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Case Study - Page 7

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Exploring habitual self-states will almost always bring up self-judgment and shame. Shame comes from a deep-seated fear that the underlying vulnerability (around which the painful self-state was created) reflects a fundamental inadequacy. Most people spend much of their lives running from their underlying vulnerabilities and the rejection they imagine coming from other people who might witness them. Self-judgment emerges both from our resentment of the habitual patterns that cause us pain and as a way to attack ourselves before someone else can criticize or reject us for our weaknesses.

Because the dynamics of shame and self-criticism are so strong when working with core-level vulnerabilities, mindfulness-based therapy must promote self-compassion. We have two main tools with which to do that. First, we seek to help clients learn how the habitual self-state originated as a response to difficult dilemmas. As Suzanne became aware of how impossible it had been for her as a young child to deal with sudden losses and a lack of parental soothing, she could bring compassion to this younger, more vulnerable part of herself. She learned that when the habitual self-state showed up (which she could now identify through the accompanying bodily experience and behavioral/cognitive patterns), these core vulnerabilities were asking to hear her own kind voice and feel her caring. The grueling moments of waiting for the phone call are still not easy for Suzanne, but she’s learned to be gentler with herself, and now dates with far less anxiety. More and more, she views the dating experience as an opportunity not only to start a romance, but also to develop a more solid sense of herself.

The second tool we have to promote self-compassion in our clients is our own compassionate presence. The practice of mindfulness isn’t inherently compassionate—it can be plagued with disinterest, dissociation, and negative self-judgments. Here, the therapist plays a crucial role. I believe that clients actually model the feeling tone of their own mindfulness around the feeling tone of their therapist’s voice. Because mindfulness-based therapy can take clients so deep into core-level experience, the therapist’s compassionate presence profoundly impacts how clients come to observe their inner world.

In essence, the therapeutic task is to model compassion and understanding as we guide clients through their pain-filled internal landscapes, learning how previous self-states were adaptive for earlier life stages, no matter how much distress they may have produced. We must recognize that all these landscapes—no matter how dangerous, strange, frightening, or sad—are always part of our common geography, the places we’ve all visited at one time or another. Longing for intimacy, pulling away from people, getting needs met in self-destructive ways, shielding our hearts—we all share these all-too-human states. For exploring these wilder shores of the self, we can take no more promising a journey of discovery than in the vessel of our own mindful body awareness. Our great privilege is that we, as therapists, have the opportunity to guide our clients on these journeys.

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