Why Practice Self-Compassion? What are the Possible Outcomes?

If we wish to make a quantum leap to greater awareness, there is no getting around the need for us to be willing to wake up, and to care deeply about waking up. In the same vein, if we wish for greater wisdom and kindness in the world, perhaps we could start by inhabiting our own body with some degree of kindness and wisdom, even for one moment just accepting ourselves as we are with kindness and compassion rather than forcing ourselves to conform to some impossible ideal. The world would immediately be different.

- Jon Kabat-Zinn, Coming to Our Senses

 

In her work, Kristin Neff (2012) has shown that Mindful Self-Compassion (MSC) “… is effective at increasing self-compassion, mindfulness, compassion for others, and other aspects of wellbeing. Moreover, the benefits of MSC appear to be enduring, lasting at least 1 year after completion of the program.” (p. 40) This study measured participants’ perception of increases in the following aspects of well-being: mindfulness, compassion for others, and life satisfaction while also measuring participants’ perception of decreases in depression, anxiety, stress, and emotional avoidance. Further, Neff found: “…the more MSC participants practiced formal meditation, the more they increased their self-compassion levels. Similarly, the degree that participants practiced informal self-compassion techniques (e.g., putting a hand over one’s heart in times of stress) in daily life also predicted gains in self-compassion. This implies that self-compassion is teachable skill that is ‘dose dependent.’ The more you practice it the more you learn it.”

It appears that healthy early childhood experiences and relationships may lay the groundwork for development of self-compassion. “Research supports the notion that self-compassion is related to the care-giving system and early childhood interactions. People who lack self-compassion are more likely to have critical mothers, for instance, come from families in which there was a lot of conflict, and display insecure attachment patterns, while the opposite is true for those with higher levels of self-compassion.” (Neff & McGeehee, 2010) Even though early childhood experiences play a part in developing healthy levels of self-compassion in an individual, self-compassion skills can be taught, as Neff shows in her work with MSC. One limitation of her work so far is that most of her study participants had prior mindfulness experience, but Neff (in press, p. 18-19) addresses this, “… it might be that practices taught in the program are only effective for those who already know how to meditate. On the other hand, the fact that MSC participants increased in wellbeing even though most had prior meditation experience suggests that MSC offers tangible benefits over and above mindfulness meditation alone.”

This difference between the practice of mindfulness and self-compassion bears further study. As we have seen, Kabat-Zinn feels that the two practices are similar enough, and that mindfulness encompasses self-compassion to such an extent, that one can ease suffering simply through mindfulness itself. Neff, however, appears to be interested in trying to separate the two practices out in an effort to further boil meditative serenity down to its most basic ingredients. To this end, Neff continues to research MSC practices in settings comparable to those that Kabat-Zinn has used to quantify the effects of MSBR. Neff is showing that: “Overall, research findings so far suggest that self-compassion may be a stronger predictor of depression, happiness, life satisfaction and psychological wellbeing than mindfulness alone.” (in press, p. 23) She describes situations where one can be mindful without being accepting, and any meditator who has practiced for any length of time will be familiar with this scenario:

 

Feelings of self-kindness and common humanity may often accompany mindfulness of painful experiences, of course, so that self-compassion may automatically co-arise with mindfulness itself. The two do not always co-arise, however. It is possible to be mindfully aware of painful thoughts and feelings without actively soothing and comforting oneself, or remembering that these feelings are part of the shared human experience. Sometimes it takes an extra intentional effort to be compassionate toward our own suffering, especially when our painful thoughts and emotions involve self-judgments and feelings of inadequacy. (Neff, in press, p. 20)

In her ongoing research, Neff is continuing to look into differences between mindfulness, self-compassion, and lovingkindness to see where the greatest successful outcomes for practitioners can be found. Her work is showing that it is these practices of loving support for the self, beyond any other meditative practice, that hold the key to wellbeing, but she admits that there is plenty of room for more quantifiable research in this area.

Although no studies have yet directly compared MSC with MBSR or MBCT [Mindfulness Based Cognitive Therapy], studies examining the outcomes of each program independently suggest that explicitly teaching self-compassion does make a difference … Research that directly compares the relative impact of MBSR, MBCT and MSC will be needed before understanding the overlapping and unique benefits of each. While MSC appears to raise self-compassion more than mindfulness-based interventions, it is likely that MSC raises mindfulness levels to a lesser extent than MBSR or MBCT, given that teaching mindfulness is only a secondary emphasis of the program … This suggests that the MSC program is complementary to MBSR or MBCT, and that it may be an effective supplement to these MBIs [Mind Body Interventions], especially for those who are self-critical … Research might also fruitfully explore whether wellbeing is maximized when both types of programs are taken, and, if so, in what order. Intuitively, it would seem optimal to learn mindfulness before self-compassion given that mindfulness is needed for compassion. However, for people suffering from severe shame or self-criticism, they might need to first cultivate self-compassion in order to have the sense of emotional safety needed to fully turn toward their pain with mindfulness. (Neff, in press, p. 26-28)

While we wait for more research into these practices to be undertaken and published, the work that Neff and Kabat-Zinn and others already have done on self-compassion and mindfulness is solid enough to point us all towards incorporating these practices into our daily lives immediately. Following the lead of these researchers, we all can begin to practice true presence with ourselves in each moment and true acceptance of ourselves as well. We can work to recognize the ubiquity of suffering as a part of what makes us human, rather than running away from suffering, denying suffering, or hiding our suffering from ourselves and others. We can learn to lean into our own personal suffering and soothe ourselves as we would do for a beloved friend or a child rather than distracting ourselves or pushing our suffering down or away. We can practice being gentle and kind with ourselves, replacing patterns of harsh self-talk with mantras of self-compassion: “May I feel safe, may I feel peaceful, may I be kind to myself, may I accept myself as I am.”

 

References

Forbes, B. (2014). Workshop entitled “Yoga for Empaths”.

Germer, C. (2009). The Mindful Path to Self-Compassion: Freeing Yourself from Destructive Thoughts and Emotions. New York, NY: The Guilford Press.

Kabat-Zinn, J. (2005). Coming to Our Senses: Healing Ourselves and the World through Mindfulness. New York, NY: Hyperion.

Kabat-Zinn, J. (1990). Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. New York, NY: Bantam Dell.

Mitchell, D.W., & Jacoby, S.H. (2014). Buddhism: Introducing the Buddhist Experience, Third Edition. New York, NY: Oxford University Press.

Neff, K. D., & Dahm, K. A. (in press). “Self-Compassion: What it is, what it does, and how it relates to mindfulness”. To appear in in M. Robinson, B. Meier & B. Ostafin (Eds.) Mindfulness and Self-Regulation. New York: Springer. Retrieved from www.self-compassion.org.

Neff, K. D., & Germer, C. K. (2013). A Pilot Study and Randomized Controlled Trial of the Mindful Self-Compassion Program. Journal of Clinical Psychology, 69(1), 28-44. doi:10.1002/jclp.21923

Neff, K. D. & McGeehee, P. (2010). Self-compassion and psychological resilience among adolescents and young adults. Self and Identity, 9, 225-240. Retrieved from www.self-compassion.org.

Salzberg, S. (2004). Lovingkindness: The Revolutionary Art of Happiness. Boston, MA: Shambhala Publications, Inc.

 

 

How is Self-Compassion Practiced?

 

 

 

 

Several years ago a small group of Buddhist teachers and psychologists from the United States and Europe invited the Dalai Lama to join them in a dialogue about emotions and health. During one of their sessions, an American vipassana teacher asked him to talk about the suffering of self-hatred. A look of confusion came over the Dalai Lama’s face. “What is self-hatred?” he asked. As the therapists and teachers in the room tried to explain, he looked increasingly bewildered.

-          Tara Brach, Radical Acceptance: Embracing Your Life with the Heart of a Buddha

 

The Buddhist teachings tell us that we all have Buddha Nature, or the embryo of the Buddha, tathagata-garbha, within us. This is identical to the Dharmakaya of the Buddha, the pure essence of the Buddha. We are all born whole and pure, embodiments of the Buddha nature, and we all have the capacity within us to reach enlightenment. (Mitchell & Jacoby, p. 163-165) In some Buddhist traditions, we can do this immediately, in this lifetime, and in others, it is the effort of many lifetimes. This Buddha Nature at our center can give us something very beautiful and innate to tap into when looking for ways to learn to practice self-compassion. As the Dalai Lama expresses in the above quote, how can you not love yourself if, at your core, you are the Buddha, in a very real and tangible way? The Dalai Lama could not even understand the concept of the type of self-loathing that is everywhere in Western society.

            Western culture in particular teaches us that we only can love ourselves if we are worthy of love. This is the difference between self-esteem and self-love or self-compassion. Self-esteem has conditions attached to it, for example, “I will love myself if I get that big bonus during my review at work tomorrow,” or, “If only I could lose ten pounds, then I would be able to love myself.” Self-compassion is loving yourself simply because you are. To overcome potentially a lifetime of learning that we only are worthy of love under certain conditions, practicing self-compassion must be just that – a practice.

I was taught a very simple way to incorporate self-compassion into my daily life and meditation and yoga practice. When encountering a difficult moment, one can make a practice of saying to oneself, “This is a difficult moment. Everyone has these moments. Where in the body do I feel this? Can I breathe/sit with this sensation?” (Bo Forbes, Yoga for Empaths Workshop, 2014) These affirmations and gentle questions mirror Neff’s three components of self-compassion: self-kindness, a sense of common humanity, and mindfulness.

            Neff (in press, 26) teaches a comparable way to deal with difficulty as it arises in daily life, or a way to go back and revisit difficult moments from the past:

The self-compassion exercises taught in the program are also designed to help people bring self-compassion to actual situations with which they are currently struggling. For instance, MSC [Mindful Self-Compassion] teaches something called the ‘self-compassion break,’ which involves intentionally calling to mind a current life struggle, finding a soothing physical expression of compassion such as putting both hands over one’s heart, then silently repeating words that convey the main elements of self-compassion (‘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.’) These types of tools are likely to help people learn to use self-compassion in their lives with greater efficacy.

 

These are moment-by-moment ways to practice self-compassion in everyday life as difficulties inevitably arise. There are more formal ways to practice as well. Traditionally, as we have seen in reviewing the metta practices, one begins by wishing happiness, health, and peace to oneself then expands these statements of goodwill to a beloved teacher or guru, to a difficult person, and to the universe at large. In Kristen Neff’s current work with self-compassion, which in many ways mirrors Kabat-Zinn’s mindfulness work of decades ago, she has aspired to boil down the broader practices of metta to just self-compassion and to simplify and systematize these practices so that they can be experienced by a broad group of people in the general public and in clinical populations. Neff also aspires to have her work be quantifiable so that the outcomes and effects of the practice on the various populations can be observed and reported on. To that end, she has developed a program called Mindful Self-Compassion, or MSC. In Neff 2012 (p. 30-31) she describes the particulars of this program as follows:

The structure of MSC is modeled on MBSR, with participants meeting for 2 or 2 ½ hours once a week over the course of 8 weeks and also meeting for a half-day meditation retreat … MSC teaches both formal (sitting meditation) and informal (during daily life) self-compassion practices. There are experiential exercises and discussion periods in each MSC session in addition to homework assignments to help participants learn how to be kinder to themselves. The goal is to provide participants with a variety of tools to increase self-compassion, which they can integrate into their lives ... The program also teaches general skills of loving-kindness, which is a type of friendly benevolence given to oneself in everyday situations (compassion is mainly relevant for situations involving emotional distress) … The program makes it clear how judging oneself when things go wrong tends to exacerbate emotional pain, while self-compassion helps to alleviate that pain … At the beginning of the program a distinction is also made between self-compassion and self-esteem, as many struggles with self-judgment are actually struggles with self-esteem. Self-esteem is often based on self-enhancement and downward social comparisons … In contrast, self-compassion provides kindness and understanding in the face of life’s disappointments, does not require feeling “above average” or superior, and provides emotional stability when confronting failure or personal inadequacies.

In place of the traditional metta phrases, in Mindful Self-Compassion, practitioners are taught these phrases: “May I feel safe, may I feel peaceful, may I be kind to myself, may I accept myself as I am.” The final phrase, “may I accept myself as I am” may prove to be the crux of the self-compassion practice, and, indeed, the crux of mindfulness as well. As more and more research and effort is put into finding out why meditation is so beneficial to well-being, as the practices are dissected and each part is quantified and measured, this piece, this accepting oneself as is, is beginning to come out on top.

To begin to practice self-compassion, one merely has to look at oneself and accept oneself in this moment. Or, as Jon Kabat-Zinn argues, practicing mindfulness itself – merely noticing each moment as it passes - is a radical act of self-compassion. There’s no excuse: We all can begin right now if we are interested in experiencing the relief from suffering that these practices have been shown to foster.

 

 

Self-Compassion Practices: A Brief History

A mind filled with love can be likened to the sky with a variety of clouds moving through it – some light and fluffy, others ominous and threatening. No matter what the situation, the sky is not affected by the clouds. It is free.

 

- Sharon Salzberg, LOVINGKINDNESS: The Revolutionary Art of Happiness

What is Self-Compassion? How does it relate to Buddhism and mindfulness?

Self-compassion as a practice was born from both the mindfulness meditation movement and the form of meditation known as lovingkindness. Mindfulness meditation traces its lineage back to vipassana meditation in the Buddhist traditions. The modern mindfulness movement was spearheaded by Jon Kabat-Zinn and his groundbreaking Mindfulness-Based Stress Reduction (MBSR) program which he started in 1979 at the University of Massachusetts. Lovingkindness as a practice is a translation of the metta meditative practices in the Buddhist traditions. To trace the roots of the current self-compassion meditation movement, one must delve into each of these traditions, mindfulness and lovingkindness, in more detail. Jon Kabat-Zinn (1990) describes mindfulness as “a particular way of paying attention … in the spirit of self-inquiry and self-understanding.” (p. 12) Kabat-Zinn studied meditation personally and over time began to feel that meditation would have great benefit to individuals and societies if it was studied by a larger number of people. He also believed that it would be easier to teach mindfulness and that mindfulness would have greater acceptance in the West if he were to separate mindfulness from its Buddhist origins. He saw the great power of mindfulness in helping to ease all manner of human suffering in his Stress Reduction Clinic and was able to report on these outcomes scientifically, which, at the time, was a breakthrough. Kabat-Zinn (1990) says, “Mindfulness stands on its own as a powerful vehicle for self-understanding and healing … one of its major strengths is that it is not dependent on any belief system or ideology ... Yet it is no accident that mindfulness comes out of Buddhism, which has as its overriding concerns the relief of suffering and the dispelling of illusions.” (p. 12-13)

The Buddha taught two types of mental practices that could be used to engender Right Concentration, one of the steps he listed on the way toward enlightenment on the Eightfold Path. One of these meditations is tranquility meditation, or samatha meditation, directing the mind to a single focal point. The second type of meditation is called insight meditation or vipassana meditation. These practices were listed by the Buddha as ways to bring about the cessation of duhkha, or suffering (Mitchell & Jacoby, 2014, p. 58). Mindfulness traces its origins back to these specific teachings on vipassana meditation by the Buddha. Jon Kabat-Zinn (2005) explains: “The attentional stance we are calling mindfulness has been described by Nyanaponika Thera as ‘the heart of Buddhist meditation.’ It is central to all the Buddha’s teachings and to all the Buddhist traditions ... Their relatively recent arrival in the West is a remarkable historical extension of a flowering that emerged out of India in the centuries following the death of the Buddha and ultimately spread across Asia.” (p. 10)

Jon Kabat-Zinn, as a long-time meditator and one of the greatest proponents of the meditative movement in the West, has distilled down his years of study and practice to find what he feels is the most powerful aspect of meditating – noticing what is happening in each moment as it happens and staying present through as many of these moments as possible. There is a distinction here between what many in the West consider meditation and the type of moment-to-moment awareness that mindfulness practitioners are working towards. In the West, many have come to understand meditation as somehow “quieting the mind” or controlling the thoughts, which is more like the meditation described in the Yoga Sutras of ancient India and samatha meditation as described by the Buddha. With vipassana meditation, or mindfulness meditation as it is commonly called today, the training is in watching the mind as it moves through thoughts and feelings, as one who sits on a hilltop can watch the clouds passing overhead in a summer sky.

Jon Kabat-Zinn makes mention of many other meditative practices in his writings on mindfulness, including the other ones discussed here – lovingkindness and self-compassion practices - and, while recognizing the power of lovingkindness practices, he has long believed that, in teaching meditation for health and well-being, there is no need to stray beyond the basics of mindfulness:

For a long time, I was reluctant to teach lovingkindness as a meditation practice in its own right in the Stress Reduction Clinic because I felt that all meditation practices are fundamentally acts of lovingkindness, and when taught and practiced that way, obviate the need for a single practice claiming that orientation. After all, the emphasis we place on mindfulness as an affectionate, openhearted attention … is itself a gesture of great hospitality and kindness toward oneself, and the suggestion that just sitting with and by and for yourself is a radical act of love captured, I felt, the essence of lovingkindness … it might be confusing for people who were in the early stages of being introduced for the first time to the attitude and practice of non-doing and non-striving that underlie all the meditation practices ... I did not want it to undermine that orientation of direct, moment-to-moment, non-reactive, non-judgmental attending, which is so unusual for us Americans to even consider adopting … The reason for my hesitation was that in the instructions for lovingkindness meditation, there is an inevitable sense that you are being invited to engage in doing something, namely invoking particular feelings and thoughts and generating desirable states of mind and heart. This feels very different from and often outright contradictory to simply observing whatever is naturally arising without recruiting one’s thoughts or feelings to any particular end other than wakefulness itself. (2005, p. 285-286)

To practice formal mindfulness meditation, one first takes a deliberate seat. Then the practitioner begins to focus on what is happening in the body, attending to the breath, or sensations in the body, or the thoughts as they play across the screen of awareness. The practitioner could choose, instead, to focus on external stimuli such as the sounds in the room. Or one could attend to whatever stimulus becomes most prominent on a moment-by-moment basis. The crux of this type of meditation is to simply pay attention to what is. But it is not always so simple. The mind will drift away from the present many times during any formal practice, and the job of the meditator is to catch it and bring it back, refocusing on the internal or external stimuli time and time again. With regular formal practice, it becomes easier to begin to practice informally, catching the mind ruminating during daily life, reminiscing over the past or planning for the future, busying itself with anything other than what is going on in the present moment. As Kabat-Zinn (2005, p. 57) explains, “Stringing moments of mindfulness together in this way allows us to gradually rest more and more in a non-conceptual, a more non-reactive, a more choiceless awareness, to actually be the knowing that awareness is, to be its spaciousness, its freedom.”

As Kabat-Zinn describes, the simplicity of noticing practiced in mindfulness is very different from the practice of lovingkindness. What, specifically, is lovingkindness, then? “Metta, which can be translated from Pali as ‘love’ or ‘lovingkindness,’ is the first of the brahma-viharas, the ‘heavenly abodes.’ The others – compassion, sympathetic joy, and equanimity – grow out of metta, which supports and extends these states.” (Salzberg, 1995, p. 22-23) One lives in the Four Divine Abodes when one attains enlightenment, when one enters Nirvana (Mitchell & Jacoby, p. 61) but, until then, one can practice meditation in any of the four abodes to cultivate these pure mind states thereby “overcoming such unwholesome states of mind as the Three Root Evils of greed, hatred, and delusion.” (Mitchell & Jacoby, p. 82) This is comparable to the idea in yoga that one can replace root samskaras or patterns of habit or thought in the body or mind with healthier samskaras or patterns. The simplicity of lovingkindness is that we are replacing other, perhaps less healthy ruminations of the mind with healthier ones.

Buddhaghosa, a fifth-century C.E. monk, describes the history of lovingkindness and its practice in the Visuddhimaga, a classic Theravada text known in English as the Path of Purification: One should seat oneself comfortably on a well-prepared seat in a secluded place. Then one should contemplate the dangers of hate … Thereupon, one should begin to develop loving kindness in order to rid the mind of hate … First of all, loving kindness should be developed only toward oneself by repeatedly thinking, “May I be happy and free from suffering. May I keep free from enmity, affliction, and anxiety, and live happily.” … One should develop this attitude in this way, “I am happy. And just as I want to be happy and dread pain and death, so too do other beings.” Then with one’s happiness as an example of what others want, the desire for others’ well-being and happiness will arise in oneself. This method was indicated when the Blessed One said, “I visited all parts of my mind, and found none dearer than myself. The self of every other person is likewise dear to them. Who loves oneself will never harm another.” (Mitchell & Jacoby, p. 82)

Sharon Salzberg, teaches and writes on metta, and is a longtime practitioner. She describes the history of the practice in her book on lovingkindness in a story about the Buddha and some monks. The Buddha sent these monks to meditate in a forest occupied by tree spirits. The spirits tried to expel the monks, and, indeed, the monks were afraid and ran back to the Buddha, begging to be sent somewhere else to practice. The Buddha sent the monks back to the same enchanted forest but with the protection of the metta practices. “This was the first teaching of metta meditation … it is said that the monks went back and practiced metta, so that the tree spirits became quite moved by the beauty of the loving energy filling the forest, and resolved to care for and serve the monks in all ways.” (p. 25)

Salzberg (p. 39-40) describes the beginning steps of the metta practice from the Buddhist traditions, where one gently repeats phrases of goodwill for ourselves and then for others. First, practitioners sit comfortably and reflect on good things about themselves or on their wishes for happiness. Then practitioners choose phrases that express what they most deeply wish for themselves and they repeat these phrases, coordinating this repetition with the breath or just resting on the phrases themselves in turn. Traditionally, the metta phrases follow a pattern similar to the ones Buddhagosa suggested in the Path of Purification, or, as I have been taught: “May I be safe, may I be happy, may I live with ease.” As a word of warning, Salzberg notes: “There are times when feelings of unworthiness come up strongly, and you clearly see the conditions that limit your love for yourself. Breathe gently, accept that these feelings have arisen, remember the beauty of your wish to be happy, and return to the metta phrases.” (40) In a formal metta practice, these phrases are then turned outward to focus on a dear teacher, a difficult person, and the universe at large, each in turn, as follows: “May [my dear teacher] be safe, may [my dear teacher] be happy, may [my dear teacher] live with ease. May [difficult person] be safe, may [difficult person] be happy, may [difficult person] live with ease. May all beings be safe, may all beings be happy, may all beings live with ease.”

Self-compassion, then, is the very basic seed of the practice of lovingkindness. Self-compassion, at its core, is the beginning of the formal metta practice where one wishes oneself safety, happiness, and ease, but it goes deeper. Kristin Neff is a leading contemporary scholar of self-compassion who is working to understand the efficacy of self-compassion in wellness and to spread the practice of self-compassion in a way that mirrors Jon Kabat-Zinn’s work with mindfulness. She defines self-compassion thusly: “Self-compassion comprises three interacting components: self-kindness versus self-judgment, a sense of common humanity versus isolation, and mindfulness versus over-identification when confronting painful self-relevant thoughts and emotions.” (2012, p. 28) We will look at each of these three components - self-kindness, a sense of common humanity, and mindfulness - separately.

In the West, we put great value on being kind to others, but, either directly or through messages from the omnipresent media, we are often taught to be harshly critical of ourselves. Imagine, for a moment, if you were to direct your own harsh self-talk toward a loved one and actually gave that self-talk voice. We can be cruel to ourselves in ways that we would never tolerate if we directed that cruelty outward. Neff (in press, p. 5) explains self-kindness as working to be “… supportive and understanding toward ourselves. Our inner dialogues are gentle and encouraging rather than harsh and belittling. This means that instead of continually punishing ourselves for not being good enough, we kindly acknowledge that we’re doing the best we can.” And, when difficult situations arise, “instead of immediately trying to control or fix the problem, a self-compassionate response might entail pausing first to offer oneself soothing and comfort.” (Neff, 2012, p. 28)

Common humanity, the second basic tenet of self-compassion, involves recognizing that, as human beings, we suffer. This is one of the primary philosophical building blocks of Buddhism. For some, when difficulty arises, there is a sense of isolation or a sense of “Why me?” or a general feeling that everyone else is somehow better off, somehow immune to suffering. Instead of seeing suffering as a basic human trait, it is easy to find oneself feeling singled out. “Self-compassion connects one’s own flawed condition to the shared human condition, so that features of the self are considered from a broad, inclusive perspective … When failures and disappointments are experienced as an aberration not shared by the rest of humankind, people may feel isolated from others who are presumably leading ‘normal’ happy lives.” (Neff, 2012, p. 29) Again, in the West, it is a common part of our identification as fiercely individualistic that we act alone, and we suffer alone and privately, putting on masks of positivity for the outside world. In our culture, asking for help – or even acknowledging to oneself that one might need help - can be seen as weakness. Common humanity asks us to see that we are all connected, that we all suffer, and that we all need compassion and help (even from ourselves) during times of suffering. “With self-compassion … we take the stance of a compassionate ‘other’ toward ourselves, allowing us to take a broader perspective on our selves and our lives. By remembering the shared human experience, we feel less isolated when we are in pain … Self-compassion recognizes that we all suffer, and therefore fosters a connected mindset that is inclusive of others.” (Neff, in press, p. 5)

It is interesting to note that Neff considers mindfulness to be a part of self-compassion, whereas Kabat-Zinn views self-compassion to be a part of mindfulness, a great illustration of the many different filters through which a meditative practice can be viewed. Though mindfulness is a component of self-compassion, the two are different, as Neff (2012, p. 29) illustrates:

Although mindfulness is required to experience self-compassion, it is important to recognize that the two constructs are not exactly the same. First, the type of mindfulness entailed in self-compassion is narrower in scope than mindfulness more generally. The mindfulness component of self-compassion refers to balanced awareness of the negative thoughts and feelings involved in personal suffering. Mindfulness in general refers to the ability to pay attention to any experience – positive, negative, or neutral – with acceptance and equanimity … Mindfulness tends to focus on one’s internal experience (sensations, emotions, thoughts) rather than oneself as the experiencer … Self-compassion emphasizes soothing and comforting the “self” when distressing experiences arise, remembering that such experiences are part of being human.

It is this emphasis on the experiencer that sets self-compassion apart and that can be useful for people learning the contemplative practices, especially for those who tend to be self-critical. Sometimes mindful awareness can be a difficult place to sit without having the tools of self-compassion at hand.

Portraits from My Hospital Stay, Part Three

A young man comes in to check my electrodes. He has an accent and a large silver crucifix around his neck. He asks if I have children. I tell him that I have twins who are eight and a younger son that is six. He has twins, too. His are seven. We talk for a while as he deftly sweeps electrodes around under my breasts and all along my belly and chest. His family lives in another state and he only sees them on the weekends. He is hoping I can give him advice on how to get his children to respect their mother when he is away. He feels that he probably should "beat" them, because the bible says to do this. He says that was how he was raised in Africa. I tell him that is how I was raised, too. He asks if I beat my children. I tell him that I do not. He asks if my children are fresh. I tell him that they are more often than not. He does not want to beat his children, but he does want peace in his home, and his wife needs help, and he is very stressed and concerned.

I'm not able to tell this man not to beat his children even though I want to. I tell him that he has to listen to his own heart, and if it does not feel like the right thing to do, then he should not do it. I try not to argue with other people about what their gods tell them to do, but he is clearly so conflicted that I try to find a way to help him. He looks like he is going to cry. He asks how I get compliance in my home. I tell him that I take things away from my children when they are fresh, things that they find important, like video game or TV turns. He says he doesn't allow his children TV or video games. I tell him that I wouldn't either, but that it is helpful to have things to take away when you need to. All my years of mindfulness parenting boiled down to this rather weak, very capitalistic and ultimately disappointing little trick. He thanks me. I ask him when I can get the IV out of my arm. He asks if it is hurting. I tell him that it is. He says that I should have mentioned it and they would have found a better place to put it, but then I would have had to have gotten another needle stick. We decide to leave it where it is. He leaves but says he will be back when it is time for me to be released.

I take a nap. I can't remember when I have slept this much, sleeping mostly through the night except for the periodic visitors, sleeping late, taking naps. My chest hurts.

The nurse comes in and says they are hoping to have a read on my stress test soon. She leaves. I get up and look out the windows. They look across a small rooftop into other people's hospital rooms. The sky is crystal blue. The new shift of doctors and nurses have all commented on how cold it is outside and how lucky I am to be in here where it is warm.

I check my phone. Nothing. I check the TV. Nothing. I flip through the book Fred brought me earlier in the day. The first paragraph is beautiful. I want to read the book, but the words aren't sticking around in my head. I prop my sore arm up and drift back to sleep.

A small young doctor wakes me up. He says he's checked my stress test. He says it looks fine. He says they aren't sure what was causing the chest pains but that it probably isn't my heart. He says to follow up with my primary care doctor in a week or two. He says the nurse will be back in to help me get ready to leave. I look at my clock. It's a little past one.

Agitated and ready to go, I try to sit and wait. The nurse finally comes in. She has papers for me to sign. I don't know what they say. I sign them. She tells me to keep taking ibuprofen for the pain. She asks me if I have a ride home. I tell her no. She says I should get a cab and not take the bus. I say ok. She says someone will be in to take out my IV and then I can leave. She leaves.

I wait. Even more agitated. Finally, the man who doesn't want to beat his children comes back in. He thanks me for my earlier advice. He says the Italian woman down the hall told him he definitely should beat his children. He says he probably will when he sees them again. He is resigned to it. I tell him he doesn't have to, even if god and the Italian woman down the hall say so. I remind him that he should listen deeply to his own heart. He reminds me that he needs his wife to be happy. He shows me pictures of his children, and they are beautiful and precious. I tell him that I can see how much he loves them. While all of this is happening, he is removing electrodes from under my breasts and from my belly.

He asks why his wife is so hurt by his children's harsh words to her. He asks if my children are able to hurt me with their words. I say sometimes, but that I always know that they love me, just as I know that my harsh words can hurt them sometimes but I hope that my children always know that I love them. He asks if my husband is the disciplinarian and I laugh. He says that he could tell, and maybe that's why I'm in the hospital.

He removes the IV. My arm still aches, but the pain is sweet. I'm still bruised there weeks later. The man thanks me again. I wish I could help him more. He tells me to gather my things and wait for the nurse.

The nurse is there quickly. She says she will walk me to the cab waiting area. I grab my things and we head off together. She reminds me to take a cab and not the bus. She says goodbye.

I call a cab. They say it will be a while. I wait inside the hospital for a bit, but then feel strongly that I need fresh air, no matter how cold it is outside. I head outside to wait. It's cold, but not too bad, really, and the air is a lot better out here after being locked down in a hospital for 24 hours. Another guy comes outside to wait for a cab. We wait near each other.

A cab comes up. Two older people get out. The cab driver yells at me and the guy that he's not picking up any fares and that we are going to have a long wait because all the cabs are at the airport. He squeals off. The older couple says we didn't want to take that cab anyway, that that guy was crazy. They go into the hospital.

We wait and wait. About ten buses have gone by in the time that we have been waiting. I give up. I tell the guy he can have the next cab. I go to the bus stop across the street. I hope the nurse isn't watching. I feel very naughty. A bus is there to pick me up within minutes. The cab guy is still waiting.

I take the bus a couple of stops, but the sun is calling to me and I have nothing but time this afternoon, so I get off at the next stop and walk the couple miles to the kids' school. I get there right at pickup time. Fred is there waiting, too. We all walk home together. It's Friday night. Homemade pizza night. Game and movie night. Everything is all right.

Portraits from My Stay at the Hospital, Part Two

I wake up concerned about how I smell. I've been told not to bathe since I'm hooked up to all this equipment. I have no deodorant. I dig through the small basket of toiletries the first nurse gave to me the night before looking for anything that might help. I choose the lotion. It doesn't help much. I brush my teeth and try to drag the small comb the hospital provided through my hair. It's like those combs they used to give you for school picture day. It's hopeless.

I decide to practice civil disobedience. I put on my yoga pants from the day before. The heart monitor battery pack fits nicely in the pocket and gives me more mobility. I try to do yoga, but the floor seems kind of gross and the battery pack keeps falling out of my pocket. I sit back down and wait.

Fred comes on his way to work. He drops off a clean pair of underwear (Animal from the Muppets) and a book and a phone charger. I forgot to ask him for deodorant. He looks grim and tired. I tell him I'm supposed to be home before dinner, hopefully, but that it all depends on how quickly they can administer and read the stress test. He sits for a while and then heads off to work.

A doctor comes in and hands me her business card. She asks me a lot of questions about the chest pain and about yoga. She tells me everything looks benign but that I need to have the stress test anyway. She apologizes for the delay.

I'm hungry. I call the cute young nurse in and ask her if I should order breakfast so that I don't miss it completely. She says no. I ask her if there's anything that we can do about the fact that the IV in my arm is killing me. She says no. I tell her I'm not taking off my pants. She says ok. She says she'll be back in soon to update me on the status of my stress test. I tell her I'm going to go for a walk. She asks me not to leave the ward.

I walk around the ward, which is decorated with lovely textiles from around the world, all framed and labeled, as if this were a wing of an art museum. I stop and read each one. I try not to peek inside the other rooms. Some have doors open, others have doors closed. Some have pieces of paper taped to them with clip art stars. I wonder what that means. My door does not have stars. I see lots of people in white coats. They are all very young.

I'm getting a caffeine or morphine headache. My face is so puffy I can see the bags under my eyes in my field of vision. This must be from the morphine. I have to walk with my right arm bent and up to avoid the searing pain from the IV. I keep walking. Walking, walking, walking until I overhear a conversation between some of the staff about one of the patients needing a death certificate but they seem unsure of the time of death. I decide to retreat back to my room. My thoughts travel around the idea of death, the surprise at having been near to someone's dying without even noticing the passing. I get sad.

A man comes into my room with a wheelchair. He checks my bar code on my hospital id bracelet. He is wearing a giant silver motorcycle belt buckle and sneakers boldly colored like the Jamaican flag. He wheels me to the stress test waiting room. We talk about Florida. He lived there, too. He says he didn't like it because you had to have a car. He likes it here better. We agree that the cold isn't fun, though. Being wheeled feels like being disembodied. I feel the length of my escort's paces, it feels almost like I am walking, but I am half of my usual height. I think of my sons and how this must be their view as they walk - of people's midsections.

Jamaica motorcycle man backs me into a waiting area and hands me an architecture magazine with Patrick Dempsey on front. I flip through the pages without anything registering. There's a woman with a giant bandage covering half of her face in the bay next to me. The nurses at the nurse station have green three inch binders on all of us. They are flipping through the one about me.

A woman comes to take me to the stress test room. She is probably ten or so years older than me. We talk about yoga. She says she tried it once and didn't like it. Too much chanting and fairies, she says. I tell her she should come to my classes. Guaranteed fairy free (most of the time).

She hooks up the electrodes. Even more than before. I'm glad I have my pants for my run on the treadmill, but I didn't bring my shoes. They were snow boots, anyway. Probably wouldn't be the best for running in.

Another woman comes in. She introduces herself. These two will be administering the stress test. She asks me about yoga, too. They take my blood pressure a couple of times. And then they get me up on the treadmill.

I have a terrible episode of deja vu as I'm stepping onto the treadmill in my yoga pants and johnnie - I notice that my johnnie is still bloody from the night before. I've definitely done this before.

The stress test is stressful. The worst part is the belt that holds the heart monitor in place is restricting my breathing. I feel like I'm going to faint. They get my heart rate up to near-explode and then stop the treadmill and help me to the hospital bed. I feel like I'm going to faint. They tell me that's normal - that the heart doesn't like to slow down that quickly from so high. I still can't breathe because of the belt, and the pressure of me trying to get deep breaths with a tight belt is making my chest hurt. I pant out that I need them to loosen the belt. They do. I pant and gasp, thinking of that fish from the end of the Faith No More video. I can't catch my breath. I think about how a yoga teacher practiced in the arts of pranayama should be able to catch her damn breath.

The women take a few more blood pressures and measurements of this and that. They hand me a clean johnnie since the one I am in is blood-stained and sweaty, and it smells really bad, and then they walk me back to my architecture magazine and wheelchair. I sit there for a while looking at Patrick Dempsey in his luscious outdoor room and watching the other stress test victims walk or wheel past. There's a parade of us.

A much older man comes to wheel me back to my room. I sit on the bed and try to figure out how to order food. I call for the nurse and wait. And wait. I go for a walk. I walk to the nurse's station. I ask the person there how to order food. My nurse comes out to help. I tell her I want food and I want a shower. She says she'll come help me. We walk back to my room together. She rips open a biohazard bag and puts it on my arm over the IV and tapes it in place. She tells me to get my shower and then order my food. It's not the order of events I would have chosen, but I comply.

The shower is awkward. It's a hand-held shower head, and I can't use my right, dominant arm because of the pain from the IV. I do my best at smearing hospital liquid soap around with my left hand and then try to squirt it off, also with my left hand. I make a really sorry attempt at washing my hair. I fear I've done more damage than good, but at least I got rid of the stress-sweat smell emanating from my pits. I try to dry off with my left hand, give up, and get my pants and johnnie back on while still mostly damp. I rip the biohazard bag off, gently, and go wait for the nurse to explain how to get some grub. I drink down a bottle of water while I wait. I check my phone. Some folks have found out I'm in the hospital. I have a string of emails and texts to the extent of "JEEZUS! Aren't you worried????" and I'm not and I think that's odd.

I notice a sign hanging under my TV that I never noticed before that says "Food Service" and a four digit number. I take a chance and dial it on my phone. I order pasta and an apple and a coffee. I hang up. I fall asleep. The nurse comes in to hook me back up to my heart monitor and to explain how to order food. She leaves.

The food comes and it's the best in the world. I'm ravenous. I tear through it all, then I go hunting for more from the kitchen across the hall from my room. I find Sanka packets. I pour four of them into some hot water and hope for the best. I grab two single-serving boxes of raisin bran and power through those. The Sanka tastes like dirty water rather than coffee, but I drink it down. I turn on the TV and flip through the channels. There's nothing to watch. I flip through my phone and check the news. Not much there, either. I wait.

Portraits from My Stay at the Hospital, Part One

Crushing chest pain, shortness of breath, stabbing pain down my left arm, seeing spots. Trying not to die on the bus. Trying to make it to the hospital stop. I really don't want to die on the bus.

I wander around inside the hospital, looking for the ER. I realize that I must not be dying, not quickly, anyway, and some of the symptoms ease. I finally find my way to the reception area for the ER, in the basement. I think it is the basement. A woman is waiting for her child's shoulder to be fixed after a dislocation. She is not allowed to be with the child while this procedure is taking place. She looks pale and worried, like a caged tiger.

I wait patiently, chest screaming, while the woman at reception talks on the phone to someone about dinner arrangements. It is almost dinner time. I'm sad about this, because I know they won't let me eat even if I'm not dying. I've been in hospitals before.

The receptionist finally hangs up and looks expectantly at me. I lean in and whisper, "I'm having chest pains. I'm sorry." And I wonder why I feel like apologizing.

I'm swept away quickly from that point. I'm put in a bay in the ER proper. I'm out of my yoga clothes and into a johnny. I'm allowed to keep on my black batgirl panties with the pink batgirl symbol on front. I'm glad about this for a number of reasons, not least of which is that these panties are fierce.

A beautiful young nurse comes in in blue scrubs. She has thick brown hair in waves all around her face. She looks for a vein, finds one, and stabs it. I bleed everywhere, onto the sheets, onto my johnnie, onto the floor. She takes some vials of blood. She asks what it's like to be a yoga teacher. She asks me where she should go for classes because she's been told she shouldn't do yoga when she's trying to get pregnant. She leaves with the vials of blood and returns with Clorox bleach wipes to clean my blood off the floor.

The woman in the bay next to me is also having chest pains. She doesn't speak much English. She was in earlier in the day, but she escaped. They have a bored-looking guard posted outside her bay. I can see him through a small opening in the curtain that is supposed to offer me privacy. He stares at his cell phone.

An older black woman comes in. She's wearing a tribal print shirt and beads. Her hair is short. She wants to tell me they have a room ready for me. That I have to stay over night. She wants to ask me about a phone plan. The nurse is back, though, and she's about to give me morphine. I tell her I don't want morphine. She says it's standard procedure for chest pain. I tell her that I don't want it but that if I have to have it, I need a low dose. She says it's the standard dose, and it's pretty low. I push back. She says she'll give it to me slow and steady.

The phone plan woman continues on about the phone plan. The morphine makes me feel like my legs are on fire. I yell for the pretty yoga nurse to stop. The phone plan woman says she can come back later and leaves. I keep yelling for the morphine to stop. The nurse tells me that I'm the only person she's ever met that doesn't like morphine. She continues to administer it.

The morphine finally stops making my legs feel like they are on fire. My chest and arm still hurt. My head feels separate from my body. And periodically, for the rest of my stay, scenes play out twice. I'm guessing that's from the morphine, but maybe it's from the anxiety. Deja vu sounds so romantic when you read about it, but in reality, replaying scenes of watching yourself in a hospital is a poor use of a drug trip, I think.

Electrodes are hooked up to me. The pretty young nurses have to lift my bare breasts to put electrodes there. This is uncomfortable, and I look down at my chest, embarrassed at the heft and weight of these things.

A young male doctor with startlingly blue eyes comes in and says some things. A beautiful resident who looks like she should be in a movie about beautiful young doctors and their romantic lives says some things, too. They look at my heart with an ultrasound. They check my aorta, too. There's some concern. They say I have to stay overnight for observation. They ask me about yoga. They leave.

A man comes in and unhooks the electrodes and wheels me to x-ray. Everyone watches as I'm wheeled past. A funeral procession or a coronation for royalty. A parade of some sort. I'm taken back into the ER bay to wait for my room. The woman in the bay next to me is being admonished for bolting earlier. She promises she won't leave this time, but she's feisty, and I love her. A man comes in to check on me. I ask him when I can eat. I've been doing yoga all day and I'm hungry and thirsty. He offers ice chips. They are the best ice chips in the world. I remember them from when I was birthing children. Like heavenly wine.

I get taken to my room, after some time. I'm told on the way that it's in the new building. It looks like a posh hotel room, with unexpected equipment hooked up on the walls. The man who wheels me in shows me how to control things. He dims the lights. I turn the TV on. It's hockey. I watch the players gliding back and forth, back and forth.

A nurse comes in to introduce herself and I love her immediately. She checks my vital signs. She brings me a sandwich. She asks me about my kids. She tells me to never take the bus to the ER again. Next time, take an ambulance, OK? She has twins, too. Hers are grown. She tells me she'll be keeping an eye on me until midnight. I feel safe and warm. I tell her not to let anyone give me any more morphine. In fact, I tell every person who walks in my room not to give me morphine for the rest of my stay. They all think it's hilarious.

I fall asleep watching hockey. I wake up and change the channel to CNN. They are making wild speculation about the missing Malaysian plane. Aliens. Tiny black holes. The Bermuda Triangle. I wonder if they are for real or if this is the morphine. I turn off the TV and go to sleep.

I have several visitors in the night. The first is a middle-aged man who says something about me being a yoga teacher. I tell him not to give me morphine. He says he loves yoga. He goes there for the chicks. I tell him he's not the only one. He gives me albuterol. I ask him why. He says he doesn't know. He stands there while I breathe and tells me more about chicks and girlfriends and I think he might be hitting on me but that can't possibly be. He leaves. I go back to sleep.

The next visitor looks like Steve-O. He says he's going to take blood. He's super nice and has the thickest Boston accent in the world. He has a giant, deep scar from his elbow to his wrist on his left arm. He's gentle. He says he'll try to let me sleep as long as he can but that he has to take more blood in a few hours. He leaves. I go back to sleep.

I wake up when a nurse shines a flashlight in my face. She apologizes and leaves.

I'm woken again by Steve-O. He's interested in yoga, too. I say something about it helping to heal the lingering effects of trauma. I guess I'm looking at his scar. He tells me the scar is a "gift from the Jamaicaway." I tell him I hate that road. He says after his accident, he came to in the ER and heard the docs saying that they were going to try to save the arm. I'm tired. I say, "Well, chicks love scars." I feel stupid. I think I might have been hitting on him. He laughs and leaves. I go back to sleep.

A very perky young blonde nurse wakes me next. Sunlight is coming in through the windows. She says we're waiting for my stress test. I tell her I'm going back to sleep, then. I've never slept this late before, not since the kids were born. I look at a clock. It's 7:30.

Gimme All Your Lovin'

This is another one of those posts that has nothing to do with yoga, I think. But in the spirit of Valentine's Day, a musing on those first subtle rumblings of sexual awakening as I recall them from my youth. Maybe that has something to do with yoga after all? Or at least with the yoga and sexual health book that I'm planning.

I was 12 years old. I was an MTV junkie. Now, I lived in a trailer in the middle of an orange grove outside the city limits, so we didn't have cable. In fact, I remember all of three channels. But I would have sold my soul to get access to MTV, and I watched it whenever I could - babysitting, at sleepovers at friends' places in town, on vacation, wherever I could. I would watch ANY video, even for songs that turned my stomach when they were on the radio (I'm looking at you, Bob Seger).

I looked it up, just to refresh my memory. There were some great songs that year. Billboard lists Let's Dance, Electric Avenue, She Blinded Me with Science, Sweet Dreams, Do You Really Want to Hurt Me, Come on Eileen, Billie Jean, Little Red Corvette. Take a look. That was a great year for pop radio. But the song that is on my mind right now is Gimme All Your Lovin', by ZZ Top. ZZ Top had a number of their big videos that year, and they all featured this fairy godmother theme where the guys in the band would show up and help out the main characters, who were usually cute but not very well dressed. They dressed up the girl from She's Got Legs with baby ankle socks and high heels and gave her some gum and then she got the guy and defeated all the people who had sexually harassed her that morning on her way to pick up some sandwiches for the people she worked with. The band was only seen briefly, as most of the action was played out by some very 80's ladies and that awesome ride.

I was just watching Live From Daryl's House the other night, with guest musician Billy Gibbons (from ZZ Top), which is what brought this all back. Billy can sling that guitar, man (or slap the plank, as he calls it). If you don't watch the show, you should, because it is awesome. They did an amazing version of LaGrange. It's the only time that Daryl's voice has sounded out of place on the show, I think, contrasting against Billy's gruff, penetrating growl.

Now, enter in 12 year old me. I very literally consumed these songs, watching the videos over and over, taping the songs off of the radio when they came on and playing them over and over til I knew every note. And it was only when I came across Gimme All Your Lovin' that I started to feel a little ... different.

I enjoyed Duran Duran and Bowie at that time. They were safe and pretty and androgynous and did I mention pretty? But when I heard the men of ZZ Top growl at me and play those guitars so deftly and somehow kinda dirty, there was an awakening. It felt like those men, because they seemed so much older than the other boys on MTV, would know how to do things to me that were similarly dirty. And I had a feeling that I would like it. I couldn't quite gel the fact that they weren't pretty, and I was curious about how they were so not pretty and still were making me have this reaction.

I was an innocent, and I wouldn't really understand any of this for a very long time. But I do believe that was the start. Those guitars and that growl. And maybe the facial hair. I waited for The Eliminator to come and rescue me, to have the men of ZZ Top or their very 80's ladies give me ankle socks and high heels and gum and drive me away some where. That part didn't happen, but it was a great teenage segue from my childhood fantasies of a fairy godmother and her pumpkin coach.