From: Paul Gilbert [P.Gilbert@derby.ac.uk] Sent: 20 September 2007 10:08 To: compassion@compassionatemind.co.uk Subject: Re: [compassion@compassionatemind.co.uk] soothing and stressin Psychology Today Dear Megan This is a key point. A lot of the therapy with high shame IS the process of helping people overcome their inabilities to be self-compassionate. There are two sources of this. One that is linked to explicit processes and meta-cognitions (e.g. beliefs of not deserving, it is self-indulgent, it is a weakness, will let one's guard down, will end up becoming lazy and not able to succeed, it feels submissive etc etc). The other source of 'difficulty' or 'resistance' is more rooted in the affect system and links to conditioned emotional reactions. For example, when you begin to work with warmth you open up the attachment system. When you do that a lot of the issues linked to attachment memory etc become available. So for example people can begin to re-exercise great sadness and become tearful. This then can become very frightening and they will shut-down because the grief is overwhelming. Another emotional reaction can be anxiety and alarm. As people begin to feel feelings of warmth for themselves it reactivates memories of feeling close to others, but others were abusive. Also, care seeking behaviour may have been punished as a child and so those feelings can be conditioned to feelings of about to be heard. These can operate as automatic emotional reactions but the person may have difficulty verbalising. There are a number of things you can do. Firstly, talk about these problems very openly, sometimes I suggest that the soothing system is like a Sleeping Beauty that over the years has got surrounded by thorn bushes etc. Write down all of the potential thorn bushes, which are in essence the various blocks linked to key beliefs, emotional reactions to compassion and so forth. This allows you and the patient to have a good understanding about why self-compassion is likely to be blocked. This also enables a deshaming and not my fault but 'makes perfect sense' approach. The next things is to collaborate on how to get the soothing system going. Here you can brain storm various ideas. These would include letter writing, imagery, bringing a picture of themselves as a child and so on. One approach that some people find easier to start with is the method acting approach. Here you will have taught the person mindful breathing, that as they breath to slip into their soothing rythmn (we did that in the workshop). They will also have learnt that their mind will hop about all over the place quite naturally and here they just bring their mind gently back on task. So then ask them to stand up and focus on their breathing for a minute or so, looking down at the floor or closing their eyes (generally the former is better to stop them sinking into a sleepiness). The idea now is to imagine oneself as becoming a compassionate person with all the qualities of compassion one would dearly like. You ask them to pay attention to their physical feelings, pay attention to their facial expressions, notice the feelings in the muscles of the face, have a slight smile, feeling one's body expanding perhaps, noticing if one feels older. Then one focuses on experiences of being kind and gentle (how does that feel), feeling unhurried (how does that feel), having a sense of wisdom because one has gone through a lot of difficulties oneself (how does that feel), and various other key aspects of compassion experience and states of mind. So this creates the method acting approach to getting one's mind into a certain state. We then teach the person how to focus on that state and practice at least five minutes every day and at other time when they are walking. Because it is them becoming compassionate this can sometimes be easier to do than them directing compassion to themselves. When they feel comfortable using this 'method acting' approach then you can begin to combine being in a compassion role and being in a angry or anxious role etc. Here you go into compassion role and then allow yourself to take on the body shape of the anxious role or injured child or whatever to feel that and then to gradually move back into compassion role feeling the compassion now go in to the difficult (e.g. anxious) or hurt child role. You then teach the person how to take a moment or two to take up the postures, facial expressions and breathing of compassion self when they are distressed. Basically you are just creating some space in the distressed state of mind to activate the compassion system. This should be done in the spirit of behaviour experiment, exploring, stopping to discuss, reflecting on what would make it easier or what makes it more difficult. The key point is that all the time one is moving back to the three circles to have clarity about what one is trying to do. This framework really does helpful to keep focused on the 'physiotherapy' like aspects. As you will know there are other compassion focused approaches that uses compassionate imagery of another being the recipient of compassion. For some people this is easier and preferred. You have probably seen lots written on that aspect. You will also know that sometimes if people have a precious stone that they can hold, like a quartz or something or have a transitional object this can help. In the Gilbert & Procter paper we used tennis balls. Anyhow see how this goes. Remember always think with your patient not for your patient. Explain the nature of the difficulties, normalise them, offer up a few exercises to try and see what happens. Good luck! Best wishes. Paul Professor Paul Gilbert, PhD., FBPsS Mental Health Research Unit Kingsway Hospital Derby. DE22 3LZ United Kingdom Phone: 01332 623579 Fax: 01332 623576 Email: p.gilbert@derby.ac.uk http://www.derby.ac.uk/schools/fehs/research/mhru/ www.compassionatemind.co.uk >>> "Megan Edwards" 19/09/2007 14:07 >>> I would too, I find it a very powerful way to work clinically, but some people struggle with it, giving them "something else they can't do"so more information would be useful please! thanks Megan Megan Edwards Clinical Nurse Specialist - Cognitive Behavioural Therapy Leeds General Infirmary tel 0113 3922240 >>> Lynne Henderson 19/09/2007 13:58 >>> I'd love to see the chapter, Paul. Lynne On Sep 19, 2007, at 4:25 AM, Paul Gilbert wrote: > That is very helpful Michelle - > CFT takes this view (although focuses on brain systems as well) and > uses > imagery to activate the system - so just as imagining a sexual scene > can be as arousing (stimulate the appropriate physiological systems - > e.g, > pituitary) > as actually seeing one -- so imagining compassionate images can > stimulate the soothing systems -- keep in mind though that for some > people this is frightening at first. I have a chapter on imagery that > is in press if any one is interested. > > here is another paper by Steven Porges that says a bit more and if any > one wants more technical papers let me know > > b.w > > paul > > Professor Paul Gilbert, PhD., FBPsS > Mental Health Research Unit > Kingsway Hospital > Derby. DE22 3LZ > United Kingdom > Phone: 01332 623579 > Fax: 01332 623576 > Email: p.gilbert@derby.ac.uk > http://www.derby.ac.uk/schools/fehs/research/mhru/ > www.compassionatemind.co.uk > >>>> "Michelle" 18/09/2007 21:33 >>> > I was interested once again to see the principles behind the > neurobiology and the soothing/attachment system being explained in a > popular magazine. It also advocates the triggering of the soothing > system as a way of calming the threat system. At this rate our > patients will soon be asking for compassion focused approaches! > > HYPERLINK > "http://www.psychologytoday.com/rss/pto-20070625-000009.html"http:// > www. > psychologytoday.com/rss/pto-20070625-000009.html > > > (I have realized that my posts are a reflection of my internet reading > material- Netmums and Psychology Today- I will let you know when CMT > appears in Take a Break magazine) > > Best wishes, > > Michelle Cree > Derbyshire Childbearing and Mental Health Service > > No virus found in this outgoing message. > Checked by AVG Free Edition. > Version: 7.5.487 / Virus Database: 269.13.21/1012 - Release Date: > 16/09/2007 18:32 > > > > ______________________________________________________________________ > This email has been scanned by the MessageLabs Email Security System. > For more information please visit http://www.messagelabs.com/email > ______________________________________________________________________ > Lynne Henderson, Ph.D. Faculty, Continuing Studies Stanford University Stanford, Ca 94305 email: lynne@psych.stanford.edu lynneh1.stanford.edu Shyness Institute 2000 Williams St. Palo Alto, CA 94306 Phone: 650-493-6398 Fax: 650-493-6295 Mobile: 650-814-9210 ______________________________________________________________________ This email has been scanned by the MessageLabs Email Security System. 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