Mindful Self-Compassion Therapy

_{“This being human is a guest house. Every morning a new arrival.}

_{A joy, a depression, a meanness, some momentary awareness comes, as an unexpected visitor.}

_{Welcome and entertain them all!}

_{Even if they’re a crowd of sorrows, who violently sweep your house, empty of its furniture,}

_{Still, treat each guest honorably.}

_{He may be clearing you out for some new delight.}

_{The dark thought, the shame, the malice, meet them at the door laughing, and invite them in.}

_{Be grateful for whoever comes, because each has been sent as a guide from beyond.”}

                                                                                                                              _{The Guest House, Rumi}

Definition and Description of Mindful Self-Compassion:

Mindful Self-Compassion (MSC) is more than a journey, it’s an inner adventure as well as an experiment. It invites its participants to be researchers of their own experience. The purpose of MSC is to help participants

                1-Know when they’re suffering and

                2-Respond with kindness and understanding.

With self-compassion, we treat ourselves or our patients with kindness, care, understanding and support, just as we would treat a friend we cared about. Also, compassion entails concern with the alleviation of suffering and the motivation to do something about it. Here, it means that there is also an action element to self-compassion. It involves actively soothing and comforting ourselves when we’re in pain and taking any kind of action which is needed to help ourselves when we’re struggling. With self-compassion, we see our own experience of imperfection, as part of the larger human experience. We recognize that everyone suffers, this is normal. In order for us to respond to our suffering with compassion, we first need to realize that we are suffering. Mindfulness allows us to turn toward painful feelings and “be” with them as they are. Mindfulness is a balanced state of awareness. We don’t suppress or avoid what we’re feeling, and we don’t become carried away by the dramatic storyline of what’s happening. Another way to describe self-compassion is that it involves being in a state of “loving, connected presence”. This corresponds to “kindness, common humanity and mindfulness”. When we embrace ourselves, our lives, and others with a sense of loving, connected presence, our experience becomes radically transformed. Most people assume that self-compassion is primarily soft and receptive because compassion is associated with nurturing relationships. However, compassion and self-compassion can be strong. To be completely self-compassionate, we need both the yin and yang of self-compassion.

                -The yin of self-compassion contains the attributes of “being with” ourselves in a compassionate way: comforting, soothing, validating ourselves.

                -The yang of self-compassion is associated with “acting in the world”: protecting, providing and motivating ourselves.

Mindfulness is the foundation of self-compassion. We need to notice and turn toward our suffering before we can respond with kindness. Mindfulness may be defined as “awareness of present-moment experience with acceptance”. Another definiton is “knowing what we’re experiencing while we’re experiencing it”. Mindfulness has 4 important roles in MSC:

                1- Knowing that we’re suffering while we’re suffering. We need to be aware of suffering to have a compassionate response.

                2- Anchoring and stabilizing awareness in present-moment experience when a person is emotionally overwhelmed.

                3- Managing difficult emotions by finding them in the body and relating to them with mindful awareness.

                4- Balancing compassion with equanimity, or calm, spacious awareness.

Self-compassion is also in close relation with loving-kindness. Loving-kindness is put in words of Dalai Lama as “the wish that all sentient beings may be happy” while compassion is “the wish that all sentient beings may be free from suffering”. When loving-kindness bumps into suffering and stays loving, it’s compassion. Both loving-kindness and compassion are the practice of good will.

Brief Historic Overview:

Mindful Self-Compassion was developed by Christopher Germer and Kristin Neff in 2010. Professor Germer brought his clinical expertise together with Neff’s pioneering research and they created MSC program, which has continuously evolved since then. There are over 1600 articles and dissertations on self-compassion in the psychological literature.

Physiology of Self-Compassion:

According to Paul Gilbert (Gilbert, 2009), when we criticize ourselves, we’re tapping into the body’s threat-defense system. This system evolved so that when we perceive a threat our amygdala gets triggered, cortisol and adrenaline are releases, and we get ready for fight, flight, or freeze. The threat response causes stress and is related to conditions like anxiety and depression. On the other hand the mammalian care-giving system is triggered by two main factors- soothing touch and gentle vocalization (Steller and Keltner, 2014). This releases oxytocin and opiates in both parents and children, helping the infant feel safe and secure. When we practice self-compassion, especially with physical gestures and a gentle tone of voice, we generate a sense of safety that counteracts the stress generated by the threat-defense system (Arch et al., 2014; Friis et al., 2016; Petrocchi, Ottaviani and Couyoumdjian, 2016). Therefore, self-compassion regulates stress through affiliation whereas mindfulness regulates difficult emotions through the higher cortical process of attention regulation.

Research:

Self-compassion is powerfully linked to wellbeing:

                -It is strongly associated with fewer negative states like depression, anxiety, stress, shame and negative body image. (Johnson and O’Brien, 2013; Zessin, Dickhauser and Garbade, 2015; Braun, Park and Gorin, 2016; Stutts et al., 2018)

                -It is also strongly linked to more positive states like happiness, life satisfaction, and optimism. (Neff, Long et al., 2018)

                -It is also linked to better physical health. (Sirois, 2015; Homan and Sirois, 2017)

Research has also been conducted on the MSC program itself. Neff and Germer (2013) conducted a randomized controlled trial in which participants were randomly assigned either to MSC or a waiting list to take the program and found that MSC resulted in:

                -Incresases in self-compassion, mindfulness, and compassion for others.

                -Decreases in depression, anxiety, stress and emotional avoidance.

                -Increases in social connectedness, life satisfaction, and happiness.

                -All gains in wellbeing maintained one year later.

                -Increases in self-compassion were linked to how much self-compassion practice participants did (either days per week spent meditating or times per day spent doing the informal practices).

Examples of Exercises (meditations) Practiced in Mindful Self-Compassion:

Soothing Touch: MSC provides multiple pathways for evoking self-compassion in daily life. One approach is somatic, with soothing or supportive touch. Evidence shows that soothing touch is a reliable way of expressing kindness and compassion (Hertenstein et al., 2006; Keltner, 2009) and a simple body gesture like putting a hand over the heart can influence how we think and feel (Parzuchowski et al., 2014). Some options would be “one hand over the heart”, “one hand on a cheek”, “gently stroking one’s arms” or “cupping the hands in one’s lap”.

Self-Compassion Break: Provides a quick and efficient self-compassion practice that can be applied whenever participants find themselves in a difficult situation.

Affectionate Breathing: Allows participants to be comforted and soothed by the rhythm of their breathing; adds a sense of being supported by the breath, pleasure in breathing, and gratitude for how the breathing nourishes the body.

Soles of the Feet: Provides an experience of mindful awareness and an anchoring practice, a way to calm the mind while feeling emotionally overwhelmed.

Awakening Hearts: Provides a direct experience of 4 different facets of goodwill—loving-kindness, self-kindness, compassion and self-compassion—and to distinguish the felt sense of one from the other.

Loving-Kindness for a Loved One: Activates feelings of loving-kindness by focusing on an easy target-the loved one-then gently adding oneself to the circle of kindness.

Silver Linings: Provides a turn toward suffering with curiosity and an experience of the power of compassionate presence alone.

Comment or Quote From An Expert:

I am a mindful self-compassion teacher and a psychiatrist, Fisun Akdeniz. With many other therapy models, mindful self-compassion serves to ones who suffer from burn-out (taking care of chronic patients, patients with dementia, patients with disabilities or chronic mental illness), self-critisiation, shame and other difficult emotions. During the 8-week mindful self-compassion therapy, the participants learn how to give compassion to themselves and others and have an opportunity to practice during the sessions and in between sessions. At the end of the 8-week therapy they will build a new skill.

Comment From A Trainee With Some Kind of Experience:

I am Özgür Özkalaycı and I am a psychiatrist. In my opinion, this psychotherapy method includes many practical tools for the broad application towards improving a lot of psychiatric symptoms, which all the psychiatrists encounter frequently in the area of practice.

I am Ecem Erbatu, psychiatry trainee from Turkey. The training of mindful self-compassion was a quite pleasant process in which I had the chance to learn how to realize my positive experiences and also stay in those experiences. I think sparing at least one part of the time I spent for thinking about daily incidents and discovering the emotions which enforce me by looking into my inner world was an important step towards understanding myself better.

My name is Selin Tanyeri, I am a psychiatry trainee and have completed 8-week Mindful Self-Compassion group therapy training. It was quite a unique experience for me because besides its effectivity as a tool in many psychiatric interviews and therapy sessions, it was beneficial and inspiring for myself.

Books, Manuals, Online Courses, Associations and Resources:

English Resources:

-The Proven Power of Being Kind To Yourself: Self-Compassion, Kristin Neff

-The Mindful Path to Self-Compassion, Christopher K. Germer

-Mindful Self-Compassion Teacher Guide, Kristin Neff and Christopher K. Germer

-Center for Mindful Self-Compassion: https://centerformsc.org/

- https://self-compassion.org/

- https://chrisgermer.com/mindful-self-compassion-msctm/

References:

1-Mindful Self-Compassion Teacher Guide, Kristin Neff and Christopher K. Germer

2-The Proven Power of Being Kind To Yourself: Self-Compassion, Kristin Neff