Mindful Self-Compassion

The concept of mindfulness and self-compassion has been around for over 2500 years, and is rooted in Eastern traditional Buddhist philosophy and Buddhist meditation. In Buddhist philosophy, mindfulness and compassion is considered to be two wings of one bird, with each concept overlapping one another but producing benefits for wellbeing. The word Mindfulness is the English translation of the word Vipassan, which a combination of two words Vi, meaning in a special way and Passana, to observe, hence implying to observe in a special way.

Compassion (karunaa) can be defined as an emotion that elicits the wanting to be free from suffering. Mindfulness in the context of self-compassion comprises acknowledging one's painful experiences in a balanced way that neither ignores, or ruminates on the disliked characteristics of oneself or life. It is essential to be mindful of one's own personal suffering in order to extend compassion towards one's self. However it is essential to pay attention to self suffering in a grounded way in order to avoid "over-identification".

Mindfulness tends to focus on the internal experience such as sensation, emotion and thoughts rather than focusing on the experiencer. Self-compassion focuses on soothing and comforting the self when faced with distressing experiences. Self-compassion is composed of three components; self kindness versus self-judgement, a sense of common humanity versus isolation and mindfulness versus over-identification when confronting painful thoughts and emotions.

Mindfulness-based stress reduction
Mindfulness-based stress reduction (MBSR), developed by Jon Kabat-Zinn is a structured group program that uses mindfulness meditation to relieve suffering associated with physical, psychosomatic and psychiatric disorders. Mindfulness-based stress reduction therapy seeks to increase the capacity for mindfulness, by reducing the need for self-focused thoughts and emotions that can lead to poor mental health. The exercise of mindfulness-based stress reduction therapy brings together the elements of meditation and yoga, greater awareness of the unity of mind and body, as well as the ways that the unconscious thoughts, feelings, and behaviors can undermine emotional, physical, and spiritual health.

Clinical research from the past 25 years has found that MBSR is efficacious in reducing distress and enhancing individual well-being. Self-Compassion can play a critical role in mindfulness-based cognitive therapy interventions. The study Shapiro et al. (2005) found that health care professionals who underwent a MBSR program reported significantly increased self-compassion and reduced stress levels compared to the waitlist control group. It was also reported that the increase of self-compassion appeared to reduce stress associated with the program.

Mindfulness-based cognitive therapy
Mindfulness-based cognitive therapy (MBCT) is an intervention therapy that combines meditation practices, psycho-education and cognitive behavioral strategies to prevent the relapse or recurrence of major depression. MBCT teaches individuals how to observe their thoughts and feelings by focusing their attention on natural objects, such as breathing and bodily sensations. Individuals are taught how to achieve awareness while holding an attitude of non-judgemental acceptance.

Within MBCT, mindfulness skills are taught in order to recognize distressing thoughts and feelings, to be aware of these experiences, and utilize acceptance and self-compassion to break up associative networks that may cause a relapse. Self-compassion in response to negative thoughts and feelings is an adaptive process, which validates it as a key learning skill in MBCT.

Self-compassion has been found to be a key mechanism in the effectiveness of mindfulness-based interventions such as mindfulness-based cognitive therapy (MBCT). Kuyken et al. (2010) compared the effect of MBCT with maintenance antidepressants on relapse in depressive symptoms. They found that mindfulness and self-compassion were increased after MBCT was introduced. They also found that MBCT reduced the connection of cognitive reactivity and depressive relapse, and that the increased self-compassion helped mediate this association.

Mindfulness-based pain management
Mindfulness-based pain management (MBPM) is a mindfulness-based intervention (MBI) providing specific applications for people living with chronic pain and illness. Adapting the core concepts and practices of mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT), MBPM includes a distinctive emphasis on the practice of 'loving-kindness', and has been seen as sensitive to concerns about removing mindfulness teaching from its original ethical framework within Buddhism. It was developed by Vidyamala Burch and is delivered through the programs of Breathworks. It has been subject to a range of clinical studies demonstrating its effectiveness.

Mindful self-compassion therapy
Mindful self-compassion (MSC) therapy is a hybrid therapy consisting of self-compassion and mindfulness practices. The term mindful is referred to in the MSC program as the basic mindfulness skills which is turning toward painful thoughts and emotions and seeing them as they are without suppression or avoidance which is crucial to the development of self-compassion. The MSC program however focuses more on self-compassion and sees mindfulness as a secondary emphasis. MSC teaches both formal (meditation) and informal (daily life) self-compassion practices. In addition there are homework MSC assignments that teaches participants to be kinder to themselves. The goal of MSC therapy is to provide participants with a variety of tools to increase self-compassion which they can then in turn integrate into their lives.[43] A study conducted by Neff and Germer (2012) found that compared with the control group, MSC intervention participants reported significantly larger increases in self-compassion, mindfulness, wellbeing and a decrease in depression, stress and anxiety which were maintained for 6 months after the initial intervention.

Compassion focused therapy
Paul Gilbert (2009) developed compassion focused therapy (CFT) that teaches clients that, due to how our brains have evolved, anxiety, anger and depression are natural experiences that are occur through no fault of our own. Patients are trained to change maladaptive thought patterns such as "I'm unlovable" and provide alternative self-statements, such as "know for sure that some people love me". The goal of CFT is to help patients develop a sense of warmth and emotional responsiveness to oneself. This is achieved through a variety of exercises including visualization, cultivating self-kindest through language by engaging in self-compassionate behaviors and habits. In CFT self-compassion is utilized through thoughts, images, and attention which is needed to stimulate and develop the contentment, sooth and safeness system.

Mindfulness skills in dialectical behavior therapy
Dialectical behavior therapy (DBT), is a derivative of cognitive behavior therapy that incorporates Eastern meditative practice. DBT is based on a dialectical world view that incorporates the balance and integration of opposing beliefs, particularly in acceptance and change. We accept ourselves as good enough, and we recognize the need for all of us to change and grow. Unlike MBCT and MBSR therapies, dialectical behavior therapy does not use meditation but less formal exercises, such as individual therapy sessions and group skill sessions. In general last for approximately a year where participants will engage in weekly individual skill therapy sessions and group skill sessions. The skills therapy sessions include four segments; core mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance skills. Dialectical behaviour therapist recommend developing self-compassion. The basic premise of using self-compassion therapies in DBT is to cultivate a compassionate mind state, defined by feelings of warmth, safety, presence and interconnectedness that can in turn relieve emotional dysregulation.

Mindfulness and related skills in acceptance and commitment therapy
Acceptance and commitment therapy utilizes behavior change process, mindfulness and acceptance process. ACT, involves non-judgmental awareness and openness to cognitive sensation an emotional experiences. It also promotes exposure to previously avoided situations that have caused anxiety in order to promote acceptance. The avoidant behavior is treated by having clients observing their thoughts and accepting that their thoughts are not necessarily harmful.

In general ACT strategies are customized to fit each participant so they obtain psycho-education, problem solving skills and psychological flexibility. Mindfulness and acceptance exercises and skills facilitate the behavioral changes necessary for its user to pursue a life that they feel is vital and meaningful. Various sources have indicated that acceptance and commitment therapy overlaps with Neff's conceptualization of self compassion particularly ACT's relational frame theory. The basic theories and concepts underlining ACT, may be relevant and have shown to be parallels and hold similarities found in self-compassion. The first is ACT's perspective and Neff's concept of self-kindness are both linked to self-acceptance. Acceptance of one's painful experiences and hurt is related to kindness to one's self.

Second Neff's conceptualization of self-compassion and ACT both emphasize mindfulness, which is practiced in ACT through the concepts of difussion, acceptance, contact with the present moment and the self as a context. Defusion is also used in self-compassion as a means of allowing self-criticisms to pass through the mind without believing, proving them wrong or engaging in a stance to make these thoughts workable. In a study conducted by Yadavaia, Hayes & Vilardaga, 2014 test the efficacy of an ACT approach to self-compassion as compared to a waitlist control, the study showed that ACT interventions led to a large increase in self-compassion and psychopathology compared to the waitlist control at post-treatment and two months post intervention.