Dr Neff is a pioneer in the field of self-compassion researchand a passionate advocate for the inclusion of self-compassion for healthcare practitioners to both ensure optimal care for our patients while avoiding burnout.
Dr Neff shares her definition of self-compassion, how it differs from self-esteem, her key findings around this important topic, and how we as healthcare practitioners can easily implement self-compassion into our own lives, and advocate for it with our patients.
This podcast is a must listen for healthcare professionals and patients alike, who are looking to increase their patient care, resilience, reduce anxiety and stress, and adopt powerful lifestyle habits to increase self-compassion and love.
COVERED IN THIS EPISODE
(00:24) Welcoming Kristin
(02:05) Kristin’s definition of compassion
(12:40) Shame and its purpose
(14:58) The difference between self compassion and self esteem
(19:35) Self compassion as a powerful coping mechanism
(23:48) Self protective mechanisms
(27:27) The neurobiology of self compassion
(34:45) The yin and yang of self compassion
(41:06) Bringing self compassion into our clinical practice and for ourselves
(46:06) Thanking Kristin and final remarks
KEY TAKEAWAYS
- As humans, we don’t have to earn the right to compassion, we are born with it.
- Physiological changes in self-criticism versus self-compassion:
- Heart rate variability
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- Changes in hormonal levels
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- Increased/ decreased inflammation
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- Immune system function
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- Sleep changes
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- Nervous system activation.
- Self-compassion is made up of three elements: Kindness, mindfulness, and a sense of common humanity.
- Self-esteem vs self-compassion: Self-esteem is a judgement of worth, an estimation of value, often comparative to others. Self-compassion is not based on judgement. It is unconditional stemming from being a human who is intrinsically worthy of care – you don’t have to earn the right to compassion.
- Studies show that self-compassion reduces burnout, stress, exhaustion, and depersonalisation.
- Evolutionarily, humans tend to be more compassionate towards others than themselves. Usually when we suffer, we feel threatened. This can push us into sympathetic nervous system overload and release adrenaline and cortisol. When the ‘threat’ is personal and not external, we can fight ourselves in an attempt to feel less threatened.
- The yin and yang of self-compassion is made up of fierce and tender self-compassion.
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- Tender self-compassion: Yin energy. Accepting and nurturing ourselves.
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- Fierce self-compassion: Yang energy. Take action to alleviate suffering.
RESOURCES DISCUSSED AND ADDITIONAL READING
DR KRISTIN NEFF
SELF-COMPASSION
TRANSCRIPT
Michelle: Welcome to fx Medicine, bringing you the latest in evidence-based, integrative, functional and complementary medicine. I'm Dr Michelle Woolhouse. fx Medicine acknowledges the Traditional Custodians of country throughout Australia where we live and work and their connections to land, sea, and community. We pay our respects to the elders, past and present, and extend this respect to all aboriginal and Torres Strait Islander people today.
I think there've been two statements circulating around the world over the past few years that couldn't be more true. The first is that we are living in unprecedented times, and the second one is that the world needs more kindness than ever before.
So, who better to talk about the signs of kindness and compassion is my guest today, Dr Kristin Neff. Dr Kristin Neff is Associate Professor in Human Development at the University of Texas. She's a pioneer who is well-known for establishing self-compassion as a scientific field over two decades ago. She created a validated self-compassion scale to help measure this once-obscure construct almost 20 years ago. She's written multiple books, online programmes in conjunction with her dear colleague Dr Chris Germer. Her work can be considered a game-changer in the arena of personal and communal psychology. And for me, I can certainly attest to its profound benefits in my own life. And I'm honoured to welcome to the show, Dr Kristin Neff.
Kristin: Hi, Michelle. Thanks so much for having me on.
Michelle: My pleasure. So, I'm going to open with a question that I'm sure you've answered many times before. What is self-compassion and why is it so important?
Kristin: Well, if you look at the Latin roots of the term "compassion," passion is about suffering and com is with. So, it's about how are we with suffering. And normally we talk about having compassion for others. How are we with the suffering of others? And so with self-compassion, it refers to how are we with our own suffering, right, whether that's making mistakes, feeling badly about ourselves, or it's stress, or a health challenge. So, how are we with the difficult stuff? And so that's, kind of, the technical way to think of it. And the easier way to think of it is just being the same type of good, supportive friend to yourself that hopefully you are to others, those you care about.
Michelle: And so why is it so important? I mean, because a lot of people talk about that kind of I guess inner critic or that, sort of...you know, the coach that kind of is harsh with you so that you don't get kind of soft and lazy or slack off. Why is self-compassion different and why is it important?
Kristin: Yeah, so a lot of people assume that self-criticism is helpful. It allows us not to be self-indulgent. It motivates us. And so that's important because this is a part of ourselves that thinks it really is trying to help. It's, kind of, well-intentioned, you might say. But having an encouraging, supportive, warm voice doesn't mean you lie to yourself. You may tell yourself straight "This is not working, but I believe in you. How can I help?" This kind of encouraging, supportive voice is actually more effective.
So, when we have a difficult thought or emotion, let's say you're a doctor, and you're trying to do something new, and you fail at this new endeavour. Maybe you're trying to come up with a new treatment modality and it's not going very well. So, you've got a couple options. One is you could just call yourself, "I'm so stupid. Who am I to think I could do this new procedure? I'm lame." You can criticise yourself, and that may get you to, I don't know, if you need to study a little more to get whatever help you need to learn the new procedure. But what it's also going to do is it's going to make you feel anxious, right? Have performance anxiety. Whenever we have performance anxiety, that actually detracts from our ability to do our job well. Shame. Feeling like you're incompetent is not exactly the most motivating mindset. And it introduces a lot of noise, these negative thoughts about ourselves undermines your self-confidence. It actually works against us. It's not very helpful.
So, what self-compassion does is, again, if you care about yourself and you don't want to suffer, that means we're going to be honest with ourselves. Lying to ourselves is not going to help us alleviate our suffering. So, you're honest, but the way a really good mentor or coach might be, which is like, "Okay, here's the issue. It happens to everyone. You know, how can we learn from this situation? How can we grow? I believe in you. I'm here to help. What do you need that would facilitate your ability to learn and reach your goals? That type of supportive voice is actually much more effective in the long run than a shaming self-critical voice. So, that's why it's so important. It helps us learn and grow and achieve our goals.
Michelle: So, I wanted to get curious with you. So, how did you... Set us the scene. Like, how did you get so interested in self-compassion and where did that come from?
Kristin: So, I actually learned about self-compassion my last year of graduate school. I was about to take my dissertation oral. And my life was a mess. I had married young, and I got divorced young. So, I was feeling a lot of self-doubt about that. And I was also feeling a lot of stress. You know, will I pass my dissertation orals? And if I do, will I get a job? The job record was really tight. And so I thought that learning mindfulness meditation would help me deal with all the stress I was undergoing. And then luckily for me, the person leading the meditation course I was on the very first night talked about the importance of self-compassion and in addition to being compassionate to others. When we turn this warm, supportive, kind mindset inward, it actually helps us cope with our stress. And it just made a huge difference to me in that time of my life, my ability to cope through the various stressors I was under. And then what happened is I did get a job eventually. I got a postdoctoral fellowship with someone studying self-concept development. I kind of became interested in how people talk to themselves, how they relate to themselves. And then when I got a job as a professor position at University of Texas at Austin, I decided I wanted to do research on this. And so that's really how it unfolded.
Michelle: And so in your early career, how did you start off by studying compassion? And what did you find were the components that actually help to define what it is?
Kristin: Yeah. So, what had happened is, when I decided I wanted to study self-compassion, I didn't come up with the idea. And in some ways, it's not a new idea. People like William James were talking about unconditional positive self-regard. So, it's not a brand new idea, but no one had really studied it exactly in this format of compassion and feelings of compassion, kindness, concern, and warmth, etc.
So, I wanted to create a scale to measure it. And so I thought, "Okay, I need a better definition than, 'It's just treating yourself like a good friend.' " That wasn't very psychometrically valid. I knew. And so I came up with a good operational definition, at least I think it's pretty good, which is that there are actually three components of self-compassion. One is the kindness, which makes sense, but I realised that there's two other elements to make self-compassion to make it healthy, and that is mindfulness, and a sense of common humanity. So, it's perhaps not a surprise that I learned about self-compassion while learning mindfulness meditation, because in order to give ourselves compassion, we have to first be aware of the fact that we're struggling. Often what happens is we either ignore it. And you can't help yourself if you don't realise that you need help, right, if you just don't have this mindset of, "I'm not going to acknowledge it," or some people do the opposite and they get swept away by their difficult emotions, right? They get carried away. They can't focus. They, kind of, become obsessed with it, and we can't function that way either.
And so what mindfulness is it's a balanced form of awareness where we're aware of what's happening right now. We can see it, but there's some perspective. There's some space around it so that we have some room to make good decisions. So, mindfulness, I realised was, kind of, the first step of self-compassion. And then we're aware that we're having a hard time and then we respond with kindness, warmth, support, this desire to help in some way. But I was really, kind of, concerned with this question. Well, what's the difference between self-compassion and self-pity? We know self-pity is not very helpful. And actually the question is it's the same question, it's what's the difference between having compassion for others and pitying others. And the difference is with pity, there's a sense of separation. If you pity someone, you look down on them. And if you pity yourself, self-pity, it's like, "It's only my problem, poor me," and it's, kind of, excluding other people. So, I realised that what made it compassion and not pity is a sense of interconnectedness with others. It's recognition that all human beings are imperfect, all human beings make mistakes, all human beings struggle. I mean, yes, some more than others. It's not like we all have the same experience but yet what makes us a card-carrying member of the human race is that we make mistakes and we struggle and things can be difficult at times. And so those are the three elements that I use for my definition of self-compassion and also my measurement of self-compassion, the sense of connectedness with others, sense of mindfulness, and then kindness towards oneself.
Michelle: I'm going to admit, when I first used your research for my benefit, for my personal growth, it was that shared humanity that was a real game-changer because I could lean into the fact that I wasn't alone, knowing that people, you know... My ancestors had felt this. People that were older than me were feeling this, people who were younger than me. So, it really was... I love the fact that you discovered that through, kind of, looking at the opposites because it really is that ability to kind of go, "I'm not my shame or how I'm feeling or my embarrassment or anything that was uncomfortable that I was experiencing." If I felt like I could share it, it just minimised it. It made it feel less so. And then it also opened up my heart to be able to care for myself more. So, I can attest to the benefit of it. It was really amazing.
Kristin: That's so beautiful to hear. Yeah, if you think about it... So, one of our main sources of suffering and distress is feeling isolated from others, feeling lonely, feeling cut off. Shame is that feeling of like you're uniquely flawed, feeling like there's something wrong with us. And so what common humanity does is, even though there's the word self in self-compassion, there's really not much self-there. It's more like inner compassion. It's really not a lot of self-focus. It's about softening that sense of separation, feeling like we're part of the larger whole that helps us relate to ourselves in a kinder way.
Michelle: So, you mentioned shame. So, is self-compassion kind of the opposite of shame or do we know how shame develops and whether it's got a biological purpose to it?
Kristin: Yeah. Actually, so evolutionarily, shame does have a purpose. So, in terms of, kind of, in-group cohesion back in the day, so if you did something that really violated the social norms of the group, you'd be sent off, right? You'd be excluded from the group. And that was in a way to help people stay in line, right? Because back in the day, if you didn't have the group, you wouldn't survive. And so that actually is an evolved emotion, the feeling of shame arises. We feel like we're somehow unlovable or being excluded by others. And it's an incredibly painful emotion, which is why we try to avoid it at all costs.
So, in my scale, actually I measure self-compassion and its opposite. So, it's kindness versus harsh self-judgement, a sense of common humanity versus isolation, and mindfulness versus overidentification, that feeling that you are your negative thoughts and feelings. And when you think about what shame is, it's harsh self-judgment, feeling isolated, and you get really identified and carried away with this feeling like, "I'm a failure. I'm bad," all these thoughts. So, what the research shows quite clearly is that helping people have more self-compassion, even if it's as simple as write a paragraph to yourself with mindfulness. Write a paragraph reminding yourself you aren't alone, you're connected to others. Write a paragraph of kindness. One of the things it does immediately is it reduces feelings of shame. So, it is the antidote to shame, which is one of the reasons why clinically it's a usually strong effect size, negative correlation with things like depression, anxiety, suicidal ideation, eating disorders, PTSD. It's largely through reducing, I would say, shame and also just this negative spiral of thoughts of, "I am bad," or, "I'm not worth anything," and then down we go.
Michelle: Yeah, absolutely.
Kristin: So, it's partly how it works, reducing shame. Yeah.
Michelle: Mm, and you also make the distinction that self-compassion is different to self-esteem, which I thought was so brilliant. And I know in my journey, I lived a life with really good self-esteem, but I realised I had good self-esteem and not great self-compassion. And again that was a really distinctive aha moment for me. Can you tell us how you discovered I guess the limitations of the pursuit of self-esteem?
Kristin: Yes. So, I think I told you I did two years of postdoctoral fellowship in self-concept development, and I was actually working with a woman who was one of the leading self-esteem researchers in the United States. And so there was a big backlash against the construct of self-esteem, at least in American psychology, not so much having it. Well, first of all, let me define my terms, by the way. So, self-esteem is a judgment of worth, an estimation of value. Do I judge myself to be worthy or unworthy? And it's nothing wrong having self-esteem and feeling worthy. The problem is, how do you get it? Why do you feel worthy? And for most people, their worth is contingent. It's contingent on being attractive, very common, looking a certain way, having people like you, popularity, social approval and success in whatever domain is important to you. And get this one, it's also comparative in that most people, to have self-esteem, they have to feel special and above average. And if I said, "Michelle, yeah, your podcast, it's average." You're going to be, "Oh." And you said, "Kristin, I read your book. It's average." I'm going to be, "Oh, my self-esteem. It's not okay to be average." And this is true for most people, no matter how enlightened you are, right?
And so the problem with this, of course, is that it sets up social comparison. Is that person more successful than me? More popular than me? Do they look better than me? It, kind of, pits us against each other. One of the things we know from research is, for instance, why do people bully other people? Well, it's partly to raise their own self-esteem. You know, why are people prejudiced? I mean, that's complicated, but at least one thing playing a role is you want your in-group to feel better than some other group of people. And the other problem with self-esteem is, because it's contingent on success, it's a fair-weather friend. It's there for you when you succeed, but what happens when you fail? If you're an athlete, and you blow the game, and all your self-esteem's invested in being a successful athlete, well, then you're in trouble, right? And then your self-esteem gets blown. And then you lose faith in yourself, and then you can't continue the game or whatever it is, whatever your profession is.
And so the worth of self-compassion is unconditional because it stems from simply being a flawed human being who is intrinsically worthy of care. You don't have to earn the right to compassion. The moment a baby is born, they don't have to go to graduate school to be worthy of compassion. It's intrinsic to our very humanity. It's actually rooted. That's one of the reasons it's rooted in our shared humanity, the sense of compassion.
And so therefore what the research shows is it gives a much more stable sense of self-worth. So, if you're that athlete and you blow that game, well, maybe your self-esteem as an athlete takes a hit but you're still worthy of kindness, and support, and care in that moment just as much as whether you win that game or lose that game. And so that's another one of the health benefits of self-compassion is its unconditional sense of self-worth.
Michelle: So, it's virtually internal validation as opposed to external validation in a way, which is much more long-lasting.
Kristin: It's long-lasting. It's more stable. Just because I failed doesn't mean that I am a failure. So, moving your sense of self-worth away from all these external markers or these... It might even be an internal marker but any markers whatsoever, it's unconditional especially when you blow it. That's when you need to bring it all out, self-compassion, and that's why it's so helpful.
Michelle: Yeah, fantastic. So, you write about in your book this kind of... I mean, self-compassion has, I guess, an idea for the uninitiated, that it is a soft skill, and that's a terminology which I personally find quite ridiculous. And there's often an aspect that self-compassion is soft, and it's kind of for, it's good but it's not really real medicine or really helpful and all of that kind of stuff. Tell us about your, kind of, take on that. Because for me, it is a game-changer, and it really can radically change somebody's relationship to not only—for example, I'm a medical doctor—their illness but also to their life, to their relationships, to so many different factors. What do you think when people say, "Well, self-compassion is a bit soft?"
Kristin: So, I say when the going gets tough, the tough are self-compassionate because it's really... I mean, there's over 7,000 studies now on self-compassion, So, the literature is quite big, right? So, we know that it's one of the most powerful sources of strength, coping, and resilience we have available to us. And so, again, it's how are you with suffering when things are difficult, when you're feeling challenged, when you're feeling overwhelmed, when you're feeling burnt out, when you're feeling stressed, whether you're sick or when you've got to tell someone they have cancer, right? So, those really difficult moments in life. Are you an ally to yourself? Do you have your own back? Are you supporting yourself? Are you asking yourself, what do I need in this moment that will help, which is what self-compassion is, or are you shaming yourself? Are you cutting yourself down or are you ignoring yourself? Are you just shutting yourself off from...? Are you not listening to the fact that you need help? That's going to make you weaker. You're like an enemy to yourself.
And so when you go into battle and life is a battle, you need to be your own ally. You need to be your own support. And one way it really plays out in the medical field, which is a lot of research on self-compassion and burnout. And we actually developed a whole training for healthcare professionals, a whole self-compassion training for healthcare professionals. And one of the biggest outcomes of that is it reduced burnout. It reduces the feelings of exhaustion. It reduces feelings of depersonalisation, which you just kind of stop caring, and it reduces the stress level. So, if you're less burnt out, then that means you're more able to do your job.
We developed a program at a children's hospital where the doctors were doing things like telling parents your child has cancer. Really, really tough stuff. If you don't have the ability to deal with your own empathic pain... So, yeah, there's a pain of the parents and the child, and that's very real pain. But if all your compassion goes outward and you don't let any of your compassion also resource you by flowing inward, by honouring that, "Yeah, this is hard. This is difficult. I'm hurting too," then you will become depleted. So, your compassion has to flow inward and outward. It's not a zero-sum game, right? The more compassion flows inward, the more resources we have available to give to others. It's not like you only have five units. And if you give three to yourself, you only have two left over. It doesn't work that way. It's additive. And again, there's a lot of research showing it does reduce burnout which means you can stay in the game, and keep working, and keep doing your job.
Kristin: Lots of research in COVID, by the way, also. People who are more self-compassionate were more able to get through COVID without all the really negative consequences of other people. I mean, it was so hard, but it gave people the strength to get through that isolation, fear, and distress, whether you're a medical worker or just an average person.
Michelle: In one of your workbooks on self-compassion, there was a line that really struck out for me, which is, you wrote, we all build barriers to love. And I wondered what you mean by that and why do we do that? I mean, from a scientific perspective, why do we build barriers to love?
Kristin: Well, it's really a self-protective mechanism. So, most of us, as children, there were times when we didn't get the love we wanted. Maybe our parents were just too busy, or maybe they weren't able to meet our needs, or they had their own stuff going on. And so, in response to not getting the unconditional love we wanted, we just closed down our hearts. We just tried to go in our shell, "Well, I just don't care." We close down our hearts as a natural response to the pain of not getting the love we wanted or perhaps really even needed. And so it's a self-protective mechanism. Again, you can think of it as a part of ourselves that loves us and wants to protect us from harm, and so it closed down our heart. But unfortunately what that does, when our heart's closed, is it means we're also cutting ourselves off from love.
And it also means that we do start opening up with self-compassion. There's a term we have that we call backdraft that can occur. You might say, when we start to give ourselves unconditional love, we remember all those times when we weren't unconditionally loved. So, when you start to open your heart, at first, a lot of old pain can come up. Some people think they're doing self-compassion practice wrong, because I think it's going to feel all warm, and lovely, and cosy. And when you actually start giving self-compassion, you just feel intense pain. Self-compassion didn't cause the pain, it's starting to release the pain that's been shut out of our awareness by closing down our hearts. And so that pain needs to be released to be healed, I mean, at a slow pace, at a safe pace, sometimes for some people with the help of a therapist or a clinician to help them through it.
But that's just the way we tend to work. We try to protect ourselves. And that's also because when we're young, we don't have the resources we have as adults. We rely on our parents and our caregivers to meet all of our needs, and they can't meet all of our needs. And so what we're doing with self-compassion is it's almost like we're reparenting ourselves. We're asking ourselves, "But what do I need? And then what steps can I take to give myself what I need?" The way an ideal parent would. Do I need acceptance? Do I need maybe to work a little harder? Do I need to draw a boundary? Do I need to leave a relationship? Do I need to do something else? What is it that I need that would really help? And that's what self-compassion is, is asking that question just hopefully an ideal parent would for their child but of course, no one's an ideal parent because we're human.
Michelle: I know. And we need compassion when we're parents as well. Self-compassion, a lot of it.
Kristin: Exactly.
Michelle: But I love the concept of reparenting because I think it really helps to I guess tend... We've all got an idea of what an ideal parent, kind of, would be like. And so we can imagine and bring that kind of imaginative kind of experience to our hurt parts of ourselves. But, Kristin, do we know what the physiology is with regards to self-compassion or the neurobiology? How does it change us on a cellular or chemical level? What do we know about that?
Kristin: Yeah, so we do know a fair amount, and we also know... You talked before about is there an evolutionary function to shame. Well, it's not only shame but also self-criticism. There's an evolutionary reason why we tend to be more compassionate to others than ourselves, and that is because, when we are suffering in some way, we usually feel threatened. There's some problem, that's why we hurt, right? Whether it's because of a health issue, or something happening in our job environment, or we made a mistake, or we feel badly about ourselves, we feel threatened. So, when we feel threatened, we go into a sympathetic nervous response—fight, flight, or freeze. We release adrenaline and cortisol, and we get ready to fight the problem. But of course, when the threat is ourselves, we're the problem, then we beat ourselves up and fight ourselves in an attempt maybe to either we'll get ourselves in line so we won't be so threatened or maybe we'll beat others to the punch or criticise ourselves before others criticise us and we won't hurt so much, or we flee into a sense of shame and isolation. We, kind of, metaphorically hang our heads and run from the group in the sense of shame, or we freeze, and we ruminate, and we get stuck.
When your best friend has something happen, like they make a mistake at work, you aren't so personally threatened, and therefore you're able to use the care response. And the care response is associated more with the mammalian attachment system, right? It mainly evolved to facilitate bonds between infants and caregivers and also group members. So, it actually evolved more to take care of others, not so much ourselves. The fight, flight, or freeze response is more natural with ourselves. And that kind of helps explain why there's a difference, but it also ties into the physiology. So, what we're doing when we give ourselves compassion is we're using basically the care system, the attachment system with ourselves.
So, when we're being self-critical, we see high levels of cortisol, for instance, inflammation, sympathetic nervous system activation. And when we give ourselves compassion, self-compassion, whether that's verbally or maybe it's even putting a hand on our heart or some other gesture, we see a parasympathetic nervous response. So, it's increased heart rate variability, reduced levels of cortisol and inflammation. And that's why another benefit of self-compassion is better physical health because the immune system functions better. I mean, you have to sleep better, which also helps everything function better.
And also, in terms of brain mechanism, it's quite complex, but it seems like the same regions of the brain linked to compassion for others are also activated in self-compassion. It’s quite complex. So, the body doesn't really know the difference if someone else is putting their hand on our shoulder or we put our own hand on our shoulder.
Michelle: I love that.
Kristin: That's good news. We can treat ourselves like we treat a friend and still get the same benefits.
Kristin: Similar benefits. Not exactly the same but they're similar.
Michelle: And it's great to have techniques to develop the caring, I guess, tending and befriending aspect of ourselves. If we think in medicine, we've got so many people with things like irritable bowel syndrome, irritable bladder, premenstrual tension, irritability in terms of our levels of anxiety. So, all of these things are almost at epidemic kind of levels. And so if we had a way that was almost like away from the physiology of that but knowing that there's techniques that actually help support the irritability of the body, we might actually start to develop frameworks that can be just so supportive regardless of what we're eating or what herbs that we're having, which are all really helpful, but there's this whole other field of possibility that is available to ourselves with some of these techniques.
Kristin: Absolutely, because of the mind-body connection, right? So, what you cultivate in your mind is going to impact your body. And so there's a lot of techniques, a lot of empirically supported techniques. So, with my colleague, Chris Germer, we developed something called The Mindful Self-Compassion Program, which is an eight-week training course with a lot of things you can do, whether it's maybe physical touch. We have something called a Self-Compassion Break. We bring in three components of self-compassion. We have various meditations. There's just so much you can do to actually cultivate that mindset of compassion.
And by the way, if you are a physician, well, first of all, you need it for yourself if you don't want to burn out. If you don't want to burn out, you want to also maintain your own mindset. But when you cultivate a self-compassionate mindset... So, there's directly telling your patients about self-compassion. You can send them to my website. I have a ton of resources for people. But here's the thing. The way the brain works, you know this, the whole field of interpersonal neurobiology, right? Through empathic resonance, we influence each other. So, just as you're influenced by the mindset of a patient, your patient is influenced by your mindset. We can feel it through our nervous system, our mirror neurons. I know there's some controversy, but we know that, through our empathy system, we register what other people are feeling.
So, if you go into that waiting room or that patient room, and you feel connected to that sense of common humanity, you feel warm to that sense of kindness to yourself and you're mindful, you feel kind of calm, those are gifts you're giving that patient. You're modelling it through your presence and maybe the types of things you say. So, it doesn't just help you, it helps every single person you come into contact with.
Michelle: Yeah, that's really inspiring too, because I mean, I think it's a really great, I guess, doorway in for practitioners. Because for all of us, as you know, we build up things like our inner critic or our internal self-criticism sort of pathways are, kind of, really thick and fast at the beginning. But to know that if we've got a tendency to care for others, which most of the people in the health profession do, if we can think about serving others in a way by serving ourselves, it's a nice kind of way of introducing and, I guess, giving ourselves permission to learn these skills in those early times of developing new ways of relating to ourselves, which I loved the way that you present things through a lot of story.
But one of the other game-changers that I feel that you offered, well, me personally, about the world is this beautiful concept of the yin and yang of self-compassion, which again I loved. Can you tell us about the yin and yang? Because I feel like that was just such a great thing to really understand that this is not a soft skill.
Kristin: Yes.
Michelle: This is a powerful skill.
Kristin: So, the yin and yang, I tend to refer to it as a fierce and tender self-compassion. It kind of corresponds. So, tender self-compassion is more this yin energy, it's more of an accepting energy. So, one of the ways that self-compassion actually heals is that we accept ourselves, flaws and all, we accept our difficult emotions, and we're there with ourselves in this kind of tender nurturing way. And this actually allows us to heal from our pain. But self-compassion is not all about acceptance. Compassion, by definition, is a motivation to alleviate suffering. And so acceptance can heal the suffering caused from not accepting ourselves and not being there for ourselves, but we don't want to accept maybe some behaviours we're engaged in that are causing us harm. And maybe we're drinking too much or smoking or doing things like that that are harmful to us. We don't want to accept those behaviours, and we don't want to accept situations that are harmful. Maybe a situation of someone's not treating us well or in a toxic work environment or someone's not respecting our rights. It's not compassionate to accept that.
And that's where fierce self-compassion comes in. So, this is more of the yang energy of self-compassion. This is about how do we take action to alleviate suffering. So, part of that is protecting ourselves, speaking up for ourselves, drawing boundaries. Very, very important. So, for instance, I talked about self-compassion and burnout. We're actually coming out with a book on self-compassion for burnout. It's not like we just have to accept our stress and then burnout will magically disappear. No, there are also real systemic problems with paperwork and insurance, at least in the States. They're different, but they're often real systemic problems that need to be addressed also in order to reduce burnout. And so it's not self-compassionate to accept these systemic problems. It's maybe more self-compassionate to go on strike or try to make some sort of change, speak up about it.
Also, on motivating change and providing for our needs, actually saying it would be so hard for healthcare professionals not to just give every single last ounce of energy and time they have to others, well, that's not sustainable. So, part of being self-compassionate is saying, "Some of my time and energy has to be spent for myself. Otherwise, I'm going to be an empty cup." But it is like yin and yang in that we need both. If we're too much about action and change and there's no acceptance, well, then we're going to be stressed and depleted. But if we're too much about acceptance and not enough taking action, well, then we may be complacent. So, we need both in order to be healthy and whole.
Michelle: And I love the word fierce because it's got this fierce self-compassion because it's sort of this internal strength that comes with the word fierce. I mean, I find words so powerful in some ways, because it's not a word we use all the time but I've been...
Kristin: Yeah. No, it's true.
Michelle: And I love...
Kristin: I love to call it mama bear self-compassion.
Michelle: Yeah, and I think we can kind of...
Kristin: Depending on their gender identity. Everyone has mama bear energy.
Michelle: Yeah, exactly. And I think it's really powerful for people to understand self-compassion in these multiple different ways. And the other one that I loved in your first book, you were talking about idiot's compassion. And I think that that kind of comes in to the yin and yang or this, sort of, fierce versus, sort of, more gentle self-compassion. Tell us about that because it kind of feeds into, I guess, this idea of, like, sometimes we have to know where the boundaries are, and know when to activate, and know when to sort of soften, if for want of a better word.
Kristin: Yes, absolutely. So, if someone is harming you or your family or the community, we can accept them as people, but you don't want to accept their behaviours or their actions. That would be idiot's compassion, right, when you're... So, you have compassion for someone... They're still an unconditionally worthy human being, flaws and all, but some of those flaws to the extent that they're being acted out on others, it's not compassionate to anyone, including that person, to accept it. And the same with ourselves, right? So, for instance again, maybe you've got some behaviours that are harming you. You can accept yourself totally unconditionally as a worthy human being worthy of love. That's a tender self-compassion. At the same time, it's not compassionate to say, "Oh, it's not a big deal, you know? So, I've got this little habit of robbing banks. That's idiot's self-compassion, right?
So, like a friend, your best friend is the one who tells it to you straight and honest but with kindness. And they do it because they love you. Those friends who are like, "Oh, don't worry, sweetheart," and they aren't really telling you when there's something you need to look at. They aren't really a good friend to you. And so to be a good friend to ourselves means sometimes needing to be fierce and saying, "Hey, this is not acceptable. We got to do something. I need help, or I need to do something different." But the thing about separating our worth as people from our behaviours and actions is really key.
Michelle: Absolutely. So, how do we start? I mean, what do we do? How do we bring this into the clinical space? How do we start this for ourselves? What's your first, kind of, tip?
Kristin: So, I've spent pretty much the last 10 years focusing... That's 20 years I've been researching it. In the last 10 years, I've been mainly interested in how to teach people self-compassion, helping people develop this skill and be able to support themselves. So, I've tried to make it really easy. So, a really easy place to start, if you just Google self-compassion, you'll find my website. That's a really easy one. That's more in terms of where you might get some resources.
But in terms of just your inner resources that don't involve going outside of yourself, a very easy place to start is just to notice... Maybe you're struggling in some way. Notice how you relate to yourself, what you say to yourself, or how you treat yourself. Just ask yourself, would I treat a good friend this way? Would I say this to a good friend? And if the answer is no, then just realise that the negative things that would happen to your good friend, if you treated them that way, are probably also happening to you with your response. And a very easy thing is, well, what would I say to a good friend I cared about who is in the exact same situation? And here's the thing, it's not rocket science. We already know how to be compassionate toward others. We've spent a lot of time over the years learning how to be supportive and compassionate, and kind to others. So, we already have that template inside of us and also passed down by evolution, right, through the care system. So, just learning to just, doing that little hack and tapping into that and saying, okay, this is what I would say to someone else. Why don't I try saying it to me? Or maybe this is my memory of what a really good friend would say to me. Maybe I can use that as my template.
So, you have the skill within you. And me and others have also spent a lot of time figuring out ways to help people. So, for instance, we have the Self-Compassion for Healthcare Communities Program that's designed specifically for healthcare professionals that you could take online through that nonprofit I co-founded called the Center for Mindful Self-Compassion. It's really not hard. It's not difficult. It's actually more draining to criticise yourself. It's actually harder to criticise yourself or to shame yourself. The effects are worse. It's just the habit of the mind that's hard to break.
Michelle: But I think you're right in saying that when we first come to something like self-compassion, it can actually sort of release and feel almost like temporarily more, that awareness and that kind of almost attention can make it feel almost worse temporarily. And I noticed when I started doing it, right in the beginning, it was almost like it made me feel even more cringy when I first started it. But as I persisted, I was really determined. I wanted to do it every day. And I just noticed that cringiness or that discomfort from turning towards myself disappeared really quickly. And so that's what I noticed when I first practiced it. And so when I teach patients to start doing that, I'll often really reassure them in those first couple of days that it really feels very uncomfortable.
Kristin: It does, yeah.
Michelle: And just to persist because it disappears almost like a craving does. It's like giving up coffee. The first couple of days are really hard and then, "Oh," a week later, you're like, "What? What's coffee?"
Kristin: Yeah, then you see the benefits. And that's where common humanity is so important. So, I just started this thing called the Self-Compassion Community so people can practice with each other. And that was so key when we taught the healthcare workers, that we taught teams to do it because when it's just you, it puts itself awkward. And then it seems, kind of, almost like, does this mean I'm full of myself? What does this mean? When you do it to other people, and then also you want to like, "Wow, you're as critical as I am. I would have never guessed," I find it's easier to do it with others. That can be really helpful. It's not necessary, but it can be helpful.
Michelle: And I found when I did it just to be playful with it as well. So, sometimes when you do feel a little bit embarrassed, you actually...when people kind of giggle when they're embarrassed I think also to bring a sort of sense of playfulness to it as well, particularly in the beginning can be really, really powerful too.
So, Dr Kristin, wow, we have just learned so much today about self-compassion. I mean, your intent or your intention to bring this common humanity piece to mindfulness practice and self-kindness has really been a game-changer personally for me, but I think really in the whole space of self-compassion and then learning also about some of the caveats with it so that it's not just, I guess, this sort of idea that it's this soft but instead it's a powerful intervention that has the power to change our physiology, it has the power to change our neurology, it has the power to change our commonality, and really bring an opportunity to bring humanity back into the health field. And I'm just so grateful for you and your work and your wisdom, and thank you so much for sharing, all your tips and insights. You've really made the world a better place.
Kristin: Well, thank you. You can make me feel special and above average. No, I really appreciate you bringing this to your community. I love talking to healthcare providers and caregivers because they need it more than anyone. So, thank you so much for your interest and bringing this forward.
Michelle: Thank you, everyone, for listening. Don't forget that you can find all the show notes, transcripts, and other resources from today's episode on the fx Medicine website. I'm Dr Michelle Woolhouse and thanks for joining us. We'll see you next time.
Emma: This podcast is intended as healthcare practitioner education only, and it is not a substitute for medical advice, diagnosis, or treatment.
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