I have an ACT psychologist with three books coming out this year. If it weren't for him, ACT would seem Sadistic. All the workbooks of ACT that I have used are great in theory, but there is something missing in the written works: compassion for yourself. ACT comes across as "Just suck it up and do it anyway." It doesn't give very good resources for managing the pain of depression, PTSD or fibromyaglia. I do love that there is a focus on my values for MYSELF, without any therapist's secret agenda forced on me, and so the therapy is focused on what I value and who I want to be, not my diagnosis. That's ACT's strength. The value and goal focused work is wonderful. The acceptance is great too, but if you did a DBT day program for a week or read an article on Buddhism, you already learned radical acceptance. Unfortunately, ACT in workbooks always comes across as harsh and unsympathetic. My psychologist also agrees - He teaches ACT at a psych grad school and the students even think it sounds cruel, like you just force people to do what makes them feel awful.
If you have a real ACT therapist, not just a workshop attendee or book reader, ACT is great, because the "Just do it" message of ACT gets toned down with human kindness.
The hopeful part of ACT - and this is why in partnership with self compssion work - is that it allowed me to live a life in spite of having severe PTSD. Instead of the epic wait most of us with any diagnosis do - searching for the CURE so we can be people again - ACT gives the tools to be a person who has a diagnosis that may or may not get worse or get better. It doesn't fix the diagnosis, it focuses on the person. For someone who has been a DSM4 diagnosis most of her life, that is awesome.
So I bought this book with my new diagnosis fibromyalgia. This books seems very out of date about pain management. Yeah, some drugs are given to me, but all my allopathic doctors suggest acupuncture, meditation, tai chi, yoga, swimming, relaxation, body work, trigger point physical therapy, diet change, and so much more. No one today thinks that FM can be solved with drugs alone - There's massive life style changes and different treatments done in conjuction with the medications. So the first section about how all pain medication cannot help you and you're doomed if you rely on the medical treatments is very scary to read and very very wrong. There are treatments that can help, unfortunately with something as weird as FM, you have to do hit and miss for a long time til you find them, and since each day is different, you have to be very flexible with your life plans.
One key thing with FM is PACING. Listening to the pain so you know when you're overdoing or underdoing it, which is a skill I have not yet begun to master.
However, if I were to just go by this workbook I'd be forcing myself to do everything no matter what my pain level. I'd be creating a lot of unnecessary sufferings I could have avoided. In the cognitive therapy world, like DBT and ACT, avoidance is seen as something horrible. That led me to a nervous breakdown when I did the DBT and ACT treatments for fear which is to approach everything that scares me and never let my terror control me. ACT really seems far too all or none in this way. Without a very well trained psychologist this really comes across as "no matter how much it harms you, don't be a wuss and do it!"
This book could have been so much better if it intergrated all the treatments for pain management into it instead of having two pages of why medicine won't help you. If it showed more respect for the need to listen to your pain, to pace yourself, to avoid things that make you worse, I'd give it 5 stars. But if I were to follow this book I would be doing things that could literally kill me. I'd be in much more pain. There are a lot of things I have to avoid for a higher quality of life and other things I cannot physically do or I might die. To ignore that is insanity. The need for honoring the pain, not seeing it as a MONSTER, as ACT tells us to, is the healthier way to live. I am not going to battle with my pain. I am not going to chose an either/or attitude rigid dogma about how I must live.
This book is far too simplistic, very outdated, and eally doesn't understand pain management techniques. Yes, pain doesn't have to rule and ruin your life (not totally), but it also needs to be respected. You have to take care of yourself with rest, solitude, and learning to say NO to doing things, the hardest part for FM folks. It makes no sense for me to do things I know will cause a flare.
Dangerous unless you have an ACT therapist who is highly trained in doing this work without it feeling like a drill sargent demanding that you listen to him and not yourself. It caused me so much anxiety, I want to burn it. The worst ACT workbook on the market, which says a lot. ACT is a great therapy, and has horrible workbooks because it just cannot be understood by reading it. It'll be interesting to read the workbooks my psychologist has coming out this year and see how he avoided this problem, one that he himself says is the main problem with ACT.