• Nick Hartkop

November 22, 2021 (ACT Exercise)

The following is an exercise from Acceptance & Commitment Therapy (ACT) (Steven C. Hayes, PH.D with Spencer Smith)

EXERCISE: Your Suffering Inventory

We would like you to write down a list of issues that are currently psychologically difficult for you

Painful and difficult issues I experience:

  • Anger not knowing what I am going to do with my life

  • Feeling I will never control my BPD/BP

  • Feeling embarrassed/ashamed of my life and failures

  • Not being able to hold a steady job because of paranoia (From people not liking me/being afraid of an active shooting and dying)

Go back and rank these items in terms of the impact that they have on your life

  1. Feeling embarrassed/ashamed of my life and failures

  2. Not being able to hold a steady job because of paranoia (From people not liking me/being afraid of an active shooting and dying)

  3. Feeling I will never control my BPD/BP

  4. Anger not knowing what I am going to do with my life

(I feel very similarly about all of these, it is hard to put them in an order)

The Problem With Pain: Often pain holds you back from the kind of life you want to live. It may be that you no longer go to the supermarket because you are afraid you might have a panic attack there.

EXERCISE: The Pain is Gone, Now What?

  1. If being afraid of people hating me and setting myself up for failure due to paranoia weren’t such an issue, I would follow my dreams of working in entertainment.

  2. If I didn’t have BPD/BP, I would have healthy relationships and live a fulfilling life, and most importantly be normal.

  3. If being afraid of active shooters weren’t such a problem for me, I would go out with my partner more, and be able to go into the grocery store to shop.

  4. If I didn't have my anger, I would have healthy relationships that i don’t ruin (This relates to BP/BPD)

The Problem with Pain: Revisited

Your pain is holding you back from living the life you want to lead. There are activities you would be engaged in if it weren’t for your pain and the role it plays in your life. The problems you wrote down in the exercises above refers to the “pain of presence” (issues that are present that you would prefer to go away) Those activities you would engage in if matters changed, represent a different kind of pain: they are called “pain of absence.” Generally, the more you live your life trying to ward off the pain of presence, the more pain you get, particularly in the form of pain of absence. While you’ve focused more on getting rid of the pain of presence, you’ve been feeling more of the pain of absence.

Living A Valued Life: An Alternative

Often we attach ourselves to our pain, and we start to judge ourselves based on how we feel and not on what we do. In a way, we become our pain. This is not about solving your problems in a traditional way as much as it is about changing the direction of your life, so that your life is more about what you value.


I have been having panic attacks lately around the uncertainty of my future. My Psychiatrist has added an additional medication on top of the 4 I am already on for my BPD/BP. It is called Hydroxyzine Pamoate. I have been adjusting to the medication I am on, and believe it has been helping me be more functional. I have been actively participating in my therapy and ACT/CBT and am staying on a path of reaching normality and working through my mental illness. I want to be successful, so I won’t give up. I am thankful for my support systems, and for the treatment I am in. I will continue to update my blog with various exercises. I apologize for the late response to the messages I have received from my team. I will be responding over the next couple days. Thank you to anyone who checks this blog out and follows my treatment. I have found that typing up my exercises helps them stick with me and allows me to gain a deeper understanding from them.


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