Many individuals walk into therapy feeling broken, weighed down by years of unworkable coping strategies and societal messages that only reinforce their suffering. But the truth is, people are not broken; they are simply trapped in patterns of behavior that no longer serve them. When individuals continue to follow unworkable rules—no matter how strongly those rules are promoted by their culture or reinforced by past experiences—their coping strategies will fail, and distress will persist.
Identifying Unworkable Rules
The primary goal in these cases is to help clients identify the rules they are following and recognize the unworkable outcomes that result. This applies equally to a person with no history of mental health issues who is coping with a divorce by numbing the pain with alcohol, as it does to a survivor of childhood sexual abuse who has spent a decade battling addiction. Neither individual is "broken" in the sense of having irreparable personality damage. Rather, they are both pursuing the same agenda: trying to control painful emotions, thoughts, or memories using strategies that ultimately create more suffering.
The implication of this stance is powerful: everyone has the ability to learn how to step back from unworkable rules and adopt a different, more effective approach.
History Gets in the Way
People suffering often build elaborate explanations of their struggles, weaving together past events to make sense of their current distress. In Acceptance and Commitment Therapy (ACT), rooted in Functional Contextualism (FC), we have a guiding phrase: "The most dangerous thing about your past is that it is about to become your future."
Unlike traditional therapeutic approaches that emphasize dissecting history, ACT focuses on what the client is doing now, in the present. This doesn’t mean history is irrelevant; rather, it means that only the aspects of history that show up as barriers to living a vital life are the focus. This ties directly into the 'Three T’s and Workability Questions'—Time, Trigger, Trajectory, and Workability—providing a practical framework for examining the present influences of past experiences.
ACT interventions often deliberately bring clients’ problematic histories to the surface, allowing them to be addressed and reframed. From this perspective, history is something to live with, not live by. It provides knowledge and insights, but it can also hinder growth if handled improperly. Personal history contributes to our intelligence and understanding of the world, but it can make us "dumb as stones" when used to justify or reinforce unworkable patterns.
Turning the DSM-IV Upside Down and Emphasizing Functionality
In ACT, the emphasis is on life functioning rather than the number or type of symptoms presented. Quality of life is determined by footprints—where people are actually going in life—not by what’s going on between their ears. Imagine flipping the Diagnostic and Statistical Manual of Mental Disorders (DSM) on its head.
Instead of focusing on symptom categories, we start by assessing the client’s functional status. Think of this as a continuum ranging from nonfunctional to highly functional, rather than relying on the unreliable Global Assessment of Functioning (GAF) scale. The client’s ability to move toward a meaningful life, grounded in their values, is the primary concern.
The second most important factor to consider are the stressors challenging the client. Third, we examine the client’s overall health status, including physical health risks, exercise, nutrition, sleep, and substance use. Fourth, we consider the client’s enduring response styles and traits—how they typically respond to various life challenges.
Only after all of this do we consider the client’s symptoms of distress—the Axis I disorders they may have been labeled with. Instead of seeing these symptoms as the core issue, we recognize them as natural consequences of struggling to live a meaningful life while adhering to unworkable rules.
Again…
The message here is clear: No one is broken. They are simply stuck, following rules and patterns that are not workable. When clients can step back from those rules and learn to approach life differently, they can begin to free themselves from suffering. The work of therapy, then, is not to "fix" people but to help them find their way out of the traps they’ve been living in and toward a more vital, fulfilling existence.
This approach integrates principles from Functional Contextualism and ACT, emphasizing that behavior must be understood within its context—historical, situational, and relational. By adopting a practical, present-focused approach, therapists can effectively empower clients to reshape their relationship with their thoughts, emotions, and experiences, ultimately guiding them toward psychological flexibility and lasting change.
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