Is “because” just as unhelpful as “but”? 

A Contextual viewpoint about causation in Acceptance and Commitment Therapy (ACT)

RFT knowledge guides us in dropping the word BUT and replacing it with AND.  For example, a client might commonly say, “I want to go on holiday, but I get too anxious when I travel.”  This sets up a conditional perspective and reasoning that anxiety being present acts as a barrier to travel.  

Pragmatically, this is an issue because waiting for anxiety to go before you travel will likely lead to long-term avoidance of a desired action.

By replacing BUT with AND, people practice a new way of relating to their experiences and hopes.  They notice that travelling and having anxiety needn’t be enemies; they can be companions.  One can choose to be an anxious traveller!

The word because is often used in ACT-related literature, e.g. in a paper about Process-Based Therapy, it’s suggested that ACT therapists talk in causal ways to their clients.  For example, by saying, “You feel anxiety because you avoid it.”  Such a statement may be consistent with radical behaviourism, i.e., the stimulus, response and consequence three-term contingency tend to describe this process as having a causal nature.

While consistent with a Skinnerian account, it is less so with a post-Skinnerian viewpoint embedded in contextualism.

The Problem of Causation

Contextualism states that the whole is primary.  In other words, although there are parts to a person’s experience, such as thoughts or feelings, you cannot reliably or consistently suggest that a single relating pattern is a cause for something else.  This is also consistent with an Inter-behavioural viewpoint, which sees function as influenced by multiple events, including setting, learning history, actions, etc.  

In other words, using the term BECAUSE to describe a sequence of events can lead to problems for the ACT therapist.  When we speak in causal ways that indicate a simplistic relationship between one event and another, we fail to consider all the other events contributing to what happens next.

By dropping the word BECAUSE, you can sidestep this issue.  Instead, the author recommends replacing BUT and BECAUSE with AND.  For example, you might say to a client, “One of the things we can see you doing is to avoid anxiety, and what you get is anxiety.  The avoidant action contributes to what you get, and if we slow this down for a moment, I suspect we’d notice several other events and actions happening in this context.”  

Becoming a more contextual ACT Practitioner

A practitioner who can operate contextually has a better chance of engaging psychological flexibility as a whole unit than a practitioner who tends to think and intervene more mechanistically.  A practitioner more influenced by the latter may subtly reinforce meaning that indicates simple cause and effect.  Doing so can increase the risk of adding coherence to a network that steers a person toward inflexibility. 

For example, a client whose dominant self-view is “I am incapable” may naturally avoid situations that risk feeling anxious.  If we take a Mechanistic viewpoint, then we may think, “Seeing yourself as incapable causes you to avoid anxiety-provoking situations.”  Therefore, once you can be more flexible in your self-related perspective-taking, you may be able to start approaching anxiety-evoking stimuli.  If the client’s learning history indicates significant coherence with the viewpoint “I am incapable”, they will be unlikely to behave in ways inconsistent with that identity.  Together, you and your client expect the one change to work. 

However, one cannot accurately predict what will happen.  You may have different results if you compare this intervention with two clients, each dominated by the “I’m incapable” self-narrative.  For one person, it may lead to multiple changes in the context that allow psychological flexibility to grow.  However, for the other person, very little may change.

A contextual viewpoint does not regard one process as the cause or the cure.  Instead, it takes a curious and experimental stance in which you change one process and see what happens. 

Jim Lucas

Based on your observations, you can make additional changes to the same process or other processes within the psychological flexibility model. 

By dropping the word BECAUSE, we can let go of generalised assumptions more easily and see the entirety of human behaviour in context.  It can free you from mentalistic operations, allowing you to sit more firmly in a functional contextual viewpoint.  For the ACT therapist who seeks to stay close to those principles, that can mostly be a good thing.

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