Full Title: Values in Therapy: A Clinician’s Guide to Helping Clients Explore Values, Increase Psychological Flexibility and Live a More Meaningful Life
Summary: Exploring values in therapy helps clients connect with what is meaningful to them. Valued living involves translating values into actions for a consistent and sustainable life. Therapists guide clients to make choices aligned with their values for a more fulfilling life.
In those cases, having our behavior guided by those thoughts and feelings may take us down a very different path, one that may not be consistent with how we would ideally choose to behave. Thus, it can be helpful to have a more reliable guide than our momentary thoughts and feelings, something that helps us see the bigger picture of who we want to be in our lives. Values provide that guide. While our thoughts and feelings are largely out of our control and change rapidly from moment to moment, our values tend to be more consistent and thus can provide a more reliable guiding beacon even during turbulent times. (View Highlight)
Nearly every time I interacted with her, I wanted to get away from those painful feelings and thoughts, which would also mean getting away from her. Pausing to connect with my values, which include qualities of patience, commitment, and com- passion, allowed me to remain consistent with these values, even when what I felt like doing was running away. In addition, what made that pause useful was that it had that quality of free choice to it that I identified earlier as an essential component of values. In those moments I wasn’t scolding myself about what I “should” do. Values aren’t shoulds, and such scolding would have just been adding more aversives to an already painful situation. Instead, in the pause I was bringing the reinforcing properties of values into that painful moment so that I could choose something I wanted (the “stinky cheese” of caring compassionately and patiently for this little critter that I had loved for nearly twenty years) rather than only focusing on what I didn’t want (the “shock” of fear and sadness at her impending death). (View Highlight)
Values also provide consistency in that they can serve as a kind of verbal glue that
links our actions and goals together to create a larger whole. Instead of life being a series of disconnected moments or accomplishments, values can be seen as part of a larger pattern or purpose. Each valued action is like a link in a chain or a key part of the plot of an important story. This connection to a larger context can help with the motivation to continue the valued pattern. It provides a kind of robustness in the face of momentary thoughts, feelings, or urges. (View Highlight)
Values also provide consistency in that they are, arguably, an inexhaustible source of motivation. This can be contrasted with motivation based on aversive control
strategies. Have you ever walked out of a doctor’s office swearing that you’re going to lose weight/eat better/floss your teeth more? I certainly have! In those times, our moti- vation is usually based on fear or shame or some other unpleasant feeling. (View Highlight)
But she was doing it through aversive control strategies. Many of our clients try to motivate themselves using such strategies. When it fails, they often conclude that they didn’t have enough motivation and increase the self-reprisals or fear or whatever their aver- sive of choice is, hoping that will do the trick. Values provide a more compassionate alternative, and, based on data from mediational analyses of ACT, a more effective strategy when it comes to sustaining behavior change (View Highlight)
Human life involves action, purpose, pursuit, direction, and an orientation toward doing something that matters. We don’t just act randomly. We don’t react based only on instincts. No, much of what we do has purpose. And we yearn for meaning, for a sense that our actions have a purpose that goes beyond just this moment, this person, and this situation. (View Highlight)
Placing values at the heart of therapy means we are putting what is most important at the forefront of our work. It clarifies the purpose of the work we do. By orienting our work around values, we help our clients connect with what is most meaningful to them even in the midst of their suffering. (View Highlight)
But we also know that a life worth living is about more than just alleviat- ing symptoms or reducing suffering. Grounding the work that you are already doing in values allows you to also address these bigger issues of meaning and purpose. Thus, even though you still may be using many of the same interventions, values can offer a different “why” to guide your work. (View Highlight)
It often takes a crisis or significant loss to make us stop the autopilot of our lives, focus on what really matters, and live life with vigor. But what if it were possible to live with that kind of clarity of purpose and values without something terrible needing to happen? No, I’m not talking about ending every day with a big slice of German choco- late cake or giving up your career to spend every moment with your dog. What I am talking about is living with the intentionality that often only comes to us in times of crisis. (View Highlight)
Living a values-based life is about living with intention, consciously choosing to live out a well-lived life, whatever that means for you personally. We don’t know how many breaths we have left to breathe or how many “I love yous” we have left to say. All we know is that it is fewer than we had yesterday. Living a values-based life is about making the most of each of those breaths in this one life we know we have to live. (View Highlight)
values as how you are living when you are living a meaningful life. (View Highlight)
this chapter will leave the technical definitions aside and instead focus on some of the main qualities and features of values that are important to keep in mind as you do values work. This includes the following: 1. Values are behaviors. They are ways of living, not words.
2. Values are freely chosen. They are not the result of reasoning, outside pres- sure, or moral rules.
3. Values are life directions, not goals to achieve. They are always immediately accessible, but you’ll never complete them.
4. Values are about things you want to move toward, not what you want to get away from. (View Highlight)
Values are the ways of living and being in this world that are important and meaningful to you. They are ongoing patterns of action. There is no “value” in the absence of action.
One way to talk about values is to say that they are a combination of verbs and adverbs, rather than nouns. They describe what you are doing (verb) and how you are doing it (adverb). Caring (verb) for sweet old Dalai committedly and compassionately (adverbs) was what was meaningful to me, and thus my “value” was shown through the quality of my caring in a committed and compassionate manner. (View Highlight)
Values aren’t about words. They are found in watching what people actually do with their lives, where they invest their time, energy, and focus. The goal of exploring values in therapy is to help build a person’s ability to contact and experience the p atterns of living they might choose. (View Highlight)
If values are qualities of action, then you could describe valued domains as being the arena in which those values are enacted. Valued domains are broad categories or areas of living that many people find to be important, though individuals differ in terms of how important each domain is to them. (View Highlight)
When doing values work with clients, especially in the initial phases, it can often be helpful to focus your exploration within one or two high-priority valued domains. Because values tend to be relatively consistent across domains, exploration of values in one domain will likely provide useful information about what that individual would choose to value in another domain. (View Highlight)
You can also describe values as being the direction you want your behavior to
move you toward. Like a compass, values provide you with a consistent sense of direction for your life. Values are not a destination, an outcome, or some goal to achieve. They are the direction you choose for your journey. As guiding directions, values are always immediately available and inexhaustible.
If you have chosen to head east, the great thing is, no matter where you are, east is always there. You don’t need to get anywhere else or have anything be different in order for you to turn toward east. At the same time, no matter how far east you go, you will never get there; you’ll never reach “east.” As long as you have a journey in front of you, there is always more east you can move toward. This allows life to have purpose and meaning in the here-and-now, rather than always looking toward some future accomplishment or milestone to offer that meaning. If values are directions, goals are milestones to reach or things that can be accomplished or obtained. Ideally, values establish the direction you want your life to head and goals serve as markers to help you navigate and let you know whether you’re still on course. Goals are helpful to orient us, but they are not the point of the journey. Applied to the therapy context, it is values that guide the therapy, and only after that direction has been established do we move on to selecting workable goals that might move our client toward their chosen direction. (View Highlight)
Values allow for more flexibility than goals. To continue with the analogy of values as directions, there are many goals that would take us east. For example, if you were in California, you could head east by setting a goal to go to New York. But if, along the way, the roads to New York became blocked by a massive snowstorm, you could con- tinue on your journey east by shifting goals and heading to Florida instead. Your life’s direction has not changed. But if you were only focused on the goal of getting to New York and lost the ability to go to New York, then you’d be stuck. In this way, a life that is guided by values is more flexible and helps us pivot as needed when the inevitable curveballs of life come our way. (View Highlight)
Values don’t depend on outside consequences, circumstances, or situations to work; they are the end in and of themselves. In contrast, behavior focused on outcomes (goals) often has a more instrumental quality—it’s more of a means to an end. A goal such as working to obtain money or dressing a certain way in order to be admired by others often functions as a means to an end, rather than something important in and of itself. Ultimately, a life filled with behavior that is experienced as a means to an end often ends up feeling empty and unsatisfying. (View Highlight)
Harry, there’s two kinds of tired. There’s good tired and there’s bad tired… Ironically enough, bad tired can be a day that you won. But you won other people’s battles; you lived other people’s days, other people’s agendas, other people’s dreams. And when it’s all over, there was very little you in there. (View Highlight)
when you hit the hay at night, somehow you toss and turn; you don’t settle easy… Good tired, ironically enough, can be a day that you lost, but you don’t even have to tell yourself because you knew you fought your battles, you chased your dreams, you lived your days and when you hit the hay at night, you settle easy, you sleep the sleep of the just and you say ‘take me away’… Harry, all my life I wanted to be a painter and I painted; God, I would have loved to have been more successful, but I painted and I painted and I’m good tired and they can take me away. (View Highlight)
Living a life in line with our own, personally chosen values, rather than pursuing others’ goals that may not be connected with our values, gives our life honor, meaning, and purpose. That is the well-lived life that ends with good tired. (View Highlight)
In sum, by keeping our primary focus on values, rather than being overly attached to specific goals, therapy (and life) becomes more flexible, workable, sustainable, and just plain rewarding. For all these reasons, in values-guided therapy, the emphasis is on the journey (the value), not the checkpoints along the way (the goals). The goals we set with our clients need to be flexible and responsive to their values, not set in stone as inherently “good” things in and of themselves. (View Highlight)
José and I took a different, values-based tack. What if the problem wasn’t that he couldn’t find a wife? What if the thing that was resulting in José’s despair was that he was not living out his values in the here-and-now with the life and people he had in front of him? He was so focused on getting someplace else that he didn’t even realize he was treating the women who were in his life right now in a way that was very incon- sistent with his stated values, which resulted in him not being proud of the man he was being. We shifted focus from the goal (getting married and having kids) to the value (caring lovingly). José and I worked together on identifying how he would be living his life now if he were being that loving person he would like to eventually be to a wife and children. “Loving,” or more precisely, relating to others in a loving way, became the direction his life was heading in. (View Highlight)
Rather than dating being solely a frustrating means to an end, it became a life-affirming way to live out who he most wanted to be in his present, non- ideal circumstances. Every date, no matter whom he was with, became an opportunity for him to live out his core values now. His focus shifted from some future destination he just couldn’t seem to reach, to a journey he could live on a daily basis, regardless of whether or when “Ms. Right” did eventually show up. While he still hoped that someday a wife and children might also be part of his path, they were no longer a pre- cursor to him living the “loving” life he wanted to live. Living his valued life now gave him a sense of purpose and honor to each day, as each day became part of being that loving man he felt was his life’s mission to be. (View Highlight)
There are also some other key characteristics of values that are worth highlighting. For one, they are experienced as freely chosen by those who hold them; also, they are appetitive—that is, they are what people are drawn to moving toward rather than focused on moving away from. (View Highlight)
A core characteristic of values is that they are experienced as being freely chosen. Similar to what Harry Chapin’s grandfather was speaking of in the story above, it is essential that people connect with the values that they would take personal ownership of, that they would stake a claim to as being their values. Values, from this perspective, are not chosen based on “shoulds.” They are not mandated by some external entity (such as a person, government, religion, or advertising agency) as being the “right” values to choose. In this way, values are distinct from what we usually think of as “morals.” Morals are “standards of behavior or beliefs concerning what is and is not acceptable for them to do” (Oxford Dictionary, n.d.). (View Highlight)
In contrast, values follow the immortal words of many a wise mother; they operate on the “just ’cause” principle. Why would I choose to live a life in which I value being loving? “Just ’cause.” It’s my life and I get to choose what would make it a well-lived life for me. I choose loving. (View Highlight)
The way out is to recognize that we need to start somewhere and say that we choose to make something important “just ’cause.” Thus, valuing relies more on things like choosing, creating, assuming, and dreaming than it does weighing out a list of pros and cons (Luoma, Hayes, & Walser, 2017). This doesn’t mean values are haphazard or chosen at random. Hopefully, deep intentionality and reflection go into choosing what we want our lives to be in the service of, which is something that values-guided therapy can facilitate. But what you choose to value can’t ultimately be justified by logical argu- ments or reason. (View Highlight)
“Freely chosen” also means that our choice of values has not been limited in any way, including by our current circumstances, life events, or our histories. The entire array of possible values one might choose to live out is available to everyone at all times. (View Highlight)
There are no life circumstances that can rob us of the ability to live lives of meaning, which I would call values-based lives. Just stop for a moment and think about how powerful that idea is. Values might be one of the few places, possibly even the only place, where we’re all on a level playing field. We all get to choose among all the options when it comes to valued lives, and nothing that has happened or can happen to you can take that away. Just imagine what an incredibly powerful and empowering idea that could be to many of the people we serve! (View Highlight)
Thus, describing values as being “appetitive” simply means that the individual is inherently drawn to move toward values. You don’t need some external reward or prize to sustain valued behavior; connecting with our values is what is rewarding/reinforcing. (View Highlight)
To get less technical, values are directions you seek to move toward rather than being about something unpleasant you are trying to get away from. You can simplify this with clients by talking about the distinction between “toward” and “away” moves (Polk, 2014). “Toward” moves are behaviors oriented around moving toward something you want (including values), whereas “away” moves are things you do in order to get rid of or away from something you don’t want (such as painful thoughts or feelings). (View Highlight)
We can either be focused on trying to get away from something unpleasant—an aver- sive—or moving toward something: an appetitive. One of the things we can explore in our work together is what you want to guide you as you move through this life of yours—the shocks or the stinky cheese? We’ve already talked a fair bit about some of the things you’re trying to get away from, like your feelings of anxiety and thoughts of being worthless—the shocks. But it seems to me that we also need to keep our eye out for your stinky cheese because I’m guessing you don’t want your whole life to be oriented around the shocks. (View Highlight)
Whatever your stinky cheese is will be unique to you, and you haven’t had much of a chance to explore that yet. You’ve been working so hard on getting away from the shocks, and so of course you haven’t been able to focus much on what might be your potential stinky cheese. I don’t know what your specific flavor of stinky cheese is yet either. Figuring that out can be part of what we do together. My word for whatever that stinky cheese in your life would be is “values.” Values are whatever would make for a meaningful, well-lived life. (View Highlight)
the ultimate stinky cheese, is to be able to have said that your journey was in pursuit of what mattered most to you and that that’s what guided how you moved through this world. Would that be something you might be interested in exploring here in therapy with me? (View Highlight)
The appetitive motivation involved in values depends heavily upon language and cog- nition. Language and cognition are the very medium of meaning, purpose, and valuing. Thus, in relation to values, language and cognition can be used strategically to harness and strengthen the influence of certain types of languaging and thinking. (View Highlight)
As just one example of how language and cognition can be constructive when it relates to values, let’s examine how thinking, remembering, and imagining have the ability to bring “there” and “then” into the “here” and “now.” Through language, an imagined future or a remembered past can be experienced as if it were happening right now. (View Highlight)
Language allows you to “taste” the value, which then might affect what you select to do next. Connecting with the bigger picture of what we want our lives to be about shifts what is reinforcing and may even allow us to overcome patterns of behavior related to avoidance or escape that we tend to get stuck in. (View Highlight)
Meaning is one of the curses and benefits of language. Language allows us to ask ourselves questions like, “Does any of this mean anything?” and feel despair. But language also allows us to think about our highest ideals for a well-lived life or remember our greatest heroes and thereby be inspired to rise to the challenge even in the most difficult of circumstances. (View Highlight)
“Life is without meaning. You bring the meaning to it. The meaning of life is whatever you ascribe it to be.” Through values we choose what would, for us personally, be a meaningful life and then, through the process of living out those values, we create meaning. Meaning is constructed in moments when we are connected with what matters, when we are in contact with a life we would define as being worth living (Luoma et al., 2017). (View Highlight)
