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Why Self-compassion is the Key to High-Quality Practice




Self-compassion is something that I completely stumbled upon.


Sometime around 2018, I bought a book called The Mindful Self-Compassion Workbook after hearing one of the authors, Kristin Neff, being interviewed on a podcast.


I often explore new things for myself so that I can offer them to my patients if I find value in them, and this was no different.


I thought to myself, this sounds like something that my patients could benefit from, while also thinking in the back of my head, of course, I don’t need this — I’m already nice to myself. I’ve got this shit dowwwwn.


But over the next several weeks (and indeed years since first reading this book) I slowly became aware of just how rude to myself I can be.


The first thing I noticed was the little jabs I’d take at myself:

Come on, Andrew.

Get it together.

You’re better than this.

Don’t be a moron.


These jabs came constantly. Working with patients, doing home renovations, meditating, hanging out with my wife— nothing was off-limits for the critic in my head.


What’s more, I began to notice what happens after these thoughts showed up. I would feel discouraged, sad, frustrated, or downright mad.


To make matters worse, my performance suffered. I’d get so tangled up fighting against—or trying to win the approval of—my inner critic so that he’d let up, that I’d lose focus on what I was doing, not think through my actions, and make mistakes. This, of course, triggered more judgemental thoughts, ultimately perpetuating the cycle.


As more time passed, I became aware of the deeper beliefs and fears underlying these surface-level statements. Like the belief that I’m actually a dickhead at heart but I’ve gotten really good at putting up a front that I’m a nice guy. Or the fear that I’m not actually that intelligent but just rather charismatic and a bit overconfident at that.


After realizing that I wasn’t quite as nice to myself as I’d thought, I began incorporating simple self-compassion practices into my daily life. I stuck with them and slowly began to see changes happen:

I was feeling less nervous and more at ease when working with patients

  • My focus and presence improved

  • My sessions went smoother

  • I learned more

  • I enjoyed my days more

  • I was happier

All of this amounted to me feeling less burned out. I felt lighter.


My journey with self-compassion isn’t over—it’s only just beginning—but I want to share with you what I’ve learned thus far so that you too can improve your performance while feeling more at ease.


In this article, we’ll discuss:

  • What self-compassion is (& what it isn’t)

  • Why it’s important & how it relates to patient care

  • Simple practices that you can implement to boost your own self-compassion


Much of this information is influenced by Kristin Neff and Christopher Germer’s research and their book: The Mindful Self-Compassion Workbook, which I highly recommend if you find yourself interested in learning more on this topic. Neff’s website, Self-Compassion.org is also an excellent resource.



What is self-compassion?


If a friend talked to you the way that you talk to you, would you still be friends with them?

Our culture places much emphasis on being nice to others, but very little emphasis on being nice to ourselves.


In fact, often the opposite is celebrated: sacrifice, grinding, hustling, relentless pushing until we achieve some tangible goal, often involving money or status.


We believe that to be successful and reach our goals, we have to whip ourselves into shape, lest we become lazy failures.


Self-compassion is learning to become an inner ally, rather than an inner enemy. To work with ourselves, rather than against ourselves.

  • It’s learning to offer ourselves unconditional acceptance, regardless of the circumstances of our lives

  • It’s a recognition that nobody has it all figured out—we all fail, make mistakes, and experience hardships in life. We’re all works-in-progress

  • And it means facing the truth of our experience—even when it’s unpleasant—without avoidance or rumination


What Self-Compassion is Not


In order for us to more fully understand what self-compassion is, let’s discuss what self-compassion is not.


Self-compassion is not:


Self-pity.

Self-compassion is actually the antidote to self-pity. Self-pity says, poor me, while self-compassion recognizes that life is difficult for everyone. Research shows that self-compassionate people are more likely to engage in perspective-taking and less likely to engage in rumination (1).


For wimps.

Many believe that being nice to ourselves will make us weak. The opposite appears to be true: self-compassionate people have been shown to better cope with difficult life situations (1).


Selfish.

Here again, we find that the opposite is true: giving ourselves what we need enables us to give more to others around us. Self-compassion allows us to take care of ourselves in a way that allows us to be mentally and physically healthy enough to take care of those around us. (2)


Self-gratification.

Self-compassion is not simply indulgence or treating ourselves. Self-compassion involves taking care of ourselves by looking out for our highest good. Sometimes the most compassionate thing to do isn’t to crush the whole bag of chips because we feel like it. But equally important is not beating ourselves up when we do. (2)


Laziness.

One of the biggest fears, which prevents many of us from being nice to ourselves is the fear that it will undermine our motivation to achieve.


We have this belief that self-criticism is an effective motivator, but it’s not, especially in the long run. While it might get you to do the thing that you believe you should do, self-criticism undermines self-confidence and creates fear of failure. This can become cyclical, one stoking the other, and can quickly get out of hand.


Research shows that self-compassionate people have high personal standards (because they care about themselves), but—importantly—they don’t beat themselves up when they fail. This means they are less afraid of failure (because failure is normal), and are more likely to try again and persist in the face of adversity (1)


Self-esteem.

This is a biggie. There is certainly overlap between self-compassion and self-esteem, but some very important differences as well.

  • Self-esteem is conditional. Self-esteem is self-regard based on self-evaluation. Self-esteem tends to be a fairweather friend, there for us when we succeed and are feeling good, but nowhere to be found when we make a mistake or go through hard times. Self-compassion is unconditional. It’s not based on self-evaluation at all; it’s about relating to ourselves the same through the ups and downs, the highs and lows. (1, 2)

  • Self-esteem requires being above average; better than others. But the problem with this is that everyone can’t be above average. Self-compassion acknowledges that we are all works-in-progress, and is not determined in relation to other people.

Self-esteem is a byproduct of self-compassion, not the other way around (2).



Why is self-compassion important?


Hopefully, by now, you’re feeling like you have some understanding of what self-compassion is. Let’s talk a bit about why it’s important.


This is honestly a bit tricky. While there are countless evidence-based reasons that self-compassion is important, some of which we’ve already discussed, at the end of the day, it all depends on you.

It depends on what you want in your life.


My journey thus far in life has shown me that what I want—what I truly want—is to be happy.


I’ve achieved much in my life and what I kept telling myself in the past was that:

I’ll be happy when I _________.

  • When I get into PT school, then I’ll be happy. Then it happens and I say…

  • When I graduate from PT school, then I’ll be happy. Then that happens and I say…

  • When I do a residency program, then I’ll be happy. Then that happens and I say…

  • When I do a fellowship program, then I’ll be happy. Then that happens and I say…

  • When I… wait what the fuck am I saying?


Somewhere along the line, I realized that if my goal is to be happy, why not focus on that, rather than some external thing that I think will make me happy (which has thus far proven to not make me happy)?


The truthat least for meis that being nicer to myself not only helps me to be happier (because I’m not putting myself down as much), but it has also greatly enhanced the achievement-oriented stuff:

  • My reasoning skills have improved, due in part to my inner critic taking up less cognitive space

  • My communication skills have improved, due in part to:

    • Being better able to relate to others from being aware of my own struggles

    • Holding more space for the struggles of others from not resisting my own struggles

  • My confidence has improved, due in part to being less self-critical and having less fear of making mistakes


And I’ve found that I still do the things that I used to do:

  • I still read a lot

  • I still work a lot

  • I still challenge myself

  • I still achieve


Only now, I’m doing it because I want to, not because I feel that I need to for fear of being a loser, a failure, or worst of all… mediocre.


See the difference? I’m still me, only now, I’m starting to work with myself, rather than against myself. And as it turns out, working with yourself requires much less energy than working against yourself, so I tend to get more done. Who would have thought??


It’s OK to want to be better at your job, to excel in your career, to make money, to have nice things. But understand why you want all of those things and focus on that deeper why.


If you’re anything like me, you too want to be happy, you want to enjoy your life.


If that’s true for you. Remember that. Let that guide you.


Self-compassion is choosing to start right now by being nice to yourself right now.


Now might be a good time to stop, take a breath, and think of something that you love about yourself. If you’re feeling really spunky, say it out loud as you look at yourself in a mirror (unless you’re driving).


How did that feel? Good? Great? Awkward? Uncomfortable? A range of responses is normal, especially in the beginning. Let’s talk through some more strategies.



How Can We Practice Self-Compassion?


Self-compassion is truly just that—a practice.


Research has shown that gains in self-compassion are linked to how much self-compassion practice we do. Not how much we talk about self-compassion or think about the concept of self-compassion. How much we practice it.


Before we get into some practices it would be helpful to discuss the three components of self-compassion, as defined by Neff & Germer (1):

  • Self-Kindness. Self-kindness includes offering ourselves warmth and unconditional acceptance, as well as engaging in self-soothing behaviors when life gets tough

  • Common Humanity. This is the recognition that pain and difficulties in life are part of a shared human experience. Suffering is something that is universal to human beings

  • Mindfulness. Mindfulness is actually the first step. Before we can act differently, we need the presence of mind—the awareness—to see what is. This was what really got me into self-compassion—the witnessing of my own inner critic


It’s also important to realize the diversity of what self-compassion can look like.

It can look like

  • Comforting

  • Soothing

  • Validating

It can also look like

  • Protecting

  • Providing

  • Motivating


We’re all different; some of us identify more with the first group, some with the second group. The commonality in these practices is the attitude behind them—an attitude of friendliness and care.


And while we may more naturally exhibit compassion and self-compassion when it comes to comforting, soothing, and validating; it’s important that we’re no stranger to protecting, providing, and motivating. The opposite is true as well. Balance is important.


There are many excellent practices for boosting your self-compassion. I’m going to provide you a bit of a smorgasbord, which is largely based on practices that I’ve found helpful. My hope is that you find one or a few that resonate with you, but know that there are many other practices out there and www.Self-Compassion.org is an excellent resource.



Formal Practices


1. The Self-Compassion Test

One thing that can help in the awareness-building process is the Self-Compassion Test. This is a measure designed by Neff & Colleagues and is used in self-compassion research. It will allow you to see where you are at baseline, to track progress over time (if you like to measure things), and the questions also serve as excellent points of reflection.


2. (Self-compassionate) Mindfulness Meditation

Given that mindfulness is really the foundation of self-compassion, meditation is one of the key formal practices. If you’ve dabbled with meditation, you’ve likely experienced frustration when your mind wanders more than you’d like it to. It’s said that the moment we realize that the mind has wandered is the magic moment. This is a practice that focuses on that very moment.


It’s called Declaring WAR!

You start out by closing your eyes and focusing on a specific object (for example, the breath as it passes through the nose). The goal is to keep your attention on your object. Each time you notice the mind wandering, you declare WAR. By this, I mean that you:

  • Witness the thought, feeling, or sensation

  • Allow it to be there

  • Return to the breath

The key part of this practice is the middle of the sandwich, the Allowing.


When we’re trying to focus on our breath and something else comes into the mind, our instinct is often to push it away. This creates resistance, which makes our focus worse. This is exactly what happens when we try not to think about something during our daily life; what we resist persists. For example, try not to think about a pink hippo right now.


Instead, when we allow the thought, feeling, or sensation to be there, it will pass soon enough. I like to speak directly to it, by saying something like, It’s OK, you can stay, or, Thank you for trying to protect me.


Just as I did with the meditations described in the clinical reasoning episode, I created a guided meditation for this so that you can simply sit down, close your eyes, play the track, and I will guide you through it.


It can be found here.


3. Mirror time

These days, we witness ourselves most often through taking pictures and videos on our phones or through using mirrors as tools to make ourselves look better (when doing hair or makeup, for example). These moments often have layers of judgment on top of them, as we assess whether our pictures are worth posting and whether we look good enough.


The intent of this practice is to witness ourselves nonjudgmentally. We’re not capturing anything to be saved or shared, and we’re not looking for flaws in our appearance, we’re just being with ourselves.


Very simple practices in front of the mirror can be very deep and very transformational. Two simple examples are eye contact and affirmations.

  • Eye contact. Simply make eye contact with yourself for a few minutes. This is an excellent place to start and you can learn a lot about your inner dialogue through noticing what comes up as you do this.

  • Affirmations. Affirmations are statements of support or encouragement. We often look outward for affirmations, hoping that others will tell us what we need to hear. But we can do this for ourselves, and it’s much more powerful when we do. The practice is looking at yourself in the mirror as you recite—silently or out loud—words that you need to hear. Some examples are:

    • I love myself as I am

    • I accept myself as I am

    • I am enough as I am.


Informal Practices


These practices are called informal practices because they’re meant to be done on the fly, in real-time, in real life. For clarity, I want to use an example from my own life to illustrate how these practices can be used.


So I have a patient who comes to me and has a lot going on. They’re short with the front-desk staff, they have a medical history a mile long, they sit down and start telling me their story, which is long, complicated, emotional, and involves many expectations about what physical therapy is and how it may or may not help them.


Thoughts start bubbling up in my head, “How can I possibly help this person?” And, “Oh man, this person’s going to be on my schedule forever.” I start to feel anxious, distracted, lethargic.


What to do?


1. Recognizing

The first thing to do is to recognize this as a moment of struggle. Simply recognizing that we are struggling allows us to make more conscious decisions about what to do next. Verbal acknowledgment can be helpful for this, so I might say to myself (in my head):

  • This is stressful

  • This is a complicated case

  • This is difficult


2. Dealing with unhelpful thoughts

I can’t always identify specific thoughts that seem to be causing or contributing to these moments of stress, but when I do, there are several strategies that I find helpful.


We’ve talked a bit about resistance, and the fact that when we push something away, it’s still there. And not only does it stick around longer, but it stresses us out even more. Like, how many times have we been upset about something, only to become doubly upset because we “Shouldn’t be feeling this way”?


There’s a formula that illustrates this well:

Suffering = Pain x Resistance

*Not Pain + Resistance; Pain x Resistance


The reality is, these thoughts are just our ego trying to protect us. When we can deal with them in this manner, by allowing them to stay, thanking them, even loving them, they tend not to stick around very long.


We can deal with unhelpful thoughts with kindness, saying things like

  • You can stay

  • Thank you (for trying to protect me)

  • I love you

We can also deal with them with humor (something that I’m learning) by saying things like

  • I don’t remember asking for my opinion!

  • Well, aren’t you sassy!

  • Welcome to the party (one of my favorites from an amazing meditation teacher called Jeff Warren)

The intention behind these strategies is to not take our thoughts so seriously.


We all have helpful thoughts, we all have pleasant thoughts, and we all have dark thoughts.


The less seriously we take our thoughts, the more we can choose which ones to listen to and which ones to let pass by.


3. Tapping into our common humanity

When something comes up that causes us stress, we often feel isolated, like we’re the only ones struggling.


It can be helpful to take a moment to recognize that we’re not alone in our struggles. Some phrases that I might say to myself, in this case, would be:

  • Challenge is a part of life

  • Everyone gets difficult cases

  • Nobody’s got it all figured out



In Summary:

  • Self-compassion is learning to become an inner ally, rather than an inner enemy. To work with ourselves, rather than against ourselves.

  • Self-compassion helps us to be more resilient, have better perspective, and show up for those around us more

  • Self-compassion includes 3 elements, which can be practiced to boost our skills

    • Mindfulness

    • Common Humanity

    • Self-Kindness


References

  1. Neff, K., & Germer, C. (2018). The Mindful Self-Compassion Workbook: A Proven Way to Accept Yourself, Build Inner Strength, and Thriveÿ ÿ. Guilford Publications.

  2. Jinpa, Thupten. A fearless heart: How the courage to be compassionate can transform our lives. Avery, 2016.

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