self-compassion from an act perspective: an intellectual and experiential exploration dennis tirch...
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Self-Compassion Self-Compassion From an ACT Perspective: From an ACT Perspective:
An Intellectual and An Intellectual and Experiential ExplorationExperiential Exploration
Dennis Tirch PhD & Jason Luoma PhDDennis Tirch PhD & Jason Luoma PhD
www.mindfulcompassion.comhttp://www.portlandpsychotherapyclinic.comhttp://www.portlandpsychotherapyclinic.com
Rate how often you behave in the ways below, using the following scale:
Almost never Almost always
1 2 3 4 5
_____1. When I fail at something important to me I become consumed by feelings of inadequacy.
_____2. I try to be understanding and patient towards those aspects of my personality I don’t like.
_____3. When something painful happens I try to take a balanced view of the situation.
_____4. When I’m feeling down, I tend to feel like most other people are probably happier than I am.
_____5. I try to see my failings as part of the human condition.
_____6. When I’m going through a very hard time, I give myself the caring and tenderness I need.
_____7. When something upsets me I try to keep my emotions in balance.
_____8. When I fail at something that’s important to me, I tend to feel alone in my failure
_____9. When I’m feeling down I tend to obsess and fixate on everything that’s wrong.
_____10. When I feel inadequate in some way, I try to remind myself that feelings of inadequacy are shared by most people.
_____11. I’m disapproving and judgmental about my own flaws and inadequacies.
_____12. I’m intolerant and impatient towards those aspects of my personality I don’t like.
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Compassion SolutionsCompassion SolutionsAncient wisdomAncient wisdom
Compassion transforms the mind. Compassion transforms the mind. (Buddhism)(Buddhism)Evolution Evolution
Evolution has made our brains Evolution has made our brains highly highly sensitive to internal and sensitive to internal and external kindnessexternal kindnessNeuroscienceNeuroscience
Specific brain areas are focused on Specific brain areas are focused on detecting detecting and responding to and responding to kindness and compassionkindness and compassionACTACT
Compassion is a value inherent in Compassion is a value inherent in psychological flexibility model – psychological flexibility model – Self-compassion related to flexible Self-compassion related to flexible
perspective perspective takingtaking
Compassion definitionsCompassion definitions
Compassion can be defined in many Compassion can be defined in many ways: ways: ““As a sensitivity to the As a sensitivity to the suffering of self and others with a suffering of self and others with a deep commitment to try to relieve itdeep commitment to try to relieve it”” Dalai LamaDalai Lama
Eight fold path - represents a multi-Eight fold path - represents a multi-modal approach for training onemodal approach for training one’’s s mindmind
Compassion DefinitionsCompassion Definitions
Neff (2003b) has operationalized self-compassion as consisting of three main elements:
1.Self-kindness vs harsh criticism and self-judgment2.A sense of common humanity vs seeing self as separate and isolated3.Mindfulness vs overidentification
Self-Compassion Self-Compassion and Psychological Flexibilityand Psychological Flexibility
These components combine and mutually interact to create a self-compassionate frame of mind.
Self-compassion is relevant when considering personal inadequacies, mistakes, and failures, as well as when confronting painful life situations that are outside of our control.
Self-Compassion DataSelf-Compassion Data
Higher levels of reported self-compassion are correlated with:•Lower levels of depression and anxiety (Neff, 2003; Neff, Hseih, & Dejitthirat, 2005; Neff, Rude, & Kirkpatrick, 2007)•life satisfaction, feelings of social connectedness (Neff, Kirkpatrick, & Rude, 2007)•personal initiative and positive affect (Neff, Rude, et al., 2007)
Compassion Training DataCompassion Training DataPractice in imagining compassion for others Practice in imagining compassion for others • produces changes in frontal cortex and immune system produces changes in frontal cortex and immune system
(Lutz et al, 2009)(Lutz et al, 2009)
Loving kindness meditationLoving kindness meditation• increases positive emotions, mindfulness, feelings of increases positive emotions, mindfulness, feelings of
purpose in life and social support and decreases illness purpose in life and social support and decreases illness symptoms (Frederickson et al, 2008, JPSP)symptoms (Frederickson et al, 2008, JPSP)
Compassion meditation (6 weeks)Compassion meditation (6 weeks)• improves immune function, and neuroendocrine and improves immune function, and neuroendocrine and
behavioral responses to stress (Pace, 2008, PNE)behavioral responses to stress (Pace, 2008, PNE)
Compassion trainingCompassion training• reduces shame and self-criticism in chronic depressed reduces shame and self-criticism in chronic depressed
patients (Gilbert & Proctor, 2006, CPP)patients (Gilbert & Proctor, 2006, CPP)
Self-Compassion Self-Compassion from a CBS perspective from a CBS perspective
Dahl, Plumb, Stewart and Lundgren, (2009)• Self-Compassion involves:
– willingly experiencing difficult emotions; – mindfully observing our self-evaluative, distressing and
shaming thoughts without allowing them to dominate our behavior or our states of mind
– engaging more fully in our life’s pursuits with self-kindness and self-validation
– flexibly shifting our perspective towards a broader, transcendent sense of self (Hayes, 2008a).
Self-Compassion Self-Compassion and Psychological Flexibilityand Psychological Flexibility
• Our learned capacity for flexible perspective taking is involved in our experience of empathy (Vilardaga, 2009), as well as our related experience of compassion.
• In order to understand self-compassion, therefore, it’s useful to consider the “self” that is the focus of compassion, from an RFT perspective.
Self-Compassion Self-Compassion and Psychological Flexibilityand Psychological Flexibility
• Deictic relations are building blocks of how we experience the world, ourselves, and the flow of time.
• Returning to an awareness of self-as-context offers us a non-attached and dis-identified relationship to our experiences.
• This allows the habitual stimulus functions of our painful private events and stories to hold less influence over us.
Self-Compassion Self-Compassion and Psychological Flexibilityand Psychological Flexibility
• From the perspective of the I-Here-Nowness of being, I can view my own suffering as I might view the suffering of another, and be touched by the pain in that experience, without the dominant interference of my verbal learning history, with its potential for shaming self-evaluations (Vilardaga, 2009; Hayes, 2008).
THEN
NOW
YOU
I
HERE
THERE
Formation of Self-as-Context:Formation of Self-as-Context:The No-Thing Self (Hayes, 2008)The No-Thing Self (Hayes, 2008)
I-Here-Nowness of Perspective Taking
Self-as-context
Brain DevelopmentBrain Development in Deep Historical Context in Deep Historical Context
Private Events and Brain Development in the Private Events and Brain Development in the context of Genotype, Phenotype, and context of Genotype, Phenotype, and
Present MomentPresent Moment1. “Old Brain”1. “Old Brain”
Emotional Responding:Emotional Responding: Anger, anxiety, sadness, joy, lustAnger, anxiety, sadness, joy, lustOvert Overt Behavioral Responding:Behavioral Responding: Fight, flight, withdraw, Fight, flight, withdraw,
engageengageRelationship Behaviors:Relationship Behaviors: Sex, status, attachment, Sex, status, attachment,
tribalismtribalism
2. “New Brain”2. “New Brain”Relational Framing, Relational Framing, Imagination, fantasize, look back and Imagination, fantasize, look back and
forward, forward, plan, plan, Integration of mental abilitiesIntegration of mental abilitiesSelf-awareness, self-identity, flexible perspective taking, self-Self-awareness, self-identity, flexible perspective taking, self-feelingfeeling
3. “Social Brain”3. “Social Brain”Need for affection and care Need for affection and care Socially responsive, self-experience and motivesSocially responsive, self-experience and motives
??
Sources of behaviourSources of behaviour
Old BrainOld Brain: Emotions, Motives, : Emotions, Motives, Relationship Seeking, Safety Seeking Relationship Seeking, Safety Seeking
BehaviorsBehaviors
New BrainNew Brain:: Derived Relational Responding, SelfingSelfingPlanning, Rumination, Planning, Rumination,
Interaction of old and new psychologies
Understanding our Motives and Understanding our Motives and EmotionsEmotions
Motives evolved because they help animals Motives evolved because they help animals to survive and leave genes behindto survive and leave genes behind
Emotions guide us to our goals and respond Emotions guide us to our goals and respond if we are succeeding or threatenedif we are succeeding or threatened
There are three types of emotion There are three types of emotion regulationregulation
1.1.Those that focus on threat and self-Those that focus on threat and self-protectionprotection
2.2.Those that focus on doing and achievingThose that focus on doing and achieving3.3.Those that focus on contentment and Those that focus on contentment and
feeling safefeeling safe
Types of Affect Regulator Types of Affect Regulator SystemsSystems
Incentive/resource- Incentive/resource- focusedfocused
Wanting, pursuing, achieving, consuming
Activating
Non-wanting/Non-wanting/Affiliative focusedAffiliative focused
Safeness-kindness
Soothing
Threat-focused Threat-focused
Protection andProtection andSafety-seekingSafety-seeking
Activating/inhibitingActivating/inhibiting
Anger, anxiety, Anger, anxiety, disgustdisgust
Drive, excite, Drive, excite, vitalityvitality
Content, safe, Content, safe, connectedconnected
Self-ProtectionSelf-Protection
In species without attachment In species without attachment only 1-2% make it to only 1-2% make it to adulthood to reproduce. adulthood to reproduce. Threats come from ecologies, Threats come from ecologies, food shortage, predation, food shortage, predation, injury, disease. At birth injury, disease. At birth individuals must be able to individuals must be able to ““go go it alone,it alone,”” be mobile and be mobile and dispersedisperse
Dispersal and avoid othersDispersal and avoid others
Protect and Comfort: Less Protect and Comfort: Less ‘‘instinctive’ brain – post birth instinctive’ brain – post birth
learninglearning
Compassion ProcessCompassion Process
Giving/doing
Mindful Acts of kindness
Engagement with the feared
Receiving/soothingSBR/boothValidation
Gratitude appreciation
ThreatMindful awareness
TriggersIn the bodyRuminationLabelling
Compassionate Self
Defusion Commitment
Psychological Flexibility
Willingness
Present Moment Contact
Self-As-Context
Values Authorship
Non-Judgment Commitment to Compassionate Behavior
CompassionateFlexibility
Distress Tolerance
Sympathy, Sensitivity
Empathy
Care For Well-Being
Defusion Commitment
Psychological Flexibility
Willingness
Present Moment Contact
Self-As-Context
Values Authorship
Contact with the presentBuild awareness of self-criticism/self-attack• Clients often do not even notice their self-evaluations. Methods:• Teach client to notice evaluation/judgment as it occurs in session
(noticing antecedents)• Help clients to notice avoidance of shame as it occurs in session
(noticing behavior)• Bring costs of self attack into the room (noticing consequences):
– Read aloud self-attacking thoughts, but imagine she were saying them to a friend in the same position
– Use a mirror when reading self-attacking thoughts to self – Act out self-attack in chair work
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Acceptance InterventionsDevelop ability to acknowledge and embrace aspect of self that
feels damaged, broken, unlovable, not-good-enough, and/or rejected
Methods:• Examine workability of behaviors aimed at avoiding shame (anger,
shutting down, addictive behavior).
– How do they avoid feeling bad about themselves or feeling rejected? What happens in shame producing situations?
• Bring process of shame and self-attacking into the room and improve ability to sit with it and with reaction to self-attack (usually with chair work)
• Practice willingness in relating shameful experiences and secrets to trustworthy others (starting with therapist)
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Defusion
Develop distance, distinction from self-attacking thoughts. • Clients typically see critical view of self as normal, earned,
or needed for motivation.Methods:• Imagery – imagine this critical self as if it were a person
(include tone, size, facial expression, etc.). Give it a name.• Naming the critic – develop a name for the critical side of
the self that has some endearing qualities• Act out criticizer as if it were another person• Many common defusion exercises can be helpful here
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Self as context/flexible perspective takingDevelop connection a sense of self that transcends our stories about self
• Shame/self-criticism is fundamentally a problem with self/other as content
Methods:
• Work on letting go of attachment to self as content, e.g., self evaluations
• Practice flexible perspective taking (loving kindness meditation, taking perspective of shamers, taking perspective of therapist, and caring others)
• Physicalize self as content through chair exercises– Add a third chair, perhaps a compassion chair or observer chair for
experiencing the ongoing dialogue.– Have client be the compassionate therapist in the third chair. What
would that person say?• Use hierarchical framing to build sense of common humanity in suffering
and normality of shame and fears
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Flexible perspective takingShift perspectives to expand possibilities
• If your best friend was watching this interaction, what would they say?
• If you were a therapist for a couple that acted this way, what would you think of them? What would you want for them? For him, for him?
• If you were (someone client admires) [in the self chair], how would you act differently
• If you were me and you heard what you are saying right now, what would you think?
Notice change in perspective
• When you look at this from another perspective, does it feel the same? Different? Do you see yourself the same way when you take these different perspectives?
Combine with augmentals
• If x (whatever the critic says) were not weighing you down, what would you be doing? What would you need from him/her to make that possible?
• If x (whatever critic says) no longer held you back, what would you be doing?
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ValuesHelp person explore and define values toward self• Most people value empathy and connection, but fusion
with self-concept impedes applying that to themselves Methods:• Empathy and compassion for self can emerge when the
damage done by fusion with self-criticism is fully contacted
• Elicit and define the kind of relationship person wants to have toward themselves
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Committed actionHelp client take steps to act on values while practicing gentleness
and compassion • Self-attacks often function as a way to coerce the self to act in line
with self-standards and values (e.g., “buck up” and “push through it”).
• Self-criticism makes it harder to take risks and learn, which inevitably involves failure and mistakes
Methods:• Build commitment to practices of self-care and self-kindness• When exploring other kinds of valued actions, explore what kind of
relationship person wants to have toward self as they do this--“and how do you want to be with yourself as you take these actions?”
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