Using Self-Compassion in Therapy

Kimberly Morrow

Self-compassion in therapy, especially cognitive behavioral therapy, is particularly useful in quieting the part of the brain responsible for anxiety.

As a mental health provider, you likely know that those who suffer from anxiety and OCD are often quick to be critical of themselves when they are triggered,  as well as during their CBT treatment.

I always note this in therapy and encourage them to find another way to describe what they are experiencing without beating up on themselves.

However, while I was attending an International Obsessive Compulsive Foundation’s annual conference, I attended a workshop that reviewed research that looked at the effects on the brain when people practice self-compassion along with Exposure and Response Prevention.

The study looked at participants’ brain activities who used only ERP versus those who used ERP and self-compassion. The study found evidence that self-compassion enhances CBT with ERP and quiets the part of the brain responsible for anxiety.

I found this to be critical information and vowed to teach self-compassion in therapy with all of my clients as part of their treatment, rather than as a side note.

Self-compassion is a simple concept, but often difficult for therapy clients to do.

We usually start with a conversation about whether their self criticism has been helpful. Then I have them practice putting their hand on their heart and saying, “Even though _______( I have these thoughts, I gave into my worries, I stayed in bed too long, etc.), I love and accept myself.”

I invite them to sit with that experience for a bit and share what it feels like to be kind to themselves.

Sometimes, they say, “What if I don’t love and accept myself?”

This leads to a discussion of what we are working towards in therapy: being able to have thoughts and feelings that do not align with the essence of who they are and loving themselves anyway.

Cognitive behavioral therapy is enhanced when our clients are able to be kind toward themselves–even when it seems that anxiety and OCD are beating them up.

Tara Brach talks about creating a space between the first arrow (the anxiety-provoking trigger) and the second arrow (our response to that stressful event).

She claims that the second arrow is the one the harmful one.

Teaching your client to take a breath after a trigger, say something kind to themselves, and ride out the anxiety is a healthy way to prevent a response that may harm them by giving anxiety and OCD more power.

For more ways to help your clients develop self-compassion in therapy (and in life), you can read Love thy self: 5 practices for the harsh inner critic.

Our course, CBT for Anxiety and OCD also explores mindfulness tools and self-compassion in therapy for the treatment of anxiety and OCD. [Click here to explore this course.]


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