Mindful Self-Compassion for Caregivers

Presenter: Patricia Williams, MSC Facilitator and Clinical Counsellor

Moderator: Kate Landreth, Education Lead with Family Caregivers of BC

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Territory Acknowledgement

Family Caregivers of BC

CAREGIVER SUPPORT

•Support Line: 1-877-520-3267

• Informational, referral & navigation

•Support groups

•Caregiver coaching

•Online resource centre

•Virtual support circle

EDUCATION

•Resource library: webinars and podcasts

•Newsletters publications, e-news, articles and blogs

•Support group facilitator training

•Outreach to community groups

ENGAGEMENT AND

COLLABORATION

•Caregiver engagement quality improvement health policy

•Participation in health committees

•Collaborations: condition specific org, health authorities, Ministry of Health research, etc.

•Non-profit charity dedicated to the well-being of family caregivers.

•Serving across B.C. since 2010, with the past 5 years as part of the Ministry of Health’s Patients as Partners Initiative.

•Three pillars: caregiver support, education and engagement and collaboration.

www.familycaregiversbc.ca

WELCOME & GRATITUDE

“Mindfulness is about being fully awake in our lives. It is about perceiving the exquisite vividness of each moment.”

Jon Kabat-Zinn

2020-11-19 Patricia Williams: www.heartworkarttherapy.com 5

Overview

• What is Mindful Self-Compassion?

• Review of Research: Self-Compassion, Burnout and Caregiver Resilience

• The Physiology of Self-Compassion

• Practice 1: The Self-Compassion Break

• Practice 2: Compassion With Equanimity (Compassionate Breathing)

• Summary

• Q & A

What is Mindful Self-Compassion?

The “Problem” with Self-Care

• Extremely important (exercise, eat well, time with friends, vacations, etc.)

• But self-care happens outside of providing care, not while caregiving

• Can’t say to the person you are caring for, “Whoa, man, this situation is just TOO MUCH!”…. I think I’ll go get a massage!”

• Can calm yourself -> calms the person you are with…

• Self-Compassion can happen in the moment…while providing care!

Mindful Self-Compassion

• A decade of research by scientist Kristen Neff consistently shows if we are compassionate toward ourselves then we are much less likely to be depressed, anxious, and stressed…

• AND we are much more likely to be happy, resilient, and optimistic about our future

• In short, we have better mental health.

Mindful Self-Compassion:8-Week Program

• Skill training based on a large body of empirical research

• Developed by Kristen Neff & Christopher Germer

• 8-Weeks (2.75 hours) + ½ Day Retreat

• Includes:

• Topics & discussion & exercises

• Experiential practices

• Formal & Informal meditation

• Home Practice & a silent retreat

• The Mindful Self-Compassion Workbook

Mindful Self-Compassion:8-Week ProgramOBJECTIVES

• Decreases self-criticism, anxiety, depression, shame

• Enhances well-being and emotional regulation

• Motivates with kindness not criticism

• Transforms challenging relationships

• Reduce risk of compassion fatigue & burnout

Mindful Self-Compassion

• MSC also = the inner resources & resiliency we cultivate based on the insights and practices outlined in the program.

• LEARN to give ourselves compassion when struggling

• KEY: a strength we call on when we are suffering – not a fair-weather friend!

How Do We Respond?

• What sound might you make if you saw this sad babe?

• What are you thinking & feeling?

• What would you want to do?

What is Compassion?

Compassion for others:

1. Notice they are suffering

2. “Suffer with” them and want to help – offer kindness and understanding when they fail, not judgment

3. Recognize suffering, failure and imperfection are shared by all humans

What is Self-Compassion?

• Acting the same way you do to others when you are falling short, failing or notice something you don’t like about yourself

• Rather than ignoring your pain, you say, “This is really difficult right now…how can I comfort and care for myself in this moment?”

• It is made up of 3 Elements

Self-Compassion: 3 Elements

2020-11-19 Patricia Williams: www.heartworkarttherapy.com

SELF KINDNESS

• Warmth

• Kindness

COMMON HUMANITY

• Not alone

• Everyone suffers

MINDFULNESS

• Awareness

• Acceptance

First Component of Self-Compassion

Self-Criticism Self-Kindness

Second Component of Self-Compassion

Isolation Common Humanity

Third Component of Self-Compassion

Over-Identification

Or Avoidance Mindfulness

Yin & Yang of Self-CompassionTwo Ways of Caring

• Yin of SC = “being with” ourselves – comforting, soothing, validating

• Yang of SC = “acting in the world” – protecting, providing, & motivating ourselves

• Yin = nourishing

• Yang = courage & strength

• Need nourishment of yin before go into world with courage and strength - yang

“Strong back, soft front” Halifax, 20122020-11-19 Patricia Williams: www.heartworkarttherapy.com 20

Self-Compassion involves kindness, common humanity & mindfulness.

In other words, self-compassion means being in a state of loving, connected

presence.

Review of the Research:Self-Compassion Burnout

Caregiver Resilience

Review of Research

• Research uses Neff’s SC Scale and an 8-week Mindful Self-Compassion (MSC) training

• Low SC scores -> mental health challenges

• As SC increases -> mental health improves

Research ResultsMindful Self-Compassion• reduced anxiety & depression• Improved well-being • Increased life satisfaction• Improved social connection

Research Results• Manage the aging process

• Transform difficult & romantic relationships

• Transform Sense of Self

• Reduce body shame, enhance self worth & body image

• Increase intrinsic motivation (healthy lifestyle)

• Reduce Compassion Fatigue/Burnout

Compassion & Caregiving

For someone to develop genuine compassion towards others, first he or she must have a basis upon which to cultivate compassion, and that basis is the ability to connect to one’s own feelings and to care for one’s own welfare… Caring for others requires caring for oneself.

~ Tensin Gyatso, 14th Dalai Lama ~

Circle of Compassion

• What we have compassion for within the self, we have compassion for outside the self.

• What we reject in the world, we also reject within ourselves.

• We cannot ignore the suffering of other people because they are part of us.

• Disconnect from suffering of others…disconnect from self.

“Caring for Others Without Losing Yourself”

• Self-Compassion for Healthcare Communities (SCHC) = a short adaptation of MSC Program

• Also supported by research

• Learning to be more self-compassionate seems to reduce caregiver stress

• Lowered stress increases wellbeing

• Reduces empathy fatigue & burnout

• Relevant for family and volunteer caregivers

“Caring for Others Without Losing Yourself”

• Self-Compassion for Healthcare Communities (SCHC)

• Designed to enhance wellbeing & reduce burnout

• Results (2 Studies): • Significantly increased SC

• Significantly increased wellbeing

• Significantly reduced secondary traumatic stress

• Significantly reduced burnout

• Self-Compassion explains the other gains

• Those with low levels of SC benefit more

Burnout

• Chronic stress + emotionally intense work + inadequate resources

• SC training reduces risk of burnout:

1. INCREASE SC, mindfulness, compassion to others, compassion satisfaction & feelings of personal accomplishment

2. DECREASE stress, depression & measures of burnout (i.e., emotional exhaustion, depersonalization, and secondary traumatic stress)

Burnout is prevalent among caregivers and self-compassion is a proven buffer against

burnout.

Compassion Satisfaction

• Goal is to reduce emotional depletion and increase a sense of accomplishment and satisfaction in your caregiving role.

• Compassion satisfaction – satisfaction in your caregiving role - not only feels good but is a powerful buffer against burnout.

• Self-compassionate people are more compassionate toward others.

Research on Partner Caregivers

• Caregivers at risk for depression and other mental health issues, reduced Quality of Life (QoL)

• Higher rates of depression associated with # of hours of caregiving, lower QoL, lower self-compassion

• SC reduces risk of issues above and promotes caregiver seeking medical help + exercise (both help depression)

• SC = bounce back from stressors faster than low SC

• Conclusion: “developing SC in partner caregivers may help to improve outcomes for both the caregiver and the care recipient.”

Yoga & Compassion Meditation: Family Caregivers of People with Alzheimer’s

• Positive Impact on:

• Quality of Life

• Vitality – important because workload so high

• Attention

“Dare to give yourself the care you give to others.”

Women tend to be less self-compassionate than men (feel more isolated & self-judgmental) and often have the role of Family Caregiver, so increasing self-compassion practice might counter that gender bias.

Empathy & Compassion:Social Emotions

• Empathy = the capacity to share +/- feelings of others

• Empathic response to suffering – 2 types of reactions:

• 1. Empathic distress: feeling WITH the other

• Self-related, aversive

• Negative emotion (stress)

• Poor health & burnout,

• Withdrawal (non-social behavior) to avoid neg. emotion

• 2. Compassion: feeling FOR the other

• Other-related concern

• Positive feelings (love, desire to help)

• Good health

• Approach (prosocial motivation)

Empathy Training vs. CompassionTraining

• Neuroscience shows an overlap in brain networks between experiencing our own pain and observing another in pain

• Empathy & Compassion training change different (non-overlapping) brain networks!

• Empathy training may lead tonegative affect

• Compassion training produces positive affect, resilience, enhanced coping – precisely what caregivers need!

Good News!Compassion can be Learned

• Several weeks of Loving Kindness Meditation (Compassion meditation)

• Increased brain activation in compassion area (neuro plasticity)

• Improved mood & well-being

• Increased resilience (coping)

• Increase in true altruism

• Fostered compassion for distress of others

• Recognize the difference between empathic distress & true compassion.

• Cultivating compassion & developing compassion satisfaction is an important key in being able to continue caregiving without burning out!

Good News!Compassion can be Learned

The Physiology of Self-Compassion

2020-11-19 Patricia Williams: www.heartworkarttherapy.comThis Photo by Unknown Author is licensed under CC BY-NC 40

The Physiology of Self-Criticism

• Self-criticism VERY different impact on body chemistry!

• Threat -> amygdala signals fight-or-flight -> increased blood pressure, cortisol and adrenaline

• Body response the same whether threat is external or internal (i.e., emotional attack by the inner critic)

• Self-compassion changes body chemistry by raising oxytocin, lowering cortisol and calming cardiovascular system

Self-Compassion through gentle touch activates the mammalian caregiving system.

Calms tension, painful thoughts and feelings…AND soothes our body chemistry.

Can be done unobtrusively…while caregiving!

Practice 1: The Self-Compassion Break

Self-Compassion Practice

• Caution: Back Draft & Self-Care

• The Self-Compassion Break ~ 3 Parts:

• This is a moment of suffering.

• I am not alone.

• What do I need right now?

• Sharing in Dyads and Group

Practice 2: Compassionate Breathing

(Compassion With Equanimity)

Compassionate Breathing

• An exercise for caregivers

• Used within the caregiving situation

• Encourages compassion for self & other

• Promotes connection

• Promotes equanimity = “balanced awareness in the midst of pleasant or unpleasant emotions”

Equanimity• Mindfulness leads to equanimity which leads to wisdom.

• Mindfulness gives us the space to see the complex, interdependent causes and conditions that make our lives as they are, the the wisdom that we have limited control.

• Equanimity gives us the emotional space to be compassionate while remaining in connection with others – engaging fully but understanding the limits of our capacity to control the outcome of our actions.

• Equanimity is not cold detachment, but arises from deep understanding of the transient, interdependent nature of reality.

• It is a different kind of caring, based on both emotional intimacy and wise discernment.

Equanimity Phrases

Everyone is on their own life journey.

I am not the cause of this person’s suffering,

nor is it entirely within my power to make it go away,

even though I wish I could.

Moments like these can be difficult to bear,

yet I may still try to help if I can.

Summary

• MSC = self-kindness + common humanity + mindfulness

• MSC/SC Research: • Increases resilience, mental health, wellbeing, QoL, compassion for

self/others, positive relationships, & compassion satisfaction• Decreases stress, anxiety, depression, burnout & empathy fatigue

• Self-Criticism = threat -> impacts the body

• Self-Compassion = safety -> counteracts at neurochemical level -> activates mammalian caregiving system

• Self-Criticism impacts the body & Self-Compassion counteracts it at a biochemical level

Summary

• Self-care happens away from caregiving situation…

• Self-compassion happens while caregiving – eases suffering & enhances compassion satisfaction.

• The Self-Compassion Break & Compassionate Breathing can be done anytime, anywhere…in the moment that you are struggling.

• “A moment of self-compassion can change your entire day. A string of such

moments can change the course of your life.” – Chris Germer

• Caregiving is challenging!• Self-Compassion lessens the risks, builds inner resources &

emotional strength.• MSC is empirically proven to help!• Replace empathic distress with compassion satisfaction to

reduce burnout.• Self-care is essential, but hard to practice while caregiving.• Self-compassion is designed to be used in the midst of

struggle…while offering care to another.

Recommendations

• Practice self-care that works for you!

• Enhance personal resources (compassion, mindfulness, positive coping strategies)

• Build compassion satisfaction – seek support to restore joy in role as a helper

• Practice Self-Compassion Break &“Compassionate Breathing”

• Practice gratitude and savoring the things you love

Questions

www.familycaregiversbc.ca532020-11-19 Patricia Williams: www.heartworkarttherapy.com

Useful resources

Resources

Evaluation

How to contact us

Family Caregivers of BC

www.familycaregiversbc.ca

1-877-520-3267

Monday-Friday 8:30 am -7pm

FAMILY CAREGIVERS SUPPORTS & EDUCATION

Caregiver Resources

• FCBC Toll-Free Support Line

• FCBC Caregiver Connection Newsletter

• FCBC Monthly Enews• Caregiver Tips and Tools

(webinars, articles, podcast, booklets)

• FCBC Social Media (FB Lives and YouTube Channel)

Book References

• Neff, K. (2011). Self-compassion: The proven power of being kind to yourself. New York, NY: William Morrow: An Imprint of HarperCollins Publishers.

• Germer, C. (2009). The mindful path to self-compassion. New York, NY: Guilford Press.

• Gilbert, P. (2010). Compassion-focused therapy. New York, NY: Routledge.

• Neff, K. & Germer, C. (2018). The mindful self-compassion workbook: A proven way to accept yourself, build inner strength, and thrive. New York, NY: Guilford Press.

Websites References

• Neff, K. (2016). Self-Compassion. Retrieved from: http://self-compassion.org

• Chris Germer’s website: https://chrisgermer.com/meditations/ includes fre, downloadable meditations, including the core meditations found in the MSC program

• Germer, C. (2016). Mindful self-compassion. Retrieved from: http://www.mindfulselfcompassion.org

• Germer, C., et al (2016). Center for mindful self-compassion. Retrieved from: http://www.centerformsc.org/who_we_are

• Center for Mindful Self-Compassion website: https://centerformsc.org/ CMSC has research articles, free meditations and much more!

• Insight Timer is a free app that has thousands of meditations related to mindfulness, self-compassion and includes some of the MSC meditations included in the training.

Journal Articles References

• Baum, J. (2016). Compassion Fatigue: Caveat Caregiver?. Children's Rights Litigation, 18(2), 7-12.

• Neff, K. D., & Dahm, K. A. (2014). Self-Compassion: What it is, what it does, and how it relates to mindfulness (pp. 121-140). In M. Robinson, B. Meier & B. Ostafin (Eds.). Mindfulness and Self-Regulation. New York: Springer. Retrieved from: http://self-compassion.org/wp-content/uploads/publications/Mindfulness_and_SC_chapter_in_press.pdf

• Thompson, I. A., Amatea, E. S., & Thompson, E. S. (2014). Personal and Contextual Predictors of Mental Health Counselors' Compassion Fatigue and Burnout. Journal Of Mental Health Counseling, 36(1), 58-77.

• Singer, T, & Klimecki, O. L., Empathy and compassion. Current Biology, 24(18).

• Hlabangana, V. & Hearn, J. H. (2019).Depression in partner caregivers of people with neurological conditions; Associations with self-compassion and quality of life. Journal of Mental Health. DOI 10.1080/09638237.2019.1630724

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