The Self in Practice ― A Clinician?s Guide to Assessing, Observing, and Supporting Change in Your Clients

Every client that partakes in ACT must identify a self as part of their treatment, and clinicians often report thatobserving the self is the most difficult of all six core ACT processes. This is because it is so hard for people to shed pre-conceived notions of “who they really are,” and negative perceptions of the self can lead to feelings of low self-worth that stand in the way of treatment.

Problems with the self arise when clients orient themselves in the world and learn to relate to others, but these problems can vary considerably. For example, some clients may have deficits in developing a strong sense of self in the first place—particularly if they are diagnosed with autism spectrum conditions (ASC). Depressed clients, or those with borderline personality disorder (BPD), may develop a skewed, negative sense of self, and those with narcissistic personality disorder (NPD) may develop an inflated sense of self.

Louise McHugh, PhD, is a faculty member in the school of psychology at University College Dublin, and coeditor ofThe Self and Perspective Taking.

Ian Stewart, PhD, is a faculty member in the school of psychology at the National University of Ireland, Galway. He is coauthor ofThe Art and Science of Valuing in Psychotherapy, ACT and RFT in Relationships, and coeditor ofThe Self and Perspective Taking.