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by Tim Desmond
W. W. Norton, 2015
Review by Kamuran Elbeyoğlu on Jan 3rd 2017

 Self-Compassion in Psychotherapy

Since the appearance of Mindfulness-Based Treatment Approaches Clinician’s Guide to Evidence Base and Applications, which is the first book to appear in Western literature on mindfulness-based therapy approaches, there have been increasing interest among therapists, who wish to integrate mindfulness into their therapeutic approaches. Self-Compassion in Psychotherapy: Mindfulness-Based Practices for Healing and Transformation by Tim Desmond is a compelling example in this trend as it offers a fascinating approach into the heart of both mindfulness and psychotherapy.

Tim Desmond is one of the leading psychotherapists in this area, who believes that self-compassion is intimately related to the practice of mindfulness. After having spent years of studying with Zen Master Thich Nhat Hanh, Desmond has learned that it is impossible to truly separate mindfulness and self-compassion, as “you cannot have mindfulness without compassion, and the practice of compassion always begins with compassion toward oneself” (p. 3).

The leading idea in this book is that teaching clients to practice self-compassion can lead to tremendous healing; and it aims to provide clinicians and therapists a handy tool to apply self-compassion practices to real-life clinical situations. Desmond maintains that the practice of self-compassion supports effective therapy in two vital ways. First of all, it helps clients become a source of compassion for themselves, and secondly, it helps therapists be happier and generate more compassion for their clients. In order to explain what is self-compassion and why it is useful in therapy, in the first chapter, Desmond describes key ingredients and near enemies of self-compassion. What he calls the key ingredients of self-compassion three specific types of understanding, namely to understand that the person suffers, to understand that the person wants to be happy and to understand that we are not fundamentally separate from each other. Desmond is very careful to distinguish self-compassion from self-esteem, which is basically an evaluation of oneself, albeit a positive one, whereas self-compassion is about relating to oneself with a kind and forgiving attitude. The other attitudes toward oneself, which he calls near enemies of self-compassion are self-ındulgence, self-pity, egotism and passivity.

By distinguishing self-compassion from other attitudes and indicating that compassion somehow makes direct contact with our pain, he continues to explore how to help clients develop self-compassion, as well as how practicing it for the therapist himself/herself can make him/her a happier and more effective therapist, with how-to manual of simple practices in the following chapters. The second chapter titled The Science of Self-Compassion is devoted exploring five distinct areas of research from various distinct fields, including cognitive science, neuroscience, psychotherapy outcome research, self-compassion research and positive psychology to emphasize that self-compassion is a vital part of effective therapy and that it is supported by cutting-edge science.

The third chapter is titled as Basic Clinical Principles. The core message of this chapter is that all self-compassion practices can arise naturally out of the therapeutic relationship, rather than rigidly following a script. Both psychotherapy outcome research and Buddhist psychology emphasize the importance of building a compassionate alliance between therapist and client. In this chapter by providing word for word transcripts he introduces what he calls dialogue-based mindfulness (DBM) in order to better guide clients through meditation exercises.

The following two chapters are about mindfulness of the body and mindfulness of mind, respectively. Mindfulness of the body includes techniques for building affect tolerance and regulation. Mindfulness of thoughts, on the other hand, includes techniques for building cognitive flexibility.

Chapter six, titled Unlocking A Client’s Natural Compassion, builds on the belief that there is a deep well of compassion inside every person and is about how we can tap into it. In this chapter, Desmond takes on to explore the meaning of compassion in more detail using a traditional Buddhist four-part definition, namely its nature, function, proximate cause and manifestation. Once we know how to get in touch with the limitless source of compassion inside ourselves, the next few chapters will focus on how we can use this energy for transformation and healing.

Chapter seven is about using compassion to heal and transform suffering in the past and present. Desmond uses Thich Nhat Hanh’s example of the image of a mother embracing her crying baby to illustrate how this process works. If we can hold our suffering like a mother holds her crying baby, with that kind of openness and warmth, this can be enough to create real transformation and healing. He introduces a basic model of the mind and mental functioning, which consists of the fact that the past informs the present; that thinking always creates stories to make sense of our experience (constructivism); and that our brains have many different processes happening in any given moment (modularity) to explain how we can direct compassion right at the source of our suffering.

The next chapter is about using compassion to overcome stubborn self-criticism and self-sabotage. In this chapter he describes a theory, what he calls modular constructivism, in order to make sense out of stubborn self-criticism and self-sabotage. The idea of this model is to direct compassion to the part of the client that is causing his/her suffering.

Chapter nine is devoted giving more specific guidance about how to use mindfulness and self-compassion practices with people experienced trauma, addiction and psychosis. The underlying idea here is the Buddhist saying that all compassion comes from suffering, and that great compassion comes from great suffering.

Chapter ten outlines several specific clinical roadblocks to self-compassion and offers suggestions for how they might be overcome. He suggests that to develop comfort and confidence using self-compassion in psychotherapy, one of the best ways is to go over the transcripts he has provided throughout in this book, especially in chapter four. Second, and the more importantly, he recommends therapists to apply the practices in this book to their own life and their own sufferings. The last chapter is entirely focused on this.   He strongly emphasizes that by cultivating the skill of self-compassion in their clients, mental health professionals can help them more effectively and sustainably navigate difficult emotions, transform negative core beliefs, manage states of depression, anxiety, and shame, transcend suffering, and motivate themselves with kindness rather than criticism. In turn, as clinicians learn how to be more self-compassionate they naturally begin to feel more compassion for even the most difficult clients.

The wonderful insights, vignettes and wise teachings sprinkled throughout Self-Compassion in Psychotherapy will be of great benefit to any clinician who wishes to incorporate compassion practices into his/her work. However, readers do not need any background in mindfulness in order to benefit from this book, since Desmond offers exceptionally clear, accessible and insightful guidance in how to facilitate deep transformation for a wide range of emotional sufferings. What really makes this book unique is to show how at-home practices can emerge naturally from a mindful and compassionate co-exploration of the client’s experience. I heartly recommend this book for any clinician who wishes to more deeply integrate mindfulness and psychotherapy.

 

© 2017 Kamuran Elbeyoğlu

 

Kamuran Elbeyoğlu (Prof. Dr.), Toros University, School of Business Administration and Social Sciences, Department of Psychology, Yenisehir, 33140 Mersin, Turkey.