The Hexaflex & The Matrix

The traditional ACT model is often represented as a process based therapy involving manipulation of six core processes represented commonly in the form of an interconnected hexagon (popularly referred to as the "Hexaflex").

“Copyright Steven C. Hayes. Used by permission”

These six processes presented in this way represent the concept of psychological flexibility and have evolved over time. In the early days of ACT, there were three core processes, which you will see referred to even now as the three pillars of ACT or the Triflex, in an attempt to simplify the model for new learners.

Much has been done to map on the hexaflex model to the ACT Matrix approach in a one-to-one way, though I discourage this practice, and will not attempt to do so here.

Instead I prefer to conceptualize ACT entirely through the matrix as a standalone method of behavior change principles rooted in Relational Frame Theory with the primary aim of increasing psychological flexibility.

There are advantages and disadvantages to each conceptualization.

The Hexaflex & Triflex Models

Advantages

The number one benefit of the hexaflex and triflex models is that they are comprised of what are known as mid-level terms. Mid-level terms are constructs which are commonly seen as easier to learn and not reliant on a deeper understanding of behavioral analytic principles and terms.

When teaching ACT to new learners you can easily get off the ground by saying "Here is what ACT & psychological flexibility are, these six processes working together in this specific way. Here is what inflexibility is, the inverse of these six processes. This is what to target and when, we're trying to move from here to there."

This has proven a helpful aid for teaching and training ACT for the past 20 years, and newcomers have been able to hit the ground running when properly exposed to the function of each process. This is also how I initially learned ACT.

Another benefit is that the hexaflex model of psychological flexibility is easy to point to as the differentiation between ACT and other modalities. It is a unique signifier that separates ACT theoretically and practically from other approaches, especially since these days more and more are integrating mindfulness, acceptance, and behavior analysis principles into their models (largely in part due to the influence of ACT itself).

Conceptually it is a difference maker, and has inspired many to learn and be comfortable with ACT, as well as conduct research into the six core processes.

Disadvantages

The main disadvantage of the hexaflex model is that it risks leading to ossification of the theory. ACT is a living thing, and should be. It's also an “open source” therapeutic model, meaning anyone can add to, build upon, and modify without being or blessings from the central founders of it. ACT is owned by the people who practice and study it, and moreso by the people whose lives it helps. This site itself is an example of some of the evolutions of ACT.

Ossification is a term that means to cease changing, to become stagnant or rigid. The risk is that if ACT is these six processes alone and anything that promotes them then what happens when something doesn't quite fit? Any cursory search in any ACT forum will lead you to hundreds of questions if “Is it considered ACT when I do this?”, “Is this ACT?”, “Where does X concept fit into the ACT framework?”

You won’t find nearly as many such questions in regards to other modalities. ACT seems to be uniquely poised to open itself up to such questioning in part due to the combination of mid-level terms and its reliance on the hexaflex.

The end result is either a circular one, “Yes that is ACT, as long as it promotes one of the six core processes.”, “No it’s not ACT, because it doesn’t promote the six core processes.”

Or slicing, dicing, and trying to compact concepts to fit the model. “Well, I guess self-compassion would be a combination of Self-as-Contexting, Contact with the present moment, acceptance, defusion, oh hell also values and committed action.”

The six core processes become the benchmark in such a way that it’s hard to think beyond them because anything beyond them might “not be ACT”.

In the end because of the use of mid-level terms which have flexible definitions you can make endless arguments as to whether something fits the criteria or not.

Mid-level terms also fall down on an important scientific rigor test in that they are self-referential. Consider the following:

When somebody is highly fused with a thought the aim is to utilize cognitive defusion skills to help them defuse and reconnect to what matters.

The unworkable process by which the client is suck is fusion, the workable process is defusion, the method is defusion, the outcome is defusion.

The process is fusion, the procedure is defusion, the outcome is defusion. That doesn’t pass the sniff test.

Here it is again in a more facetious example:

Imagine you’re painting a wall blue, but by looking at it you have a sense that the wall is not blue enough. So the solution is to add more blue. After which it will get to a point where it is blue enough.

But there are countless different ways of adding blue (methods/techniques/interventions), and also countless different things that make up “blue” (paint, ink, powder, pigment, etc).

If you want to make the wall less blue well then you’ll have to create a “De-Blue-er”.

We create measures of is the wall blue or not.

How blue is the wall?

Does this method promote more blue-ness?

Does this method promote less blue-ness?

But all of these methods are full of confounds.

If a method is shown to make the wall more blue, then a million other studies must be done to examine each condition under which that method makes the wall more blue, because it may or may not work under every condition.

Blue in this context is Fusion, or Acceptance or any of the other mid-level terms.

The bottom line is that mid-level terms are great for ease of access, but that access is sometimes too easy. Mid-level terms are poor for intensive scientific rigor.

Not least of all is that there is currently no standard measure for psychological flexibility or psychological inflexibility.

These main disadvantages are why I prefer to use the matrix in my work and teaching.

The ACT Matrix

The ACT matrix is not perfect, I will be the first to admit that. This site itself is a testament to how complex the matrix can be and the many ways it can be used. Below are what I see as the advantages and disadvantages of the ACT matrix approach.

Advantages

Since its inception, the matrix has served as a dead-simple method for setting up ACT concepts and getting going with clients without the use of jargon (ACT, RFT, ABA, or otherwise).

Setting up the ACT matrix initially with the client bakes in several ACT concepts at once, most prominently the idea of Creative Hopelessness, and begins to undermine the control agenda immediately upon its first use.

Now here on this site I cover a rather structured and fairly long method of setting up the matrix with clients. Over the years I have honed this method into what it is and I find that it is what works best for me and the clientele I work with. For others it may not be the most workable way of setting up the matrix. Luckily, the flexibility of the matrix allows for countless ways of introducing it to clients. Many clinicians use a much shorter demonstration in setting up the matrix with clients for the first time. In any case, when the matrix is set up well and understood both by the clinician and client, the client can then immediately put the approach to use in their own life and report back at the next session. The work begins just like that.

The set up of the matrix also allows for initiation of rapport building and alliance between client and clinician. If used on the first session the client leaves feeling heard, validated; with a game plan, and a sense of action.

The graphical user interface of the matrix serves to solidify the concept of analyzing the function of behavior and exercises deictic relational framing. In other words, there is a reason that the four questions of the matrix are not simply presented in writing in a list form. When presented as a part of a visual structure the matrix becomes a kind of “map” which meets our yearnings for coherence and orientation and allows the client to place themselves as an actor along this three-dimensional plane corresponding to their own life.

Additionally, the lack of jargon, and other core processes by name provides an avenue to working with clients without becoming entangled in trying to teach or lecture concepts. It also side-steps problematic questions such as “Is this defusion or not?”, “Does this count as acceptance?” by both the client and clinician. Instead, the emphasis is put on behavior, behavior activation, and behavior analysis, not only done by the clinician from a distance, but by the client in real-time. Function is at the forefront when it comes to the matrix.

Returning again and again to the matrix as a diagram and tool allows the clinician and client to feel as though they are truly collaborating. A sense that “I am using the exact same framework of understanding the world as you are.” Using the matrix actively in session also means that the clinician need not “be in their own head”, but rather present in the room with the client both looking at the same map together.

Disadvantages

Although the matrix is simple it is incredibly easy to misconstrue the language of the matrix as I have discussed previously here. The terms toward and away are so commonly and naturally understood relationally to be in opposition with one another that it can be difficult for clients and clinicians to understand that in terms of the matrix and our behavior it is possible to be moving away from one thing and toward another at the same time.

The most common misunderstanding of toward and away is that they refer simply to moving toward what is important to us, and moving away from what is important. In this context an away move cannot also be a toward move. Even Steve Hayes himself appears to make this mistake regarding toward and away as he presents the matrix in his training course ACT Immersion.

There is already a tool that maps out toward values and away from values, it is called the Choice Point, popularized and used extensively by Russ Harris, and a main conceptualization in the ACT Made Simple 2nd edition.

The ACT matrix is different than simple toward values and away from values.

Another main misconception is that away moves are all experiential avoidance all the time. This is not the case. Many different motivations and behaviors can make up both toward and away moves in matrix work. Consider urges or even basic desires, such as hunger or the desire for sex. Many couples can tell you that one or the other partner’s desire for sex per se, has gotten in the way of who or how they want to be in their relationship or independently. When this desire shows up we may place it in the bottom left-hand quadrant as “inner stuff that shows up”, and certain outward actions in the upper left quadrant (Away moves, or things I do when I’m under the influence of the stuff below). Actions that may be away moves, whatever they look like in response to desire for sex in this example, need not be avoidance-based moves.

The ACT matrix is not a simple experiential avoidance tracker. When it is used as such it loses so much of its power and potential. It is for this reason that I have developed the Survival-Vital Matrix.

The Bottom Line

The ACT matrix and the Hexaflex each have their benefits and disadvantages. Use of each should be done in a functional contextual way, and with intention and good working understanding of the risks involved.

It is not necessary to try a one-to-one reconciliation of the hexaflex model of ACT and the Matrix model. It is okay for them to be distinct in their function and in their place in the wider Acceptance & Commitment Therapy world. At the same time, acknowledgment of the six core processes must be made when learning the ACT matrix as a clinician otherwise multiple clinicians all claiming to be doing ACT may not be able to communicate with each other. The fact of the matter is almost all ACT training converges on the six core processes and now the six fundamental human yearnings.