Morning Bells

Stop “Should”ing All Over Yourself: The field of self-compassion and implications for treatment of eating disorders


by Rachel Guerra · Camden Matherne, PhD

“I should be a better mom;” “I should recover faster;” “I shouldn’t need help with [insert myriad things here]”… these are the comments I hear every day from family members, friends, and patients… (and let’s be honest, sometimes I “should” on myself too!). This is the type of mindset that our “pull yourself up by your bootstraps, you can do anything if you put your mind to it” culture and societybreeds. Redirecting these self-judgmental statements is what the self-compassion movement is all about. More broadly, in the words of Kristen Neff, one of the prominent researchers in the self-compassion field, self-compassion is “acting the same way towards yourself (as you would another) when you are having a difficult time, fail, or notice something you don’t like about yourself. Instead of just ignoring your pain with a “stiff upper lip” mentality, you stop to tell yourself “this is really difficult right now,” how can I comfort and care for myself in this moment?” For a lengthier definition of self-compassion, check out Dr. Neff’s website.

My common experience as a therapist is that many of my patients struggle significantly with demonstrating self-compassion. Patients often tell me they feel that, on some level, it’s their fault for developing an eating disorder and go on to describe experiencing much guilt and shame related to their symptoms. Science backs up this clinical experience—individuals with eating disorders are more likely to be self-critical and less likely to express self-compassion than with women without eating disorders. Notably, patients who become more self-compassionate early in treatment have a greater reduction in disordered eating behaviors than those who do not. Importantly, self-compassion may also be protective against some of the known risk factors for eating disorders, such as poor body image and cultural pressures for thinness. Among individuals with and without eating disorders, those with higher self-compassion report lower levels of disordered eating symptoms. All of this research indicates that self-compassion could be an important target to consider for both prevention and treatment of eating disorders.

In the treatment arena, researchers have developed compassion-focused therapy(CFT), which specifically targets reducing self-criticism and shame and improving overall emotion regulation in the treatment of mental illness. Recently, CFT has been adapted for the treatment of eating disorders, and this focused therapy aims to help patients understand the relationship between eating and emotions, develop self-compassion regarding disordered eating symptoms and their effects, and become more motivated for effective self-care. So far, the few published studies indicate that adding a compassion-focused aspect to treatment reduces disordered eating behaviors in a clinically significant, or meaningful, way.

To sum it up, the concept of self-compassion seems important to the eating disorder field (and our overall psychological health). Interested in learning more, or ready to try developing more self-compassion? Check out the exercises at Dr. Neff’s website or at the website for the Center of Mindful Self-Compassion.

References:

Braun, T. D., Park, C. L., & Gorin, A. (2016). Self-compassion, body image, and disordered eating: A review of the literature. Body image17, 117-131.

Steindl, S. R., Buchanan, K., Goss, K., & Allan, S. (2017). Compassion focused therapy for eating disorders: A qualitative review and recommendations for further applications. Clinical Psychologist21(2), 62-73.