Self-compassion With Persistent Pain
Self-compassion has become a key strategy used within modern psychology treatments. Dr Kristin Neff and Dr Paul Gilbert (known for Compassion Focused Therapy – CFT) and many others have helped to develop and research the use of self-compassion and bring it into the practices of many psychologists for treating people with a range of psychological conditions.
Self-compassion is often described as developing a kindness to the self, rather than being a harsh critic to the self (which is often a normal human response). There is a growing body of research suggesting the benefits of people practicing self-compassion for a range of psychological conditions and this is now moving into the realms of persistent pain and chronic illness.
A recent study in the Journal of Clinical Psychology* found that developing self-compassion might be a useful strategy for people suffering with persistent pain. The study showed that people with lower levels of self-compassion struggled more, compared to those with higher levels of self-compassion, in coping with their pain and participating in their normal daily life activities. Lower participation in normal daily life activities (despite pain), was also associated with increased depressive symptoms.
People with persistent pain often find themselves impaired in many of their normal (including pleasurable) daily activities. This can often impact upon their mental health and key relationships around them. For some this might lead to self-blame or becoming self-critical when they can’t engage with activities or with those around them. The longer the pain persists the harsher the self-criticism might become.
To understand how self-compassion might provide people with persistent pain a kinder way of dealing with themselves, it might be worth trying this exercise. Imagine someone you know from now, or the past, who seems to embody kindness. Take a moment to bring them to your mind. If you can’t think of someone, imagine a person from a book or movie that embodies kindness.
Now imagine a time when you made a big mistake or messed-up badly. Try to remember how you felt about yourself, what your mind was saying to you. Now imagine if this person you brought to your mind was there at that time, how might they respond to you differently?
Often with an exercise like this the person brought to mind would be much kinder to you, than you were likely to yourself. Whilst neither is right or wrong, the kinder approach might help distinguish ‘a bad decision, or judgement’, rather than ‘you are bad’. This kindness might make it easier to let go of what has happened, or even to take more effective steps to improve the situation
Imagine now that a person with persistent pain had a really bad day and did not do much and did not engage with those around them. This is not a nice situation to be in. if their mind becomes overly critical, it is likely they will not only be physically overwhelmed with pain, but perhaps now emotionally overwhelmed as well. If they had a more “self-compassionate mind” instead, they are likely to still be struggling, but it might be slightly easier to let go about their difficult day and maybe even provide them energy toward trying to engage with the next task or person around them.
There are many strategies and meditation exercises that can be used to practice self-compassion, and many are free on the web. Whilst much more research is required, it would appear self-compassion may have a useful place in the treatment of people with persistent pain.
Charles has spent 12 years working as a psychologist in hospital and private practice settings. This has included assessing and treating patients, managing and supervising multi-disciplinary teams, developing and delivering training and providing consultancy services. Charles has strong clinical skills in a range of areas with a particular interest in: chronic pain conditions, stress conditions, workplace injuries (physical and stress related), returning to work after a workplace injury (physical or stress related).
*Sérgio A. Carvalho, David Gillanders, Lara Palmeira, José Pinto‐Gouveia, and Paula Castilho (August, 2018). Mindfulness, self-compassion, and depressive symptoms in chronic pain: The role of pain acceptance. Journal Of Clinical Psychology