Podcast: The Power of Self-Compassion

Jenn talks to Dr. David H. Rosmarin. David explains the impact of self-compassion on our mental health, shares simple ways that we can become kinder to ourselves, and talks about how to introduce compassion into our day-to-day lives.

David H. Rosmarin, PhD, ABPP, is the director of the Spirituality and Mental Health Program at McLean Hospital and an associate professor of psychology in the Department of Psychiatry at Harvard Medical School. He collaborates with laboratories to study the clinical relevance of spirituality to anxiety, mood, psychotic, substance use, and other disorders.

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Episode Transcript

Jenn: Welcome to Mindful Things.

The Mindful Things podcast is brought to you by the Deconstructing Stigma team at McLean Hospital. You can help us change attitudes about mental health by visiting deconstructingstigma.org. Now on to the show.

Hi folks, and thanks for tuning in wherever you are and whatever time it is there to join our conversation about self-compassion and the positive impacts that it can have on us. I’m Jenn Kearney and I am joined today by Dr. David H. Rosmarin.

Before we even get things started, I just want to address self-compassion is one of those words that can get thrown around a lot and because it has, like self-care can be really loosely interpreted at times, sometimes it’s hard for us to understand what it really means. But once the concept clicks, it can actually improve our relationships, improve our wellbeing, even improve our mental health.

So how exactly do we harness its power so that we can be happier, kinder people, not just toward ourselves, but toward others. So that’s why I’m really glad David’s with me because we’re going to talk all about the perks of self-compassion for our mental health, simple ways that we can become kinder to ourselves and how we can foster more compassion, both for ourselves and for one another.

So if you are unfamiliar with David Rosmarin, allow me to introduce him to you. Dr. Rosmarin is the director of the Spirituality and Mental Health Program at McLean Hospital. He’s also an assistant professor of psychology in the Department of Psychiatry at Harvard Medical School.

As if that wasn’t enough work for him to do, he is also a clinical innovator whose work on integrating spirituality into cognitive behavioral therapy has wide acclaim including media attention from just to name a few, ABC, NPR, Scientific American, the Boston Globe and the Wall Street Journal. So, David, thank you so much for joining me.

I know we were talking before the session started. When we’re recording this, it’s like right toward the end of the year and I really think that it’s a great time to start reflecting on this stuff and how we can incorporate it into our future selves.

So I’d love to kick it off just by asking, what is self-compassion and how can having a good grasp on it be impactful both to ourselves and other people that we care about?

David: Yeah, it definitely is a timely topic and I’m very honored to be part of this conversation. In terms of what self-compassion is, I think I’ll start by telling you about a case that I dealt with and that’s really going to illustrate it. It’s a patient of mine, we’ll call her Alexis which obviously is not her real name, and she was actually in Europe for a good deal of time and she had pretty significant panic attacks, very significant anxiety.

She had this tendency of blaming herself for the anxiety. She would judge herself. She would say, “Something’s wrong with me. I’m broken. I’m a weak person,” that was something that she used to tell herself. And of course there’s the catastrophic thinking as well, “I’m never going to get over this. I’m never going to be able to.”

But I really want to focus on that aspect of it that, I’m a weak person, I’m broken, something’s wrong with me, the fact that I’m having this panic. In Alexis’ case, what ended up happening is she undermined herself with that way of thinking that she needed a respite from it, and the only respite that she found was these, we’ll call them romantic relationships which weren’t even that romantic frankly and she would act out in a sexual way with different partners.

It was a way of making herself feel better in a certain sense and she knew this. But it left her feeling even more depleted and then she would beat herself up mentally for engaging in those behaviors. And then that led to even other behaviors and this sort of cascaded down that she had a fairly discrete problem with these panic attacks.

But she blamed herself for it, developed other behaviors, blamed herself for those, and then developed other behaviors as a result. And my work with Alexis, we really focused on self-compassion because that, to me, was at the core of it. Did she really... Would she give herself permission a, to panic and b, to make mistakes without beating herself up.

The reality is that Alexis isn’t perfect and nobody’s perfect. None of us are perfect and everybody has something that they need to deal with. And what self-compassion is, is can you continue to be kind, withhold judgment and continue to bestow kindness and goodness to yourself if you’re not perfect, if something’s wrong, so to speak.

If you’ve done something, if you’re engaging in something, if you have a certain aspect of yourself that you don’t like. We see it in many, many different cases in mental health. But that to me is the core of self-compassion, refraining from judgment and remaining kind to oneself, even though it’s let’s say, not deserving or it doesn’t seem to be that it’s a deserving thing.

Jenn: So psychologically, based on what you’ve talked about with your patient who is going through all of these cycles, is there some sort of reason why we’re so comfortable with getting into a cycle of beating ourselves up?

David: That’s a great question. Why does it... Why do people do this, right? Like why would they? I think it’s actually really hard to be kind and patient and bestow kindness to oneself and to accept our difficulties.

The reason is because it entails accepting the fact that we’re imperfect and remaining conscious of that, remaining aware of that. When Alexis was acting out, she’s not thinking about her panic attacks. She’s not thinking about aspects of her that she doesn’t like.

She was distracting herself, and that’s easier than getting an extra night’s sleep or making sure that her diet is in check, or even going to a therapist and speaking about her panic attacks.

It’s easier to divert attention away from these things and to engage in behaviors even if they’re not healthy, even if they’re potentially problematic for her because the other way requires acknowledging that something’s wrong. That’s uncomfortable.

Jenn: So as being the spirituality director, you have experience and knowledge with tons of different cultures and religions. Have you found that self-compassion is especially difficult and what is more of the American culture of almost refusing to rest or take a break?

David: Yeah, I’m definitely not an expert in world religion by any stretch. But the American culture is, I’ll say all Western culture, frankly is particularly problematic in this regard.

We have a culture of individualism where every individuals learns to stand for themselves and has to stand on their own as opposed to more of a collectivistic culture looking at the entire group as a whole and that means everybody is under their own microscope, and that means our flaws are going to be much more in HD quality.

If you have a collectivistic culture, you can blend into the background and if something’s not perfect, then okay. Other people make up for it, I make up for other people and there’s sort of a more healthy, if you will, a healthier understanding that we do need each other, nobody is perfect and that sort of goes with the territory a little bit. I would also say that as our culture gets away from more core spiritual values, these kinds of things are harder.

If somebody has more of a spiritual frame, it’s not so bad if you’re not perfect. Okay? If there’s something greater, whatever it is that if somebody has a more of a transcendental view of things where the material world is not the end all and be all of everything.

However that’s expressed within whatever religious framework that somebody does or even doesn’t have for that matter, this general concept that there’s something greater than the physical world. It doesn’t really matter that I slept in one day or that I went to bed too late or that I messed up or that I have aspects of myself that I don’t like or even that I did something that I’m not particularly proud of.

It’s like, in the grand scheme of things, it doesn’t matter as much. So I think our culture is missing the collectivism and the spirituality aspects and those definitely make it harder.

Jenn: Have you found that the rise of technology, in particular like social media has led to less self-compassion. It constantly... It seems like we’re constantly in a comparison game with one another and things like filters don’t really contribute to us feeling better about ourselves.

David: Yeah, the social comparison factor is definitely a big one. The scientific literature has found that, even experimentally that exposing people to images of same sort of colleague, peers, like people your same age. People will compare themselves to others like how successful they are, how good looking they are, how wealthy they are, how whatever they are, how accomplished they are just naturally.

So yeah, there definitely is that piece of it. I think there’s some other ways that technology and in fact, I think there’s even more insidious ways that technology has made it hard to have self-compassion.

These devices are extremely powerful and you can sit, especially now, you can sit anywhere anytime and be in touch with hundreds of people and run your whole operation or do whatever it is that you do. You know, whether you’re business or healthcare even, or whatever it is, whatever you’re involved in, you can.

As a result, we’re sort of in some ways expected to be always running or always up and running. The work week or the work day is not 9:00 to 5:00 anymore, or 8:00 to 10:00 or 8:00 to 6:00 or whatever it is. It’s more like, you know, 24 hours and that, need to be responding to emails at 11:00 PM.

It’s just too much for people. And those expectations that are placed on ourselves by ourselves, they make it substantially harder to be self-compassionate because our expectations just aren’t matching who we are.

Jenn: So if the expectation has been set that we should “always be on,” do you have any advice for how to start breaking the cycle of shaming ourselves for things like needing eight hours of sleep or logging off to spend time with our families?

David: Yeah, I have a bunch of advice. It’s good to be logged off and spend time with your family. I think let’s start with the basics though. Americans tend not to take their vacation in time. So people just don’t... There’s unused vacation time and people just don’t use it.

That to me, firstly, it’s not even good for the economy. It’s not even good for one’s employer. The data in fact it just came out in the Harvard Gazette this week. I don’t know if you saw it. It just published a piece on the importance of self-care in the work place for the purposes of the employers. Never mind the employees. I mean, of course to take any work, taking that, but it’s actually good for the whole economy.

So take your work, take your scheduled vacations. That’s one thing. It’s never going to be easy, just put it in your calendar and don’t go. Another thing is you could put an auto responder on your phone, like “I’m not going to be available.” And then that could reduce the expectations.

I do think though, it’s important to have candid conversations with people about when you are and are not available. If an employer, for example expects you to be answering emails after 10 or 11:00 PM or even 9:00 or 8:00 PM, if it’s beyond your comfort zone, then say like, “listen, I’m going to be on but during the day but 8:00 to 8:00.”

A 12 hour work day is plenty and having that, extend the 16 hours or whatever it is impossible. And if that’s eight hours, then fine. If it’s going to be 9:00 to 5:00 then you’re on. I think we have to have candid conversations with people about it and just be clear with them that this is what I am willing to do, and this is what I’m not willing to do as opposed to them having it unstated.

And then, then it sort of insidiously, like I mentioned before, there’s this tension that builds, expectations just compound upon each other. So those are a couple of reasons.

Jenn: I think one of the things too, that you’ve really like you’ve struck upon is having the conversation. If we notice that we’re not being compassionate toward ourselves, how do we have a conversation with people that we care about in order to help enroll them in changing our thoughts and behaviors?

David: It’s a really great question. I’ve been doing a lot of thinking about this recently because it’s just such a critical issue ‘cause it’s an interplay of both how people relate to themselves and how they relate to other people.

So it’s a complex question. I’ve come to the conclusion and it’s based on some of the scientific literature on emotionally focused therapy which is a form of couples therapy actually, very up and coming form of couples therapy with some very interesting science behind it.

In a nutshell, the more we can acknowledge and speak to other people about our needs, the stronger we become and the stronger our relationships become.

So Jenn, if I told you, I really need your help with something, like if I called you after this webinar and I’m like, “Jenn, it was a great conversation but I got confide in you. I really need your help.” Do you think we’d have a closer relationship or not as close a relationship?

Jenn: I would say, substantially closer.

David: Substantially closer. If I’m going to come to you with a personal and vice versa, but that draws people closer together when you acknowledge your vulnerability, when you acknowledge that you need them.

So it turns out that self-compassion and creating connections with other people actually uses the same mechanism. If we can acknowledge our fallibility, acknowledge that we have needs and state them to other people, rely on them to come through for us, that creates, I mean, harmony is almost the word without overstating it and I might call you for a favor.

Jenn: Totally fine, I would pick up the phone for you.

David: I’m sure. I know you’ve got my back.

Jenn: Do you have any advice around applying self-compassion when food is being used as a coping mechanism?

David: Yes, this is a classic. Let’s describe how it’s a problem and then how we can, okay. So the problem is like this. Somebody will, let’s just say, look at themselves in the mirror and they don’t like what they see. They think they’re too fat, too thin, whatever it is. They don’t like the shape of a certain body part, they don’t like it. They’re triggered by it.

The trigger increases their stress, increases their anxiety. And instead of dealing with that which is a lot by speaking to somebody else, by having getting a therapist, by reading about it, by focusing on those aspects, maybe by making some behavioral changes for all we know, like exercise, diet, decreasing whatever it is, going to the nutritionist.

Instead of doing that, they go to the freezer and a pint of ice cream later, the situation’s probably worse. And then they beat themselves up for having eaten the ice cream, they’re feeling even worse about themselves. And then you tell me, are they more or less likely to binge again?

Jenn: I mean more likely, right?

David: Much, because the caloric intake was not in order to stave off a physical need, it was in order to stave off an emotional need and it was not effective. So what ends up happening, let’s just say somebody thinks they’re overweight, the body image issue gets worse, the stress level goes up, the eating goes up, the self-deprecating talk goes up, I can’t believe I just did.

Then the next thing you know, this is one of the ideological models of how a binge eating disorder occurs. It’s a very common pathway, and you can see clearly how these loops can substantially. So the issue is like this. The self-compassion can come in in two ways.

The first is when looking at oneself in the mirror, “Okay, I’m not perfect and neither is anyone else and I’m going to be kind to myself no matter what,” and remaining conscious of those aspects of ourselves that we don’t like and being kind anyway, that’s really the core of self-compassion.

Then of course, if somebody engages in a maladaptive coping behavior, it’s almost like letting it go, but being okay with it and saying, “Hey, I’m not there yet. I’m struggling with this. This is what happened, this is what I did. I’m not proud of it, not happy about it, but it is what it is.” And not judging or berating oneself for it.

Jenn: So if we notice that folks that we’re close to, whether it’s a partner, a child, a parent are in a cycle of ruminating and beating themselves up, how can we talk to them about their lack of self-compassion without coming off as being overly critical?

David: Yeah, being overly critical with someone who’s lacking self-compassion is the last thing you want to do, right? ‘Cause you’re just going to compound the problem. At the same time, though, it might be important to speak to someone about it and say like, “Hey, I noticed that you’ve been really beating yourself up recently. I don’t love you any less for it, but I do think we should talk about this. What can we do to make it better?”

That’s sort of striking a bit of a balance, that line where you’re holding the person accountable while not judging them for it. You’re maintaining awareness and helping them to gain awareness of the behavior that they’re doing while showing that you love them, as opposed to coming at it in a judgmental way. I wouldn’t just distract from it, not focus on it at all.

At some point it has to be said like, “Hey, you’ve been really beating yourself up recently and I’m concerned about you and about us and what it’s doing to the family.” Or whatever it is. I think that that’s fine, but it has to be said in a kind, gentle way.

Also, the timing is important. You don’t want to have a conversation like that when someone’s really down in the dumps. You have to know when to play that card.

Jenn: Yeah, some of the advice that I’ve been told about having difficult conversations has been when you’re both sitting on the sofa, or if you’re both in the car for a long drive, just somewhere where you don’t necessarily actually have to look at one another because sometimes that eye contact can make somebody feel more defensive and uncomfortable.

David: Depending on the person. Also the time, like do not have it at one or two in the morning. This is at best in the evening, at worst, I would say an evening conversation when the person is decently well rested, not during a stressful week. Not when you’re having a stressful week. These are critical factors.

Jenn: Yeah, you just want to make sure that the timing is right. And if the timing doesn’t feel right, it’s something that you can also have the grace to say, we can talk about it later because it lets them know that you’re concerned, you’re supportive and you’re here whenever they’re ready.

David: That makes sense to me.

Jenn: I’m really, really glad that that made sense to you. I did want to ask about self-compassion and mindfulness. How complimentary are they of one another and can you have one without the other and still have it be effective?

David: That was a good, good question. Mindfulness was distilled from Buddhist roots and has become a very popular technique or a method, which is used pretty widely in the mental health world and also some gaining popularity outside the mental health world with the use of apps and all sorts of stuff these days, which is kind of cool.

Mindfulness involves attending to the present moment, not what’s in the future, not what’s in the past, not something else, but really just focusing right now on, on the here and now.

In that regard, mindfulness can enhance self-compassion because as I’ve stated a couple of times, self-compassion involves being aware of one’s flaws and continuing to bestow kindness and goodness towards oneself, not ignoring or sort of engaging in what we call cognitive avoidance, avoiding dealing with, avoiding and ignoring one’s difficulties, difficult aspects of ourselves.

Not doing that. So it requires that sustained attention to ask this of ourselves, but in a nonjudgmental way. So in that regard, mindfulness can very much enhance self-compassion. Is it possible to be compassionate without being mindful? I think was your question.

Not really because you have to have some aspect of awareness of the dark side of who we are in order to practice self-compassion. I don’t think that means necessarily that somebody has to have a mindfulness practice though to engage in mindfulness exercises in order to be self-compassionate.

I think you could enhance it and it can certainly help for many people. I don’t know if it’s necessary, but the actual being mindful is necessary for self-compassion. I don’t know if that makes sense.

Jenn: No, that makes sense. Are you familiar with childhood trauma being a contributing factor to self-blame or an overall lack of self-compassion?

David: Yeah, it’s interesting. There’s not a ton of literature on this subject. We know that childhood adversity in general can make it and particularly trauma like you mentioned. Traumatic events can make it harder in a person’s life.

Later, it can set people up for mental health difficulties. I have seen in my clinical practice a couple of trends, and I guess I’ll share them with you. People will often internalize a voice towards themselves that their parents took towards them.

So if you have, and if you had or have an overly critical parent who sort of didn’t get your limitations, didn’t accept your limitations, expected more than you were capable of, they’ve minimized difficulties that you had, wasn’t really able to be emotionally present and available when you had difficulties or sort of didn’t see your successes when you really push beyond your limits but it didn’t register, just off the top of my head.

Those kinds of patterns can really make it harder to have self, can make it very hard, much harder to have self-compassion later in life. It doesn’t mean that you can’t. It doesn’t mean that a person can’t develop self-compassion.

In fact, all the more reason that it’s important for such a person who grew up in that house to have self-compassion because they grew up without compassion. So they need to compensate for it from within because it wasn’t provided from without to a sufficient degree.

But that’s often the pattern that occurs, self-compassion is particularly important I would say, if the people who grew up with critical parents.

Jenn: So if a person is having a hard time identifying their emotional needs, what can they do to become a little bit more attuned to that?

David: Great. I would say two main aspects of self-compassion. One is not to judge oneself as we’ve been speaking about. But the other, which I mentioned a little bit, but want to highlight more now which is acts of kindness towards oneself. acts of kindness, being kind.

These can include exercise, having an adequate and well-balanced diet, getting sufficient sleep, turning off electronics at a reasonable time in order to reduce the demands on ourselves, being mindful of our stress level and acting appropriately, acting accordingly to that.

I would say, all of that is critically important to do. There are other things though which is, they’re probably staying in certain things that you like, some things that you, whether it’s listening to certain music or whether it’s going to a movie or whether it’s, I don’t know, flowers. Or whether it’s having a brightly colored room or it could be anything, going for a walk.

Everybody’s got certain things that they like to do and often what’ll happen is people, when they need it the most, when they’re stressed out the most and once they’ve either done something or feeling a certain way or appearing a certain way that they’re least proud of, they’ll stop engaging in those very behaviors. That’s exactly the opposite direction.

So we want to be kinder to yourself when you’re struggling and kinder to yourself when you’re stressed. These are acts, actual behavioral things that we can do and they can have a massive difference.

Jenn: So how can being kinder to ourselves positively impact our mental health overall?

David: Sure. In a couple of ways. I think the most important way is, when we’re struggling and we do something nice for ourselves, there’s almost an implicit acknowledgement that it’s okay to struggle and then nothing’s wrong with that because why would we be in kind to ourselves if we’re struggling?

It’s almost like, being nice is not dependent on our performance. It’s simply because of who we are. I’ll give you an example. So I don’t know if you noticed. Someone decided to start mowing their lawn I think it’s like the minute we started this talk.

Jenn: I actually haven’t heard anything.

David: You haven’t heard anything?

Jenn: Your headphones are doing beautiful job at blocking that out.

David: I guess I got the noise cancellation, but I appreciate that reassurance. But now they’re actually blowing the leaves, which is even louder. But I think they started in like 11:02, right? So I’m kind of kicking myself here and I’m like, “Man, maybe I should have gone to the office today. I knew I was giving this talk.”

So then I have two choices, right? I can ignore that. I can just let it sit in the back of my mind and beating myself up really like, “You moron, what are you thinking? This is McLean Hospital. This is a serious place. Don’t you know better? Shouldn’t you be in the office?” And then just leave it at a distance?

Or I can be like, “Okay, why are we at home? Oh, I remember what happened. Last night was a late night and this morning and there’s a reason why I’m here.” Now, you can hear it better, right? No, he’s literally at my window, it’s hilarious.

Jenn: No, I can’t. No, still can’t hear it. unless I have terrible hearing, but you sound great.

David: No, that’s really funny. So funny, sometimes it’s like all in your head, right? I’m not going to be mean or unkind to myself. Even if I did mess up here, that’s part of being human.

And you mentioned COVID before, I think these last couple of years have taught us that that none of us are perfect. We’re all so fallible and so in need of support and in need of bandwidth. So when we take that approach, all that tension dissolves. It’s not even annoying.

Jenn: That’s such a nice, peaceful thought to have too as I’m sure that there’s a leaf blower that is just going directly in your ear right now.

David: But it’s not a meaningful sound anymore now that we spoke about it.

Jenn: I think that’s a really good application to have because I work from home, I have noisy neighbors at times, and it certainly is something that can grate on me, but having that kindness toward myself that I can’t control other people, I can only control what’s in my own locus of control and I can ride this wave, it’s going to be okay. Is just a way to feel significantly better about landscaping.

David: Right and the place is going to look really clean when I leave it too, right? So perfect, win win.

Jenn: That seems like a win win. Absolutely. Have you heard anything about making people aware of the word should as a good starting point to helping others discover their own self-compassion?

David: Yeah, Albert Ellis talked about that years ago in the rational emotive behavior therapy, should being not a good thing. In other words that we shouldn’t should. And I think there’s something to that. I definitely think there’s to some degree there. There’s a piece of that.

I don’t necessarily agree that holding oneself to any standard means you can’t be self-compassionate ‘cause in some ways, if you hold yourself to a standard and then you don’t make it, it gives you more of an opportunity to be self-compassionate because I didn’t make it but that doesn’t mean that I’m a broken person and that doesn’t mean that I’m not worthy of kindness and it doesn’t mean I’m not going to practice being loving to myself.

So if anything, in some ways, having a certain standard for oneself can be a context for learning to be less judgmental and more kind, practicing more acts of kindness ‘cause it increases the stress. But I wouldn’t do it right away. If someone’s really struggling with self-compassion, then it probably is a good idea to avoid that for six months, a year maybe.

Jenn: Do you have any advice for ways to teach self-compassion to children and adolescents that are having a hard time with low self-esteem?

David: Yes, be compassionate and kind to them. Kids and adolescents will internalize the voices that you, I assume as a parent, mentor or whatever it is, or even as a friend for that matter, bless you, will give towards them. So they’re having a hard time or they screwed up so to speak and you’re kind to them and say, “You know what, that’s okay. Everybody screws up once in a while, this is part of life. Let’s go for a walk, let’s go get a coffee.”

That’s such a powerful message. I’ll tell you something, a story just popped into my mind. So couple years ago, I picked up the hobby of long distance running and I got myself a coach and the coach is, he’s a really awesome coach named Owen Anderson and he lives in Michigan, actually in Lansing, Michigan. And I meet with him primarily virtually and he’s trained some really top athletes, some people who’ve competed.

Not me, I’m not in that group. I’m sort of definitely lower ended in his rank. I’m just lucky to work with him. He told me something really fascinating. He said, “When an athlete doesn’t place as high in a race as they wanted to or they expected, they’ll come out of the ending corrals and they’ll see their coach and there’s this very split second opportunity for the coach ‘cause the coach will know how well they did, they’ll see the leaderboard, right? And there is like a couple of seconds that they’ll pick up on the coach’s feelings and sensations.”

And he says, “Those moments crystallize the relationship with that athlete or it could be the last time that they ever work with you again.” Because they need to see. And he said, “What crystallizes it? If they see that the coach is not judging them” They’re like, “So you came in fifth place?”

This is a really competitive field. It was hot day and you’ve been injured and we didn’t feel adequately and your course markings were off, like, whatever it is, but just conveying it almost with body language that like, this is okay, like, we’re good. So those high impact moments are particularly critical, I think for child and adolescent development and for runners apparently.

Jenn: So if somebody who is already struggling with self-compassion, this is like playing off of the coach question. If a person’s already struggling with their self-compassion, but they’re consistently interacting with someone like a coach or a friend or a boss that’s focusing on what this person doesn’t do well, how can they address this?

David: Yeah, it’s tough ‘cause then they’re in this position as a subordinate, right? They have a superior who’s basically not being compassionate enough, that’s it. That’s a tough situation. A couple things. One, all the more reason to practice self-compassion. Two, a person’s self-care needs to be optimal. And three, at a certain point, they’re going to have to have a crucial conversation with that said boss.

They’re going to have to sit them down and say, “Hey, listen, I know you’re disappointed about this, that, and the other, you’ve said this, you’ve done this, it’s very clear. I want to be very clear about my limitations. I can do this and I do it well, but I can’t do that. And if you’re expecting me to do that and not just this, then you’re going to be disappointed and I’m going to be stressed. It’s going to make it harder for me to do everything. So let’s be... We have to have a conversation about this.”

That’s a hard thing to do and I wouldn’t do it right away. Good nights sleep for several weeks, adequate preparation for it in advance, feeling good about it and then scheduling the meeting. But at some point, it has to be done.

Jenn: Do you have any advice about simple ways to shift our mindset from feeling ashamed or embarrassed about ourselves toward having more compassionate and accepting thoughts?

I know that negative thought patterns can be one of the hardest things to break out of, but I’m sure that there’s got to be just simple turns of phrase, right? That we could use to make it just a little bit easier.

David: Yeah, it’s a good question. I guess I’ll start by saying one of the best ways to, you’re right. Changing our thought patterns is one of the hardest things to do. A couple of, a couple ideas. One is, don’t underestimate the importance of behavioral change in making it possible to make cognitive change.

So being kind to yourself, it’s so much easier to talk yourself out of something, some negative thinking pattern when you’ve had a decent night’s sleep. Don’t do that when you’re stressed. If you’re low on sleep and you haven’t been eating adequately and you haven’t exercised in three weeks, it’s probably not the right time just having those conversations with yourself to try to change your thinking patterns. It’s not going to work, everything’s inflamed.

You want to settle things down first and then have those conversations. In terms of the next one, it’s being aware of it. I have this exercise I’ve had with some of my patients which is just to count the number of times that they say out loud something negative about themselves every day. Even if it’s like, “Oh, that was so stupid.” That’s one.

You know, “I can’t believe I did that,” two. “I’m an idiot,” three. Even, don’t, four. I’ll count that one. Some sort of verbal expression of negativity towards oneself. “I hate how this looks on me,” five. And being aware of it. And if you can’t... They say, “If you can’t measure it, you can’t change it.”

So just measuring it, just being aware of it and then trying to try to decrease those verbal statements over time. You have to catch yourself sort of doing it but again, I would decrease the inflammation first, so to speak.

Jenn: And also don’t beat yourself up if you have a long list. That’s certainly something for you to work on and don’t fall into that negative pattern of like, “I can’t believe I said so many bad things about myself.”

David: No, in fact, I’m glad you mentioned that. I’m glad you mentioned that. When I challenge my patients to do this, I want them to have high numbers. Not that they’re intentionally seeing negative things about themselves, but if not, then they’re probably not aware of it.

So if somebody can get up to a hundred times a day, then that’s great. That means they’re aware of the fact that they did it a hundred times a day. That would be a positive thing, not a negative. I’m glad you mentioned that.

Jenn: So as we are recording the session, we’re getting closer to the new year, which means a lot of folks are going to be doing new year’s resolutions and crafting some very lofty and or ambitious goals that they might be setting for themselves or enrolling other people in.

So how do we apply self-compassion toward goal setting? Because I know I’ve said before, I’m going to get to the gym five days a week and three weeks into January, I have four projects at work, I’ve gone twice and I’m already annoyed at myself.

David: Yeah, I think we’ve all been there. Yeah, the killer about new year’s resolutions is usually not that we make them, I don’t think that’s a problem. There’s been some literature about that and I still think it could be a good thing to do, it is a good thing to do. But to make the bar really low, it should be almost a slam dunk to be able to do it.

For example, going to the gym once a month, or maybe even once a week, as opposed to what you really want to do. So I always say, I say this to my patients a lot that, if you have a goal for yourself, cut it in half and then cut it in half again. You might even want to cut it and have one more time, but at least twice and that can be like a resolution.

Your goal might be going five days a week, which would be a lot by the way. Fantastic but a lot. But we want to cut that, it’d be two and a half and then one and a quarter. So let’s call it one. But once a week, if you really want to go five days a week, then once a week would be your resolution, means like not do or die, but basically like you’re going to the gym.

I’ll give you another one. Somebody says, “I want to run more.” So I would say to them, “Lace up your shoes and walk out your front door at least three times a week.” Even if you don’t run it all, that’s doable. You walk five feet out your front door with your laces on and you’re good.

That’s cutting it in half, cutting in half again. And coming up with those resolutions and you’re not going to feel bad about yourself because it’s basically a slam dunk. It is totally doable.

Jenn: And it’s also engraving the pattern of, now that I can do this three days a week, it’s going to be easier for me to start increasing the time that I spend outside. Or if the weather’s not great, you just go out your front door with your sneakers on, and then you go, “I’ll try this again tomorrow when it’s not raining or snowing or whatever.”

David: Right and sometimes you might be like, “No, I’m going to run a mile in this crazy weather.” And then you feel really great about yourself, but it wasn’t an expectation.

Jenn: Exactly. One thing that we have talked about during the session is practicing self-compassion and also acknowledging about shifting blame. How can we help people practice self-compassion without necessarily focusing blaming on other people?

David: Yes, I’m so glad you asked that. There’s this, actually it’s written about in EFT, in emotionally focused therapy. It’s called find the bad guy. It’s a pattern in relationships where I don’t like blaming myself, so I blame you ‘cause someone’s got to take the heat, right?

Self-compassion in many ways is the exact opposite of that where yes, something happened but it’s not a matter of blame. It’s a matter of how can we strengthen our relationship either with myself or with someone else in order to address the issue from a place that’s more loving and more caring.

Basically, if you’re shifting the blame, you know you’re not being compassionate. But that doesn’t mean not holding other people accountable. Like if somebody does something that’s egregiously, we talked about a boss before or someone in the family who’s being overly demanding, I think we can say, that’s not an expectation that I can live up to but that can be done within a compassionate framework.

I don’t blame my boss. My boss is wonderful by the way. But it’s just to say, I don’t blame my boss for being a jerk ‘cause he grew up with that or he’s under a lot of stress or she’s having a hard time in her life or I feel bad for her.

Jenn: Yeah.

David: That’s a compassionate way of keeping someone accountable and that’s much more healthy than the find the bad guy approach.

Jenn: Are you familiar with any problems that could arise if a person with low self-worth keeps their locus of control outside of themselves?

David: Locus of control is an interesting topic especially as somebody who studied spirituality. In some ways my research has found that having an external locus of control is not necessarily a bad thing as long as that locus of control is positive. So if somebody has belief in a higher being, that’s an external locus of control.

But if they have positive beliefs about that and believe that someone up there has got their back, that could be extremely positive. And I’ve found that number of studies myself and a number of my colleagues have also. So I’m not sure it’s necessarily a bad thing to have an external locus of control and in fact if anything, it might enhance self-compassion because it’s not all up to us.

There are so many factors that make it impossible for me to function perfectly all the time that are really beyond my control like the leaf blower or my kids keeping me up at night, or like the weather, COVID. There’s so many different factors that get in our way.

So I don’t necessarily think it’s a problem to have an external locus of control as long as it’s not like a menacing external force or like a random external force. Like if we have a sense that there’s a rhyme and reason for things, I don’t know if it’s necessarily a bad thing.

Jenn: We had a parent of a teen, write in asking, how can you balance being compassionate but still push your teen to achieve more than what they believe is possible or to just simply have them put in a little bit more effort?

David: It’s a great question and the common one. I’ll start by saying that most American teens have pretty high expectations of themselves and pretty high standards. I don’t think our standards and our expectations have decreased over time.

I think that with all the devices that we have and all the advancement that there’s been in science and technology and really in any field, even in law and every everywhere, humanities, education, I mean any field today. Mental health is far more advanced than it was 10, 20, 50, a hundred years ago and the expectations commensurately have increased.

And especially when dealing with a teen, we’re better off getting them to understand from within why it’s important to do that as opposed to sort of holding them accountable from an external, not external locus, but an external motivator.

Typically, when a kid is not launching, when a kid is not putting in their effort, it’s not because they don’t see the importance of what they’re doing, it’s ‘cause they don’t believe that they can. Usually when kids are not thriving today, it’s ‘cause they don’t believe in themselves.

It’s because of a lack of self-compassion in many ways that they don’t accept that, they say like, “I’m such a failure. I got 94 on my test. How could I possibly... There’s so many other kids with that 96 or 98, how am I ever going to be successful?” And that’s really how a lot of kids think today. And it’s like, well, don’t beat yourself up.

Often self-compassion can increase the motivation. It’s not really self-compassion, but compassion towards the child can increase their motivation and get them to hold themselves accountable. Why are they not holding themselves accountable? ‘Cause they don’t believe in themselves, usually.

Jenn: I wish that that was advice that I had heard like 15 plus years ago when I was a teenager because that would’ve made a world of difference moving forward. So when you were talking about that, I had a giant grin on my face ‘cause let me tell ya, light bulb moments all over the place in my job.

For adults that experienced judgment from their parents from childhood, do you have any practical advice about how to reduce that self-critical voice that’s really been instilled in their minds?

David: Yes, speak to someone about it. Have an open, honest, raw, emotional conversation about how it affected you, how it impacted you and what you need today as a result of that.

If that is a significant other like a spouse or a romantic partner, if it’s a good friend, a very close friend or if it’s a therapist a professional, great. But it has to be somebody. You have to have a chat about it. You got to be aware of it and you got to speak about it.

Jenn: We had someone write in saying that they have a sense of urgency at work to resolve every issue that’s presented immediately despite also understanding that there is some impracticality to it. How can they apply self-compassion in their workplace?

David: Great, some impracticality to it. That’s going to be my response to that person. What they wrote, I haven’t seen it, but apparently they wrote some impracticality. No, it is impractical, you are not going to fix everything. That is the way it is.

I don’t know what your spiritual leanings are but if you’re my patient and you’re interested in that, I would say, “You’re not God, and you’re not going to fix all the problems in the world. Nobody is, that’s just the way it goes.”

I might even encourage you to leave certain things specifically undone every single day and learn to live with it, that it’s okay to have things that don’t go well at work. And yeah, maybe you could have like pushed herself over the line, but you didn’t.

And can you be compassionate and kind to yourself while letting things fall through the cracks. Like get yourself... Like have a terrible day at work and then go get yourself a really nice dinner. That’s what I would.

Jenn: That’s rewarding in and of itself. I would love to have bad days at work if I got a good steak out of it in the end.

David: Exactly. But ironically, It would actually improve this person’s performance in the long run. You’re going to burn out otherwise. You can’t do that.

Jenn: I think we have time for one more question. So are there any specific exercises that you can do to increase self-compassion? And a piggyback question would be, do you know of any resources available for free that have self-compassion exercises?

David: Great questions. That’s two questions by the way which is a lot to ask. I don’t even know if I can do it, so I might only be able to answer one, In fact, I will. The second one, I can’t do both and I have to be kind to myself about that fact.

Jenn: Thank you for the acknowledgement that I snuck two questions into one.

David: It’s okay, just have to be aware of my own limits. Kristin Neff is a well-known psychologist who’s done work on self-compassion and I don’t know about free, but I believe she has a book. I think there’s also a website.

So Jenn, I might give you that honor of figuring it out and I don’t know if you’re going to post it or what, that’s the follow-up from this session. But, but I’ve done some clicking around online and I saw some pretty cool resources that she has. So that might be a good place to start.

Jenn: Perfect and for folks tuning in, you will get access to the resources that he mentioned plus any other ones that we have from McLean that are about being compassionate toward yourself, as well as mindfulness.

I’m going to throw one more question at you though. Any final words of wisdom that you would want to impart to people tuning in about just being nicer to yourself?

David: Yeah, I’ll mention this that, we didn’t speak much about COVID, but I will tell you the last two years have been unordinarily stressful for all of us. And people’s self-compassion tends to go down when stresses go up and that’s exactly the opposite direction that we want to move in.

If there was ever a time to be kind to yourself, to be patient, to be more loving, giving, tolerant, less judgmental, acknowledging the stresses that were having, speak to other people about it, doing kindness to yourself, even if you’re not perfect, and to accept that we’re not going to be perfect. All of that, if there was ever a time to do it in our lives, it’s now.

In fact, I even wonder whether that’s one of the best things that came out of this is an opportunity to potentially increase our relationships with others because the work life balance, I think changed a lot. It’s another topic.

But the other one is to just acknowledge that we’re really not perfect. We’re human beings. Human beings, we are not perfect. We’re imperfect creatures. And can we have a relationship with ourselves despite that? That’s in some ways the question of the day and we have a great opportunity right now.

Jenn: Awesome, that’s all I can say about this session and you. This was awesome. So David, thank you so much.

David: Thanks Jenn.

Jenn: Thanks for making this the best hour of my day.

David: Aww, thanks.

Jenn: And to anybody tuning in, this actually ends the session. So thank you so much for joining. And until next time, be nice to one another. But if you’ve learned anything from this session, be nice to yourself. Thank you so much and take care.

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Don’t forget, mental health is everyone’s responsibility. If you or a loved one are in crisis, the Samaritans are available 24 hours a day at 877.870.4673. Again, that’s 877.870.4673.

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The McLean Hospital podcast Mindful Things is intended to provide general information and to help listeners learn about mental health, educational opportunities, and research initiatives. This podcast is not an attempt to practice medicine or to provide specific medical advice.

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