Mindful Self-Compassion Makes Me a Better Therapist

I have been using meditation to de-stress since I was a teenager. In recent years, I have been practicing mostly mindfulness meditation. I have professional training in this and often teach these skills to clients, both in individual session and in groups. It appears to help my clients get where they need to go faster and I believe it helps me get them there.

Better Outcomes

Then I came across an interesting article on the benefits of mindfulness by Daphne M. Davis, PhD, and Jeffrey A. Hayes, PhD. It seems that therapists who meditate show less reactivity, less stress and anxiety, and increased empathy and compassion. In addition, clinicians who practice mindfulness meditation personally have better outcomes with clients, even if they do not actually use mindfulness techniques in therapy. In one 9-week trial, the clients of therapists who meditate showed increased reduction in their symptoms, faster change, higher scores on measures of well-being and they reported that their treatment was more effective than the clients of therapists that did not meditate.

Mindful Harmonica

These days, we are hearing about mindfulness everywhere and for everything: Mindful Lawyering, Mindful Clowning, etc. And, I am not making this up, I was recently invited to a Mindful Harmonica workshop. Joking aside, hundreds of peer-reviewed studies describe the benefits of mindfulness training. Simply put, mindfulness is being aware of the present moment, without judgments. We are often stuck ruminating about the past or worrying about the future – and miss the present moment completely. Mindfulness tools help anchor us back to the present, increasing focus and awareness of, well, our actual, real-time life.

There is good evidence that mindfulness tools can help manage stress, anxiety and pain. It can improve emotional regulation, which is why Marsha Linehan includes mindfulness in her DBT protocols. Mindfulness skills can also help people make better decisions (about food or about substance use). Mindfulness practice provides a tool for interrupting the automatic processes, a chance for the prefrontal cortex to engage and provide reflection, decision-making and more balanced judgment. We can’t stop an unhealthy behavior and replace it with a healthier response until we develop early awareness signs of problematic triggers or cravings.

Self-Compassion is the Missing Piece

All well and good, but what about when things get difficult or uncomfortable emotions come up? Do we just become aware that we’re miserable and sit with that? To some extent, yes, that can be helpful. Just the act of labeling, “Oh, I’m feeling sad right now,” can reduce emotional intensity. And sitting with painful emotions can build distress tolerance (see the DBT manual again) and teach us that emotions do not kill us or last forever. But to tell clients with complex trauma and grief, to just learn to sit with their extreme emotions seemed a little unkind at times and “just observing” didn’t always propel them into rational reflection of their possible choices.

Then I went to a Mindfulness Self Compassion (MSC) workshop given by Kristin Neff, PhD (University of Texas) and Christopher Germer, PhD (Harvard University). Together, they have developed an evidence-based curriculum to teach people to cultivate self-compassion skills. This means when the going gets rough, you treat yourself with kindness and compassion, the same way you would treat a good friend going through the same thing. Germer says that self-compassion begins to soften the edges of our pain and “a little space grows around our destructive emotions that allows us to make positive changes in our lives.”

Self-compassion is the missing piece.

So we develop awareness, then label what we find and then we lean into what is there with kindness. We can recognize that difficulty is part of life, that everyone suffers at some time, which connects us to – rather than separates us from  others. And we can develop an invaluable tool for comforting ourselves and moving on.

With this technique, we not only cultivate healthy compassion for our clients, but we are able to recharge our own batteries so we have more to give.

So How Does this Help Me Exactly?

In his workshops and in the book, Wisdom & Compassion in Psychotherapy, Dr. Germer teaches a technique of self-compassion – compassionate breathing to use when working with difficult clients. We’ve all had them – clients whose stories are tragic, heartbreaking, harrowing. We want to be empathetic, but not take it all on ourselves (aren’t we calling this caregiver fatigue lately?). With this technique, we not only cultivate healthy compassion for our clients, but we are able to recharge our own batteries so we have more to give. Dr. Germer talks about taking in a deep breath of compassion for ourselves, then exhaling kindness and compassion for the other person (client). One for us, one for them. Our clients begin to pick up on the fact that we are calm and open (mirror neurons) and you will hear them start to breathe more audibly. When people ask me how I can do therapy all day, how can I listen to people’s problems, I explain about this. So, Mindful Self Compassion is something my clients find useful and it helps me be a better therapist myself.