Steven C. Hayes, Kirk D. Strosahl, Kelly G.

Wilson, Acceptance and Commitment Therapy

CHAPTER 1

The Dilemma of Human Suffering

(paragraph 1) Nothing external ensures freedom from suffering. Even when we human beings
possess all the things we typically use to gauge external success—great looks, loving parents,
terrific children, financial security, a caring spouse—it may not be enough. Humans can be
warm, well fed, dry, physically well—and still be miserable. Humans can enjoy forms of
excitement and entertainment unknown in the nonhuman world and out of reach for all but a
fraction of the population—high-definition TVs, sports cars, exotic trips to the Caribbean—
and still be in excruciating psychological pain. Every morning a successful businessperson
arrives at the office, closes the door, and reaches quietly into the bottom drawer of the desk to
find the bottle of gin hidden there. Every day a human being with every imaginable advantage
takes a gun, loads a bullet into it, bites the barrel, and squeezes the trigger.

(paragraph 2) Psychotherapists and applied researchers are all too familiar with the
grim statistics that document these realities. U.S. statistics, for example, show that lifetime
prevalence rates for mental disorders are now approaching 50%, while even more persons
suffer the emotional distress of problems with jobs, relationships, children, and the natural
transitions that life presents to us all (Kessler et al., 2005). Nationwide there are nearly 20
million alcoholics (Grant et al., 2004); tens of thousands of people commit suicide each year,
and countless others try to but fail (Centers for Disease Control and Prevention, 2007).
Statistics like these apply not only to those who have been beaten down over decades of living
but equally well to adolescents and young adults. Almost half of the college-age population
met the criteria for at least one DSM-related diagnosis within recent years (Blanco et al.,
2008).

(paragraph 3) If we wished to summon up numbers to document the ubiquity of human

misery in the developed world, we could do so almost indefinitely. Therapists and researchers
often cite such statistics in one problem area after another when discussing the need for more
clinicians, greater funding for mental health programs, or increased support for psychological
research. At the same time, professionals and the lay public alike seem to miss the larger
message these statistics communicate when taken as a whole. lf we add up all those humans
who are or have been depressed, addicted, anxious, angry, self-destructive, alienated, worried,
compulsive, workaholic, insecure, painfully shy, divorced, avoidant of intimacy, and stressed,
we are compelled to reach a startling conclusion, namely, that psychological suffering is a
basic characteristic of human life.

(paragraph 4) Human beings inflict misery onto one another continually as well.
Consider how easy it is to objectify and dehumanize others. The world community is literally
staggering and reeling under the weight of objectification, with all of its attendant human and
economic costs. We are reminded of that sad fact every time we have to partially disrobe to
enter an airplane or have to empty our belongings onto a conveyor belt in order to enter a
government building. Women make almost one-quarter less than what men make when
performing the same work. Ethnic minorities often find it difficult to catch a taxicab in major
cities. Skyscrapers are attacked by terrorists in planes as a symbol of what is hated; in
retaliation, bombs are then dropped from on high because those thought to be evil may live
below. People not only suffer, they inflict suffering in the form of bias, prejudice, and stigma
in a way that seems as natural as breathing.

(paragraph 5) Our most popular underlying models of psychological health and

pathology barely touch upon human suffering and its infliction on others as general human
problems. Western behavioral and medical sciences seem to have a well-developed myopia
for truths that don`t fit neatly into their accepted paradigms. Despite overwhelming evidence
to the contrary, we too readily conceptualize human suffering through diagnostic labels as
though it were a product of biomedical deviations from the norm. We prefer to view
objectification and dehumanization in ethical or political terms—as though prejudice and
stigma were strictly an attribute of the ignorant or immoral among us rather than the readers
and writers of books such as this one. There is “an elephant in the room" that no one seems to
acknowledge. It is hard to have compassion for ourselves and for others. It is hard to be a
human being.