Dr. Ingela Thuné-Boyle
Self-compassion in chronic illness: How well do you treat yourself?
When we live with a chronic illness, it's so easy to focus on our shortcomings. So easy to fall back on self-criticism and self-blame. You may feel guilty because you're no longer able to contribute to society in ways you would like to. You may feel embarrassed and ashamed over medical symptoms. You may feel inadequate as a spouse. You may not feel like a good enough parent to your children. You may feel like you let your friends down because you've had to cancel on them more times than you can remember. You may feel like a burden to those around you. You may blame yourself for all those difficult medical encounters because you weren't assertive enough or failed to set appropriate boundaries. You may start to feel useless as you're unable to meet work-commitments. Maybe you can't even work anymore! You may resent your body. You may be utterly fed up with your inability to be who you used to be before you got ill, but the fact of the matter is, being ill is not your fault! Maybe it's time to cut yourself some slack. Maybe it's time to be kind to yourself.
Author and psychologist Jack Kornfield said, "If your compassion does not include yourself, it is incomplete." Indeed, self-compassion means extending compassion to yourself in instances of perceived inadequacy, perceived failures or suffering in general. It's about being kind to yourself when encountering pain and personal shortcomings rather than hurting yourself with self-criticism or self-blame. More than just stopping self-judgement, it involves actively comforting yourself by responding, perhaps, as you would to a friend in need. Being self-compassionate also means setting some pretty clear boundaries with those around you. It means getting used to saying no. It means standing up for yourself when someone is trying to minimize your illness experience or symptoms. It means having your own back!
Self-compassion is actually a really important part of self-management for those of us living with a long-term illness. There is evidence that it can help regulate emotions; it can not only overcome feelings of shame, it's also linked to more helpful coping strategies, greater well-being, including lower levels of stress, anxiety, depression, reactive anger and rumination. It's associated with improved sleep, less loneliness and a greater compassion for others. Overall, it's an important factor of emotional resiliency. That means we need to stop with the self-blame and self-criticism. It means providing kindness and comfort to ourselves and our bodies when we're in distress. This is not to say that we can always control our symptoms and our health; however, we can do things to help manage our illness experience better. So, how do we do it?
Kristin Neff, PhD, the author of 'Self-Compassion: Stop beating yourself up and leave insecurity behind', describes self-compassion as honoring and accepting our humanness; that things will not always go the way we want them to; that we will encounter frustrations and losses in life, and; that we will make mistakes and fall short simply because this is the human condition - a reality shared by all of us in one form or another. Specifically, self-compassion consists of three components: 1. Self-kindness: Being kind, gentle and understanding with yourself when you’re suffering. 2. Common humanity: Realizing that you’re not alone in your struggles. 3. Mindfulness: Observing life as it is, without being judgmental or suppressing your thoughts and feelings. In order to be truly self-compassionate, we must combine these three in some form or another. There are several ways to do that. Here are some examples.
Consider how you’d treat someone else. Imagine that a friend or someone you love came to you in distress, asking for help, after failing at something or being rejected. What would you say to that person? How would you treat them? Construct your ideal compassionate other from that and treat yourself the same way. Be a really supportive, compassionate version of yourself - someone that's there for you come rain or shine just as you would be there for someone you love, whenever they ask for help.
Treat yourself as you would a small child. Now that you have constructed your ideal compassionate other, you can use that person to talk to your distressed self as if you were a child. This might seem incredibly weird and unnatural, even silly, but the thing is, it really does help. Make sure you are kind, compassionate and non-judgmental. You are older and wiser so how would you help your distressed 10-year-old self?
Watch your language. It's important to pay attention to the words you use when you speak to yourself. Also, what is the tone of your voice? Is it harsh, impatient and angry or gentle and kind? You may be so used to criticizing yourself that it's become an unconscious habit. Ask yourself if you would speak like this to someone you care about and if the answer if no, you're being self-critical. Imagine instead how a compassionate friend would speak to you and follow that lead.
Comfort yourself with a physical gesture. Kind, physical gestures have an immediate effect on our bodies because they activate the parasympathetic nervous system (i.e. provides a calm and relaxed state which is necessary for healing to take place). Research indicates that physical touch releases oxytocin (a social bonding hormone), provides you with a sense of security, soothes distressing emotions and calms the cardiovascular system. Physical gestures also allow you to get out of your head and into your body which is important since the head loves to run away with stories that may be distressing or not true. You could, for example, put your hand over your heart or gently stroke your arm or even give yourself a hug! What's important is that you make a clear gesture that conveys feelings of love and kindness. I know this might seem a bit silly at first but as Neff points out, your body doesn't know that - it just responds to a physical gesture of warmth and care. (And if it makes you laugh because you feel silly, well, hey, laughing is good too!)
Remember that you're not alone. It's so easy to find ourselves isolated or even to isolate ourselves when we have a chronic illness. Indeed, sometimes it's hard to find support and friendship. However, remember that there are other people out there with your illness or symptoms. You are not alone in your suffering. Perhaps make an effort to connect with others who are living with the same condition by joining an online support group. Whatever you decide, make sure you remind yourself that you're not alone.
Practice mindfulness. Mindfulness means focusing on the present moment while calmly acknowledging and accepting, without judgement, your feelings, thoughts and bodily sensations. It's a non-judgmental, receptive state of mind where you observe thoughts and feelings as they are, without trying to suppress or deny them and without reacting to them. For example, you may feel angry so notice the anger and how it feels in the body but don't react to it by shouting or throwing things. Just notice it, how it feels and without judgement. You simply accept thoughts and feelings in the present moment as they are and allow them to pass through while noticing any bodily sensations you may have.
Whenever you find yourself being self-critical or in distress, it helps to have a few phrases at hand. These can also be used as part of a mindfulness meditation. Pick statements that really resonate with you and combine them with a physical gesture like a hand over your heart. Neff has suggested the following phrases: This is a moment of suffering. Suffering is part of life. May I be kind to myself in this moment. May I give myself the compassion I need. The first phrase (This is a moment of suffering), is designed to bring mindfulness to the fact that you’re in pain. You might argue that, well, I suffer on most days. All the more reason to practice self-compassion! Make it a daily habit. Every time you catch yourself being self-critical or find yourself in distress, just stop and acknowledge that you are suffering.
The second phrase (Suffering is a part of life), reminds you that imperfection is part of the shared human experience. When you have a chronic illness, it might be hard to accept that the suffering you're experiencing is somehow part of life when all your friends are perfectly healthy and able to do all the things you no longer can; however, it's important to remember that we all suffer in many different ways, to a greater or lesser degree. That's not to minimize your experience but to remind you, you are not alone.
The third phrase (May I be kind to myself in this moment), helps bring a sense of caring concern to your present-moment experience. The final phrase (May I give myself the compassion I need), firmly sets your intention to be self-compassionate. Remember, you can change the wording of these sentences to something that better suits you and your situation. For example, you can more explicitly include your illness, symptoms or your body as a whole.
For some people, being self-compassionate might seem unnatural at first but it gets much easier very quickly. For others, it can be much harder, especially if they've experienced trauma at some point in their lives. Indeed, if you have trauma in your background or have a lot of issues around shame, make sure you work with a supportive psychologist or therapist instead of going it alone. In general, a psychologist or therapist can use a compassion-focused therapeutic approach and guide you to use compassionate self-correction rather than shame-based criticism.
So to wrap up, self-compassion means being kind to ourselves when we experience pain, distress or personal shortcomings. This is so important when living with a long-term illness as it has a knack of knocking us down at regular intervals. Indeed, living with a chronic illness is hard so why make it even harder? Most humans deserve compassion and that includes you, so do yourself a favour and have some compassion for your own body, your shortcomings and your distress. Your illness is something you have to manage every hour of every day so why not add some self-compassion to the equation? Make it a daily habit! It actually helps you figure out how to deal with difficult situations. You basically learn how to be helpful to yourself. So, choose self-compassion over self-blame and self-criticism. Be kind to yourself.
Do you have a tendency to fall back on self-criticism and self-blame? Please let me know in the comment section below. If there’s something important you’d like to add, please do so. I'd love to hear from you.
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Dr. Ingela Thuné-Boyle is a licenced Practitioner Health Psychologist specializing in improving the quality of life of people living with a long-term illness. She lives with Ehlers-Danlos Syndrome, a connective tissue disorder and runs a private online (telehealth) practice at www.ingelathuneboyle.com.
Please note: Advice given in this blog is not meant to take the place of therapy or any other professional advice. The opinions and views offered by the author is not intended to treat or diagnose, nor is it intended to replace the treatment and care that you may be receiving from a licensed physician or mental health provider. The author is not responsible for the outcome or results following their information and advice on this blog.
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