ACT With Compassion

In a recent post, we wrote about how the absence of criticism in a person’s history is not the same as the presence of warmth.  It is not necessary for clients to have a history of extreme levels of abuse or verbal criticism from others in order to develop a shame prone and self-critical tendency. A mere absence of responsive and warm communications and physical contact from their caregivers can contribute to high levels of shame and self-criticism, even in the relative absence of abuse or criticism.

Rather than overt criticism, clients might have experienced emotional neglect or indifference that led them to question their worth or place in the family. Maybe it wasn’t that their failures were highlighted, but rather that their accomplishments weren’t celebrated or were ignored. Or maybe caregivers’ social signaling did not indicate warmth and love toward the client on a regular basis. These environments that may not have as much overt criticism or harshness but that lack of warmth and responsivity may not be as obvious can still have a very powerful impact.

We provided a handout in the previous post about patterns associated with combinations of high/low criticism and high/low responsivity from caregivers. For example, here is what we might expect if someone has a history of low responsibility even without high criticism (from the handout):

Low Criticism/Low Responsivity: While there may not be a high level of intense criticism or harshness in these relationships, you could say there isn’t much of anything. Growing up in an environment in which there wasn’t much warmth, vulnerability, or openness could leave you feeling unseen, not understood, or not valued. As a result, you may feel quite lonely. You may have learned that you’re on your own and you can’t really trust in others’ care for you or that they will be there for you. Lacking the modeling of warmth and nurturance, you may also not know how to best be warm and nurturing to yourself and maybe to others as well. It may also be difficult to know how to interact with others in relationships.

It’s often difficult for clients to report what their early experiences with warmth and responsivity were like. They only had their own experiences and may often have little sense of what it was like for others growing up. They may feel what happened in their family was typical and have no sense of how it may relate to their current self-criticism or shame. One way to be able to help clients have a sense for how much warmth they experienced is to have them fill out a measure that allows them to compare their scores to established norms. We’ve found that giving clients the scale below and then discussing it in session can help them to have a better sense for how their experience compares to others and how warmth or the lack thereof may have contributed to their current difficulties.

Early Memories of Warmth and Safeness Scale (EMWSS)

The total score on this scale can provide a rough sense of how warm, safe, and cared clients felt in childhood. The total score is obtained by adding the scores from each item 1-21. We calculated some guidelines for interpreting the scores based on published samples. We have found it useful to discuss the scores with our clients and created the following cutoffs to use for discussion.

• Low feelings of warmth in childhood = below 30
• Somewhat low feelings of warmth in childhood = 30 to 46
• Average feelings of warmth in childhood = 46 to 78
• High feelings of warmth in childhood = above 78

We recommend giving this measure out to clients and discussing it as part of our collaborative case conceptualization process.

Reference:
Richter, A., Gilbert, P. & McEwan, K. (2009). Development of an early memories of warmth and safeness scale and its relationship to psychopathology. Psychology and Psychotherapy: Theory, Research and Practice, 82, 171-184.