Mindfulness and Self Compassion Dr. Gerard Pauley

Four Key Points What is Compassion Focussed Therapy? Why is being mindful important to the process of becoming compassionate to self? How do we model and provide the care and attention required for this process? What is the future in this area? 20 minutes is not enough time to do any justice to the first question. However, I intend to give you a snapshot. Today’s theme of mindfulness: Another example of how important being mindful is in terms of what it can help us to achieve. You cannot just learn and apply these techniques to people: there is a different reality of with these types of psychological interventions. We can look forward to more but what might that more be?

Compassion Focussed Therapy Evolved out of regular reports of incongruence: “I can think that I am okay, but I don’t feel it.” Developed to target shame and self-criticism (internal & external threats) Focus on developing positive emotions, e.g., safeness, soothing. Considers a range of perspectives including: evolutionary, neurological, attachment theory, cognitive-behavioural, and mindfulness (Buddhist).

Multiple Processing Systems Basic Emotional Regulation Social Mentalities Cognitive Systems Self-Identity Basic Emotional Regulation: Conditioning occurs here and so does the laying down of emotional memories. Emotional systems are linked to a stimulus response: 1. Threat, 2. Seeking, 3. Soothing/content. CFT focusses on affiliative and attachment systems because of their important role to play with other systems. (NEXT SLIDE FOR EXPLANATION). Social Mentalities: Motivational systems / role forming. Our mind seeks to create certain types of interaction with others: care eliciting, sexual, friendship. For example, caregiving = sensitivity to distress calls and behaviour to return to do something. Cognitive Systems: Recent evolution. Its about attention and how we reason, plan, ruminate, anticipate etc. = increasing conscious control. Predator = Threat! = Motive to Escape = Emotional systems to enact behaviour. We cannot stop these initial responses but can choose not to act on them. (Buddhist sexual desire). So, it regulates the lower systems but is also regulated by them. Self-Identity: Evolution of self-awareness. The need to create a self for social interaction. Compassionate Self = creating a self-identity which regulates downwards through the other 3 systems. In other words, imagining who you want to be and projecting that into the future and then building steps to reach that future you.

Three Types of Affect Regulation System Use the example of the person who is punished for getting things wrong. Becomes a perfectionist and this works well but keeps returning to the threat because perfection is only one step away from failing and reigniting the threat.

Stimulus-Response Sexual Bully-threat Meal Sex Meal Kind, warm and caring Bully- threat Limbic system Compassion Soothed Safe This diagram demonstrates the ability of our mind to internally create the same sorts of stimulus that we might experience externally. In effect, our ‘new brain’ can trick our ‘old brain’ into believing what might not indeed be true. What this diagram demonstrates is that it is possible to engender safe and soothing emotions in the same way that we might generate the negative ones. Stomach acid Saliva Fearful Depressed Arousal

Key Targets of Therapy Thinking Reasoning Attention Imagery Fantasy Behaviour Emotions Motivation

Key Targets of Compassion Thinking Reasoning Attention Imagery Fantasy Compassion Behaviour Motivation Emotions

Multi-modal Compassionate Mind Training SKILLS TRAINING Warmth Warmth Imagery ATTRIBUTES Attention Reasoning Sympathy Sensitivity Distress tolerance Compassion Care for well-being Feeling Behaviour Empathy Non-Judgement Sensory Warmth Warmth

Contrast of a Competitive Mind

The Importance of Mindfulness Helps to counter the trivialisation of changing the relationship with self. Developing self-compassion requires a wise space. This ‘space’ is one in which people can try out a different relationship with self: you would not embark on this process without being able to adopt a different stance to it. Too many existing interventions either deliberately or inadvertently make change seem easy – this is invalidating for many of the people we work with. If it was that easy, would they not have already done so? Mindfulness has been used this way when it has been seen as just another psychological technique. Changing habitual thoughts and behaviours is hard. Being conscious of the need to change and adopting a stance to it that allows you to wish to pursue is more likely if you can see a compassionate reason to do so.

The Importance of Mindfulness Question: What happens when you just sit with yourself? Question: How might you go about learning to sit with yourself? Once you can do that you can: Reflect rather than avoid your experiences Develop a different perspective Accept the emotions and thoughts that arise Have a relationship between you and your mind I often ask this question of clients who initially think it fairly odd and then struggle with it because they either avoid this scenario or find it too challenging for them. If you can learn to be mindful then you can engage wisely with these processes. There can be less pain involved as a result or it can be just as painful but seem a more manageable pain. You can support difficult change and not find yourself ignoring that it needs to be made. For example, hectoring about stopping smoking may work but often builds resistance. When the person finds a self-compassionate reason to stop it is still a difficult decision but the psychological framework within which they are operating allows them to do so and also to cope should they not succeed.

Encouraging a Compassionate Mindfulness The truth of self-experience. Validating the uniqueness of the experience. Providing a rationale for Mindfulness. Self Compassion The underlying approach of CFT: demonstrating compassion in session. The attributes we endeavour to teach should be engendered in session. Toe-dipping to full emersion with kindness and support. It is generally agreed that regular experience of mindfulness is important when trying to teach it to someone else. Mindfulness creates a varied response in individuals – it is important that these responses are validated as they are – they probably won’t neatly fit into the descriptions provided in the literature. Mindfulness needs a rationale – people have either never heard of it, been exposed to it incorrectly, or cannot see a reason why it might be helpful for them. (Physiotherapy analogy). Being compassionate with our clients is a key part of CFT. They might find it difficult to receive but this is an important issue within therapy anyway. There needs to be a genuineness about what we are suggesting to people – it is not going to work to suggest a compassionate approach if we are offering something very different in session.

The Future Accessibility of Mindfulness & Compassion. Encouraging structural change: Compassionate communities. Refocusing on the process of therapy: How I am with you helps you to change. Evolution of new therapeutic techniques informed both by science and clinical experience. Are there other ways of making Mindfulness accessible to the masses? Both in terms of the methods through which we share Mindfulness with people and how readily it is made available in a useful format. The logical extension of a compassionate stance is encouraging that in the communities we live in and have an investment in. If we could encourage a different social mentality then this could expose large numbers of people to environments in which they could achieve healthy psychological growth. CFT puts at its centre the therapeutic relationship and encourages a stance of compassion in people. We know how important that relationship is and yet we can easily become distracted by ‘techniques, technologies and quantitative outcomes studies. That said, CFT’s inclusive nature encourages clinicians and researchers alike to think outside of existing techniques or to incorporate what is new into what we already have. It is important to emphasise what we experience in our individual experiences with clients as this informs so much of what we do.