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Self Compassion

Rachel Roberts MD

March 16, 2021

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Compassion

• Compassion is the response to suffering that motivates the desire to help or alleviate the suffering

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Compassion Training and Neural Network Activation

After brief compassion training, neural networks in the “compassion network”are activated when watching suffering

Singer T, Klimecki ). “Empathy and Compassion.” Current Biology Vol 24 No 18 R876

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Self-Compassion

• Being mindful or “noticing”

• Common humanity

• Kind intent or action

• How would you treat a friend?

Credit Kristen Neff, PhD

https://www.freepik.com/free-vector/high-self-esteem-man-looking-into-mirror_10631704.htm

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Self-Compassion

• Being mindful or “noticing” our emotions

vs over-identification

• Common humanity vs isolation

• Kind intent or action vs self-criticism

• How would I treat a friend?https://www.freepik.com/free-vector/high-self-esteem-man-looking-into-mirror_10631704.htm

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Increased Self-Compassion is associated with

• Improved wellbeing and resilience

• Improved Sleep

• Motivation

• Healthy behaviors

• Personal accountability

• Better romantic relationships

• Being more authentic

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Self-Valuation

• Constructive commitment to excellence

• Prioritization of personal well-being

• Growth mindset perspective that seeks to learn and improve as the primary response to errors and imperfections

Trockel MT, Hamidi MS, Menon NK, Rowe SG, Dudley JC, Stewart MT, Geisler CZ, Bohman BD, Shanafelt TD. Self-valuation: Attending to the Most Important Instrument in the Practice of Medicine. Mayo Clin Proc. 2019 Oct;94(10):2022-2031. doi: 10.1016/j.mayocp.2019.04.040. Epub 2019 Sep 19. PMID: 31543254.

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Self Compassion is Associated with Lower Burnout and Higher Professional Fulfillment

Trockel MT, Hamidi MS, Menon NK, et al. Self-valuation: Attending to the Most Important Instrument in the Practice of Medicine. Mayo Clin Proc. 2019 Oct;94(10):2022-2031. Hashem Z, Zeinoun P. Self-Compassion Explains Less Burnout Among Healthcare Professionals. Mindfulness (N Y). 2020 Sep 10:1-10.

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Systemic Factors that Impact Self-Valuation

• Culture of Self Sacrifice

• Deferred self careo Habits developed in residency trainingo Increased work demands

• Culture of perfection (intolerance of human error)o Error treated with contempt and shame

Trockel, et al

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Low self-valuation

Suboptimal performanceBurnout

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Shame

Self-Judgement

IsolationOver-identification

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Shame

Self-Judgement

IsolationOver-identification

Self-compassion

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Shame

Self-Judgement

IsolationOver-identification

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Shame

Self-Judgement

IsolationOver-identification

Self-compassion

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Shame

Self-Judgement

IsolationOver-identification

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Shame

Self-Judgement

IsolationOver-identification

Self-compassion

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Shapiro, Shauna L. . Good Morning, I Love You. Paul Gilbert and Chris Irons, “Focused Therapies and Compassionate Mind Training for Shame and Self-Attacking,” in Compassion: Conceptualisations, Research and Use in Psychotherapy, …263–325.

Self-compassion

Oxytocin is released

Distress is reduced; feelings of care and support increase

Threat-defense system is deactivated; care system is

activated

Shame

Amygdala triggers a cortisol & norepinephrine

cascade

Stress level increases; cognitive flexibility is

inhibited

Fight, flight, or freeze response à inhibits the learning centers of the

brain

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Objections to Self Compassion

• It’s correlated with weakness

• Confusion with self pity

• False belief that it’s selfish

• False belief it’s self indulgent

• Confusion with self-esteem

• Belief that we need harsh criticism for improvement

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Self-Compassion

• Strength

• Awareness

• Caring and accepting

• Encouraging

• Stable sense of self-worth

• Effective coach

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Self-Compassion Exercises

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Self-Compassion Break

• Being mindful or “noticing”

• Common humanity

• Kind intent or action

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Cognitive Reframing

• Identify a negative conclusion or thought

• Identify the emotions around it

• Identify the thoughts around it

• Determine if the thoughts are balanced

• See if there are more balanced thoughts that might replace the negative thoughts

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Common Cognitive Distortions

• Polarized Thinking • Overgeneralization• Mental Filtering• Discounting the Positive• Jumping to Conclusions• Magnification• Emotional Reasoning• “Should” Statements• Labeling• Personalization and Blame

Burns M.D., David D.. Feeling Good: The New Mood Therapy

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Cognitive Reframing – Growth Mindset

• Return to the scenario you used in the previous exercise

• Identify a negative conclusion you made about yourself

• Define the terms you used

• Determine the extremes – best and worse

• Consider where you are on this continuum

Credit Mickey Trockel MD

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Compassionate Cognitive Reframing: Positive ReframingA technique to view one’s motives and behaviors in a more positive light and resist the urge to criticize and blame.

1. Think of an upsetting event2. Name some of the emotions you are feeling3. Notice what your negative thoughts are

Ask yourself : o What do the negative feelings/thoughts show about me

and my core values that are positiveo What are the advantages of feeling/thinking this way?

How can these emotions/thoughts help me?

Credit: Maryam Makowski, PhD

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Guided Meditation for Self Compassion

Credit: Monica Hansen

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References

• Burns M.D., David D.. Feeling Good: The New Mood Therapy. Burns, David D. Feeling Good: The New Mood Therapy. New York, N.Y: Penguin Books, 1981.

• Hashem Z, Zeinoun P. Self-Compassion Explains Less Burnout Among Healthcare Professionals. Mindfulness (N Y). 2020 Sep 10:1-10.

• Singer, Tania and Olga Klimecki. “Empathy and Compassion.” Current Biology Vol 24 No 18 R876

• Klimecki OM, Leiberg S, Lamm C, Singer T. Functional neural plasticity and associated changes in positive affect after compassion training. Cereb Cortex. 2013 Jul;23(7):1552-61. doi: 10.1093/cercor/bhs142. Epub 2012 Jun 1. PMID: 22661409.

• https://ggia.berkeley.edu/practice/loving_kindness_meditation• https://greatergood.berkeley.edu/article/item/the_five_myths_of

_self_compassion

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References• Neff KD, Knox MC, Long P, Gregory K. Caring for others without losing yourself: An adaptation of

the Mindful Self-Compassion Program for Healthcare Communities. J Clin Psychol. 2020 Sep;76(9):1543-1562. doi: 10.1002/jclp.23007. Epub 2020 Jul 6. PMID: 32627192.

• Kristin Neff and Christopher Germer, The Mindful Self-Compassion Workbook: A Proven Way to Accept Yourself, Build Inner Strength, and Thrive (New York: Guilford Press, 2018).

• Neff K.D., Dahm K.A. (2015) Self-Compassion: What It Is, What It Does, and How It Relates to Mindfulness. In: Ostafin B., Robinson M., Meier B. (eds) Handbook of Mindfulness and Self-Regulation. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2263-5_10

• Kemper KJ, Mo X, Khayat R. Are Mindfulness and Self-Compassion Associated with Sleep and Resilience in Health Professionals?. J Altern Complement Med. 2015;21(8):496-503. doi:10.1089/acm.2014.0281

• Kemper KJ, Mo X, Khayat R. Are Mindfulness and Self-Compassion Associated with Sleep and Resilience in Health Professionals?. J Altern Complement Med. 2015;21(8):496-503. doi:10.1089/acm.2014.0281

• Trockel MT, Hamidi MS, Menon NK, Rowe SG, Dudley JC, Stewart MT, Geisler CZ, Bohman BD, Shanafelt TD. Self-valuation: Attending to the Most Important Instrument in the Practice of Medicine. Mayo Clin Proc. 2019 Oct;94(10):2022-2031. doi: 10.1016/j.mayocp.2019.04.040. Epub 2019 Sep 19. PMID: 31543254.

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References • Juliana G. Breines and Serena Chen, “Self-Compassion Increases Self-Improvement Motivation,”

Personality and Social Psychology Bulletin 38, no. 9 (2012): 1133–43, doi.org/10.1177/0146167212445599.

• Sirois FM, Kitner R, Hirsch JK. Self-compassion, affect, and health-promoting behaviors. Health Psychol. 2015 Jun;34(6):661-9. doi: 10.1037/hea0000158. Epub 2014 Sep 22. PMID: 25243717.

• Breines JG, Chen S. Self-Compassion Increases Self-Improvement Motivation. Personality and Social Psychology Bulletin. 2012;38(9):1133-1143. doi:10.1177/0146167212445599

• Neff K.D., Dahm K.A. (2015) Self-Compassion: What It Is, What It Does, and How It Relates to Mindfulness. In: Ostafin B., Robinson M., Meier B. (eds) Handbook of Mindfulness and Self-Regulation. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2263-5_10

• Zhang, J. W., Chen, S., Tomova, T. K., Bilgin, B., Chai, W. J., Ramis, T., … & Manukyan, A. (2019). A compassionate self is a true self? Self-compassion promotes subjective authenticity. Personality and Social Psychology Bulletin. https://doi.org/10.1177/0146167218820914

• Zhang, J. W., & Chen, S. (2016). Self-compassion promotes personal improvement from regret experiences via acceptance. Personality and Social Psychology Bulletin, 42, 244-258. https://doi.org/10.1177/0146167215623271.

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