ACT With Compassion

We at ACT with Compassion have been working out how to understand and describe the ways we could use personal perspective taking frames (from relational frame theory) in our work with shame and self-compassion. A few months ago, we wrote a post that described some examples, especially focusing on perspective taking between client and therapist. In that post we noted that during moments of high self-criticism, people tend to get fused with a conceptualized self (e.g., “I am broken”), and this narrow perspective tends to interfere with learning and connection. High self-critics (HSCs) tend to fused with a flawed conceptualized self much of the time. Thus, it is important to work with the client on multiple occasions, and sometimes in creative ways, to help them move toward a more flexible, self-as-context perspective and loosen the grip of the old shame story.

Using videos to facilitate perspective taking

Perspective taking work can be especially useful when working with HSCs to build a more compassionate perspective on those parts of themselves they feel are deserving of shame and self-criticism. Often, using imagery or videos can facilitate this perspective taking. In this post, we wanted to share a recent real-life example of how you might use a video or imagery to facilitate work with these perspective taking frames.

When working with a client who was particularly self-critical and highly shame-prone, I asked the client to watch a brief video in session with me -- The Present. Based on my previous work with the client I was pretty sure she would connect with the characters in the video. Before reading on, I’d first recommend watching the video. Trust me, it’s worth watching:

https://vimeo.com/152985022

As expected, when we debriefed the video, the client expressed that she felt touched, which I could also see. I conceptualized her emotional response as a sign that watching the video had been useful in that we were activating the response tendencies related to compassion and sadness that I had wanted to target. Thus, rather than just talking about the client’s difficulties, we were working in a more experiential mode of learning, as evidenced by the presence of the client’s in vivo demonstration of what appeared to be a combination of sadness and compassion, which was a shift from her previous emotional coolness and harshness with herself.

Model transcript showing perspective taking

In discussing her reactions to the video, I focused on questions designed to elicit perspective taking, as modeled in this dialogue below. The main idea was to use the video as a metaphor for the various sides of the client (i.e., perspectives she takes) and to use the characters and the relationships between them to build new ways of responding to those various sides. Although not a verbatim transcript, the dialogue below reflects the general focus of that session. Through talking about these various characters in the video, the client was able to take a more flexible stance in identifying and relating to her own various sides and how those sides might relate to each other just as the characters relate to one another in the video.  The transcript starts up after we have already discussed her reactions to the film.

Therapist: Is there a part of you that is like the boy?

Client: Well, yeah, there’s a part of me that’s like the boy at the start.

Therapist: A side that’s so caught up in avoidance, trying to keep busy, stay focused on something, to just distract.

Client: Yeah.

Therapist: Part of why I wanted to share this video with you is that I felt like you might identify some with the puppy as well. I know that there’s a side of you that feels really broken and that you reject because of that sense that it’s damaged.  Do you connect with that?

Client: Yeah. [tearing up]

Therapist: The thing is…it also feels like that side of you that feels so damaged is also kinda like that puppy. It’s vulnerable, it needs attention, love. Maybe even it’s the part of you that knows how to play. Does that connect with you too?

Client: Yeah [continues to cry]

Therapist: [pause] What’s happening right now?

Client: [pause]  I don’t know. I guess I just feel sad.

Therapist: Yeah, I wonder if that’s how that puppy would feel if it kept being rejected…when what it really needs is love, attention, someone to play with it...[said tentatively]

Client: Yeah.

Therapist: To me, it seems like that side of you that wants love, wants attention, wants to play is a pretty cool side of you. I really like that side of you and feel really fond of that side myself…[client tears up again] It’s kinda like that puppy. Puppies are pretty cool, you know? And it’s innocent, like that puppy, it just wants some attention…[pause] And yet your response is to push it away.

Client: Yeah. That seems right.

Therapist: What if we need to help you to be more like the boy in the second part of the video?  Are you like that much?
Client: No, I don’t play with the puppy much. I usually try to keep her locked away.

Therapist: I wonder if we need to do something to learn how to appreciate that damaged puppy side of you? Cause, after all she’s pretty cool? Make sense?

Client: I’m not sure I can.

Therapist: That’s OK. I know you’re not sure how to. You’re kinda stuck in the first part of the video…

Client: Yeah, it feels like I’m stuck in the first half.

Therapist: My favorite part of the second half of the video is how the relationship transforms when the boy starts to attend the puppy and begins to appreciate what’s cool about her. He starts to appreciate the puppy’s puppiness and things start to change. I’m not sure if you noticed, but the puppy actually helps the boy by opening the door. By starting to have a cooperative relationship the puppy actually starts to help the boy. And even more, I’m not sure if you noticed it up, but there’s one part where the puppy actually runs under the missing part of the boy’s leg. It’s like the missing part is part of the play now. The missing part becomes something that brings joy to the puppy, it’s part of the puppies play. Like the whole situation transforms and the thing that seemed like damage, isn’t even damage anymore, but now it’s an asset…I wonder if we need to do something like that with you. To find a way to play with that puppy-like, vulnerable side of you that feels so damaged. To start to transform the relationship with it, so that you are on more friendly terms. Maybe even to discover that the seeming damage doesn’t need to interfere and perhaps could even be something that was embraced or appreciated. Would you be interested in working for something like this?

Client: Yeah, that would be nice.

For the remainder of the session, we focused on identifying some goals for homework that the client could do this weekend that would be in the service of giving the puppy some attention or giving herself some space to play in her life.

There are many different ways to help clients develop a more self-compassionate view of themselves. In fact, research shows that more than 75% of us report being more compassionate to others than we are ourselves. This data suggests that if we could help HSC clients take a more flexible perspective of themselves, to see themselves as simply another “person”, then those compassionate behavioral repertoires that get activated for others, may also be applied towards themselves. Using perspective taking frames, especially when harnessing the power of imagery or video, can be a particularly effective way to tapping into these compassionate behavioral repertoires that may already exist.