ACT With Compassion

One of the processes that allows for the development of self-compassion in highly shame-prone and self-critical people is the ability to take the perspective of a warm and caring other person. Therapists are often able to offer that caring perspective on the client’s experience. We at ACT with Compassion encourage therapists (including ourselves) to intend to see the client as whole, complete, and perfect even when, and perhaps especially during the times when the client sees himself as flawed, broken, or unlovable. Therapists may use self-disclosure to help the client access a warmer perspective on their own experience, or they may invite the client to physically sit in their seat and look at their own experience from the therapist perspective.

A few weeks ago, a client of mine expressed frustration that there are no public child abuse memorials. She asked, “Why are there war memorials, AIDS quilts, breast cancer ribbons, but nothing for child abuse?” Her question echoed a statement by Judith Herman in her book Trauma and Recovery from the early 1990s. Herman states, “The most common trauma of women remains confined to the sphere of private life, without formal recognition or restitution from the community. There is no public monument for rape survivors.” Although Herman focuses on sexual assault of women and my client was focusing on child abuse, both point to the common theme of the lack of public recognition of relational trauma.

Shame is fundamentally disconnecting. The person feeling shame is often acutely aware of their own perceived flaws and inadequacies, and may misinterpret attempts from others to connect with them. For example, a person feeling shame may interpret another’s warm smile as condescending or ridiculing. Or they may accurately interpret the other person’s caring expression, but be so locked into their own internal experience that they are not able to feel the other person’s warmth or benefit from it.

Below is some guidance on case conceptualization using this month’s Tool of the Month - Exploring the Past - Warmth and Compassion.

One of the first steps in case conceptualization with shame-prone and self-critical clients is to assess their relational history with shaming/criticizing and compassionate/caring others. As mentioned in our previous blog post, understanding clients’ relational history of being treated with warmth and compassion can identify resources for self-compassion building work, and identify barriers to self-compassion and to letting warmth in from others.

ACT with Compassion is turning one year old!

ACTwithcompassion.com is one year old and we decided to celebrate by sharing a short guide to the best material for therapists interested in using compassion in their work.

For many of us, there is something uniquely vulnerable in our love for our companion animals. These relationships can teach us about love, pain, values, and compassion in ways that are difficult to get from our relationships with other humans sometimes.

We have written up some of our thinking to accompany last week’s Tool of the Month - Exploring the Past - Shame and Self-Criticism.

One of the first steps in case conceptualization with shame-prone and self-critical clients is to assess their relational history with shaming/criticizing and compassionate/caring others. As mentioned in our previous blog post, understanding clients’ relational history can help remove blame and may also help to begin defusion from self-critical “programming.”

We have a new paper out in the journal Current Opinion in Psychology about shame, self-criticism, stigma, and compassion in ACT.

Five studies show ACT helps with shame and self-stigma
In this paper, we reviewed the existing research demonstrating that Acceptance and Commitment Therapy (ACT) can help with shame and what is called self-stigma, or buying into negative public attitudes related to a certain characteristic (e.g., “I’m a dirty smoker.”) At the time we wrote this paper, there were five studies showing that ACT helps to ease shame and self-stigma. These studies focused on people struggling with substance abuse, obesity, sexuality-related distress and stigma, and stigma related to HIV.

Last week, The Compassionate Mind Foundation listserv discussed the issue of working compassionately with a client experiencing feelings of betrayal, anger, and shame in her relationship with her parents. This client seemed to be experiencing a pattern typical of survivors of betrayal trauma in which, when she allowed herself to experience any anger toward her parents, the anger would always be followed by beliefs that she was betraying her parents with her anger, and then she would feel shame.

Dr. Russell Kolts chimed in with some clinical wisdom worth sharing about how he would bring compassion to this situation. Here is some of what he said:

Do you have any clients coming to see you because their minds tend to run away with them? Or rather, because your client tends to run away with their mind? The mind says, "You are doing everything wrong!" and your client says, "Yes, let's think about that all day." The mind says, "I don't think you should work on that project today. You really want cookies" and your client says, "Okay." Alternatively, your client might say, "Why would I listen to you? You are a terrible, broken mind!"