1. Self-Compassion From an ACT Perspective: An Intellectual and Experiential Exploration Dennis Tirch PhD & Jason Luoma PhD

2. Rate how often you behave in the ways below, using the following scale:
Almost never Almost always
_____1. When I fail at something important to me I become consumed by feelings of inadequacy.
_____2. I try to be understanding and patient towards those aspects of my personality I don’t like.
_____3. When something painful happens I try to take a balanced view of the situation.
_____4. When I’m feeling down, I tend to feel like most other people are probably happier than I am.
_____5. I try to see my failings as part of the human condition.
_____6. When I’m going through a very hard time, I give myself the caring and tenderness I need.
_____7. When something upsets me I try to keep my emotions in balance.
_____8. When I fail at something that’s important to me, I tend to feel alone in my failure
_____9. When I’m feeling down I tend to obsess and fixate on everything that’s wrong.
_____10. When I feel inadequate in some way, I try to remind myself that feelings of inadequacy are shared by most people.
_____11. I’m disapproving and judgmental about my own flaws and inadequacies.
_____12. I’m intolerant and impatient towards those aspects of my personality I don’t like.

3. Compassion Solutions Ancient wisdom
Compassion transforms the mind. (Buddhism)
Evolution
Evolution has made our brains highly sensitive to internal and external kindness
Neuroscience
Specific brain areas are focused on detecting and responding to kindness and compassion
ACT
Compassion is a value inherent in psychological flexibility model –
Self-compassion related to flexible perspective taking

4. Compassion definitions
Compassion can be defined in many ways: “As a sensitivity to the suffering of self and others with a deep commitment to try to relieve it” Dalai Lama
Eight fold path - represents a multi-modal approach for training one’s mind

5. Compassion Definitions
Neff (2003b) has operationalized self- compassion as consisting of three main elements:
Self-kindness vs harsh criticism and self- judgment
A sense of common humanity vs seeing self as separate and isolated
Mindfulness vs overidentification

6. Self-Compassion and Psychological Flexibility
These components combine and mutually interact to create a self-compassionate frame of mind.
Self-compassion is relevant when considering personal inadequacies, mistakes, and failures, as well as when confronting painful life situations that are outside of our control.

7. Self-Compassion Data
Higher levels of reported self-compassion are correlated with:
Lower levels of depression and anxiety (Neff, 2003; Neff, Hseih, & Dejitthirat, 2005; Neff, Rude, & Kirkpatrick, 2007)
life satisfaction, feelings of social connectedness (Neff, Kirkpatrick, & Rude, 2007)
personal initiative and positive affect (Neff, Rude, et al., 2007)

8. Compassion Training Data
Practice in imagining compassion for others
produces changes in frontal cortex and immune system (Lutz et al, 2009)
Loving kindness meditation
increases positive emotions, mindfulness, feelings of purpose in life and social support and decreases illness symptoms (Frederickson et al, 2008, JPSP)
Compassion meditation (6 weeks)
improves immune function, and neuroendocrine and behavioral responses to stress (Pace, 2008, PNE)
Compassion training
reduces shame and self-criticism in chronic depressed patients (Gilbert & Proctor, 2006, CPP)

9. Self-Compassion from a CBS perspective
Dahl, Plumb, Stewart and Lundgren, (2009)
Self-Compassion involves:
willingly experiencing difficult emotions;
mindfully observing our self-evaluative, distressing and shaming thoughts without allowing them to dominate our behavior or our states of mind
engaging more fully in our life’s pursuits with self- kindness and self-validation
flexibly shifting our perspective towards a broader, transcendent sense of self (Hayes, 2008a).

10. Self-Compassion and Psychological Flexibility
Our learned capacity for flexible perspective taking is involved in our experience of empathy (Vilardaga, 2009), as well as our related experience of compassion.
In order to understand self-compassion, therefore, it’s useful to consider the “self” that is the focus of compassion, from an RFT perspective.

11. Self-Compassion and Psychological Flexibility
Deictic relations are building blocks of how we experience the world, ourselves, and the flow of time.
Returning to an awareness of self-as-context offers us a non-attached and dis-identified relationship to our experiences.
This allows the habitual stimulus functions of our painful private events and stories to hold less influence over us.

12. Self-Compassion and Psychological Flexibility
From the perspective of the I-Here-Nowness of being, I can view my own suffering as I might view the suffering of another, and be touched by the pain in that experience, without the dominant interference of my verbal learning history, with its potential for shaming self- evaluations (Vilardaga, 2009; Hayes, 2008).

13. Formation of Self-as-Context: The No-Thing Self (Hayes, 2008)
YOU I
HERE
THERE
THEN
NOW

14. I-Here-Nowness of Perspective Taking
Self-as-context

15. Brain Development in Deep Historical Context

16. Private Events and Brain Development in the context of Genotype, Phenotype, and Present Moment
1. “Old Brain”
Emotional Responding: Anger, anxiety, sadness, joy, lust
Overt Behavioral Responding: Fight, flight, withdraw, engage
Relationship Behaviors: Sex, status, attachment, tribalism
2. “New Brain”
Relational Framing, Imagination, fantasize, look back and forward, plan,
Integration of mental abilities
Self-awareness, self-identity, flexible perspective taking, self- feeling
3. “Social Brain”
Need for affection and care
Socially responsive, self-experience and motives ?

17. Sources of behaviour Interaction of old and new psychologies
New Brain:
Derived Relational Responding, Selfing
Planning, Rumination,
Old Brain: Emotions, Motives, Relationship Seeking, Safety Seeking Behaviors

18. Understanding our Motives and Emotions
Motives evolved because they help animals to survive and leave genes behind
Emotions guide us to our goals and respond if we are succeeding or threatened
There are three types of emotion regulation
Those that focus on threat and self-protection
Those that focus on doing and achieving
Those that focus on contentment and feeling safe

19. Types of Affect Regulator Systems
Content, safe, connected
Drive, excite, vitality
Non-wanting/
Affiliative focused
Safeness-kindness
Soothing
Incentive/resource- focused
Wanting, pursuing, achieving, consuming
Activating
Threat-focused
Protection and
Safety-seeking
Activating/inhibiting
Anger, anxiety, disgust

20. Self-Protection
In species without attachment only 1-2% make it to adulthood to reproduce. Threats come from ecologies, food shortage, predation, injury, disease. At birth individuals must be able to “go it alone,” be mobile and disperse

21. Dispersal and avoid others

22. Protect and Comfort: Less ‘instinctive’ brain – post birth learning

25. Compassion Process Compassionate Self Giving/doing
Mindful Acts of kindness
Engagement with the feared
Receiving/soothing
SBR/booth
Validation
Gratitude appreciation
Compassionate Self
Threat
Mindful awareness
Triggers
In the body
Rumination
Labelling 25

27. Present Moment Contact Psychological Flexibility
Values Authorship
Willingness
Psychological Flexibility
Commitment
Defusion
Self-As-Context

28. CompassionateFlexibility
Sympathy, Sensitivity
Care For Well-Being
Distress Tolerance
CompassionateFlexibility
Commitment to Compassionate Behavior
Non-Judgment
Eisenberg model of altruism research, sympathy, empathy, and personal distress (in Harrington and Davidson, 2002) + Compassionate Motivation and Attention (Buddhism) + Nonjudgement – Gilbert, 2009 (also Allen Fogel’s model of nurturant behavior
Empathy

29. Present Moment Contact Psychological Flexibility
Mindfulness
Values Authorship
Willingness
Psychological Flexibility
Self-Kindness
Commitment
Defusion
Self-As-Context
Common Humanity

30. Contact with the present
Build awareness of self-criticism/self-attack
Clients often do not even notice their self-evaluations.
Methods:
Teach client to notice evaluation/judgment as it occurs in session (noticing antecedents)
Help clients to notice avoidance of shame as it occurs in session (noticing behavior)
Bring costs of self attack into the room (noticing consequences):
Read aloud self-attacking thoughts, but imagine she were saying them to a friend in the same position
Use a mirror when reading self-attacking thoughts to self
Act out self-attack in chair work

31. Acceptance Interventions
Develop ability to acknowledge and embrace aspect of self that feels damaged, broken, unlovable, not-good-enough, and/or rejected
Methods:
Examine workability of behaviors aimed at avoiding shame (anger, shutting down, addictive behavior).
How do they avoid feeling bad about themselves or feeling rejected? What happens in shame producing situations?
Bring process of shame and self-attacking into the room and improve ability to sit with it and with reaction to self-attack (usually with chair work)
Practice willingness in relating shameful experiences and secrets to trustworthy others (starting with therapist)
Some evidence outside our lab suggests thatthis might be helpful, for example teaching children to be more mindful of their thoughts about handicapped people resulted in less prejudiced behavior and lower levels of avoidance of the handicapped, even though there was no attempt to censor or suppress the subjects’ knowledge of stereotypes (Langer, Bashner, & Chanowitz, 1985).

32. Defusion Develop distance, distinction from self-attacking thoughts.
Clients typically see critical view of self as normal, earned, or needed for motivation.
Methods:
Imagery – imagine this critical self as if it were a person (include tone, size, facial expression, etc.). Give it a name.
Naming the critic – develop a name for the critical side of the self that has some endearing qualities
Act out criticizer as if it were another person
Many common defusion exercises can be helpful here
Name badges, with shame
Three chairs - demonstrate and practice

33. Self as context/flexible perspective taking
Develop connection a sense of self that transcends our stories about self
Shame/self-criticism is fundamentally a problem with self/other as content
Methods:
Work on letting go of attachment to self as content, e.g., self evaluations
Practice flexible perspective taking (loving kindness meditation, taking perspective of shamers, taking perspective of therapist, and caring others)
Physicalize self as content through chair exercises
Add a third chair, perhaps a compassion chair or observer chair for experiencing the ongoing dialogue.
Have client be the compassionate therapist in the third chair. What would that person say?
Use hierarchical framing to build sense of common humanity in suffering and normality of shame and fears
Letting go of self as content
Three chairs - demonstrate and practice
Letter to yourself
“What does xx need right now? What would be good for xx right now?

34. Flexible perspective taking
Shift perspectives to expand possibilities
If your best friend was watching this interaction, what would they say?
If you were a therapist for a couple that acted this way, what would you think of them? What would you want for them? For him, for him?
If you were (someone client admires) [in the self chair], how would you act differently
If you were me and you heard what you are saying right now, what would you think?
Notice change in perspective
When you look at this from another perspective, does it feel the same? Different? Do you see yourself the same way when you take these different perspectives?
Combine with augmentals
If x (whatever the critic says) were not weighing you down, what would you be doing? What would you need from him/her to make that possible?
If x (whatever critic says) no longer held you back, what would you be doing?

35. Values Help person explore and define values toward self
Most people value empathy and connection, but fusion with self-concept impedes applying that to themselves
Methods:
Empathy and compassion for self can emerge when the damage done by fusion with self-criticism is fully contacted
Elicit and define the kind of relationship person wants to have toward themselves
Simply introducing the idea of self-compassion and kindness, vs self-esteem can be liberating for clients. Most have never thought of the idea of intentionally being kind to themselves, like they might be with others.

36. Committed action
Help client take steps to act on values while practicing gentleness and compassion
Self-attacks often function as a way to coerce the self to act in line with self-standards and values (e.g., “buck up” and “push through it”).
Self-criticism makes it harder to take risks and learn, which inevitably involves failure and mistakes
Methods:
Build commitment to practices of self-care and self-kindness
When exploring other kinds of valued actions, explore what kind of relationship person wants to have toward self as they do this--“and how do you want to be with yourself as you take these actions?”
Donkey metaphor.
“If a job is worth doing” it’s worth doing poorly at first. Joel Salatin of Polyface Farm