The Activation Game - Embracing the principles of values-based therapy

Tasneem Abrahams
Apr 22nd, 2016

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Cognitive behavioral therapy (CBT) is believed to be the most effective form of therapy for body-focused repetitive behaviors (BFRBs) such as compulsive skin picking. However there are various methodologies within CBT that can be applied and at we believe it is the combination of these methods that has the most sustainable results. Our online therapy program combines Habit Reversal Therapy (HRT), Mindfulness, Values-based Therapy, and Acceptance and Commitment Based Therapy (ACT) to take clients through a guided journey toward managing their skin picking behavior. While HRT has been found to be very effective for many, this practical approach does not always yield long term results. It is therefore critical that clients develop cognitive skills and strategies to underpin the HRT, and that can be applied as life inevitably throws more challenges in our path. ACT, Mindfulness and Values-based therapy are therefore a very important part of the therapy process. However, reflecting on one’s values does not come naturally to most people and clients often struggle with this section of the program and can be quite overwhelming for some. It is therefore very exciting to discover a values-based ‘game’ that encourages everyday people to reflect and discover their values in a fun and non-threatening way. It is called The Activation Game and was produced by a South African team of writers, philosophers and audio-visual artists. The purpose of the course is to encourage people “to embark on a personal adventure that accentuates inner values and inspires you to apply and demand them in your everyday life”.

What does values have to do with compulsive skin picking?

Values-based therapy encourages the individual to assess their personal values and set goals based on these values. They are then guided in analyzing how skin picking is in direct contrast or interferes with these values and look at alternative solutions that are more in line with their beliefs. The goal in therapy is to help clients strive toward a values driven life rather than focusing solely on the goal to stop picking. The belief is that this shifts the thinking from “I wish I could stop picking” to “what can I meaningfully do in this moment?”. Values clarification is therefore an important aspect of therapy whereby the therapist will guide the client to define their values and take effective action guided by those values.

How will The Activation Game help?

The Activation Game is essentially a 12 ½ week self-development course structured within a multimedia adventure that focusses on human values and is set in your everyday life. It all starts with a book that leads you on a journey through a variety of websites, motivational videos and you are given things to do in your life. The goal is to rediscover human values. The Activation Game was so named because the producers recognized that it is difficult for us to take time out of our busy schedules to focus on self-development and that the serious nature of self-help courses often demands a huge amount of self-motivation to stick to the program. The concept of a game is that through the 12 ½ weeks you are set challenges and given clues that sets you on a path of self-discovery, but in a fun and anticipatory way. The goal is to provide people with a weekly adventure that does not disrupt our everyday lives and responsibilities. 

Why was it created?

Coincidentally when we approached one of the producers, Mustapha Hendricks, and asked him if we could feature The Activation Game on this site, he was surprised to learn that there was a clinically recognized disorder called excoriation disorder, because he too has been struggling with picking of the skin around his nails for many years. We asked him why they created The Activation Game and this is what he had to say:

We created the activation game to bring human values into people’s daily lives. Give them a day to meditate on a value and to reflect on themselves and then give them practical ways of implementing those values.  We say ‘try it out and see how it feels’'. It is only through experience that something becomes part of our muscle memory.

We’ve all heard about human values and have some idea of what they mean in theoretical sense but we want people to feel what these values mean to them. Do you want more honesty on your life? Do you want to be kinder?

Well you’ll only really know when you act. When you act, you get a result. Our goal is that people see the importance of these values through the results they get. And through that they change, just a tiny bit, in their everyday lives.

One thing I struggled with was opening up. Instead of sharing I would find a scapegoat and shut people out. Sort of brush over it because growing up there was never anyone who was there to listen or give me advice (or at least that is how it felt to me). I think it was through the course I did that I learned to share and open up. And by doing that on small scale, on a daily basis, with the little things, I realised that people actually could understand. And through the sharing the burden was much lighter. And it’s not perfect yet but I am aware of it and it’s that awareness that helps. Because it’s the voice inside me: ’Hey little boy, stop bottling things up. They will explode'

 The Activation Game was so named because the producers believe it will activate that which already exists within us.

What can you expect?

The game is designed to keep you in suspense whereby each week you will receive of the 40 audio files, 50 videos, 75 text files, and 100 photographs along with a variety of challenges and tasks. However for those who do not like suspense and prefer to know everything upfront, you can download a file from their website that explains the whole process. In a TV interview Mustapha provides an example of how sitting on a bench and clearing your mind of all thoughts and worries for 10 minutes, focusing only on the what you are experiencing sensorially can help you feel more present in the moment. Being present is another fundamental aspect of ACT and Mindfulness wherein it teaches clients to become present in each moment fully as a conscious human being and how to engage with and overcome painful thoughts and feelings, to develop self-compassion and flexibility, and to build life-enhancing patterns of behavior. Being present just so happens to be one of the focus areas in one of the weeks of The Activation Game. They are currently running a crowd-funding campaign on Indigogo to fund their goal to send 300 copies of the game to writers and creatives across the US, Canada, UK and South Africa who can share it with their network.

It's not about control, it's about acceptance

BFRBs such as excoriation disorder and trichotillomania (hair pulling) is characterized by an intense and irresistable urge to engage in a body focused behavior such as picking the skin or pulling ourt bodily hairs respectively. This can often lead to skin damage, hair loss and scarring. But it also leads to feelings of shame and guilt, often resulting in social isolation and loneliness. It is often poorly misunderstood as there are many who engage in similar behaviors simply as a bad habit. But for people with this disorder, the struggle to stop engaging in the behavior and the impact of the severity of the behavior on their daily living is all encompassing. When you have excoriation disorder it seems like the more you try to control the behavior, the stronger the urge to pick becomes. Acceptance and Commitment Therapy is based on the premise that the struggle is not about lacking control, but rather lacking acceptance. For many, skin picking is triggered by underlying negative thoughts and emotions that cause stress or anxiety and picking becomes an outlet for those emotions we often tend to try to supress or deny. ACT does not attempt to directly change or stop unwanted thoughts or feelings, but instead encourages people to develop a new and compassionate relationship with those experiences. This shift can free people from difficulties attempting to control their experiences and help them become more open to actions consistent with their values, values clarification and the definition of values-based goals also being key components of ACT. We hope The Activation Game lives up to its promise of providing participants with an opportnity to discover themselves in such a way that they will become more open to this kind of acceptance.



Tasneem Abrahams

Tasneem is an Occupational Therapist, and a graduate of the TLC foundation for BFRBs professional training institute. Her experience in mental health includes working at Lentegeur Psychiatric hospital forensic unit (South Africa), Kingston Community Adult Learning Disability team (UK), Clinical Specialist for the Oasis Project Spelthorne Community Mental Health team (UK). Tasneem is a member of both the editorial team and the clinical staff on Skinpick, providing online therapy for people who suffer from excoriation (skin picking) disorder.

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