ACT With Compassion

“I don’t understand why I’m like this. I wasn’t abused or bullied. My parents weren’t ever critical of me. What’s wrong with me that I hate myself so much?” Statements like this are fairly common when someone who is highly self-critical and shame-prone clients is asked to reflect on the origin of their problems.

A core part of our collaborative case conceptualization process with highly self-critical and shame-prone clients involves exploring how a client’s self-criticism and shame makes sense given their learning history. In this process, one of the first things we give clients is the “History Related to Shame and Self-Criticism Handout” in which clients review their history related to critical and shaming experiences and relationships. In the process of working through this handout, clients who report growing up with relationships that were highly critical, where there was a lot of shaming, punishment, or harshness present, can generally see how their own self-criticism and shame may have developed out of that environment. This can be a very validating experience.

However, if a client didn’t grow up in an overtly or intensely critical environment, or if they don’t have a lot of specific memories of their childhood, they often struggle with feeling like they shouldn’t feel the self-criticism and shame they do. They can feel confused or even ashamed of why they struggle so much with self-criticism and shame.

That is why we find it essential to also assess clients’ experiences of warmth, compassion, and responsivity in their relationships. One way we do this is to give clients the “History of Compassion and Connection Experiences Handout.” In reviewing their responses to these two handouts, we discuss how criticism and responsivity/warmth are not two ends of the same spectrum. In other words, the lack of criticism is not the same as the presence of responsivity. Just because they didn’t necessarily experience a lot of direct criticism and shame from their primary relationships doesn’t mean they experienced much warmth or responsivity from their caregivers.

Once you and your client have assessed their history of receiving both criticism and/or responsivity, you may find it helpful to provide some information to the client about how various relational environments can tend to impact adult relational styles, including one’s relationship with themselves. For this, we have borrowed from the literature on adult attachment styles.  Based on Mansfield and Cordova’s (2007) work on a behavioral perspective of adult attachment style, we created a simple matrix and accompanying handout we sometimes use with clients that describes some of the likely outcomes may be for someone who grew with that early learning history. The matrix itself (shown below) can also help clients see that criticism and responsivity are not mutually exclusive, but rather two separate, interacting variables.

We’ve created a new handout (Responsivity in Relationships vs Criticism and Shaming) that has the above matrix on it. Together you can explore where your client might lie on this matrix along with reviewing the descriptions of adult relationship styles within that category. The idea is to help clients who report a relative lack of obvious criticism and shaming to have a coherent and validating way to understand how their self-criticism or self-hatred may have come about. This further serves the case conceptualization process and also builds the alliance with the client through sharing a more complete understanding of the unique ways in which the client experiences relationships, including their relationship with themselves.

We used this handout recently in a group we ran for highly self-critical and shame-prone individuals. Many of the participants noted that this was extremely helpful and validating for them. Seeing how the lack of received responsivity and warmth could have its own unique influences on adult relationship allowed them to have more understanding and compassion for themselves and their struggles.

So next time you have a client who feels like they don’t understand why they struggle with self-criticism and shame the way they do, you might try using this Criticism and Responsivity Handout as a follow-up to discussing their history related to compassion and warmth and their history related to criticism and shame.