Attacking Self-Attacking and Self-Criticism in Therapy: Developing a Compassionate Mind

Author: Dr. Hilary Cahalane

Position: Clinical Psychologist, Teacher of Counselling Theories at UNYP

We all experience self-critical thoughts sometimes, but for most of us these thoughts are situation-specific and relatively fleeting, and result in little enduring damage. 

However, for some people, often those who have received harsh, critical, rejecting or abusive care from caregivers growing up, their self-attacking thoughts are relentless, acting as a damning running commentary of their actions and performance, and leading over time to the development of deeply entrenched beliefs about being worthless, bad, unlovable, defective etc.   Such chronic self-criticism is often associated with powerful feelings of shame and guilt, and can also contribute significantly to mental health problems such as major depression, anxiety disorders and some personality disorders.  For these people, traditional cognitive behavioural therapy (CBT) techniques focusing on challenging and restructuring these negative thoughts often have limited effect, such is the conviction with which their self-critical beliefs are held and the strength of the associated feelings of shame.  They often say, “I understand the logic of the therapy [CBT] but I just can’t feel it” (Gilbert, 2009, p. 277) .  

In recent years, Professor Paul Gilbert, a UK-based clinical psychologist, has developed a psychological theory and treatment model to help this sub-group of people: Compassion Focused Therapy (CFT), drawing on empirical research findings from evolutionary neuroscience.   In essence, CFT is based on the finding that securely attached children, who consistently receive comfort and reassurance from their parents when distressed, develop from these experiences neural pathways in their brains, which provide the mechanism by which they to learn to comfort and soothe themselves as they get older.   CFT posits that individuals who experienced highly critical or abusive parenting instead internalised the criticism to which they were exposed and did not have the opportunity to learn how to self-soothe or regulate their emotions.   Their self-attacking thoughts developed a retrieval advantage in their brains and over time such thoughts became an automatic response to any perceived failure, conflict or rejection. 

CFT aims to help highly self-critical clients to develop self-compassion for their own experiences and distress and teaches them to develop a “compassionate mind” (Gilbert, 2006).   It educates clients about the fact that the body’s emotional arousal system does not distinguish between internal and external criticism, meaning that self-critical thoughts may have the same impact on the individual’s emotional and physiological functioning as if they had come from an external source.  Thus, the brain interprets self-critical thoughts as if they have come from a third party.   For somebody who experiences almost constant self-attacking thoughts, the impact of these thoughts on their self-esteem and their perception of themselves would inevitably be significant.   The reverse of this should therefore logically be true: if the individual can learn to develop compassion for themselves, it should generate the same feelings of warmth internally as if somebody else was soothing them.   Once clients understand the rationale for CFT, they develop a compassionate image based on their own ideals of care, which they learn to draw on throughout therapy when they notice self-criticism.  Techniques such as compassionate letter-writing, compassionate reframing and mindfulness can be used to strengthen the individual’s “compassionate mind” and help them to develop compassion for themselves.

The idea of developing self-compassion can initially be frightening or threatening for highly self-critical individuals.  They may think they do not deserve it or they may associate it with “wallowing” and “feeling sorry” for themselves.  They may believe that their self-criticism is positive as it keeps them striving and working hard, and if they try to imagine living without it they imagine themselves becoming lazy or selfish.   Many highly self-critical people are very capable of showing love and compassion towards other people, but not towards themselves.  Acknowledging and accepting these worries becomes a target for the individual’s self-compassion.  Despite some of these potential barriers, CFT can be a powerful approach to use when working with self-critical people and should also remind us to check, whether we are prone to self-criticism or not, if we are in touch with our own “compassionate mind”.

Useful resources for further reading:

http://www.compassionatemind.co.uk/

Gilbert, P. (2009).  The Nature and Basis for Compassion Focused Therapy. Hellenic Journal of Psychology, 6, 273-291.

Gilbert, P. & Proctor, S. (2006).  Compassionate Mind Training for People with High Shame and Self-Criticism: Overview and Pilot Study of a Group Therapy Approach.  Clinical Psychology and Psychotherapy, 13, 353-379.