Why Teach Patients to Practice Self-Compassion?

As clinicians, we are well aware of the vicious anxiety/avoidance/self-defeat cycle. Those seeking to conquer their anxiety will often criticize and blame themselves for their failed attempts at controlling, eliminating, and avoiding debilitating worries and fears. But, we know that persistent negative criticism, whether originating from self or others can trigger the fight-flight system which serves to protect threats to our sense of self. So, when anxiety arises, and an individual is ill-equipped to manage or cope with the experience, enters the negative self-evaluations and judgments. That is followed by more negative self-judgment for their preconceived failure. Overtime, these individuals buy into the idea they cannot “handle” unpleasant emotions and stress, contributing to a fundamental sense of insecurity, shame, guilt, and self-dislike.

Promising research has shown self-compassion training as an effective approach to breaking this vicious cycle and reducing secondary anxiety associated with negative self-evaluations. This training requires that an individual extend the qualities of compassion toward ones own suffering (Neff, 2011). Three primary ingredients for self-compassion training according to Kristen Neff and Christopher Germer (2013) are as follow:

Self-Kindness vs. Self-Judgment: Treating ourselves with care, support, and understanding just as we would treat a dear friend.

Common Humanity vs. Isolation: Recognizing that we are not alone in our suffering; all beings suffer as part of the human experience.

Mindfulness vs. Over-Identification: Acknowledging that moment of suffering and allowing our experience to just be, without getting lost in the storyline of our thoughts (i.e., judgments).

When individuals approach difficult internal experiences with compassion, they create a feeling of safety that counteracts the negative impacts of fight-flight activation, while combating depression and chronic stress. Intentional and consistent acts of self-compassion can also increase positive states of happiness, optimism, and overall life satisfaction. And once the patient learns how to offer self-compassion their perception shifts. They start to acknowledge that their suffering is a natural part of the human experience, and they are fostering a sense of connectedness with themselves and others.

The next time your patient is struggling in session and appears to be feeling defeated by their experience, try this simple approach called the Self-Compassion Break:

Ask the patient to pause and take note of their pain and suffering in the moment:

What does it feel like in your body?
What thoughts and feelings are present?
Notice any negative self-judgments or urges to “get rid” of your feelings.

Remind your patient of the humanness of their experience, shared by all people:

Have them repeating to themselves: “This is a moment of suffering.”, “Suffering is like this.”, “This is what _______(e.g., anxiety, fear, shame, guilt, etc.) feel like.”, or “We all struggle in our lives.”

Encourage the patient to offer themselves an act of care and kindness because they are struggling:

This may mean placing a gentle hand on the body where support needed. This could be the heart, belly, neck, or any other place that senses emotional pain.
You might explain to them that as mammals, the warmth and comfort of touch can deactivate fight-flight activity in our brains (think of the effects of a parents nurturing embrace on a child’s emotions).
For others, repeating a simple yet supportive phrase can also generate a sense of safety and ease.
“I am kind to myself in this moment of suffering” or “I am strong and safe.”

The more individuals practice kindness towards oneself, in their daily life, the less power the inner-critic has over their thoughts, feelings, and decisions. Self-compassion training, together with traditional Cognitive Behavioral Therapy techniques, can shift the negative perspectives and can be helpful to those struggling with the persistent inner critic that won’t quiet down.

References

Neff, K. D. (2011). Self-compassion, self-esteem, and well-being. Social and Personality Compass, 5, 1-12.

Neff, K. D., & Germer, C. K. (2013). A pilot study and randomized controlled trial of the

Mindful Self-Compassion program. Journal Of Clinical Psychology, 69(1), 28-44.