An ACT Approach to
Self-Soothing
By Russ Harris
Bestselling author of 'ACT Made Simple' and 'The Happiness Trap'
9 MIN READ APPROX.
ACT Tips and Insights for Mental Health Practitioners
Self-Soothing
To soothe means to calm, comfort, or provide relief from pain. Self-
soothing involves learning to do this for yourself rather than relying
on others. There is much overlap between self-soothing and self-
compassion. (A simple definition of self-compassion is: acknowledge
your suffering and respond with kindness).
Acceptance-Based Self-Soothing
When we include self-soothing in ACT, we want to ensure it is
acceptance-based, not avoidance-based. In many models, the primary
aim of self-soothing is to provide relief and comfort through reducing
or removing pain, or distracting yourself from it.
In ACT, the aim of self-soothing is quite different. We bring it in as part
of a broader agenda of acceptance and self-compassion. The primary
aim of self-soothing in ACT is to provide relief and comfort through:
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a) Accepting your pain and treating yourself in a kind and
caring manner,
followed by
b) Engaging in calming, comforting values-guided activities
Pain Relief
The word ‘relief’ comes from the Latin term ‘relevare’, which means ‘to
raise or lighten’. Pain is a burden, and naturally we strive for relief from
it. We want to ‘lighten the load’, ‘raise ourselves up’ from underneath
the burden.
Many people assume that relief from pain means removing, avoiding
or distracting from the pain. But mindfulness‐based approaches
offer a different form of pain relief: the huge relief that comes from
dropping the struggle with pain, stepping out of the battle and
making peace with it.
The Pushing Away Paper Exercise dramatically conveys the instant
relief that comes from dropping the struggle with pain. That’s why it’s
a good precursor or adjunct to any acceptance work.
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Is Acceptance-Based Self-Soothing
Bad?
There is nothing ‘wrong’ or ‘bad’ about avoidance-based self-soothing
(i.e. doing activities with the primary aim of reducing, avoiding,
distracting from pain). Often, such activities are very helpful.
Remember, ACT does not target all experiential avoidance. ACT
sees experiential avoidance as normal, not pathological. ACT ONLY
targets experiential avoidance if and when it is so excessive, rigid or
inappropriate that it becomes problematic and gets in the way of a
rich and full life.
However, if the primary aim of self-soothing is to reduce, avoid, get rid
of pain there are times that this simply will not work. So in this sense,
acceptance-based self-soothing is ‘superior’ - because we can practice
it whether or not pain reduces. (Of course, very commonly, pain
reduces significantly as a by-product of acceptance. That’s not the
aim, but it’s a lovely bonus, and we can certainly appreciate it when
it happens.)
When is Acceptance-Based Self-
Soothing Problematic?
Many self-destructive experientially-avoidant behaviours - including
the inappropriate or excessive use of drugs and alcohol, overeating,
gambling, and even, in some contexts, self-harming - can be viewed
as avoidance-based attempts to self-soothe.
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It’s often be useful for the therapist to reframe such behaviours as
forms of self-soothing, for the purpose of fostering self-awareness, self-
acceptance and self-compassion. (We don’t have to use the term ‘self-
soothing’, of course.)
Basically, we want to validate the adaptive functions these behaviours
have had in the past. For example, we might say: “These things have
helped you in the past. They were good strategies, in the sense they
helped you to get through all the bad stuff that was happening, and
cope with those painful feelings.”
And then we’d go on to compassionately and respectfully look at the
long-term costs, if these behaviours continue. (In ACT textbooks, this
kind of work is often called ‘creative hopelessness’ or ‘confronting
the agenda’.)
Once the client reframes these behaviours as unworkable (i.e. they
work in the short term to avoid pain, but they don’t work long term
to build a rich and full life), then we can segue into alternative, more
workable behaviours.
A Quick Recap
So, we can define self-soothing, from an ACT perspective, as:
“Calming and comforting yourself through a) first accepting your
pain and treating yourself in a kind and caring manner, and then b)
engaging in calming, comforting values-guided activities.”
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A First Step In Self-Soothing
‘Soothe’ is derived from the old English word ‘sooth’, which means
‘truth’ or ‘reality’.
A first step in self-soothing is often simply to acknowledge to yourself
the truth or reality that in this moment life is painful and you are
hurting. And the aim is to do this with a kind, caring, supportive inner
voice. (This is also often the first step in self-compassion.)
From here we can segue into any type of acceptance and/or self-
compassion work. And then, after accepting the pain, the next step is
self-soothing.
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Self-Soothing Activities
Any mindfulness-based activity can function as a self-soothing
process. This can include formal meditative-style mindfulness
exercises such as:
• Mindful body scans
• Mindful breathing
• Self-compassion meditations
Clients can also create
self-soothing activities
through mindfully
exploring the five senses
and physical activity.
We might ask clients to
consider what they find
comforting, calming or
soothing to:
• Look at
• Listen to
• Smell
• Touch or be touched by
• Taste, eat, drink
• Do
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Sight
What have you ever found comforting, calming or soothing to look
at? Consider: movies, paintings, sculptures, architecture, fashion, the
sky and the weather, animals, plants, the ‘great outdoors’, theatre,
dance, and so on.
How can you create self‐soothing activities that draw on sight?
For example, could you consider watching movies, going to an art
gallery, going for a walk in nature?
The key to making these self-soothing is to engage fully in the
activity; give it your full attention (while allowing your feelings to be
as they are).
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Sound
What have you ever found comforting, calming or soothing to listen
to? What types of music, favourite songs, sounds of nature, voices of
particular people, prayer or chanting, religious hymns?
How can you create self‐soothing activities that draw on sound?
For example, could you consider listening to favourite music, joining
a choir, singing favourite songs, praying or chanting?
The key to making these self-soothing is to engage fully in the
activity; give it your full attention (while allowing your feelings to be
as they are).
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Smell
What have you ever found comforting, calming or soothing to eat or
drink? Consider favourite types of food, drink (that are life-enhancing
rather than self-destructive when you consume them).
How can you create self‐soothing activities that focus (in a healthy
way) on eating and drinking?
For example, could you consider eating or drinking a favourite food
or drink slowly and mindfully, and truly savouring the experience
(instead of doing it rapidly and mindlessly, without savouring it).
The key to making these self-soothing is to engage fully in the
activity; give it your full attention (while allowing your feelings to be
as they are).
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Taste
What have you ever found comforting, calming or soothing to eat or
drink? Consider favourite types of food, drink (that are life-enhancing
rather than self-destructive when you consume them).
How can you create self‐soothing activities that focus (in a healthy
way) on eating and drinking?
For example, could you consider eating or drinking a favourite food
or drink slowly and mindfully, and truly savouring the experience
(instead of doing it rapidly and mindlessly, without savouring it).
The key to making these self-soothing is to engage fully in the
activity; give it your full attention (while allowing your feelings to be
as they are).
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Touch
What have you ever found to be comforting, calming or soothing
ways to touch or be touched?
Consider: brushing hair, massage, stroking a dog or cat, cuddling
or hugging or snuggling up against loved ones, having your back
rubbed or your head stroked, running your fingers through grass,
walking barefoot on the beach, warm showers, hot baths, etc.
How can you create self‐soothing activities that draw on touch?
The key to making these self-soothing is to engage fully in the
activity; give it your full attention (while allowing your feelings to be
as they are).
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Other Activities
Are there any activities you have ever found comforting, calming or
soothing?
E.g. yoga, meditation, prayer, dancing, singing, hot baths, playing
sports, arts & crafts, woodwork, fixing up the house, tinkering with the
car, writing, reading, acting, getting out into nature, physical exercise,
cooking, visiting museums or galleries, gardening?
How can you turn these into self-soothing activities?
The key to making these self-soothing is to engage fully in the activity;
give it your full attention (while allowing your feelings to be as they
are).
If the questions/explorations covered above reveal that clients have
little or no prior experience of self-soothing to draw on, we can ask
them to experiment with a range of activities and actively notice what
happens as they engage in them.
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Self-Soothing and Relaxation
In ACT, committed action includes skills-training. If clients do not have
the necessary skills to live their values and effectively pursue their
goals, the ACT therapist would either teach those skills in session or
help the client find a way to learn those skills outside the session.
Relaxation skills are no exception. In ACT, we may well teach relaxation
skills in the service of self-care. However, if we do teach relaxation
skills, we need to be crystal clear that they are radically different to the
core ACT mindfulness skills of defusion, acceptance, self-as-context
and contact with the present.
How so? Well, relaxation skills are in the service of experiential
avoidance: their primary aim is to reduce, avoid or get rid of unwanted
feelings of anxiety, stress, etc. And this is the very opposite aim to the
core ACT mindfulness skills. So if we aren’t crystal clear with clients
about the difference, we can expect confusion and mixed messages.
The good news is, most self-soothing activities can readily be turned
into relaxation strategies. If we encourage clients to do this, then (as
with any relaxation strategy) we want to:
a) Emphasise it won’t always work, and
b) Clarify when it’s most likely to work (in non‐challenging,
non-threatening, low-demand situations), and
c) Clarify where it almost certainly won’t work (in challenging,
threatening, high-demand situations).
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'It's Not Working'
If your client is practicing a self-soothing exercise and they say ‘It’s not
working’, always ask what they mean. Usually they will report that the
pain is not reducing or going away.
This indicates they have understood self-soothing as a way to escape
or avoid pain. (I.e. they are treating it as an avoidance strategy.)
If so, we’d need to explain that: “While self-soothing often reduces
pain, it won’t always. It’s a way to support yourself, comfort yourself,
be kind to yourself, in the midst of your pain. If the pain reduces, as
it often does – enjoy it, appreciate it; but please don’t make that your
main aim, or you’ll soon be disappointed.”
When Avoidance Creeps In
Despite our best intentions, many clients will do self-soothing
activities with an avoidance agenda – primarily to avoid/escape/
distract from pain.
This is often NOT a problem. However it can become a problem when:
a) The client thinks ‘It’s not working’ because their pain
isn’t reducing
b) The client’s trying so hard to avoid pain, she is unable to
engage fully in the activity
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How to Enhance Self-Soothing with
Other ACT Processes
We can enhance any self-soothing activity with defusion, acceptance,
contacting the present moment, and values.
• Defusion
Unhooking from thoughts that would otherwise ‘pull you out’
of the activity.
• Contacting the present moment
Engaging fully in the activity, focusing attention on what
is relevant.
• Acceptance
Making room for the pain that is present and allowing it to come
and go.
• Values
We can further enhance any self-soothing activity by explicitly
linking it to the values of self-kindness, self-caring, self-nurture,
self-support. As we do this, we see huge overlap between self-
soothing and self-compassion.
And That's Not All, Folks
I hope you’ve enjoyed this eBook. It’s based on materials from
my online course: Trauma-Focused ACT
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The course also includes:
• How to incorporate polyvagal theory and attachment theory
into ACT
• How to do formal exposure to traumatic memories
• How to work mindfully with flashbacks
• How to work with emotion dysregulation, dissociation,
and hypoarousal
• And a whole lot more!
There’s just so much more to ACT with trauma than you can get from
textbooks or chapters. To find out more, visit the online course.
Well, that’s it for now.
Good luck with it all,
Cheers,
Russ
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