While completing a doctoral program in clinical psychology, I found myself providing psychotherapy to a client* who felt trapped by her high standards. She attempted to seek perfection across the many roles in her life — at school or work, in her relationships, with her children, and with her possessions.
When she failed to meet her expectations, or made even small mistakes, she would respond by becoming incredibly self-critical. She would say the meanest things to herself — “I’m an idiot,” “I’m such a loser,” “I don’t deserve happiness” — things that she would never let others say to her, and that she would never say to anyone else! And often, the mistakes she made, and her self-critical thoughts, would increase her feelings of sadness, anger, and anxiety in ways that greatly impacted her life.
In my training in Cognitive Behavioral Therapy, a therapy technique with a large research base supporting its effectiveness, I learned to notice and point out my client’s self-critical thoughts and explore with her how these thoughts might be contributing to her struggles. I asked whether she was thinking about her failures accurately, and looked for ways that her interpretations might be distorted. We looked at her thought “I’m an idiot” and explored evidence from her life that she often made intelligent decisions, and discussed how judging herself as “an idiot” over small mistakes was an example of dichotomous thinking.
I tried to help her see her critical thoughts more objectively, and to give her the perspective that her thoughts were not useful and likely made her feel worse. We explored how these thoughts hurt her relationship with her family and kept her from taking risks in her career. However, over and over again, I noticed how she fell into the same pattern, finding only harsh words for herself in times of difficulty. I felt ineffective, and also like a hypocrite, because I saw critical thoughts popping up in my mind as I responded to my failure to help my client.
Luckily, a supervisor introduced me to the work of Dr. Kristin Neff, a research psychologist at the University of Texas at Austin. Her research on self-compassion provided an alternate response to failure.
Instead of responding to failure by criticizing ourselves and feeling alone and isolated in our struggles, self-compassion emphasizes that when we are struggling, we give ourselves comfort and kindness, and accept that failure and disappointment are part of the human condition.
The research on self-compassion is compelling — people with more self-compassion have a greater sense of well-being (Neff, Kirkpatrick, & Rude, 2007), deal more effectively with stress (Barnard & Curry, 2011), have more fulfilling relationships (Neff & Beretvas, 2013) and are less likely to have psychological problems (MacBeth & Gumley, 2012). Interventions aimed at increasing self-compassion are still being tested for their effectiveness, but preliminary studies show that increases in self-compassion with treatment are linked to decreases in depression, anxiety, and stress (Neff & Germer, 2012).
Now, as a postdoctoral fellow, I find that self-compassion plays an increasingly important role in the way I work with my clients. I use the Self-Compassion Scale developed by Dr. Neff to assess the extent to which clients respond to difficulty with criticism and feelings of being alone in their struggles. I work to help my clients develop a self-compassionate voice, one that provides them with comfort in the face of loss, and one that they can use to respond to their critical thoughts. For example, I may help a client say “mistakes are a part of being human” or envision an image of comfort that they can conjure when disappointed. I also teach mindfulness skills to help clients see their critical thoughts as the habitual way that their mind responds to failure, and not as evidence of their inability to reach their goals. I have found that these approaches are effective with many of my clients, and help them become more resilient to the inevitable challenges that life presents.
Finding self-compassion as a therapeutic technique has transformed the way I work with my clients, and has helped me as I respond to my own life disappointments. As the research base grows, I think self-compassion will play a larger and larger role in the way health professionals work with clients. As part of a culture where achievement is highly valued, and failures and mistakes are inevitable, we can all use a little kindness to help us live more fulfilling, meaningful lives.
* This description of a patient is an amalgam of many patients I have worked with, and is not referring to any one person in particular.