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Psychological flexibility

Updated: Oct 27, 2021


Psychological flexibility means having the abilities to respond to life in a more fluid way, a way where we are reacting based upon the present moment and unshackled from rule-governed behavior that holds us back. When we are psychologically flexible, we can respond better to the situation--with the appropriate intensity, and aligned with what we care about. When we're psychologically rigid, we respond in familiar, but many times unhelpful ways.


Areas of psychological flexibility





The three areas of psychological flexibility are:

  • Exist - Exist in the present moment from a place of presence and creative self-awareness.

  • Expand - Let emotions thoughts and feelings arise, accepting that our bodies are not fully under our control.

  • Engage - Choose actions based upon what we really care about, not reacting or doing what is just familiar (like avoiding


Exist

Existing in the present moment is difficult for people. Because we think in words, and because our minds are essentially threat-detection machines, we are constantly and without effort trying to solve life's problems. We don't have to do anything to make this thinking happen, our brains just do it. To exist in the moment allows us to be more open and creative regarding whatever situation we are in, rather than ruminating on the past or worried about a future. This category of psychological flexibility is under the label of "creative awareness." Existing also means accepting of ourselves as the experiencer of our lives, rather than living according to identity constructs or idealized versions of ourselves. This category of psychological flexibility is under the label of "self."


Self

As we develop, we start to get ideas about who we are or who we think we should be. For example, if we do well in school and this is how we get rewards and attention, we might really cling to the identity of ourselves as someone who dies well academically. If we cling too tightly to this identity, we will create all kinds of rules about how we can and can't behave based upon believing that this identity is who we really are. This can be a rigid and empty way of living that might turn into seeking achievements at the expense of relationships or other meaningful aspects of life all because we are so fixated on "being" the identity that is a fiction.


We are more like the experiencer of our lives rather than a bunch of suits we put on to live out various identities. The experiencer lives in a state of creative awareness. That this is so is why "self" and "creative awareness" are grouped closely together under the umbrella of "exist." These two aspects of psychological flexibility help us be centered in the present moment in a non-judgmental way without "shoulding" ourselves.


Presence

Presence happens naturally when we accept that we are in this moment and let go of the past and future worries. When we allow ourselves to exists grounded in the "now," presence arises. The category of psychological flexibility labeled as "expand" helps us to expand our presence. By now you are likely seeing an interesting aspect of psychological flexibility, as we develop psychological flexibility in one area, all areas of psychological flexibility are affected.


Expand

To expand means to increase our tolerance for internal sensations. When we experience life, we are really experiencing our own nervous systems. To learn to accept our nervous systems and know that we can't avoid it, means giving ourselves the power to affect what we can affect and be more effective in our lives.


Thoughts

We don't have control over our thoughts. Try to forget your name or what the color pink looks like. Yeah. It doesn't work. Instead of trying to control our thoughts, we can expand by just noticing thoughts as thoughts and not being overwhelmed by their content or messages. We all have thoughts come up that we don't like. It doesn't make us broken or bad, it's just our minds generating thoughts which is what minds do.


Emotions

Like thoughts, we also spontaneously feel emotions in various circumstances. When we see emotions as bad or ourselves as bad because we are having emotions, we can shrink or beat ourselves up. To be psychologically flexible means to allow ourselves to feel our emotions. This doesn’t' mean to be controlled by them. That's where the "engage" part of psychological flexibility comes in.


Engage

We all have thoughts and emotions that we may or may not find helpful. Regardless of what comes up, we have some ability to choose what we engage with. In order to give ourselves the best chance possible, we have to know what we care about and be willing to take action.


Values

Values help us navigate when deciding to action. Values never end, meaning they aren't goals. For example, a goal is to buy a house. A value is to fill a house with love. One ends, the other doesn't. What we care about is knowing what we value and bringing those values into our actions.


Actions

This is it---the final piece of psychological flexibility. If we are in the present moment, not struggling with thoughts and feelings, and know what we stand for in life, we can now move our bodies in ways that bring us meaning. This is the taking action part of psychological flexibility. Once we start doing this in a way that's aligned with what we value, our lives become transformed in that we understand that we've had far more power than we ever imagined.


How I use psychological flexibility in my practice

While everyone I work with will hopefully leave our work together more psychologically flexible and less psychologically inflexible, my approach isn't like a classroom where we take a linear, scheduled approach. Experiencing growth in psychological flexibility is dynamic and creative. Whatever is coming up in a session can be looked at through the lens of psychological flexibility and an intervention can happen at any time that illuminates where there are rigidities.


What is psychological flexibility?

The history of psychological flexibility goes back to the middle of the 1900's. Today, the term is mostly associated with Acceptance and Commitment Therapy, or ACT. Under ACT, psychological flexibility is typically defined as a psychological process composed of six other psychological processes that aid people in dealing with life's adversity. Here are some definitions of psychological flexibility from current research articles:


  • Psychological flexibility is defined as acting in accordance with personal goals and values, in the presence of potentially interfering thoughts and feelings, and with a greater appreciation of what their current situation or context allows (McCraken et al. 2021)

  • Psychological flexibility refers to a set of skills to "recognize and adapt to various situational demands; shift mindsets or behavioral repertoires when these strategies compromise personal or social functioning; maintain balance among important life domains; and be aware, open, and com mitted to behaviors that are congruent with deeply held values" (Yu et al. 2021).

  • Psychological flexibility is defined as the ability to pursue valued life aims despite the presence of distress (T. Kashdan & D. Disabato 2021).


Is the term "psychological flexibility" too generic and inaccurately researched?

Cherry et al., 2021 raise some important concerns regarding the term psychological flexibility and one of its most important measurements, the AAQ-II. Their first task was to identify the mass of overlapping and related terms that have appeared in research in recent decades. They found twenty-three concepts related to psychological flexibility in 220 articles. They also examined twelve tools that purport to measure psychological flexibility.


Some of the terms the paper found where there is significant overlap that leads to muddying what psychological flexibility is and how to measure it include: "coping flexibility," "explanatory flexibility," and "cognitive flexibility." In neuropsychology, the paper found that studies of flexibility went back to 1948. Much of modern flexibility studies still operate within this model of "psychological flexibility" not the popular ACT model of six processes of psychological flexibility. In this neuropsychology perspective, psychological flexibility is how a person: "(1) adapts to fluctuating situational demands; (2) reconfigures mental resources; (3) shifts perspective, and (4) balances competing desires, needs, and life domains."


Cherry et al., 2021 also criticizes the main measure of psychological flexibility research in ACT, the Acceptance and Action Questionnaire. The paper asserts that rather than measuring psychological flexibility, the AAQ-II actually measures negative affect and neurosis. As a result, the paper writes that using this measure for research resulted in conclusions based upon circular reasoning. The paper recommends using the Personalized Psychological Flexibility Index (PPFI) instead. They also recommend reconsidering the results of much of ACT research that has been based upon what they believe is a faulty instrument that yields tautological results.


What is psychological inflexibility?

Psychological inflexibility is typically defined opposite psychological processes that hinder people in dealing with life's adversity. Here are some definitions of psychological inflexibility from current research articles:


Experiential avoidance, lack of contact with the present moment, self-as-content, fusion, lack of contact with values, and inaction (Peltz et al. 2020


According to Cherry et al. 2021, psychological inflexibility is most associated with depression and anxiety, which are two of the most common mental health symptoms.


Psychological flexibility instruments and scales

Like other measures in psychology, various questionnaires are constructed and tested for validity and reliability. Some of the ones used for measure psychological flexibility include:

  • 60-item Multidimensional Psychological Flexibility Inventory - assesses six dimensions of psychological flexibility: acceptance, present moment awareness, self-as-context, defusion, values, and committed action; and the six dimensions of psychological inflexibility: experiential avoidance, lack of contact with the present moment, self-as-content, fusion, lack of contact with values, and inaction (Peltz et al. 2020)

  • Chronic Pain Acceptance Questionnaire (CPAQ-8). The CPAQ-8 is a measure of acceptance of chronic pain. It encompasses participation in activities while experiencing pain and willingness to experience pain without efforts to either avoid or control it. CPAQ-8 is the short version of a 20-item questionnaire, and is also fully validated (Yu et al. 2021).

  • Self Experiences Questionnaire-8 (SEQ-8). The SEQ-15 is a 15-item self-report measure of self-as-context, within the psychological flexibility model.


Kashdan et al. 2020, in agreement with Cherry et al. 2021, recommends using the Personalized Psychological Flexibility Index (PPFI) over other measurements of psychological flexibility. The paper suggests that other instruments don't consider enough valued goals and the relationship to distress tolerance. The key difference is that rather than measuring negative emotionality (a flaw found in much of the early and current ACT research), the PPFI measures effective daily goals and the pursuit of meaningful experience in adaptive ways.


Why is psychological flexibility important?

Psychological flexibility is important because it has been linked in thousands of studies to improved psychological health and the ability to handle life's adversity. According to Kashdan et al. 2020, "psychologically flexible individuals are less preoccupied with controlling the form or frequency of uncomfortable internal states solely to maximize pleasant and minimize unpleasant feelings. Psychologically flexible individuals are willing to tolerate uncomfortable states if doing so facilitates meaningful goal pursuit."


What does the research say about psychological flexibility?

There are now 1000's of research articles published regarding psychological flexibility. Domains from parenting to chronic pain have been examined to discover how psychological flexibility can help.


How psychological flexibility is relevant to navigating the emotional and mental challenges of COVID-19

Yu et al. 2021 investigates psychological functioning in the context of COVID-19, including fear and avoidance in the context of COVID-19, specifically its association with daily functioning and the role of psychological flexibility among people with chronic pain. According to the paper, "acceptance refers to the willingness to experience undesirable thoughts and feelings. Cognitive defusion involves contacting our thoughts in a way that can reduce their influence on our behaviors. Present awareness entails flexible awareness of ongoing events. Self-as-context entails an experience of taking a perspective, from which to observe one’s psychological experiences, a sense of separation from or containing psychological experiences. Values are ongoing purposes and qualities of our behavior that we want to reflect. Committed action is the ability to build and flexibly persist in actions guided by values." The paper found that the higher the fear related to COVID-19, the higher the pain and worse daily functioning for those with chronic pain. They found an association between COVID-19-related fear/avoidance and pain, anxiety, depression, and daily functioning. They also found that psychological flexibility lessened the effects of the COVID-19 situation on daily functioning.

Psychological flexibility resources

Psychological Flexibility as a Fundamental Aspect of Health - This article from US Library of Medicine and the National Institutes of Health describes psychological flexibility as a fundamental aspect of health.

NCBI, Psychological Flexibility as a Fundamental Aspect of Health


"Traditionally, positive emotions and thoughts, strengths, and the satisfaction of basic psychological needs for belonging, competence, and autonomy have been seen as the cornerstones of psychological health. Without disputing their importance, these foci fail to capture many of the fluctuating, conflicting forces that are readily apparent when people navigate the environment and social world. In this paper, we review literature to offer evidence for the prominence of psychological flexibility in understanding psychological health. Thus far, the importance of psychological flexibility has been obscured by the isolation and disconnection of research conducted on this topic. Psychological flexibility spans a wide range of human abilities to: recognize and adapt to various situational demands; shift mindsets or behavioral repertoires when these strategies compromise personal or social functioning; maintain balance among important life domains; and be aware, open, and committed to behaviors that are congruent with deeply held values. In many forms of psychopathology, these flexibility processes are absent. In hopes of creating a more coherent understanding, we synthesize work in emotion regulation, mindfulness and acceptance, social and personality psychology, and neuropsychology. Basic research findings provide insight into the nature, correlates, and consequences of psychological flexibility and applied research provides details on promising interventions. Throughout, we emphasize dynamic approaches that might capture this fluid construct in the real-world."


Keywords: flexibility, self-regulation, emotion regulation, mindfulness, resilience, vulnerability


Science Direct, Topics on Psychological Flexibility -
"Psychological flexibility involves an open, willing, nonjudgmental stance in relation to the full range of one’s internal experiences, including—but, importantly, not limited to—trauma-related internal experiences such as intrusive memories, emotional distress, and physiological hyperarousal."

keywords: Psychosocial Intervention, Mindfulness, Self-Compassion, Avoidance, Burnout, Chronic Pain, Cognitive Behavior Therapy, Posttraumatic Stress Disorder


Psychological Flexibility References

Anna Guerrini Usubini, Giorgia Varallo, Valentina Granese, Roberto Cattivelli, Simone Consoli, Ilaria Bastoni, Clarissa Volpi, Gianluca Castelnuovo, & Enrico Molinari. (2021). The Impact of Psychological Flexibility on Psychological Well-Being in Adults With Obesity. Frontiers in Psychology, 12. https://doi.org/10.3389/fpsyg.2021.636933


Bi, D., & Li, X. (2021). Psychological flexibility profiles, college adjustment, and subjective well-being among college students in China: A latent profile analysis. Journal of Contextual Behavioral Science, 20, 20–26. https://doi.org/10.1016/j.jcbs.2021.01.008


Cherry, K. M., Hoeven, E. V., Patterson, T. S., & Lumley, M. N. (2021). Defining and measuring “psychological flexibility”: A narrative scoping review of diverse flexibility and rigidity constructs and perspectives. Clinical Psychology Review, 84. https://doi.org/10.1016/j.cpr.2021.101973


Constantinou, M., Gloster, A. T., & Karekla, M. (2021). I won’t comply because it is a hoax: Conspiracy beliefs, lockdown compliance, and the importance of psychological flexibility. Journal of Contextual Behavioral Science, 20, 46–51. https://doi.org/10.1016/j.jcbs.2021.03.001


Daks, J. S., & Rogge, R. D. (2020). Examining the correlates of psychological flexibility in romantic relationship and family dynamics: A meta-analysis. Journal of Contextual Behavioral Science, 18, 214–238. https://doi.org/10.1016/j.jcbs.2020.09.010


Daks, J. S., Peltz, J. S., & Rogge, R. D. (2020). Psychological flexibility and inflexibility as sources of resiliency and risk during a pandemic: Modeling the cascade of COVID-19 stress on family systems with a contextual behavioral science lens. Journal of Contextual Behavioral Science, 18, 16–27. https://doi.org/10.1016/j.jcbs.2020.08.003


Fonseca, A., Moreira, H., & Canavarro, M. C. (2020). Uncovering the links between parenting stress and parenting styles: The role of psychological flexibility within parenting and global psychological flexibility. Journal of Contextual Behavioral Science, 18, 59–67. https://doi.org/10.1016/j.jcbs.2020.08.004


Grégoire, S., Gagnon, J., Lachance, L., Shankland, R., Dionne, F., Kotsou, I., Monestès, J.-L., Rolffs, J. L., & Rogge, R. D. (2020). Validation of the english and french versions of the multidimensional psychological flexibility inventory short form (MPFI-24). Journal of Contextual Behavioral Science, 18, 99–110. https://doi.org/10.1016/j.jcbs.2020.06.004


Grom, J. L., Maloney, M. A., Parrott, D. J., & Eckhardt, C. I. (2021). Alcohol, trait anger, and psychological flexibility: A laboratory investigation of intimate partner violence perpetration. Journal of Contextual Behavioral Science, 19, 100–107. https://doi.org/10.1016/j.jcbs.2021.01.006


Ingrid Schéle, Matilda Olby, Hanna Wallin, & Sofie Holmquist. (2021). Self-Efficacy, Psychological Flexibility, and Basic Needs Satisfaction Make a Difference: Recently Graduated Psychologists at Increased or Decreased Risk for Future Health Issues. Frontiers in Psychology, 11. https://doi.org/10.3389/fpsyg.2020.569605


Jeffords, J. R., Bayly, B. L., Bumpus, M. F., & Hill, L. G. (2020). Investigating the Relationship between University Students’ Psychological Flexibility and College Self-Efficacy. Journal of College Student Retention: Research, Theory & Practice, 22(2), 351–372. http://dx.doi.org/10.1177/1521025117751071


Kashdan, T. B., Disabato, D. J., Goodman, F. R., Doorley, J. D., & McKnight, P. E. (2020). Understanding psychological flexibility: A multimethod exploration of pursuing valued goals despite the presence of distress. Psychological Assessment, 32(9), 829–850. https://doi.org/10.1037/pas0000834


Levin, M. E., Krafft, J., An, W., Ong, C. W., & Twohig, M. P. (2021). Preliminary findings on processes of change and moderators for cognitive defusion and restructuring delivered through mobile apps. Journal of Contextual Behavioral Science, 20, 13–19. https://doi.org/10.1016/j.jcbs.2021.02.002


McCracken, L. M., Badinlou, F., Buhrman, M., & Brocki, K. C. (2021). The role of psychological flexibility in the context of COVID-19: Associations with depression, anxiety, and insomnia. Journal of Contextual Behavioral Science, 19, 28–35. https://doi.org/10.1016/j.jcbs.2020.11.003


Ong, C. W., Pierce, B. G., Petersen, J. M., Barney, J. L., Fruge, J. E., Levin, M. E., & Twohig, M. P. (2020). A psychometric comparison of psychological inflexibility measures: Discriminant validity and item performance. Journal of Contextual Behavioral Science, 18, 34–47. https://doi.org/10.1016/j.jcbs.2020.08.007


Papalini, S., Ashoori, M., Zaman, J., Beckers, T., & Vervliet, B. (2021). The role of context in persistent avoidance and the predictive value of relief. Behaviour Research and Therapy, 138 https://doi.org/10.1016/j.brat.2021.103816


Peltz, J. S., Daks, J. S., & Rogge, R. D. (2020). Mediators of the association between COVID-19-related stressors and parents’ psychological flexibility and inflexibility: The roles of perceived sleep quality and energy. Journal of Contextual Behavioral Science, 17, 168–176. https://doi.org/10.1016/j.jcbs.2020.07.001


Samiyeh Siahpoosh, & Tahereh GolestaniBakht. (2020). The effect of acceptance and commitment therapy on psychological flexibility and emotion regulation in divorced women. Fiyz̤, 24(4), 413–423.


Singh, R. S., & O’Brien, W. H. (2020). The impact of work stress on sexual minority employees: Could psychological flexibility be a helpful solution? Stress & Health: Journal of the International Society for the Investigation of Stress, 36(1), 59–74. https://doi.org/10.1002/smi.2913


Waldeck, D., Pancani, L., Holliman, A., Karekla, M., & Tyndall, I. (2021). Adaptability and psychological flexibility: Overlapping constructs? Journal of Contextual Behavioral Science, 19, 72–78. https://doi.org/10.1016/j.jcbs.2021.01.002


Yannik Terhorst, Harald Baumeister, Lance M. McCracken, & Jiaxi Lin. (2020). Further development in the assessment of psychological flexibility: validation of the German committed action questionnaire. Health and Quality of Life Outcomes, 18(1), 1–9. https://doi.org/10.1186/s12955-020-01497-8


Yu, L., Kioskli, K., & McCracken, L. M. (2021). The Psychological Functioning in the COVID-19 Pandemic and Its Association With Psychological Flexibility and Broader Functioning in People With Chronic Pain. The Journal of Pain. https://doi.org/10.1016/j.jpain.2021.02.011

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