Profile: Exploring Values In Therapy With Dr Jenna LeJeune
Dr Jenna LeJeune is a clinical psychologist, author, ACT trainer and researcher. She is a co-founder of Portland Psychotherapy, and the author of Values in Therapy – A Clinicians Guide to Helping Clients Explore Values, Increase Psychological Flexibility and Live a More Meaningful Life. As part of our Profile series she sat down with Psychology Tools to speak about her path to ACT, a values-led approach to the scientist-practitioner model, and her thoughts on what makes her clinical life special.
The pathway to ACT and values-based therapy
What was your route into clinical psychology initially?
My journey into psychology is a little cliché. Growing up I suppose I was socialized to be the emotional one. I tended to be the one in my friendship group, and at school, that people would come to. I always knew I wanted to be a psychologist – I didn’t ever really question it. I did my undergrad, and then went right into my doctoral programme, but I do think that I had clarity about my path. I felt that it made sense, that this was the treadmill I was on and I knew how to do it. What I think I was missing, though, was a sense of specific choice. There have been two separate periods of my life that I took time off to really question whether or not I wanted to continue doing this work, and both times I chose to come back to this area, but in significantly different ways. Those times were really important to me in terms of intentionally choosing why I do this.
What led you to ACT and then to focus on values?
The story about how I got into ACT [Acceptance and Commitment Therapy] is kind of funny, it tells you something about me. I got exposed to ACT really early on. It was about 1996, before any book had been written about it, and I went to graduate school with my now husband and co-author on the book, Jason Luoma. In our first year, our professor gave us this article by Steve Hayes that described ACT, and I hated it. I was like ‘What the hell is this? Why would you want to try and make people feel hopeless?’ [There’s a process in ACT called creative hopelessness]. Jason just loved it, so he took off and started studying it, but for three or four years, I was resistant… there was this strong feeling of ‘I don’t like ACT because my boyfriend likes it. I’m not just going to follow something because he does’. But then the values part of ACT wasn’t as prominent in those really early years. That’s the thing I would say, though, is that values drew me to ACT rather than ACT drawing me to values.
Is that how you’ve always approached it, that values are central, even before you started writing your book?
Yes, I would say it has always been the central part of how I practice. Now, because I’ve been practicing this way for many more years, I’m much more explicit about that to my clients. I will explicitly say ‘I practice values-based therapy. This is what our therapy is about, this is what I want our work to be in the service of.’. I wasn’t as explicit in the beginning, partly because I wasn’t as clear about it, but it has always been there at the core of what I do, and why I do it.
There’s also another piece that attracts me to ACT. I really like the idea of allowing people choice in our world. It’s so important to me; I really feel like there’s so many damn injustices in our world. People don’t have the same opportunities, and they don’t get to start from the same playing field. So I like this idea that anybody, regardless of what has been done to them, or what opportunities are in their current environment, or where they live, or anything, could live a life of meaning and purpose. I will sign up for that kind of a world.
For people that don’t know much about it, what is most interesting about this area?
It’s about starting from a place that nobody is broken; that really is the core of ACT. We all get stuck on the same very normal human processes, but every single person has the possibility of getting to live a meaningful, worthwhile life. That’s going to look very different for somebody that has the privileges I have, compared to somebody who has a different set of circumstances, but it still can be a meaningful, well lived life. That draws me to ACT.
It’s almost like you’re describing ACT as a way of life, rather than helping people deal with some immediate issues that they have.
I really appreciate you bringing that up. In each session I am not always talking about these grand and sort of philosophical ‘your life can be so extraordinary’ ideas. Most of the time, I’m working on concrete skills with my clients. I’m working on what would be useful here, what would be helpful, but it is all in context. It is all in the service of people getting to live a life of meaning and purpose, not so we can fix something that’s wrong with them. So, in many ways, my therapy is way more practical these days than it used to be, but it is couched in this way because I want them to have an extraordinary life of choice.
Over the time you have been working with ACT, what about your approach has changed the most?
The overarching thing that I would say is, I don’t play small anymore. I used to play pretty small in therapy, I was more cautious. And now I’m just much more bold. Even being able to say, ‘this is what’s important to me’, ‘this is what I want to be about’, I wasn’t taught that in grad school.
I think over the years, as I have come into contact with the possibility of people getting to live extraordinary lives, I’ve become more bold. For therapists or anybody out there, if your work could be about helping somebody live an extraordinary life, or having them go from a place of just living life, to living a life that is meaningful, why wouldn’t you be? That is so inspiring to me, so when I can be in that place, I’m just much more bold.
Values are where there is life
How do you describe values, and why are they such an important area to focus on in therapy?
With clients, I often don’t define values very much. I don’t say ‘A value is not a goal’, or ‘A value is not a whatever’, because that’s just putting words onto something that can’t be labeled. Values aren’t words, values are ways of living. What I’m doing with my clients is trying to notice when I think values are in the room, like a truffle hunter sniffing out truffles. I’m watching and listening, so I can point out ‘did you notice what was just happening with your face?’ or ‘did you notice something internally?’ That might be a sign that we’re onto something important here, something meaningful. That’s how I’ll approach it, but if a client says ‘what the hell do you mean by values?’, I say something like, ‘Values are how you are living, when you are living a meaningful life. Values are actions, not words. They’re not beliefs or morals, they’re ways of living that are meaningful to you.’.
Does describing values in words have the potential to limit them?
Absolutely. This is one of the main pitfalls when I’m doing training or supervision around values. Therapists will very often approach it as if their task is to help the client identify their values. They ask them to pick a values word like ‘I want to live with compassion’. But doing it that way means it’s flat – there’s nothing alive in that.
The way I describe it is by saying that we put words on these things, because we’re verbal creatures, and that’s what verbal creatures like to do. But values aren’t words, although sometimes words can be used to point to a value. If I think about some of the most powerful work I’ve done with clients, and if I asked them as they left the session what their top five values were, they probably couldn’t give me the words, but they would be able to paint a picture of what they look like when they are living a values-based life. That’s what matters.
This is a really unique way of thinking for most people, a way that we’re not really taught in our society. So sometimes in the beginning, it can be helpful to say ‘Here’s some words that point to things that people choose to value.’, but then I very quickly move away from that way of exploring values. It’s more experiential, and it’s more about noticing, than it is about an intellectual decision process.
How do you go about the process of clarifying what a person’s values are?
I’m mostly looking. I’m doing this even in a first phone call with a client, when they call and say they’d like to work with me. For the actual client session, I am looking for places of life. Sometimes life or vitality shows up in pain, and sometimes it shows up in more positive experiences. I’m looking for where there is life, because that’s where meaning is happening, and that’s where values are happening. I’m listening for it in the tone of voice in people’s expressions, and what they continue to come back to. Sometimes I’ll notice it and just log it away in the back of my head, and sometimes I will bring it up. I can hear, when they’re talking about being with their kids, and who they want to be as a mom, that there’s something really meaningful for them about that, and then I’ll just move away from it.
Do people worry about how to deal with conflicting values?
This is one of the most common things that therapists and trainees will say to me – how do you deal with value conflicts? I don’t know that I have ever once had a client ask this, but therapists are coming at it from a different perspective.
What may initially seem like value conflicts are often time management problems. For example, maybe they’re worried about how they can fully be a mom, when they also want to fully be a teacher and a wife, but that’s not a values conflict. I’m a foodie so I’m going to use a food example: this isn’t about picking one food you want. This is about creating a recipe that incorporates all these different kinds of flavors. We need to look at how things work together. It’s not that you can’t have this and that simultaneously, it’s about you getting to be the person you would most want to be in all aspects of your life. When people are oriented to values in that way, it isn’t about valuing one thing in this domain, and one thing in that domain, and whether those might be in conflict.
A values-led professional life
Your working life is interesting because you combine clinical work, training, research and writing. The centre you co-founded is run using a social enterprise model, with a non-traditional research profile that runs and funds research outside of a university setting. Can you tell us why you decided to structure the clinic in this way?
The way we set it up was very much a values-based decision. In the beginning, my husband and I developed it, in part because I wanted to be primarily a clinician, but somebody who was still involved in research, and he wanted to be primarily a researcher, but who was still directly influenced and tied to clinical work. There wasn’t anything we found that existed which could meet all of those needs, so we created it.
I think it is the only place in the world, as far as we know, that’s a psychotherapy clinic based on a social enterprise model. The idea is that, although it is technically a for-profit business, any of the profits that come into the clinic through either research, training that we offer, or clinical services, all go back to fund social good projects. So this means all the profits outside what we pay our staff and the costs to run the business. The two main ways that we have chosen to contribute to the social good are through offering low, low fee services to people who don’t have insurance or can’t afford it, and also through funding scientific research, because our priority here is contributing to the world through science.
All of the research that we do out of the clinic is independently funded. As opposed to pursuing grants or federal funding. Essentially, we don’t actually want our research or what we do at the clinic to be dictated by what NIH thinks is important. One of the reasons why we’re pursuing psychedelic research (our next project) on the use of psychedelics in clinical work, is because lots of us researchers are super interested in that. We want to be able to do what we think is important.
Why is being involved in research important to you and what benefit does it bring to your work as a clinician?
Both Jason and I were trained in the scientist-practitioner model, where the idea is that you both contribute to and implement science. Now I know people who do this, but before we set up the centre, I didn’t know anyone who actually did both. People were either researchers in academia, or clinicians. It was ‘I go over here, and I do my research, then I see some clients on the side.’. Everything was very separate and we really wanted something that was much closer, more intertwined.
As a therapist, I get so inspired when I hear the folks here in the clinic who are more focused on research than I am at the moment. I want to do awesome clinical work, because I want to be able to help inform them as they’re developing their latest study. Then, of course, I learn about their findings, and that helps me in how I approach my clinical interventions.
Tell us about your experience of writing the book, and how did you feel when you finished it?
Completing it I felt there was a sense of pride, but actually it was mostly sadness. I absolutely loved writing that book. Not every single moment of it, but I loved it in large part because writing it with Jason was so meaningful. What I mean by that is, I have this tendency to start trying to make sure people think I’m smart, and that isn’t something that I would choose to value. So Jason’s job in the book was constantly coming back to ‘Jenna, what are your values? Where’s your heart?’. Getting to spend an entire year just writing from a place of values, felt like one of the biggest privileges I’ve ever had.
I would say that the book is very intentional, I put a lot of my heart into it. There were definitely times when maybe effort is the right word, but only really the times when I was getting a bit heady and trying to look smart, did it feel like such hard work. I’m not saying that I am not a smart person. I’m saying that’s not what I would I prioritize, it wasn’t in line with my values and that’s when it was hard.
I guess that might be something for people to notice in terms of their own values – when we are living in line with our values, it just feels different. It’s not like everything is plain sailing, but it is rich.
How does it feel knowing that people around the world have had their therapy direction or style influenced by your work?
I can’t even tell you how meaningful and humbling that is to me. In one way I’m mostly a clinician, just sitting in a room with one other person with the door closed. Most of the time, I have no idea what that person’s life is like, and to be able to get the perspective that there’s somebody across the pond who read my book, who liked my book? That’s really special.
The bigger piece is that the ripple effect is so freaking awe inspiring. I think about this when I work with individual clients as well. If one person read the book, and had one session with an individual where they treated them from a place of possibility and values, rather than from a place of having to fix them as the problem, that person is going to go home to their partner or their kids, and maybe they’re going to raise their kid differently. Maybe that kid then is going to be a teacher and teach their students differently. I think about the ripple effect of that, and it’s kind of awe inspiring.
That’s why I fought really hard for the cover of our book. I had other titles I wanted, but I understand marketing-wise why it actually has to describe what it is, so I agreed to give them the title, but I insisted on choosing the cover. It’s a picture of an amazing, star filled sky, filled with endless possibility. It’s about living a life where you have moments where you sort of open up and think WOW – there are people in the UK or the world that like reading what I wrote. Then they’re going out, and maybe impacting other people’s lives, and then those people are impacting other people’s lives and it’s freaking amazing. It feels a little bit like standing under the dark sky reserve looking up at all the stars.