Self-Compassion in Chronic Illness
A dose of kindness for improved health.
Posted August 10, 2018
It’s easy to like ourselves when things are going well in our lives. We feel competent, friendly, smart and upbeat. When we’re struggling with illness, though, our self-esteem can plummet. We may see ourselves as slow, irritable, unlovable and stuck. Research shows that maintaining positive feelings about ourselves during illness flares can improve both physical and mental well-being. This month’s “Chronically Me” post explores this research and offers tips on how to cultivate and maintain self-regard in difficult circumstances.
Self-compassion is defined as a positive self-view that encompasses relating to oneself with kindness and acceptance in times of difficulty. Dr. Kristin Neff, preeminent self-compassion researcher, notes three key features that comprise self-compassion: self-kindness, common humanity, and mindfulness.
Living with chronic illness offers a constant temptation to self-blame. When illness flares, we may reproach ourselves for getting sick. “If only I took better care of myself . . . “ “Why did I overdo it at work last week?” “If I can’t calm my stress levels, then it’s no wonder my disease is active.” Sound familiar? And then there is the further self-criticism about all the things we can’t do when we feel sick. “My house is a mess.” “I’m behind on my work; I’m so stupid.” “Nobody would want to be around me; I’m just a lump on the sofa.”
What if we try something different and treat ourselves with acceptance? Instead of chastising ourselves for everything we’ve done wrong, we could try to understand it. “I do tend to overdo things in a way that exacerbates my illness. Sometimes I just so want to be ‘normal’ that I forget my limitations. I’ll try to take better care of myself in the future, but I can feel empathy for the part of myself that wants to do everything.” “I feel so blah when I’m sick, and that’s okay. I can’t expect myself to be energetic and cheerful when I’m hurting.”
Warning: Don’t start criticizing yourself for not mastering self-kindness right away! This is a process that ebbs and flows and generally gets more assured with lots of practice. So when your inner voice tells you that you’re horrible at self-kindness, just notice it and say, “I’m a work in progress, and I’m practicing something hard.”
Another important component in developing self-compassion is maintaining a belief that painful experiences are part of the human condition and that we are not isolated in our suffering. While we know that pain and loss are part of the fabric of every person’s life, it can be easy to forget this when we are in the throes of our own suffering. During the fall of my senior year, I had to withdraw from college due to illness. Thirty years later, I can still call up the memory of being driven away on a breathtakingly beautiful September afternoon, catching a last glimpse of my classmates enjoying life on the campus green. The loneliness of isolation with its bitter accompaniment of “Why me?” is - for me - one of the most painful experiences associated with illness. I have come to understand “common humanity” not as trying to drive away the feeling of being cast out of the human race; but rather, as attempting to know in my bones that this forsaken, broken feeling has been and will continue to be experienced by all of those who suffer. Paradoxically, it is comforting to know that I have company in isolation.
Finally, self-compassion is cultivated by attention to mindfulness, defined as taking a balanced view of one’s negative emotional states rather than becoming embroiled with them. Importantly, mindfulness does not mean ignoring or denying our negative feelings. On the contrary, it’s important that we pay attention to them. What mindfulness asks of us is that we not get stuck in those feelings. When sadness overtakes us, for example, we need to feel the ache in our chest and the darkness in our mind. We say, “Here is sadness. It is a feeling that is part of being human and eventually it will pass.” We try not to chastise ourselves for feeling sad or cling to the false belief that sadness will last forever. We simply sit with it and breathe.
We know that self-compassion is linked to lower stress levels, increased resilience, and adaptive coping. We know that it’s been positively shown to improve well-being in people living with chronic illnesses including IBD, diabetes, and arthritis. Here’s the thing: Self-compassion is not something we pull out when we’re ill and forget about during our relatively well periods. Rather, it’s a way of being that radically changes how we see ourselves at all times and in all dimensions of our lives. We want to be practicing it every day so that when the going gets really tough we will be rooted in it as we face our challenges. So let’s start now with some small changes that can have large effects.
*Self-kindness: Find a self-kindness mantra that you can pull out when you start to self-criticize. “Nobody’s perfect.” “All will be well.” “This too shall pass.” “I’m only human.” “I’m choosing to give myself a break.”
*Common humanity: Find small ways to experience connection with the people around you. Make small talk with the check-out person at the grocery store. Smile at someone in the elevator. Let that car merge in front of you during rush hour. Practice empathy for others, trying to understand what it may be like to be in their shoes.
*Mindfulness: Meditate! It works so well that we’d all take it if it came in a pill form. The good news is that it’s not too difficult to work into our daily lives, as smartphone apps and websites offer a variety of short and lengthier guided meditations. If that feels like too much just now, take a few deep, intentional breaths when you think of it, noticing with pleasure the air moving in and out of your lungs.
Do these sound like changes you can make in your life? Please feel free to report your experiments with self-compassion in the comments below.
Ferrari, M., Dal Cin, M., & Steele, M. (2017). Self-compassion is associated with optimum self-care behaviour, medical outcomes and psychological well-being in a cross-sectional sample of adults with diabetes. Diabetic Medicine, 1–8.
Sirois, F.M., Molnar, D.S., & Hirsch, J.K. (2015). Self-compassion, stress, and coping in the context of chronic illness. Self and Identity, DOI: 10.1080/15298868.2014.996249
Sirois, F.M. & Rowe, G. (2016). The role of self-compassion in chronic illness care. Journal of Clinical Outcomes Management, 23(11), 521-527