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Self-Compassion in Chronic Illness

It’s the essential prescription in living with long-term illness. Learn what it is and how to access it when you need it.

Frustration, anger, sadness, loneliness, isolation, depression, fear… these are the themes I hear most often in my clinic room when working with people who’s bodies seem to have failed them and left them with pain, disability and/or uncertain futures.

It doesn’t seem to matter if a patient has experienced a stroke, car crash, years of pain, disability… many people just seem to naturally turn to being hard on themselves and frustrated at themselves and their bodies. Shame, a sense of unfairness and fear for the future can also dominate thinking — the sum total of all of this being distress and self-loathing with no obvious way out.

It’s important to recognise that we don’t really have societal narratives for how to cope with not getting well. For those of us with chronic illnesses, faith in the almost magical wonders of medicine lead us convinced that not getting well is perhaps a consequence of not having found the right drug, not having had the right test or having failed somehow. For those who have suffered injury,persistent messages in society to ‘fight on’, ‘move on’ and ‘forget about the past’ dictate how we should cope.

When I work with patients, I always start by naming their negative emotions and validating their experience to date. There are often tears, with apologies for, “being stupid” or “pathetic”. Right in front of me, people act out their low opinion of themselves for not being able to cope with their distress.

A lot is said in therapy, but one of the most powerful 2-step questions I ask people is:

“how would you respond if your [partner / parent / child / friend] had the same health problem as you — would you be angry at them or regard them as pathetic for not coping?”

The answer is always one of compassion and empathy.

“Why then, do you feel you deserve to be angry and hostile to yourself?”

Often there is silence.

People are instinctively capable of understanding compassion for others. I have never needed to coach anyone in understanding how to be compassionate. What I have needed to do, is help people to label this as something they give to others and not to themselves. To distinguish the differences between compassion and self-compassion, the latter often being totally non-existent.

It is unhelpful to regard a health condition as unfair or being done to you by your failing body. It is helpful to realise that these experiences are you and your body is distressed alongside your emotional self.

In the context of this new experiencing of yourself, which includes new pains, limitations and fears about the future — you have new needs that your previous life did not have. These needs are often unrecognized and unmet. They include the need to have emotional distress soothed, to be lifted up, to be comforted (physically and emotionally) and to adapt your life to serve your ambitions within new limitations. 
These are needs we can spot in a heartbeat in others — in our children, family and friends. We offer immediate comfort, lift people up, sooth them when they are upset and offer numerous solutions to help them get on with life. All without anger or frustration.

I tell all of my patients that their road to recovery — and by this, I mean a return to meaningful living — starts with loving themselves and rejecting all negative feelings towards themselves.

I ask them to respond to their own anger and distress as they would to their child’s or friend’s. Only allow positive and accepting perceptions of themselves. If they need to cry and stay in bed for a day — so be it — there is no shame in needing to wallow once in a while. But, be sure that they are listening for their needs and meeting them, rather than hiding away from themselves.

The prescription I provide is both simple and extra-ordinarily difficult for people to start, but the formula is easy to remember:

Pause,

Listen to your needs

then

Self-compassion

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