Cultivating Self-Compassion in Cognitive Behavioral Therapy

One of my favorite applications of cognitive behavioral therapy is to cultivate self-compassion. I try really hard to not have a favorite technique or application because it might bias me against what the client actually needs. But self-compassion is usually helpful for most people. Everyone makes mistakes, no one is perfect, and learning to be gentle with ourselves afterward goes a long way in addressing depression and anxiety.

The cognitive part of cognitive-behavioral therapy is usually where we start with self-compassion. But before we get into the how, let’s look at what compassion is. Merriam-Webster defines compassion as “sympathetic consciousness of others' distress together with a desire to alleviate it.” Self-compassion is acknowledging one’s own distress and working to reduce it. It involves acknowledging our own pain and that it is valid to work to reduce that pain, even if we blame ourselves for it.

In cognitive therapy, self-compassion means examining self-critical negative, automatic thoughts and challenging those thoughts. For example, a client might feel anxious about being out in public and the client feels guilty for being anxious and how this affects others. A compassionate approach would acknowledge that it is understandable and okay for the client to be struggling with anxiety right now. The client’s automatic, negative thought could be: “I should just get over this anxiety.” “I’m a terrible spouse for being this anxious.” The automatic thoughts would be challenged by identifying cognitive distortions such as magnifying the effect of the anxiety and minimizing the good things the client does. A more realistic thought could be: “I’m working on my anxiety and I need to take things slow right now so I can get better; it’s okay for me to take this time.” Challenging self-critical negative thoughts to make them more realistic can be a first step in cultivating self-compassion.

The behavioral part of cognitive-behavioral therapy can also be a key part of self-compassion. Many of the behavioral techniques involve activities to improve one’s mood or reducing activity to allow oneself to heal. This goes back to our definition of compassion, acknowledging the distress and working to alleviate it. For depression, this might mean making time for beloved hobbies and making time for oneself instead of focusing entirely on the needs of others. For our client with anxiety about being in public, it could mean slowly trying different ways to get out of the house but not moving too fast. The client might try walking by the store first, then going into the store for two minutes followed by ten minutes in the store. Combining self-compassionate thinking with self-compassionate behavior is one way that cognitive-behavioral therapy can help clients acknowledge their distress and work to alleviate it.