO TRANSFORM FUNCTION ALTERING THE CONTEXT TO TRANSFORM FUNCTION I notice the thought I notice the thought I am anxious I am anxious when I m doing what matters in my life when I m doing what matters in my life Artist: Nate Neal
TWO TYPES OF CONTEXTS TWO TYPES OF CONTEXTS EXTERNAL CONTEXT EXTERNAL CONTEXT (non INTERNAL CONTEXT INTERNAL CONTEXT (symbolic world) (non- -symbolic world) symbolic world) (symbolic world) Experiential (5 senses) Direct, actual, lived experience Non-human animals are good at this Verbal (thoughts, language) Socially and arbitrarily constructed Humans are good at this
RELATIONAL FRAME THEORY (VERBAL/SYMBOLIC CONTEXT) RELATIONAL FRAME THEORY (VERBAL/SYMBOLIC CONTEXT) Through verbal skills, we can learn to relate anything with anything else (symbolically) This behavior of relating leads to categorizing, comparing, problem-solving, and other abilities that can be a curse and a blessing given its arbitrary nature Various forms of relating (or relational framing ) have been identified in research with humans
TYPES OF RELATIONAL FRAMES TYPES OF RELATIONAL FRAMES COORDINATION Sameness / similarity COMPARISON More-less / better-worse DISTINCTION / OPPOSITION Different from / Opposite of HIERARCHICAL Class membership COORDINATION CONDITIONAL Cause-effect / if-then SPATIAL Near-far / front-back TEMPORAL Before-after DEICTIC I-you / here-there / now-then CONDITIONAL COMPARISON SPATIAL DISTINCTION / OPPOSITION TEMPORAL HIERARCHICAL DEICTIC Those skills are the source of our greatest human achievements and of much of our misery. Hayes, 2017
TRAINED VS DERIVED RELATIONS TRAINED VS DERIVED RELATIONS Transformation of Symbolic Function Arbitrarily Applicable Relational Responding Not good enough trained derived
CLINICAL RESEARCH ON EFFECTS OF RELATIONAL RESPONDING CLINICAL RESEARCH ON EFFECTS OF RELATIONAL RESPONDING Gil-Luciano, Ruiz, Valdivia-Salas, & Su rez-Falc n. (2017). Promoting psychological flexibility on tolerance tasks: Framing behavior through deictic/hierarchical relations and specifying augmental functions. The Psychological Record, 67(1), 1-9. Moran & McHugh. (2019). Patterns of relational responding and a healthy self in older adolescents. Journal of Contextual Behavioral Science. Murthy, Villatte, & McHugh. (2019). Investigating the effect of conditional vs hierarchical framing on motivation. Learning and Motivation, 65, 33-42. Carpenter, K. M., et al. (2016). Derived relations moderate the association between changes in the strength of commitment language and cocaine treatment response. Experimental and clinical psychopharmacology, 24(2).
More of this research is needed to improve the efficacy of clinical interventions targeting derived relational responding as a mechanism of behavior change. LANGUAGE AS INTERVENTION: GOING FORWARD LANGUAGE AS INTERVENTION: GOING FORWARD Villatte, M., Villatte, J. L., & Hayes, S. C. (2018). A reticulated and progressive strategy for developing clinical applications of RFT.
FROM PAIN TO PURPOSE: CONDITIONAL FRAMING FROM PAIN TO PURPOSE: CONDITIONAL FRAMING If you could make room (create some space) for this pain, what would that enable you to do that matters in your life? NOTE: conditional relations are present in many of the examples on the following slides Contextual cues: if/then ( what would )
FROM PAIN TO PURPOSE: COORDINATION & COMPARISON FROM PAIN TO PURPOSE: COORDINATION & COMPARISON What might this pain be revealing that you care about (that s important to you) here? Is the pain more or less present when you re doing something meaningful?
FROM PAIN TO PURPOSE: DISTINCTION/OPPOSITION FROM PAIN TO PURPOSE: DISTINCTION/OPPOSITION How would your life be different if you were willingly open to having this pain? If pain was on one side of a coin, what would be on the opposite side that s important to you?
FROM PAIN TO PURPOSE: TEMPORAL & SPATIAL FROM PAIN TO PURPOSE: TEMPORAL & SPATIAL What have you learned from past experiences with pain like this that could be helpful now? If this pain was on the outside protecting something precious on the inside, what might that be?
FROM PAIN TO PURPOSE: DEICTIC & HIERARCHICAL FROM PAIN TO PURPOSE: DEICTIC & HIERARCHICAL Ten years from now, you re looking back, what would you want your life to have stood for in the presence of this pain? How could you use this pain in the service of something greater, to enrich your life in some meaningful way?
FROM PAIN TO PURPOSE: COMBINING FRAMES FROM PAIN TO PURPOSE: COMBINING FRAMES There are two worlds: one in which you ve never known this pain, and the other where you know it intimately well. Someone you deeply care about (child, etc.) experiences this pain for the first time, and reaches out to you for understanding and support - which world would you choose? Kelly Wilson (printed with permission)
FROM PAIN TO PURPOSE: EXPERIENTIAL EXERCISE FROM PAIN TO PURPOSE: EXPERIENTIAL EXERCISE Image: pixabay.com
EXERCISE: SKILL EXERCISE: SKILL- -BUILDING BUILDING Objectives: 1. Facilitate contact with painful private event 2. Model and evoke openness and curiosity 3. Select, augment, or add purposeful functions via relationally framed interventions Format: Portland-style quads (or triads) 10-min real-or-role plays with 5 min debrief
SKILL SKILL- -BUILDING ROLES BUILDING ROLES Skill-Builder (Therapist) Experiment with RFT-based interventions (from hat or created) to transform function of private events Assistant to Skill-Builder Available as support (reference cheat sheet) Case Presenter (Client) Presents NON-challenging case in the service of Skill-Builder s learning (NOT to solve case) Monitor/Observer Notes interventions and transformations
SKILL SKILL- -BUILDING TIPS BUILDING TIPS Take off competent clinician hat Treat exercise as an opportunity to experiment and learn from each other Embody flexibility and sensitivity Modify questions to client and context Watch for pauses following interventions Contemplation often precedes transformations Continue shaping integration of pain & purpose
In some ways, suffering ceases to be suffering at the moment it finds a meaning, such as the meaning of a sacrifice. Viktor Frankl Image: Lance Lang
