Compassionate Mind Trainingapi.ning.com/.../LP12CompassionateMindV2.pdfCompassionate Mind (For FNP Supervisors and Family Nurses) Team Based Learning Pack 12 ... “We can still be

Compassionate Mind(For FNP Supervisors and Family Nurses) Team Based Learning Pack 12

Produced by the UK FNP National Unit, Tavistock and Portman NHS Foundation Trust Restricted to use by FNP licensed teams only

DH INFORMATION READER BOX

Policy Estates HR/Workforce Commissioning Management IM&T Planning Finance Clinical Social Care/Partnership Working

Document purpose Best Practice Guidance

Gateway reference 15789

Title Family Nurse Partnership guidance

Author Family Nurse Partnership

Publication date April 2011

Target audience NHS teams implementing and delivering FNP – commissioners, providers, managers, supervisors, nurses, administrators and psychologists

Circulation list

Description Family Nurse Partnership guidance

Cross-reference

Superseded docs

Action required N/A

Timing N/A

Contact details Family Nurse Partnership

For recipient’s use

© Crown Copyright 2011 for use within FNP sites Reproduced with kind permission by Department of Health

Compassionate Mind Training

Acknowledgement�

This learning pack was developed for FNP teams by

Michelle Cree�Consultant Clinical Psychologist

Derby Perinatal Mental Health Service

The FNP National Unit would like to express their thanks to Michelle for all the work she has put into both the training and the development of this learning pack.

Michelle also wishes to acknowledge that Compassionate Mind Training was developed by Professor Paul Gilbert, a Clinical Psychologist, and Head of the Mental Health Research Unit in Derby. His model and practice of CMT is explained in detail in the excellent and highly readable

“The Compassionate Mind” published in 2009 by Constable.

“We can still be crazy after all these years. We can still be angry after all these years. We can still be timid or jealous or full of feelings of unworthiness. The point

is….. not to try to throw ourselves away and become something better. It’s about befriending who

we are already”.�

Pema Chodron in “The Mindful Way to Self-Compassion” (Germer, 2009).

© Crown Copyright 2011 for use within FNP sites Reproduced with kind permission by Department of Health


Introduction�

The approach of this learning pack

The assumption behind the Compassionate Mind Approach is that we all have the same basic brains and that any of us could potentially be in the same shoes as another person given the same cocktail of genetics, and external influences. The theory thus applies to all of us, whether we are the supervisor, the family nurse, the parent, or the baby.

This pack is therefore written for all four groups:

1. Supervisor

2. Family Nurse

3. Parent, with the Family Nurse

4. Baby, with the parent

rather than being separated into a different learning pack for each group.

The aim is that you will take this learning pack as a gift for yourself, first of all, for you to revisit and absorb the theory introduced to you in the masterclass, practice the exercises for yourself and become comfortable with the framework. You can do this individually, or in your teams, or both. Once you have made yourself familiar with the approach and techniques, we hope you will try offering the approach and exercises to those clients you feel will benefit from support to look upon themselves and their babies with compassion and kindness, and develop self soothing techniques that work for them.

Please note:

The use of this approach within FNP is experimental and, as such, we are keen to learn from you about how well this approach fits with your practice in FNP, the programme itself and what sense your clients make of it. We would like to work with you to develop any client materials you think would be helpful to you and will be asking for feedback on your use of the Compassionate Mind so that we can consider the integration of it as an augmentation to the FNP programme.

© Crown Copyright 2011 for use within FNP sites Reproduced with kind permission by Department of Health 2


Compassionate Minds: The flow of relationships

•� Parents who feel supported and cared for by others, are more likely to be caring and supportive of themselves, which in turn makes it easier for them to be caring and supportive of their babies. We know too that babies who grow up in caring and supportive environments are more likely to develop their own compassion to others and themselves.

•� We can think of compassion as a kind of flow: Compassion is felt and expressed by the nurse, which is experienced as soothing and helpful by the parent, which is in turn communicated to the baby via the mother’s general ‘soothed’ and calm parenting.

•� The process starts with oneself, so each exercise is aimed at developing awareness in the individual doing it, rather than thinking about it in relation to teaching it to somebody else.

•� However, compassion for ourselves and others is not always easy – indeed it can be tough at times.

•� The exercises are therefore designed to be understood at an emotional or “felt” level as well as at an intellectual level. Once there is this “felt” understanding then it makes it much easier to be able to teach it to somebody else.

•� For this reason it is advised that teams work together on this pack and support each other to understand and experience the approach for themselves, before using it with clients.

•� As the Supervisor and Family Nurse shift in their view of themselves, this then creates a change in the system which ripples all the way down to the baby. As we shift to a more compassionate view of ourselves it changes how we view and relate to others. We will see how even the tiniest changes in our facial expression or voice tone are detected instantly by people we are with and their brains are hard wired to respond to this.

Through the individual and team exercises you will become more familiar with the approach and more confident about using it with clients. Your experience of grappling with the ideas and the exercises will guide how and who you choose to use the approach with. Being thoughtful about when and how to integrate the Compassionate Mind Approach into visits will be vital to ensure that it is experienced as helpful by clients.

Most crucially it is essential that it doesn’t ‘take over’ the expected, and important, usual visit content. Rather the introduction of this approach into FNP is intended to enhance the quality of the therapeutic relationship between client and nurse, optimizing the potential for all clients to engage with and get the most out of the content of the programme.



Compassionate Mind Training in Three Parts

1.� The First Part of developing our compassionate mind is to develop an understanding and compassionate acceptance of our amazing, but often difficult brains, and realise that a considerable amount of how we feel, think, and behave is not of our choosing, is “not our fault”. This part is more educational.

2.� The Second Part is about consciously and deliberately changing the way we relate to ourselves through exercising a particular part of our brain associated with kindness, safeness and soothing. It is practice and exercise based.

Clients are likely to need different levels of CMT depending on their own experiences. Some will respond very well to part one and will get the hang of part two very rapidly. Some will need a great deal of practice of part two but understand the model and just need to tone up their “compassionate mind”. Others however, will have a real fear of becoming compassionate to themselves. They are likely to show resistance and wariness of the model.

3.� The Third Part: “Troubleshooting Resistance or Blocks to Self-Compassion” addresses some of the reasons for this fear, and gives suggestions for helping clients to move through it. You may well be faced with some of these issues right from the outset so familiarity with part three would be useful before you start.

In summary the learning pack will be organised into these three sections:

•� Part One Understanding Our Brain

•� Part Two Strengthening Our Compassionate Mind: A Complete Workout

•� Part Three Troubleshooting: Resistance or Blocks to Self-Compassion



The Structure of The Learning pack:�

PART ONE: UNDERSTANDING OUR BRAIN� 8�

Module One: Understanding Our Emotions 9�Topic One Old brain, new brain 9�Topic Two The three circles 10�Topic Three How the three circles work together 15�Topic Four The power of the soothing system 16�Topic Five How to balance the three circles: a gym workout for the brain 19�

Module Two: Self Criticism, Self-Compassion 20�Topic One The voice on your shoulder: Bully or Friend? 20�Topic Two Self criticism as our bodyguard: keeping us safe from rejection 28�

Module Three: How Our Own Environment Shapes Our Emotions 31�Topic One Emotional conditioning: How different feelings become linked 31�Topic Two How we learn to protect ourselves: Safety strategies 34�Topic Three Unintended consequences: When safety strategies become a hindrance 35�Topic Four Formulation: Bringing our experiences together 36�

PART TWO:� STRENGTHENING OUR COMPASSIONATE MIND: A COMPLETE WORKOUT 40�

Module Four: What Do I Need To Work On To Strengthen My Compassionate Mind? 41�Module Five: Compassionate Attention 47�Module Six: Compassionate Imagery 54�Module Seven: Compassionate Thinking 65�Module Eight: Compassionate Behaviour 70�Module Nine: Compassionate Feelings 72�Module Ten: Compassion All Around: Using All Of The Senses 74�

PART THREE:� TROUBLESHOOTING: RESISTANCE OR BLOCKS TO SELF-COMPASSION 78�

I don’t deserve to be kind to myself 78�Fear of kindness triggering overwhelming emotions 80�When kindness feels horrible 81�Kindness might make me vulnerable 82�Can I really change my brain? 83�

THE KEY STEPS� 84�



GETTING STARTED

THE NACC APPROACH (Notice, Accept, Compassion, Change) A four-step approach called NACC is used throughout the learning pack as a way of reinforcing the gentle shift to a more compassionate mind:

Step one: Notice

Step two: Accept and understand

Step three: Compassion and kindness

Step four: Change

Step One: Notice

•� The first step is to start to notice the way we think, feel, and behave so that we bring it to our attention.

•� We are often at the mercy of our emotions and just get “swept along” by them as if we are in a fast-moving river.

•� Once we become more aware of them we can then think about how we relate to these emotions.

Step Two: Accept and Understand

•� The Compassionate Mind approach helps us to understand that many of our emotions just “flush through” us before we have a chance to think.

•� We may at times feel sad, frustrated, angry or ashamed that we reacted in a particular way but our first flash of emotion is “not our fault”, an important saying in this work.

•� This does not mean that we shed all responsibility for our actions however. Instead, by noticing and accepting them, we no longer try to block out or ignore difficult emotions. Instead we enable ourselves to bring them out in the open where we can try to understand them better.

•� From awareness and understanding flows validation of our experiences and emotions, and helps us to relate to ourselves with compassion (step three).

•� This in turn helps us to consider what we could do to help us to move on and develop from this point (step four).



Step Three: Compassion and Kindness

•� By adding compassion and kindness to this acceptance of ourselves it encourages warmth and a kind of softening towards ourselves.

•� It helps to “turn up” the care-giving, compassionate part of ourselves which can then sooth us and help us to move forwards and develop.

•� It can be imagined as a kind smile towards ourselves, or as a gentle hand on our shoulder.

Step Four: Change

•� For many, the first three steps are enough, and people can experience a great relief in being able to understand themselves, and accept themselves as they are. This is a significant change in itself.

•� However, others may decide that they would like to be able to behave, think, or feel a little differently.

•� This stage is thus a more active stage where an individual deliberately works at and practices moving into their compassionate mind as much as possible. This is really the “training” part of “Compassionate Mind Training”.

•� Another way of thinking about this is imagining building up muscles at a gym. In this case the “muscle” is compassion and kindness. The more a muscle is worked the stronger it gets.

•� As soon as the training stops the muscle starts to get weaker. This is therefore a life-long endeavour.



Part One: Understanding Our Brain�

Introduction

This part of the pack explains the whole Compassionate Mind model and sets you up for all of the work that you do with it from here on in. We would recommend that teams work through this in one session as it reminds you of the direction of travel; the answer to the “so I understand now why I am like this, now what?” It can be covered at a push in an hour, but if it grabs people (which hopefully it will) then it may bring up a flurry of questions, so it may be best to allow a couple of hours for this module. It may take longer than this the first few times you work with it.

Once you have worked through this section for yourself, or as a team, we would recommend that you begin to introduce the model to clients. The materials in this section have been reproduced for clients as educational materials and facilitators that will help you to explore the model with them. Throughout the text of this learning pack we have introduced the connection of this material to clients and infants, to help you see how you might use the materials with clients.

Starting off with clients: It may be hard to explain the model to your clients when you perhaps don’t feel familiar enough with it. Being honest about this with your client allows you to start to have a go. It may also reduce the power difference between you. It might help to say that you are learning a new model that you would like to share with them, because from what they have told you, you think it might help. You can explain that you are only just getting the hang of it yourself but you could both try and work it out together if they would like. This sets it up right from the start as a collaborative process and sets the tone accordingly. It may be that the paragraph below may help you to introduce the approach to a client.

Introduction to the Compassionate Mind approach

Life can bring us great joy, but it can also throw things at us that can unsettle us or really unseat us. Much of this we cannot control no matter how much we might try to do so. We can however learn how to respond differently both to these difficult times and to ourselves as we struggle to cope.

Having a compassionate focus is one way to learn how to cope with the tough times. When things are hard it is easy for us to lose our perspective, then feel inadequate and become self-critical. However, though sometimes well-intentioned, self-criticism can make us feel much worse. So in this approach we are going to explore how and why developing kindness and compassion for ourselves can help.



Module One

Understanding Our Emotions

Topic One: Old Brain, New Brain

Old Brain The key point is that we have a whole set of emotions that we never chose to have. These have been wired into our brains over millions of years, with the main function of just helping us to stay alive long enough to reproduce our genes. These emotions include anxiety, anger, disgust and also joy and excitement.

New Brain Of course we are much more than these basic emotions. What makes us human, and so successful as a species, is the amazing new part of our brain that can imagine, invent things, and think about our own and other people’s minds. But this new brain can also cause us difficulties; it is this bit that criticises us for having all the feelings and reactions that the old brain just flushes through us without our choosing. We might say to ourselves “there must be something wrong with you if you feel panicky when your own baby cries”, or “what an idiot, fancy getting upset over nothing”.

But we can use our ‘new brain’ to help us take a step back, understand how our brain works, and use it to make our brain work a little better for us.

So lets start the “stepping back” by understanding these emotions and how they work in us.



Topic Two: The Three Circles

There are a number of emotion systems in the brain that give us different feelings and are needed by us to do some quite different jobs. They are shown here as three circles. It is of course a lot more complicated than just three circles but it can be very helpful to simplify them in this way.

Three Types of Emotion Regulator Systems

Drive, excite, vitality Content, safe, connected

Wanting, pursuing, achieving, consuming

Activating

Safenesskindness

Soothing

Threatfocused

Protection and Safetyseeking

Activating/inhibiting

Anger, axiety, disgust

We will keep coming back to these three circles as they can be a very helpful way of working out which circle (emotion system) we are in, and importantly, whether it would be better for us if we were able to move into a different system. We will just call them the threat system (red), the drive system (blue) and the soothing system (green) from now on.

Drive Soothing

Threat

© Crown Copyright 2011 for use within FNP sites 10 Reproduced with kind permission by Department of Health


Threat System There are only three basic threat emotions: anxiety, anger and disgust:

1. Anxiety

Exercise:�Imagine you are walking through the woods and you saw some long, snaky looking thing curled up on the floor? What happens in your body?�

Learning Point: (NACC – “Notice”) Your heart probably started thumping and you might have stood still, or wanted to move away carefully. A little while later your new brain might start saying “don’t be daft, there are hardly any poisonous snakes in this country”, but what if you were wrong? Your old brain reacts first, before your new brain can think, because that way it could save your life. It uses the philosophy “better safe than sorry”.

Baby notes: How can you tell when a young child is scared or worried about something, for example if you showed it a scary clown’s face?

The child usually starts moving towards their safe person. Their instinct is to be in mum or dad’s arms. This is wired into a baby’s brain because it is the best way to keep safe from predators.

Keeping safe is more important to a baby even than getting food. This was shown in the “Harlow’s monkeys” experiment. Baby monkeys were taken from their mothers and given the choice of being in a cage which had a teat providing milk, or in a cage where there was no food, just a wire “monkey” wrapped in a towelling blanket. They chose the towelling monkey. This demonstrated the importance of attachment; that the urge to stay close to an attachment figure, usually the mother, was stronger even than getting food. This is because a monkey could survive for a few days without food but could be wiped out in an instant by a predator. This is why your baby has such a strong drive to be near you and be held by you, and will be so upset if he or she can’t see you. The crying is wired in like a baby animal’s cry when it is lost, to bring you to it so that it can stay safe.



2. Anger

Exercise: Close your eyes and imagine someone has made you feel really angry. Where do you feel it in your body? What does your body want to do if you let it?

You could also imagine a cartoon picture of an angry person – what shows you that they are angry?

Learning Point (NACC – “Notice”): You may have a thumping heart again, and similar feelings to anxiety, but you may also notice that you clench your fists, and perhaps your teeth. Your urge might be to hit out or push away, or to use physical force if someone is in the way of what you need. This is another form of keeping you safe from threat by energising you and keeping the threat away from you, or trying to get what you need if you believe nothing else would work.

Baby notes:

Exercise: What do babies and young children do when they are angry?

Learning Point Babies do not display what an adult considers anger until about one year of age, but do have some elements of anger from a few months of age. Anger in a young child or baby is often related to frustration. It is a key emotion in helping a baby to control its environment.

3. Disgust

We also have a way of keeping away from things that might be poisonous or harmful to us if we ate them. Think of your face and what happens in your body if you think about eating something that looks mouldy and slimy. (NACC – “Notice”)

Interestingly we can also be disgusted by people, which may be something that was wired into our brains when we lived in small groups millions of years ago, and had to be wary of “outsiders” who may bring in new diseases to our group. We can also of course be disgusted with ourselves too, which may be a way of keeping an eye on ourselves and making sure we stay acceptable to our “group”.

Baby notes: Babies are born with a dislike of bitter tastes. Disgust for things like faeces and rotting food come later. They also learn what is disgusting from others around them. They therefore rely



largely on us first off to make sure they never eat something that will make them ill, which is why for a while they will happily put a slug in their mouth that they find in the garden although they may spit it out if it tastes horrible.

Drive System The drive system is the energetic, excited, “buzzy” system.

Exercise: Imagine you had just found out you had won £1000. How would you feel in your body? What does your body want to do if you let it?

Learning Point (NACC – “Notice”): Your body is likely to feel full of energy, and might want to jump about. You might have the urge to tell people, to shout and laugh.

Baby notes:

Exercise: How do you know when a baby is excited?

Learning Point:

You can see how babies and young children can’t hold in the excitement; it comes out in their whole body.

This is the system that drives us to eat, get things that we need, do well, achieve, even fall in love. It gives us a “reward” for doing these things by giving us a flush of buzzy feelings, of joy, happiness, excitement and pleasure. The trouble is, it works so well, and we like the feeling so much that it can get a bit out of control, so we might keep on eating, exercising, playing exciting computer games, checking to see if anyone has texted us, buying things, and so on because it gives us that little buzz of good feelings.



Soothing System This is a very different system to the drive system. This system is the one that makes us feel calm, contented and peaceful. We feel it when there is nothing that we need in that moment (so the drive system is switched off) and we feel safe (so the threat system is also switched off).

Exercise: Imagine a time when you felt real warmth and kindness towards someone, or something such as a pet or baby animal. What happens inside your body? What does your body want to do if you let it?

Learning Point (NACC – “Notice”): We usually feel calm, at peace, and soothed inside. We also often have an urge to move closer and to want to hold or cuddle. So it is very different to the threat system which keeps us away from people who threaten us, or keeps people away from us.

Baby notes:

Exercise: What switches on a baby’s soothing system? How do you know when a baby feels soothed, and safe?

Learning Point (NACC – “Compassion and Kindness”): This is usually switched on when a baby is held, talked to in a soothing voice, or sung to, rocked, or when it is sucking. It is very much linked with gentle contact with someone seen as safe. This is the same for us as adults. Our soothing system is switched on without us even thinking, when someone is kind to us, when we are held by someone we love, when someone smiles kindly at us.



Topic Three: How the Three Circles Work Together

Exercise (NACC – “Notice”): Imagine there is a baby in the room with his mother. He is happily playing with some toys when suddenly there is a really loud noise. What does the baby do?

Learning Point: He is likely to jump, perhaps cry and turn to his mum for comfort and reassurance. This is because his threat system has been switched on and of course the threat system is there to get us to safety as quickly as possible. He is hard wired to see his mum or dad as his best source of safety.

Exercise (NACC – “Compassion and kindness”): What might mum do?

Learning Point: Mum is likely to pick him up, hold him, talk to him in a soothing voice, perhaps rock him, and have a concerned but reassuring face. Our brains are hard-wired to respond to the distress in others, and what’s more, to know what to do. So we “know” inside that the baby needs picking up, holding and soothing. Even young children’s brains are hard-wired to be concerned about another child’s distress and even to know instinctively how to soothe it.

So what happens here is that the baby’s distress switches on the mum’s soothing system.

(We will see later how this “wiring” inside us can get muddled up and confused by disorders such as autism, and also by our experiences as we grow up).

Exercise: What happens inside the baby when mum holds him?

Learning Point (NACC – “Compassion and Kindness”): He calms down, his body relaxes, and he stops crying. So the mother has now switched on the baby’s soothing system. And what is amazing here; the baby’s soothing system has the power to turn down his threat system. It might even be able to switch the threat system off completely. Then the baby can get down and start playing again, which he can only do properly when his threat system is turned off.



Topic Four: The Power of the Soothing System

So this soothing system, which you might think is the soft, “fluffy” system, is actually so powerful that it can tame the mighty threat system.

Our society has almost lost sight of this important system. Instead we may try to get rid of threatening feelings by relying largely on the drive system. So if we are upset, sad, or angry we might choose to eat chocolate, drink alcohol, exercise hard, work even harder, go shopping to cheer ourselves up, clean the house and make everything sorted so we feel “sorted” and so on… rather than being able to look to others or ourselves to be soothed and calmed. The key point is to feel able to use both the drive and the soothing systems to help us, rather than relying solely on one or the other. So, for example, having a bar of chocolate, going for a walk or a jog, or tidying the house may indeed the best thing to help us, but we also need to be able to judge whether four bars of chocolate, or relentless exercise is helpful, or actually harmful to us, or whether in fact what we need is to be listened to or comforted.

Exercise (NACC – “Notice”): What do you do when you feel upset, angry or sad? Which circle do you try to use?

Learning Point (NACC – “Accept and Understand”): We try to use the most effective way that is available to us to deal with our distress. You might find that you are instinctively drawn to use the soothing system but may feel, for example, that nobody is available who could provide it. Instead you use the drive system.

Self-Harm, Drugs, Promiscuous Sex (NACC – “Accept and Understand”) If you have ever used self-harm, drugs or promiscuous sex to calm your distress, think about which circle they are switching on for you. You may be using them to give you a buzz, from the drive system or to make you feel soothed and calm, for example. This gives you some understanding of how you are instinctively trying to manage your distress. These methods, although potentially destructive and harmful are used because they work in the short-term. Knowing how they help you, points you in the direction of what you know you intuitively need to help you. Often, the solution is in the soothing system- once this system is strengthened then the need for self-harm, drugs or promiscuous sex can fade away.



Balancing the systems: Which is your strongest circle?

Exercise: Which circle seems to be in charge a lot of the time for you? Which one is most easily triggered? Draw how big this system is in relation to the other two systems in the space:�

Which is the smallest? Which is the hardest to switch on? How small is it compared to the first one? Draw it in the space above in relation to the first one.



It may look like this:

How are the three systems balanced…? Drive Soothing

Threatfocused & safety seeking

Anxiety, anger, sadness

This helps to show that the easily triggered Threat System has been developed by the brain for self-protection. People with such threat systems often say that they feel on “red alert” a lot of the time waiting for the next bad thing to happen. Often struggling to feel soothed and calm they instead manage the threat as best they can through the drive system.

Baby notes: Notice how a baby naturally shifts between the drive, threat and soothing system as they move through different states of arousal. Sometimes, when their state of arousal is low, they may need their drive system to be stimulated. At other times they may need calming down which involves switching on their soothing system instead. When they are scared they are likely to need soothing. When they are frustrated this might be because they need to be in their drive or soothing system, but need help from an adult to get into one of these systems.



Topic Five: How to Balance the Three Circles – A gym workout for the brain

The idea behind Compassionate Mind Training is that we are designed to manage threats through the soothing system. Our brains are hard-wired to be close to people and to seek help and soothing when distressed. It is the soothing system that can most effectively calm our distress. What is more we can learn to build up the soothing system by exercising it, like exercising muscles in the gym. There are many ways of exercising the soothing system, some of which are listed in the second part of this learning pack. As we get more and more tuned in to the part of our brain we are training up, and the feeling we are trying to experience, we will start to identify our own ways of building that part of our brain too.

Compassionate Mind Training-Starting right now!

Exercise (NACC – “Notice”): What gives you that feeling of calmness, peace and contentment (even if it is just a tiny hint of the feeling)? It might be listening to the birds, a particular song or piece of music or a ringtone, it might be the moment you put your hands into warm water, the smell of your favourite handwash or shampoo, a picture in a magazine, or a photo on your mobile.

Start off by just deciding to notice what makes you feel calm and content…

and then move onto start doing a little bit more of those things that make you feel like this (NACC – “Change”).

You might also like to start using some of the exercises in Part Two of the learning pack: Soothing Breathing Rhythm is a good one to start with (NACC – “Notice”, “Accept” and “Compassion”).



Module Two

Self-Criticism, Self-Compassion

Topic One: The Voice on Your Shoulder: Bully or Friend?

From Module One we have learned that using our soothing system is a powerful way of calming us when we feel anxious, angry or upset. We can see that, like babies, our soothing system reacts to the kind voices, faces, thoughts and behaviour of others. This Module will focus on how our soothing system can also be switched on by the kindness of our own voice, face, thoughts and behaviour towards ourselves. It will also focus on the flipside to this; how we switch on our threat system when we criticise ourselves.

The aim of Compassionate Mind Training (CMT) is to strengthen the soothing system by developing compassion towards ourselves.

Compassion in CMT is made up of five main attributes:

1. Kindness

2. Warmth

3. Acceptance

4. Wisdom

5. Strength of character

These attributes help us not only accept and understand ourselves as we are, but help us move forward, develop, and change. When we are in the compassion system we are better able to make creative decisions which take in information from the past and look to the future. When a baby feels soothed and safe he/she is able to explore and play. It is the same for us as adults; when we feel soothed and safe we can explore solutions and be more creative. We can learn to use this system to do more and more of our thinking for us. It is fascinating to notice the solutions that the compassionate part of us comes up with compared to the threat system.

However, relating to ourselves in this way is not easy. We may be able to find some kindness towards ourselves when we are doing well, but what about when we behave in ways that are unhelpful to ourselves but we seem to keep doing them? This module will focus on the challenge of being able to be compassionate to ourselves, even when we think and behave in ways which we would usually criticise ourselves for.



Voices and Faces

Voice tone and facial expression are often referred to in Compassionate Mind Training. This is because our brains are particularly tuned in to voice tone and facial expression. In Module One there was a diagram showing the almond shaped amygdala deep in our brain. This detects threat and sends out very fast reactions to the rest of our body. It has been discovered that the amygdala has two sites on it; one for detecting voice tone and one for facial expression. You may have had that experience where somebody says something which is apparently nice, but you feel really annoyed by it. The chances are that your amygdala has picked up something in the speaker’s voice tone or facial expression that shows they are not being as sincere as their words suggest. Even babies are able to detect this. The amygdala also rapidly detects kind, safe voices and faces. We can feel better inside very quickly if somebody looks at us or speaks to us in a genuinely kind way. In fact recent research has shown that a kind voice can calm us as effectively as a warm embrace.

NACC – (“Notice”)

We can use this knowledge in Compassionate Mind Training to think about what happens when we talk to ourselves or look at ourselves in an angry or critical way, and what happens when we change this to a kind, warm and accepting voice and face. We will look at this in more detail later in this module.

Threat and Soothing: Outside Us and Inside Us

Exercise (NACC – “Notice”):�The following exercise is a good demonstration of one of the skills of our new brain: the power of our imagination; how it can cause us problems and how we can use it to help us.

First of all, think about what happens in our body when we smell our favourite meal.

Our stomach rumbles, and we produce saliva.


Emotion Brain

SexualBullythreat

Kind, warmand caring

SoothedSafe

Fearful

DepressedArousal

Stomach acid

Saliva

Meal

Meal Sex Bullythreat

Compassion

Pink represents our inner images and thoughts

How our own thoughts and images affect our brains


What happens if we imagine smelling our favourite meal? Well, the same thing happens.

So whether the meal is real or imagined the same brain activity occurs producing the same physical reaction.


Sexual Bullythreat

Meal

Meal Sex Bully Kind, warm threat and caring

Emotion Brain Compassion

Soothed Safe

Stomach acid Fearful

Saliva Arousal Depressed


What happens inside us if we see someone we think is attractive on the t.v.?

We get feelings of arousal.

So what about if we fantasize about that person?

Again, the same physical changes occur as when we really see the person. As with the meal example the brain reacts just the same to something we think about or imagine (internal) as to something that is real (external).



Now how would we feel inside if someone was repeatedly bullying or criticising us?

We are likely to feel upset, angry, and depressed.

Now what about when we bully and criticise ourselves?

Again, our brain will react just the same regardless of whether the critical person is someone else, or ourselves. When we criticise ourselves our threat system will be switched on immediately and it will flush us through with anger, or anxiety, or even shame. When someone criticises us we tend to then criticise ourselves for getting into the position where someone can criticise us. In this way our threat system experiences a ‘double whammy’; it gets fired up by the original criticism, and then again by our own criticism of ourselves.

The Threat “Double-Whammy”

Threat from outside us Threat from inside of us

She thinks I am a rubbish mother

I am rubbish at everything. I can’t even make my own

baby happy.

Your baby cries a lot

Friend

Now, how do we feel inside if someone is kind, warm, and caring to us?



We are likely to feel calm and soothed.

So you can probably guess where this is going now. What happens inside us if we are kind, warm and caring to ourselves?

Just as in the other examples, our brain reacts just the same as if it is someone real who is being kind to us; it will switch on our soothing system in response to our own kind, warm voice to ourselves.

Soothing the Threat System

Threat from outside us Soothing from inside of us

Threat is calmed

I do get upset when I think someone

is criticising me this is just how I am at the moment.

She does cry a lot. That’s hard, but on the whole I cope quite well, considering

she’s my first baby.

She thinks I am a rubbish mother

Your baby cries a lot

Friend

Learning Point (NACC – “Notice”, “Acceptance”, “Compassion”, “Change”): This is the basis of Compassionate Mind Training; that threat can come from inside us as well as outside, but just as others can soothe us, we can soothe ourselves.

We might not be able to change the threat from the outside, but we can work at trying to change the threat from the inside. However as we know, changing from criticism to kindness towards ourselves is very difficult. Later in this module we will look at why we do criticise ourselves and how important it is to us.

Now that we have seen how powerful our imagination can be, we can put it to good use and start building up this sense of a kind, warm, compassionate part of ourselves.



Exercise: Voice on our shoulder (NACC – “Notice”) Think for a minute how you talk to yourself when things go wrong. Imagine you could see your voice sitting on your shoulder. What does is look like? What is its facial expression? What does it sound like when it talks to you?

And how do you feel inside when it talks to you?

Learning Point: If it is a critical, cross, humiliating kind of voice, it might look pretty horrible, sometimes even scary. It might make you feel angry, anxious or beaten down.

Now imagine a kind, warm, wise, strong, accepting voice sitting on your other shoulder. What does it look like? What is its facial expression like? What does it sound like when it talks to you?

How do you feel inside when it talks to you?

Learning Point (NACC – “Notice”, “Acceptance”, “Compassion”, “Change”): You might find you feel calmer inside with this voice. You might find however that this voice doesn’t seem as big and powerful as the other voice. This shows that this is the part that needs strengthening up.

In Compassionate Mind Training the two voices are not pitted against each other in a fight or argument because the critical voice is likely to get bigger and angrier. Also the aim isn’t to get rid of, or destroy the critical voice. As we will see, it exists for a very good reason. Instead, the aim is to strengthen the kind, soothing voice then use it to understand the critical voice and why it is there. As this becomes easier to do, a strange thing sometimes happens; the critical voice starts to fade away or shrink, or change into something less scary. One person described their critical voice as like a terrifying gremlin on her shoulder. As she built up her compassionate, strong, wise voice and used it to understand her gremlin, she noticed to her surprise that her gremlin became small and furry. She imagined keeping him in her pocket in case she ever needed him!

Compassionate Mind Exercise (NACC – “Compassion”, “Change”) A good exercise to try now is the Compassionate Self exercise that you can also find in Part Two. It can be quite hard to do but it is the intention, or the trying to do it that is more important than whether or not it comes clearly to you. It is sometimes easier to do if you imagine you are going to act the part of a really compassionate, kind, wise, strong, accepting person as if you are an actor playing the role of a compassionate person on the t.v., just imagine what they would look, sound, walk like. The exercise works best if you don’t use someone you know.



The Compassionate Self

•� Find somewhere quiet, and with your head upright and looking forward, and your eyes shut, start to focus on your soothing breathing rhythm.

•� Bring your attention to your breath moving gently through your body.

•� Your mind will wander. When you notice this just gently bring your attention back to your breathing.

•� Your breathing will settle into its own soothing rhythm.

•� Now imagine that you are going to play the part on T.V or in a play, of an ideal compassionate person, of a compassionate person at their very best.

•� First of all imagine yourself with real wisdom; you have an understanding of how much of who we are is to do with the brains we have evolved and the experiences and influences we have been exposed to as we have grown up, none of which we have chosen. Imagine how you change as you move into becoming that wise person in this exercise – notice the expression on your face, your posture, the clothes you wear, whether you are male or female, fat or thin, tall or short.

•� Now imagine that you have real strength of character. You are sensitive but you stand strong and firm. You are moved by what people say and do but you never crack or crumble.

•� From wisdom and strength comes responsibility. This is related to ‘not turning away’ from problems but recognising that although something is ‘not our fault’ we can make a commitment to ourselves and others to do our best to change it; even small steps at a time. So taking responsibility is not blaming or criticising (because that is usually focused on things in the past) but is genuinely wanting to act in ways that are helpful and based on our wisdom, strength and warmth.

•� You are also kind and have real warmth. Just notice your facial expression as you look with warmth and kindness. Notice how your voice would sound if you spoke with warmth and kindness.

•� You are also accepting without judging or condemning.

•� Imagine yourself standing up and walking along. Notice how you hold yourself and how you walk, with wisdom, strength, kindness, warmth and acceptance.

•� As you walk along you come across people. Notice how you look and smile at them with kindness, warmth, strength, wisdom, acceptance and responsibility. Notice how your voice would sound if you spoke to them.

•� Holding on to those feelings inside you, gently bring your attention back to the room, to your feet on the floor, the feeling of the seat beneath you, the sounds in the room, and in your own time just gently open your eyes.



Remember, the trying, the wish to do the exercise will also be building up the soothing system in you, regardless of whether or not you get the feeling. With practice a feeling of real warmth and kindness will come with it too, but this can take many, many hours of practice, especially if you have had little kindness or love in your life up until now. But no matter what your experiences have been, it will come in the end and will be worth the wait.

This exercise works particularly well for clients if the Family Nurse can record it so that it can be listened to repeatedly. Interestingly, people request that it is recorded using the voice of the person who is doing this kind of work with them, as people come to associate warmth, soothing, and kindness, with the voice and facial expression of this person.

“Growing a Tulip”

Christopher Germer in his book “The Mindful Way to Self-Compassion” likened developing self-compassion to planting a tulip bulb; you clear the weeds and put in compost to really prepare the ground. You plant the bulb and then you imagine growing it with warmth, kindness, wisdom and strength, and acceptance. For a long time nothing seems to happen, and you don’t feel you are getting anywhere, but perhaps without you realising it, the

green shoot is growing up through the soil. One day you are surprised to see the green shoot appear out of the soil and you realise that all your effort has paid off.



Topic Two: Self-Criticism as our Bodyguard: Keeping Us Safe From Rejection

We have looked at how differently our brain, and our bodies react if we speak to ourselves with kindness and warmth rather than bullying self-criticism. We have also started to consider what might happen if we think about that bullying voice with kindness and understanding.

So why do we have this bullying self-critical voice, particularly if it causes our brain to react just as if it was a real life bully? An understanding of this can make it easier to respond to ourselves with kindness.

Exercise (NACC – “Notice”): Imagine for a minute that we had a magic wand that took away our ability to criticise ourselves from this moment onwards. Although it might sound wonderful to start with, what would it be like if you could never criticise yourself again – what might be your fear?

Learning Point: Our fear might be that we would upset other people by what we do or say, or by not working hard enough, or by thinking only of ourselves and so on.

If we take it a step further and ask ourselves the next question: “and if someone was upset with me what would be scary about that?” We might find that underneath this is a deep fear of being rejected by the people around us.

Our worry then about getting rid of our critical voice might be that we would lose the capacity to judge whether what we say or do is acceptable to other people. And that if as a consequence we upset someone, then they would reject us.

The Pain of Rejection Our minds are incredibly sensitive to any signals that suggest people do not think well of us. The amygdala picks up signs in the voices and faces of others that they are cross, disapproving, humiliating, or even indifferent to us or ignoring us. Many of us know, or can imagine, how it feels when no-one wants to pick us to be on their team, or when our child wants to be with somebody else rather than us, for example. We can react very strongly to being rejected or ignored even if we try to console ourselves by saying that it is not important to us, or that there are lots of other people who do like us. Often this reassurance does not seem to make any difference and we keep going over the incident again and again.



Exercise (NACC – “Notice”): Imagine that you have discovered that a number of people you know had agreed to meet up in town but they had not invited you.�How would you feel inside?�What would you think and do?�How long would you think about it?�

Learning Point: You might feel sick inside, angry, upset, or ashamed. You might want to get back at them, or hide away and avoid them for example. Often our minds keep going over it again and again. Our reactions are usually very strong and our minds try to work out what happened to try to prevent it from happening again.

Recently it has been discovered that when we are rejected, the same parts of our brain are triggered off as when we have been physically hurt. Indeed, people often describe the experience of rejection as a strong physical pain. It seems like our brains are hard-wired to treat rejection as a very serious threat so that we do whatever we can to prevent ourselves from being rejected.

Baby notes: Consider how it must feel to a young child when a new baby arrives home and there is that time of wondering whether or not your parents want you any more now there is a cuddly, demanding new little person on the scene. Or what does a child feel when parents are cuddling and the child desperately tries to get in to the cuddle too? Our brains are hard-wired to need to be noticed and held in mind. So why is this, what would happen if we were not noticed or held in mind? There is a fascinating experiment called the “still face”. Here a mother talks to her child normally for a few minutes and is then instructed to make her face still and unresponsive. The child immediately becomes distressed by this. It is thought that the child experiences this as a kind of abandonment and finds it very threatening. This shows how we can feel abandoned by someone even when they ignore us or don’t respond to us.

Why do we react so strongly to criticism or rejection from others?

Imagine living once again as we did for millions of years in small groups of between twenty and a hundred people in caves and on the African plains. It is hard work finding food and there are many dangers. Consider what could happen if we had upset people in our group, or if they ignored us or forgot about us.



To be forgotten about, rejected, or cast out of a small group in such dangerous surroundings is a considerable threat, in fact it could mean that we might die. Our brains are still hard wired to detect such a threat even though we live in much safer surroundings. This is why our brains panic so much when it registers that we might be thought of in a negative way by someone else, or when we are not thought of at all.

Self-Criticism – Our Bodyguard?

Self-criticism can be a way of making sure that we don’t step out of line or put ourselves at risk of being rejected, humiliated or criticised by others. In other words self-criticism can be thought of as a “safety strategy”. Our self-criticism is almost like our body-guard who we have employed to protect us. (Perhaps if we have really been hurt a lot in our lives then we will choose an extra strong bodyguard for the job). As we will see, sometimes our body-guard gets a little

carried away and will react even when there is no longer a threat. This is because our body-guard tends to use the belief “better safe than sorry”. For example, that it is better to assume that a person will harm us so it safer to so push them away, rather than take a risk, let them get close to us and then get hurt.

Summary So we have been given a brain by nature that is super-sensitive to being rejected, criticised, or ignored by others. This is because we are hard-wired to need other people to help us and care for us, particularly when we lived in risky environments, so losing the good-will or the attention of others can be a very serious threat. Our brains are still hard-wired to create fear and anxiety in us at any sign of rejection even if we could cope well enough without others.

Now that we see that it is not our fault that we react this way to criticism from others, and importantly, to criticism from ourselves, we can choose to be kinder to ourselves when we feel so awful. This has the very significant effect of stopping us from giving ourselves another dose of self-criticism which threatens us again, and instead gives us kindness, strength, wisdom, acceptance and understanding.



Module Three

How Our Own Environment Shapes Our Emotions

Topic One: Emotional Conditioning: How Different Feelings Become Linked

So now we know that we just find ourselves in this world with a brain that tries to keep us safe, and reacts quickly to feeling threatened, with anger, anxiety or disgust. It drives us to find food, shelter, a partner, have babies, achieve and so on, and to experience joy, excitement and pleasure when we do. It also drives us to be connected to others and to feel safe and soothed when we are, but to panic when we fear that we will be rejected or forgotten. We did not choose any of this, but this is the brain we have been given and we try to work out how best to manage it.

In addition to this we are shaped by our environment in many ways, none of which we chose either. For example, we didn’t choose when we were conceived, whether we are first born, third born, born into a rich or a poor family, or into a rich or poor country, we didn’t choose how our parents brought us up, what school we went to and so on and so on……. So we are just trying to do the best we can with brains that have largely been shaped for us.

One of the many powerful forces which shape our brain is “emotional conditioning”.

Exercise: Imagine for a minute that you had eaten a slice of pizza and then later on that day you became ill with a stomach bug.

How would your body react the next time you were offered pizza?



Learning Point: You are likely to react with a strong feeling of nausea. This is because our brains will try to keep us safe from anything that might poison us. It makes a connection between the pizza and being sick. This connection is made even if what we eat hasn’t in fact caused us to be sick. This is called “conditioning”. The brain thinks “better safe than sorry”, i.e. better treat all pizza in future as potentially poisonous just in case.

Most people can remember food or drink that they have never eaten again after being sick because the body remembers this in such a strong and protective way. These are sometimes known as “body memories” or “gut reactions”.

Conditioning occurs for all sorts of events; For example a particular smell can bring back a whole flood of memories. We can also use conditioning to help us, for example we can deliberately link two feelings or senses together. Recent research has shown that we can make new, more beneficial emotional memories to lay over the top of emotional memories that are powerful but unhelpful to us. For example, there was a woman who had a newborn baby who suffered from colic. She had no-one to help her and would pace her flat in the evening and during the night alone with her baby. She became very frightened that she would harm her baby in desperation to make him stop crying. Eventually she was able to ask for help from her doctor but found that she did not want to be at home with her baby because it brought back memories of helplessness, fear and shame. She even considered moving house. After a lot of help, she eventually decided to set about deliberately creating new memories of good times with her baby in the house. In the end her home became her safe place again rather than a frightening place.

Emotional conditioning occurs without us realising it. It helps us to learn, and to develop rapid ways of protecting ourselves. It can be helpful to think about how it may come into play when we are children. The body memories that come from childhood can be played out over and over again even in adulthood.



Exercise:�Imagine for a minute a young child who, whenever they got angry, was shouted at or punished in some way? What would they feel inside when they were shouted at or punished?�

Anger in child Punished for being angry

Learning Point: Each time the child was punished for being angry the child might feel scared or anxious. In the end feeling angry would become linked to (or conditioned to) feeling scared.

Anger in child Anxiety in child

As the child grows up, each time the child started to feel angry then the brain would pull up the feelings connected to it (ie. Anxiety). Sometimes the anxiety can almost replace the anger so that instead of feeling angry a child will feel anxious.

Now imagine that a child was hurt or scared and wanted to be looked after. But instead the child got shouted at. What would the child feel when it was shouted at?

Scared child seeks care Punished for wanting care

Again the child might feel scared.

So seeking care would become linked to fear or anxiety:

Child needs care Anxiety

If this happened repeatedly then as the child grew up, each time she needed help or looking after then she may feel scared or anxious.



What would happen if each time the child needed looking after, there was no response?

Child needs care No response

This time the child might shut down or feel abandoned and hopeless. As the child grows up,whenever the child needed help or looking after then his or her brain pulls up the memories of shutting down, or feeling abandoned or hopeless.

Child shuts down, hopelessness, despair

Child needs care

Learning Point: Emotional conditioning can help to understand why sometimes we react in ways that don’t seem logical to us. For example we may push away someone who is loving and kind to us, or feel uncomfortable, sick or scared when people are nice to us.

When we have a baby or get close to someone who cares for us this opens up our attachment system. This is the system that drives us to reach out to others when we need looking after, or to reach out and care for others when they need looking after. As the attachment system opens up it pulls up all the feelings that have been conditioned to it throughout our lives. This can help to explain why some people find that they have overwhelming feelings of anxiety, fear, helplessness and so on when they have a new baby. The cry of a baby can bring up particularly powerful feelings from childhood which may be why some parents find it very difficult to soothe their baby and instead feel panic or helplessness for example.

Topic Two: How we learn to protect ourselves: Safety Strategies

Exercise:�Imagine a child who has a mother who seems to ‘flip’ without warning between being happy and being angry. What would the child learn to do to manage this?�

Learning Point: The child might learn to always watch mother’s face carefully for clues to how she is feeling, or to always be good and quiet to keep her happy. These are called “safety strategies”.

Baby notes: Even babies under one year old learn to use safety strategies. These ensure that a baby can keep as safe as possible and to maximise the chances of getting care from care-givers.



Topic Three: Unintended Consequences: When safety strategies become a hindrance

As our brain usually reverts back to its “better safe than sorry policy”, our safety strategies often stick even if we move into safer environments where we don’t need them anymore. For example, if our safety strategy is to be “good and quiet”, we might go through our lives in fear of doing something wrong, or of getting angry, so we never test out what actually does happen. We might find ourselves still being “good and quiet” as adults, but then finding that we cannot get what we need in our relationships, or that people seem to walk all over us. These are called “unintended consequences”.

Exercise: What might be the unintended consequences of the following safety strategies?

• Keep everybody at a distance so they can’t hurt you.

• Never try anything new in case you fail and get laughed at.

• Direct your anger at yourself rather than others so they don’t get angry with you.

Learning Point: Although the unintended consequences can have a significant impact on how we live our lives, these are not our fault. We may know in our head that behaving as we do is not helping us, but it can be difficult to change our behaviour, because our behaviour is driven by some of our very deepest fears, often from our childhood. For example the woman who has met a loving partner but pushes them away, even though she knows this might mean she will end up alone.

So is there a way out of this sometimes painful and difficult loop? Thinking back to the section on “Getting the NACC”, the first stage is to notice what is happening rather than being swept along in it. This allows us to step back a bit from it and gives us space to think about it. The second step is “acceptance” – rather than trying to hide it away or squash it down we can take a position of “I didn’t choose to be struggling like this, this is just the way it is – it is neither good nor bad”. Acceptance can be helped by developing an understanding or “wisdom” about how we come to be the way we are. Pulling our experiences together into a formulation or kind of map can be very helpful in developing this understanding of just how much we have been shaped by our experiences. We will explore this below. The third step is to view our struggling with kindness, compassion, and warmth. The fourth step is to use the compassionate part of ourselves to think about what might help us to develop and gently change to a position that helps us a little more.



Topic Four: Formulation: Bringing Our Experiences Together

Exercise:�Imagine yourself in a kind of fairy story where you are an big wise person looking down on your land as if from the top of a mountain or castle. You can see people far below going about their day. You watch a woman with her baby girl as if you are watching a speeded up film.

(NACC – “Notice”)�You see how she is with the baby and how the baby responds to her. You see all the things that happen to the baby and how the baby learns to respond. You see how the baby grows up and how she then responds to those around her, including her own baby.�

(NACC – “Acceptance”)�You have a real understanding from your wise place of how the baby turns into the adult you see; how she has been influenced by the old and new parts of her brain, by her genes, the country she has been born into, how her parents bring her up and so on.�

You accept the adult this baby has now become, just as she is without judging her.

(NACC – “Compassion”)�You feel kindness and warmth towards them as they go through life as best they can.�

(NACC – “Change”)�You can also see what might help her now, and what might help her to develop, grow and prosper in the future.�

What the wise person sees can be put together in a four part formulation comprising:�

1. Background (key childhood experiences)

2. Fears (key fears arising from these experiences)

3. Safety Strategies (ways of trying to prevent the feared event from happening again)

4. Unintended Consequences (what happened through life as a result of the safety strategies).



Here is an example of what this might look like:

Background Fears Safety Strategies Unintended Consequences

Angry, violent, unpredictable father.

Other people can be scary. Other people can hurt you.

Watch others closely for any small signs of anger.

Don’t notice your own feelings or what you need. Lose your sense of self eg. what you like/dislike.

Be good, never upset anyone.

Get “walked “over. Don’t get your own needs met.

Keep your own anger in, in case you hurt others.

Never get to learn how to handle your own anger. Scared of getting close to people in case you get angry.

Exercise:�Imagine looking at this formulation with a judgmental, critical mind.�Now imagine looking at it with a kind, warm, accepting, wise mind.�



Your Own Formulation It can be helpful to write down some of your key experiences that you had as you grew up, listing the fears that these created in you and some of the safety strategies you developed to try to prevent your fear from happening again. Then list some of the unintended consequences that came about as a result of the safety strategies.


Now imagine that you are looking at this from your warm, wise, kind, accepting place.

Or imagine a very wise, kind friend was looking at your formulation with you. What might your friend say?

What might you suggest from your wise, kind place or what might your wise friend suggest to help you to move forward from here?

Learning Point: We can’t change the experiences we have had, but we can change how we look at and feel about them. If we can see ourselves from our soothing system then we can understand and accept the way we have tried to manage our worries and fears as best we can. Not only that but the soothing system is also the most helpful system in trying to find solutions and moving us forward in life. It holds our best interests at heart.



Exercise: Take Two Teachers

Imagine two teachers at school. One uses the threat system to try to get children to improve and move forward. This teacher threatens, humiliates, and punishes children to get them to learn and to not make mistakes. The other uses the soothing system to try to get children to improve and move forward. This teacher uses praise, encouragement, is firm but fair, understands difficulties and helps to find ways to overcome them. You can probably remember teachers who are like these examples.

Which one would you prefer? Which one do you think would be better at getting you closer to where you would like to be in life? Which teacher would you prefer your child to have at school? Which kind of teacher would you like to be for your child?

Learning Point: We can often be the critical teacher for ourselves and believe that if we are not harsh with ourselves then we will make mistakes, get too soft, not work hard enough and so on, when actually it is the kind, firm, understanding, encouraging teacher in ourselves that helps us to develop, and move much closer to our goals.

However, it is not easy to pull ourselves into thinking from our soothing system, from our kind, wise, strong, accepting part of ourselves, particularly if we have not had many people being that way with us, or if we have spent many years being critical of ourselves.

Part Two of the learning pack will look at many ways in which we can build up and strengthen our soothing system so that it becomes easier to use our soothing, compassionate mind to pull ourselves out of our threat focused, critical mind.



Part Two: Strengthening Our Compassionate Mind: A Complete Workout

Introduction

This part of the learning pack focuses on activities to change the way we relate to ourselves through exercising a particular part of our brain associated with kindness, safeness and soothing.

It is recommended that family nurses and supervisors support each other to understand the intention of these exercises and practice them together, so that they are comfortable with them and feel their benefits.

It may be that you also spend some time thinking together about how you will link the descriptive elements of the compassionate mind training described in Part One of this learning pack, with the activities in this part.

As you work through this part of the learning pack you may become aware of resistances to self-compassion, either in yourself or with your client. If this happens, move on first to Part Three: “Trouble-shooting: Blocks to Compassion”, then return to Part Two.



Module Four

What do I need to work on to strengthen my Compassionate Mind?

The many ways of strengthening our Compassionate Mind

From Part One we have seen how our soothing system (or Compassionate Mind) can help us. We have also seen how easily we get pulled back into the anxiety and anger of our threat system by our brain as it tries to protect us. Moving ourselves into the soothing system takes effort and practice. But with practice it becomes easier for the soothing system to step in when we need it.

So, how can we develop the use of our soothing system? Well like the development of any new skill, it takes practice. In the early days of practice, it may be difficult to see that we are getting anywhere. But with repetition it slowly gets smoother and easier. It is best to start off practice when things are easy, like learning to swim; it is better to try and learn to swim in the shallow end of a warm swimming pool rather than when you have fallen into a stormy sea.

Practicing will also literally be changing our brain so the more we practice the stronger the new connections in our brain will become. Even a tiny amount of practice will have an effect.

There are many ways to build up our Compassionate Mind. We can imagine compassionate people or scenarios, think in a compassionate way, behave in a compassionate way, move our attention to things that make us feel soothed and safe, switch on compassionate feelings, and use our senses of taste, touch, sound, smell, and vision to stimulate our soothing system.

This is shown in the next diagram:



Compassion

Attention

Motivation

Imagery

Thinking

Behaviour

Senses Feelings

Notice how different each of these “spokes” would be if you were, say, feeling angry:

Anger

Attention

Motivation

Feelings Senses

Imagery

Thinking

Behaviour



Exercise (NACC – “Notice”):�Imagine for a minute that you had had an argument with somebody you really cared about.

1.� What would the angry part of you

a) Focus on?�b) Think and feel?�c) Want to do?�

2. What would the sad part of you


3.� What would the anxious or worried part of you


4.� Now for a minute bring up the kind, compassionate part of yourself and think about what this part of you would


Learning Point

•� You might have noticed that it is easier to bring up some parts of you than others, for example it may be easier to imagine the angry part than say the sad, or compassionate part.

•� You might also have noticed that some feelings seem to keep you there like a magnet and moving out of them takes a lot of effort. For example you may feel like you want to stay and ruminate and pull up angry memories in the angry state and really resist moving into the compassionate state. This shows how the threat system has an almost magnetic pull, like a black hole which pulls us in really fast without a great deal of effort on our part. But moving to the compassionate part can take time and considerable effort, as if trying to pull yourself away from the magnet. This is why building the Compassionate Mind is effortful and requires practice, just like going to the gym to tone up and strengthen particular parts of your body.



•� What you attend to can be very different too. You might have found that in the angry state you focused on the other person for example, in the sad state or the anxious state you might have focused more on the feelings within your self for example, and in the compassionate state you perhaps focused on both of you. Sometimes it is as if you are looking down from above when in the compassionate state, able to take in “the whole picture” ie understanding how the past has come to influence you both, and also being able to look to the future.

•� Your motivation is your direction of travel, intention or desire.

When you are in an angry state your motivation may be to hurt the other person, or make them feel as you do, for example.

When you are in the sad state your motivation may be to be alone, or you may even find you lose your motivation and feel like giving up.

When you are in the anxious state it may be to try to hold on to the other person or protect yourself.

When you are in the compassionate state your motivation may be more about how you move both of you forward, trying to reach a compromise, or how to make things better for the future.

The compassionate part of a person can be better at finding solutions and ways out of stuck or destructive positions.

Baby notes You could also support your client to try this same exercise in relation to their baby. For example, you could support them to imagine becoming cross and frustrated with their baby. Then think about the reactions of the angry, sad, anxious and finally compassionate part of themselves. This exercise shows how we are made up of many parts of ourselves and so our feelings and reactions can sometimes be complicated and confusing.

Compassionate Motivation Developing an understanding of the importance of the Compassionate Mind system in helping to calm our anger and anxiety and increase our feelings of safeness and soothing helps to shape our motivation i.e our direction of travel, intention, desire. Compassionate motivation is a turning towards kindness to ourselves, a moving ourselves forward with gentle encouragement. However where there has been little experience of soothing or where there was a great deal of



threat then our motivation may be to keep a very strong threat system, and to keep away from the soothing system as this is where we feel vulnerable. Until we make a conscious decision to view and treat ourselves with kindness and compassion, even if we don’t yet feel it, then we will continue to fear and resist building up compassionate thinking, behaviour, imagery and so on.

Three examples used previously in the learning pack help to illustrate compassionate motivation:

1) Two Wolves – A Native American Indian Tale Grandpa to Grandson “There are two wolves inside

me; one is anger and one is compassion”.

Grandson “Which one will win Grandpa?”

Grandpa “The one that I feed”.

2) Which Teacher? Which teacher would you prefer to teach you, one who uses the threat system to help you learn by threatening, punishing, humiliating, criticising, or the one who teaches using compassion; with encouragement, praise, support, and focusing on your strengths?

3) Preparing your Garden We can decide how we want to be, and give ourselves the best chance of getting there. It is like taking a wild garden and deciding which bits you want to focus on and get to grow well. You might dig these parts over, put in lots of good soil, plant the seeds and then water and look after them. In Compassionate Mind Training it would be the compassionate part of us that we try to cultivate and grow.

The next modules will look at specific exercises for toning up or strengthening each of these “spokes” of the compassion wheel.

Here is a summary of the exercises used for each of the spokes:




Exercises for building each “spoke” of the Compassionate Mind

Attention 1. Moving the Torchlight 2. Diary of Compassionate Moments 3. “Zooming in” 4. Mindful eating of an apple 5. Soothing Breathing Rhythm 6. “Leaves in the Stream” 7. Kind faces in magazines/at

supermarket

Motivation 1. “Two Wolves” 2. Preparing Your

Garden 3. Compassionate

teacher

Feelings 1. “Growing the Tulip” 2. Calming the Horse 3. Anchoring

Compassion

Imagery 1. Safe Place 2. Compassionate Colour 3. Developing the Compassionate Self 4. Memories of Compassion

Flowing Out 5. Imagining Compassion Flowing Out 6. Compassionate Self From a Distance 7. Ideal Compassionate Person 8. Compassion Under the Duvet

Thinking 1. Getting the “NACC”

Senses 1. Vision 2. Touch 3. Sound 4. Smell 5. Taste

2. Thought Balancing 3. Letter-Writing 4. Voice of a Very Good

Friend

Behaviour Each day: 1. Do one spontaneous act of kindness. 2. Speak to someone and find out a

little about them. 3. Do one thing to reach a longer

term goal. 4. Practise one act of forgiveness to

yourself or others. 5. Do one thing designed by you to be

enjoyable. 6. Practise compassionate exercises. 7. Spend 5 minutes remembering kindness

from during the day. 8. Practice and Practice and Practice.


Module Five

Compassionate Attention

Attention can be thought about as the beam of light from a torch. You can move the beam of light about as you wish and choose what you want to illuminate.

Exercise 1: Moving the torchlight of attention (NACC – “Notice”)

For a moment direct your attention to your left big toe. Notice how it feels, the sensation of it being in contact with your shoe or the floor, whether or not you can feel anything of it at all.

Now direct your attention to your right big toe. Just notice any sensations, or whether or not you feel anything.

Now direct your attention to your nose, perhaps noticing the sensation of the air as it passes through it, any feelings on the skin of your nose, on the inside of your nose.

As you attend to your nose, what happened to your attention to your right toe, to your left toe?

Learning Point: As you move your attention about, the focus of your attention seems to expand to fill your awareness. The things you have previously focused on seem to fade into the background. So attention really is like a beam of torchlight; as soon as you move it away then those parts now “in the dark” are no longer in your mind. So when you move your attention to threat focused memories, for that moment you lose sight of the compassion focused memories. But this also works the other way; when you move your attention to compassion focused memories, you are no longer ruminating on threat focused memories. Building up the Compassionate Mind involves consciously trying to direct your attention to sources of soothing, kindness, and warmth, no matter how small, as often as possible each day.



Exercise 2: Daily diary of Compassionate Moments (NACC – “Notice”)

Set aside time each day to spend bringing to mind, or writing down, moments that occurred (no matter how tiny or fleeting) when you felt a spark of warmth, kindness, or soothing. To get into the habit of doing this, identify a time when this would be easiest to do. Imagine yourself doing this exercise, then place this diary somewhere where it will remind you to complete it.

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday



Strengthening the soothing system or Compassionate Mind involves directing attention to things that make you feel soothed, warm, and safe. These could be memories, images, thoughts, behaviours, feelings, pictures, smells, textures and so on.

Exercise 3: “Zooming in” (NACC – “Notice”)

1. Draw your attention to memories of a time when you felt warmth and love for your baby or partner, or when you felt you had a moment of kindness with your child, friend or even a stranger.

2.� Really intensify your attention as if you are zooming in through binoculars or a camera zoom.

3.� Focus on how you imagine the expression on your face and the tone of your voice to be in that memory.

4.� Then draw your attention to how you felt inside.

5.� Then move your attention to the facial expression and voice tone of your child or other person as they receive your kindness or warmth in the memory.

Learning Point: As we have seen before, it can take a lot of effort and practice to move your attention to sources of soothing and compassion. Sometimes it can feel like you are having to drag the “torchlight” of attention from sources of threat (such as times when you didn’t feel like you did so well, or lost your patience with someone) to these moments of soothing, warmth and compassion. But this is how our minds are designed, so when you struggle to move your attention to sources of compassion, notice this struggle with kindness and understanding.

Mindfulness (NACC – “Noticing, Acceptance”) The ability to take control of your attention and move it about as you wish, can be a difficult skill to master. However, there is increasing evidence that just this ability to move and focus your attention without judging what you find there, is a powerful tool. Research is finding many benefits to practicing this technique, for example helping to ward off quite serious depression, increasing the speed of recovery from physical illnesses, and decreasing your chances of getting a number of physical illnesses. This ability is called “mindfulness”.

Baby notes: You might notice that babies and children are naturally mindful. They exist in the moment just looking at the world without making any judgments or having their thoughts overtaken with “shoulds” and “shouldn’ts” or what they need to be doing next. You might notice how they explore a toy, or a raindrop on a leaf, a muddy puddle, or stick, your face, or teeth, or someone’s glasses, just totally caught up in the wonderment of it. Of course this can be frustrating to us when we are in a hurry, but what would it be like if we could re-capture a bit of their skill?



Mindfulness is an important skill in building the compassionate mind. It is the skill involved in the “Notice” and “Accept” part of “NACC” (Notice, Accept, Compassion, Change).

Many of the following exercises will use the skill of mindfulness, of noticing without judgment.

Exercise 4: The Mindful Eating of An Apple (NACC – “Notice, Acceptance”)

1. Take an apple or other piece of fruit. If you don’t have anything to hand you can still use your imagination to do this. First look at the apple and note all of its colours and textures.

2.� Then hold it in your hand and notice the temperature of it, the weight of it in your hand, the feel of its skin.

3.� You might notice that your mind wanders from your focus on the apple (as it most likely will). When this happens just gently bring your focus back to it.

4. Then smell the apple and focus your attention on this smell.

5. Next put the apple to your lips and notice the sensation of the apple against your lips.

6.� Then take a bite of the apple. Focus on the sound as you bite into it, then the sensation of the apple in your mouth.

7. Now move your focus to the taste of the apple in your mouth.

8.� Chew slowly, noticing how the juice is affecting your salivary glands and how the saliva feels in your mouth.

9. As you chew notice what happens to the apple.

10. As you swallow, pay attention to the sensation of swallowing.

Learning Points: If you had eaten the apple without mindful attention then your thoughts may have wandered all over the place. You might have also have made judgments about it “I don’t like apples” or “I should really eat more apples”. When doing something mindfully your awareness is taken up with it. You might have noticed that the sensations were sometimes quite intense. Often we can eat something without even noticing we have eaten it.

In mindfulness we learn to notice the distraction and to gently and kindly bring our minds back to the task and refocus again. In fact this repeated bringing of our attention back seems, in itself to make important changes in our brain that help us to manage our emotions.



Mindfulness doesn’t just mean sitting in peace though, or looking at the joys of the world, it is noticing, without judgment, anything at all. So noticing that an angry feeling has just swept through you, or that you have just sworn at yourself again, or that your mind has wandered off for the tenth time, and noticing it without judging yourself for it, is mindfulness.

Exercise 5: Soothing breathing rhythm (NACC – “Notice, Acceptance, Compassion”)

This is a way of calming and quietening yourself whilst also switching on your soothing system. It is used at the beginning of a number of the Compassionate Mind exercises. Don’t worry too much about the breathing, or getting it “right” just enjoy the sense of calm that it brings.

1.� Sit comfortably with your legs uncrossed and your hands in your lap. Sit with your back straight so that you stay alert rather than become sleepy.

2.� Gently close your eyes, or look down, whichever feels the most comfortable.

3.� Allow yourself to have a gentle facial expression, maybe a kind smile.

4.� Now just gently bring your attention to your breathing, perhaps to the end of your nose where your breath moves in and out, or noticing the movement of your ribs as you breathe.

5.� Your attention will wander and many thoughts will pop into your head. Just notice this with a gentle smile, and gently bring your thoughts back to your breathing.

6.� You might start to notice that your breathing starts to find its own soothing rhythm. As it does, you might notice a feeling of calm and peace flowing through you.

When you feel ready, bring your attention gently back to the sounds in the room, the feeling of your feet on the floor, and gently open your eyes.

Learning Point: You might have noticed how many times your thoughts wandered off and how difficult it is to keep your attention on your breathing. This is just how the mind works. You are not trying to do anything but notice and then return your attention to your breathing.



Exercise 6: “Leaves in the Stream” (NACC – “Notice, Acceptance”)

This exercise introduces the idea that we are separate from our thoughts, feelings and physical sensations. When we have a thought such as “I am useless at all this”, we can feel that this is who we are; we have the thought and therefore assume that this is a truth about us. In fact, it is just one of the many hundreds of thoughts that pass through our minds each day. It is like saying that water with an apple in it is apple juice, when in fact, water with or without an apple in it is still water. We can

become much less affected by our thoughts, and even our feelings, and physical sensations when we distance ourselves from them and feel separate from them.

1.� Sit in a comfortable but alert position with your hands on your lap, legs uncrossed, and eyes gently closed or looking down. Start with the soothing breathing rhythm exercise for a few minutes, just focusing your attention on the gentle rhythm of your breathing.

2.� Now imagine that you are sitting by a stream. Notice your thoughts that pass through your mind (even if it is, “but I am not having any thoughts”) and imagine that each thought appears on a leaf.

3.� Imagine this thought floating past you on the leaf. You notice the thought without any judgment.

4.� Imagine this for each thought that pops into your mind.

5.� When you are ready just bring your attention back to the room you are in and gently open your eyes.

Learning Point: With practice, rather than feeling that a thought has pulled you “into the stream” so that you are struggling about in your threat system, this exercise helps you to feel that you are looking at your thoughts from a distance, as if from the bank of the stream.

You can do this with feelings too, such as “I feel angry”, or “I feel sad”, or “I feel calm”, and place these on the leaves, or even physical sensations such as “I feel tightness in my chest”, “I have butterflies in my stomach”, “I can feel heaviness behind my eye like I am going to cry”, or “I feel a warmth in my body”. This helps to show that our thoughts, feelings, and physical sensations, change constantly; they come and they go, and they are not us, they are just passing through us.



Exercise 7: Focusing on Kind Faces (NACC – “Notice, Acceptance, Compassion”)

When we are in our “Threat Minds” when we are feeling self-critical, angry, or anxious for example then our minds will draw our attention to faces that confirm our feelings. At these times we are more likely to notice people with cross, critical, or hostile facial expressions. We may even misinterpret other people as having hostile faces when that isn’t the case because our minds tend to have a “better safe than sorry” policy; “if in doubt, assume a face is hostile”.

When practicing compassionate attention, we intentionally try and pull our minds to seeking out kind, compassionate faces. This takes practice, and also kindness when our focus inevitably slides back to hostile faces. When this happens, we can try to just notice with a gentle smile that our attention has moved to hostile faces and then gently move our attention back to looking for kind faces.

We can practice this by looking through magazines or on the internet, or when we are out and about in the supermarket or in town for example, for all the kind faces.



Module Six

Compassionate Imagery

You might remember from previous modules, the power of our imagination. For example it can switch on our saliva and make our stomach rumble when we imagine a meal, or make us feel angry or anxious if we imagine being bullied, or make us feel soothed and safe if we imagine someone else, or ourselves being kind to us.

This module helps to build up the Compassionate Mind using the power of imagery. Some people find it hard to imagine things, other people find it easy. The key here is simply to try to just notice what happens with kindness and without judgment.

Some people get clear images, and others just have a fuzzy sense of something. Images may also change. This is all normal. Again it is just the trying that is the key.

As always, your attention will wander all over the place. When you notice this happening just gently bring your attention back to the image.



Exercise 1: Creating a Safe Place (NACC – “Notice, Acceptance, Compassion”)

In this imagery we are going to try to create a place in our mind – a place that could give you the feeling of safeness and calmness.

This place will be unique to you. Sometimes it can be difficult to make it feel truly safe. Because it is a place in your mind, you can use your imagination to change or bring in anything you want until you feel you can be safe and calm there. Start off with your soothing breathing rhythm and when you are ready, begin to create a place in your mind that gives you a feeling of safeness and calmness.

1.� Imagine looking around you. What can you see? Look at the colours, and how the light falls on what you can see.

2.� Now focus on what you can feel with your skin. In might be the feeling of the air, or the sunshine on your skin, or the warmth of a log fire. Notice what you feel as you touch things or as you sit down. Notice how it feels underfoot.

3.� Next think about what you can hear. It might be the rustle of leaves in the wind, the sound of water in a stream, the crackle of a log fire, the sound of birds.

4.� Now think about what you can smell, such as the sweetness of the air, or wood smoke from a fire, or the fresh smell of the water, or the smell of the grass.

5.� When you bring your safe place to mind allow your body to relax. Think about your facial expression; allow it to have a soft smile because you are in your safe place.

6.� Imagine that the place itself takes joy in you being there. You notice that when you go to your safe place, it welcomes you and is pleased that you are there. Notice how you feel when you imagine this place experiences joy at you being there.



Exercise 2: Compassionate Colour (NACC – “Compassion”)

1.� Start with your soothing rhythm breathing and, when you are ready, imagine a colour that you associate with compassion, or that gives you a sense of warmth and kindness.

2.� It might only be a fleeting sense of colour, but when you are ready, imagine your compassionate colour surrounding you.

3.� Then, imagine this entering through your heart area and slowly flowing through your body.

4.� You may prefer to think of the colour like a mist or light that just flows through you.

5.� As this happens try to focus on this colour as having wisdom, strength and warmth, with a key quality of total kindness.

6.� Now, as you imagine the colour flowing through you, focus on the feeling that the sole purpose of this colour is to help you, to strengthen you, and support you.



Exercise 3: Developing the Compassionate Self (NACC – “Notice, Acceptance, Compassion, Change”)

This is a key exercise as the Compassionate Self can help us in many ways; helping us to feel kinder and have a greater sense of well-being. It can also help us to make decisions about the best way forward in life that might be different from the decisions made by the other parts of ourselves.

In all of us there are many different parts; the angry part, the sad part, the joyful part, the creative part and so on. We can decide which bit we would really like to grow and develop, like an artist deciding they are going to put time and practice into developing the creative part of themselves. In this exercise, the focus is on developing the compassionate part of ourselves. We have the seed of these parts in all of us. In some the compassionate part is a flourishing plant, in others it may not have had the opportunity to grow very much at all. This exercise focuses on really trying to grow the seed into a tiny plant, or the tiny plant into a strong plant.

1.� Sit quietly and comfortable in an alert position. Start with your soothing breathing rhythm.

2.� Imagine that you are a very deeply compassionate person. Some find it easier to imagine that they are going to act the part of a deeply compassionate person in a play or a film, and that they are practicing getting into role as that person.

3.� So imagine that this person that you are going to play act is a very wise person who understands that we just find ourselves here with genes and a brain that has evolved over many millions of years neither of which we designed or have chosen. We also struggle with emotions and memories that we haven’t chosen to have. This person knows that is not our fault but something we need support and kindness to move through. Imagine your facial expressions and tone of voice as you play this person. Imagine the size of your body, whether you are male or female, or perhaps you find yourself as an animal or tree for example. Imagine your posture and how you move as you play this compassionate person.

4.� This person that you are play acting is also very strong with great courage. Imagine your facial expression and voice tone as you play the person who has such strength, who can face and heal suffering, who might be moved in the face of distress or anger, but never cracks or breaks. Imagine your posture and how you might move and walk.

5.� You also have great warmth and openness. Imagine being warm and kind, feeling filled up with it and it flowing out of you to other people.



6.� You also want to do the best you can to help yourself and others move forward in what is often a difficult situation. You have a sense of responsibility; an awareness that although something is “not our fault” we can make a commitment to ourselves and others to do our best to work on it, even small steps at a time.

7.� Imagine yourself growing into this part, playing this person who is wise, strong, warm, responsible and accepting. Imagine yourself walking along. Notice how you relate to anyone you come across, perhaps smiling at them with real kindness and warmth, real wisdom and strength and acceptance.

Extension to Compassionate Self Exercise – Relating to the sad/angry/distressed part of ourselves

8.� Now imagine that as you walk along you come across the sad/anxious/angry/distressed part of yourself. Notice how that part of you looks, the expression on their face and how they might sound if they spoke.

9.� Feel yourself grow with strength and wisdom and courage, with the knowledge that no matter what that part of you says or does you can bear it and stand firm with kindness and compassion. You can understand with kindness and wisdom just why that part of you is the way it is and why it struggles, and just what it needs from you right now.

10. Imagine yourself walking up to that distressed part of you and relating to them with kindness and warmth, strength and wisdom. Stay with them as they become soothed and calm. Notice what happens to the distressed part of you as you stay with them with kindness, warmth, strength and wisdom.

11. If you feel yourself becoming pulled into their emotions just take yourself back a bit and anchor yourself, imagining yourself becoming even more solid and strong, warm and wise, before going back and being with them once more until they calm.

12. Holding on to those feelings of wisdom, strength, warmth, and kindness, in your own time just gently bring yourself back into the room, becoming aware of the sounds in the room, the feel of your feet on the floor, and gently open your eyes when you are ready.

Don’t worry if you struggle to get a sense of these feelings, or to get an image. As always it is just the intention, the desire, the wish, the trying, that is the key. The more the exercise is practised, the easier and more powerful it becomes.

Baby notes: You might like to try this exercise where at point 8 you imagine coming across your upset, angry or worried child rather than yourself. You then imagine relating to your child with warmth, wisdom, strength, acceptance and kindness and notice how your child responds to this.



Exercise 4: Memories of Compassion Flowing Out (NACC – “Notice, Acceptance, Compassion, Change”)

In this exercise we are going to imagine kindness and compassion flowing from you to others.

1.� Start by sitting quietly in an upright, alert position with your eyes closed or looking down. Focus on your breathing.

2.� Try and recall a time when you felt very kind and caring towards someone (or perhaps to an animal), when you felt real warmth towards them.

3.� Focus on the desire to help and feelings of kindness. It is your behaviour and intentions that are important. Your feelings may follow on behind.

4.� Imagine yourself expanding as if you are becoming calmer, wiser, stronger and more mature, and able to help that person.

5.� Pay attention to your body as you remember your feelings of kindness.

6.� Spend a moment expanding with warmth in your body. Note a genuine desire for this other person to be free of suffering and to flourish.

7.� Think about the expression on your face of kindness and warmth, and a real desire to help.

8.� Think about how your voice might have sounded if you spoke, with kindness, warmth, wisdom and strength.

9.� Think about your pleasure in being able to be kind.

10. Just focus on how it feels to be filled up with these feelings of warmth, kindness, wisdom and strength.



Exercise 5: Imagining Compassion Flowing Out (NACC – “Notice, Acceptance, Compassion”)

1.� Sit quietly, with your eyes closed or looking down and just focus for a moment on your breathing.

2.� Imagine yourself filling up with kindness, warmth, strength, and wisdom. You might imagine it as a light or colour that flows through your whole body, filling you up and making you grow.

3.� Imagine this kindness, warmth, strength and wisdom, flowing out of you, and into each of the other people in your house, to your next door neighbours, to all the people in your street, to the whole town, to the whole country, and then flowing across the sea and across the whole world.

4.� You might notice that it is harder to send the feelings out to some people than others, but just notice this with curiosity and kindness, and without judging it. Just continue with your intention to send out this kindness, warmth, strength, and wisdom to everybody, no matter their relationship with you.



Exercise 6: Focusing the Compassionate Self on Yourself: Looking From A Distance (NACC – “Notice, Acceptance, Compassion, Change”)

1.� Sit quietly, in an upright, alert position, with your eyes closed or looking down. Spend a few moments focusing on your breathing.

2.� Imagine yourself filling up and expanding with strength, wisdom, and kindness. Remember that it is the intention and desire to be kind and helpful that is important.

3.� Focus on your facial expression of warmth, kindness, strength and wisdom. Notice how your body feels.

4.� Imagine that you are watching a video of yourself, through your kind, wise eyes. So you see yourself get up in the morning, and, holding your position of kindness and compassion, watch your self moving around in your room and then slowly getting on with your day.

5.� Notice how the person that you’re watching (i.e. you) is troubled by self-critical feelings or thoughts about themselves, perhaps fears of their relationships with others or of being criticised.

6.� Be in touch with the struggle of the person you’re watching, but just hold your position of inner calmness and wisdom, looking out through the eyes of your compassionate self with the intention of being kind and helpful.

7.� If that sense of the compassionate self wanders, or you lose it in any way; just let the imagery fade, go back to your soothing breathing rhythm, your compassionate expression, sitting up straight in a confident posture, and begin again.

8.� This exercise can also be carried out as if you are a big, wise, kind mind looking down from above, watching yourself as you get on with your day.

This exercise helps us take a wider view of our difficulties and also begin to see our own wisdom and abilities help ourselves feel better and move forward. Once we no-longer fight with ourselves but become more accepting, and recognise the struggle that we can have in life (through no fault of our own), we might find it easier to gradually learn how to change.

Baby note: This can be a helpful technique to use when you have been struggling in your relationship with your baby. You can imagine looking down from above or watching as if on a television as you go about your day with your baby. You watch with kindness and wisdom as you see yourself and your baby together, with a real understanding of just why you come to struggle sometimes with your baby. Your distance and your position of warmth and kindness can help to offer up solutions about what might help at the time and what might move you forward in the future.



Exercise 7: Creating an Ideal Compassionate Person (NACC – “Notice, Accept, Compassion, Change”)

The aim of this next exercise is to help you build up a compassionate image for you to work with and develop (you can have more than one if you wish, and they can change over time). Whatever image comes to mind or you choose to work with, note that it is your creation and therefore your own personal ideal – what you would really like from feeling cared for or about. However, in this practice it is important that you try to give your image certain qualities. These are superhuman – complete and perfect compassionate qualities that are there for you to practice creating and bringing to mind.

1.� Sit quietly in an upright, alert position with your eyes closed and gently draw your attention to your breathing.

2.� As you notice a sense of calm flowing through you, focus on the kind expression on your face. Bring to mind your safe place; the sounds, the feel, and the sights. Remind yourself that this is your place and it delights in you being here. This may now be the place where you wish to create and meet your compassionate image. You can imagine your image being created out of a mist in front of you, for example. The image may be walking towards you.

It has the following qualities:

•� A deep commitment to you: A desire to help you cope with and relieve your suffering, and take joy in your happiness.�

•� Strength of mind: It is not overwhelmed by your pain or distress, but remains with you, enduring it with you.

•� Wisdom: Gained through experience. It truly understands the struggles we go through in life. We all ‘just find ourselves here’, doing the best we can.�

•� Warmth: Conveyed by kindness, gentleness, caring and openness.

•� Acceptance: It is never judgemental or critical; it understands your struggles and accepts you as you are. However, remember too that it is deeply committed to help you and support you.

3.� You notice how your ideal caring, compassionate image looks. Does your ideal compassionate image seem old or young? Is it male or female (or nonhuman looking, e.g. an animal, sea or light)?

4.� How does your compassionate image sound if it spoke to you with a kind, warm voice?



5.� You notice how your ideal compassionate image relates to you, how it is with you. Remember your image really wants for you to be free of suffering, to be able to deal with the difficulties, and to flourish. It knows that we all just find ourselves here, living as we do, trying to make the best of our minds and lives. It understands that our minds are difficult, that emotions can run riot in us and that this is not our fault.

6.� Notice what it is like to focus on the feeling that another mind really values you and cares about you no matter what.

7.� Now focus on the idea that your compassionate ideal is looking at you with great warmth. Imagine that they have the following deep desires for you:

•� That you be well

•� That you be happy

•� That you be free of suffering

Learning Point: You may find that you don’t have a clear image. Indeed some people don’t really see their images in any clear way at all. The key to the exercise is the focus, and practice of imagining another mind wishing for you to flourish.

You might have thought ‘yes but this is not real, I want somebody real to care for me’. That is very understandable and even doing this exercise could make you feel sad. That is because your intuitive wisdom recognises that you need to be connected to other people. The key point to remember is that what we are trying to tackle is our own attitudes towards ourselves, particularly feelings of shame or self-criticism. While it is important to find people who are caring, it’s also important that we create these feelings within ourselves too – so that we gradually learn to focus on compassion for ourselves, rather than self-criticism.



Exercise 8: Compassion Under the Duvet (NACC – “Notice, Accept, Compassion”)

Ideally try to practice “becoming the compassionate self” each day even if this is just for a few minutes. It can be done when you get into bed at night or just before you get up in the morning. It can be done whilst you are feeding your baby or cuddling your baby, or whilst pushing the pushchair, or doing the washing up.

1. Just spend a few minutes bringing a kind, warm expression to your face.

2. Focus on your real desire to be wise and compassionate.

3. Focus on feeling wise and strong.

Notice how you fill up and expand with this feeling of warmth, kindness, wisdom, strength and complete acceptance.



Module Seven

Compassionate Thinking

When we feel worried, angry, or down then our threat system automatically takes control. When this happens, it is hard to pull ourselves out of thinking in a worried, angry, or depressed way. Compassionate thinking involves slowing down and becoming more aware of how our threat emotions direct our thoughts without our choosing. We can then choose to think with warmth and kindness instead, about what is helpful.�

This is where you may find it helpful to use the “NACC” technique, when you are caught up in your threat thoughts and are struggling to get out of them:�

“Getting the NACC” Technique�N Pause, notice what is flushing through you.�A Accept – these thoughts are not necessarily of your choosing, they are often difficult,

painful, but understandable. C Compassion – think about your struggles with real warmth and kindness. C Change – think with wisdom and strength about what would really help in this moment,

and in the future.

Exercise 1: Compassionate “NACC” Card

Choose a card or postcard that has a picture on it which makes you feel soothed and safe when you look at it. Print out or write down, on the card, the above “NACC” technique and keep it with you to be used when you are struggling to get out of a difficult train of thought.

Exercise 2: Compassion Focused Thought Balancing (NACC – “Notice, Acceptance, Compassion, Change”)

1.� Using the thought balancing sheet (below), first write down what has triggered off the feelings you are struggling with.

2.� Second, write down the thoughts associated with the difficult feelings you are experiencing.

3.� Now, just focus on your soothing breathing for a moment and then imagine your compassionate self or your compassionate image coming to you. Think about them being with you with warmth, kindness, wisdom and strength and a real desire to help you. Notice what they might say to you in their warm, kind, wise voice. Write these down in the “Helpful/kind thoughts” section.



Trigger Unhelpful/ distressing thoughts

Helpful/kind thoughts (try to create warm tone)

Example: I am useless It is awful to feel like this. I didn’t set out today to get angry Got angry with my child. with my child Now I think about it, I am really tired, and just need a bit

of quiet time for myself, so it is understandable that I am feeling short tempered.

It is sad for me and my child that I feel so worn out at the moment. I think I would like a bit of looking after myself actually but I hate asking for help.

What I need right now is to try to take a few soothing breaths and to smile kindly to myself and my child even if I don’t really feel like it; this isn’t the fault of either of us, it is just difficult at the moment. Then I think I will just get us out of the house, even if it is raining, for some fresh air because that gives us both a bit of peace and calm. I can then think a bit more clearly about what will help me.



Trigger Unhelpful/ Helpful/kind thoughts (try to create warm tone) distressing thoughts

Another way of doing this is to imagine what a really good friend might say to you.



Exercise 3: Compassionate Letter-Writing (NACC – “Notice, Accept, Compassion, Change”)

Some people find it very helpful to write down their thoughts and feelings. We can write in many ways, such as writing about all the negatives but we probably wouldn’t feel so good, or write about what has gone well which might give us a bit more balance. This exercise helps us to write from the compassionate part of ourselves. We will look at two ways of doing this;

A) From our compassionate self�B) From our compassionate image or good friend.�

A) Compassionate Letter-Writing From our Compassionate Self

1.� Take your pen and paper and then spend some moments using your soothing rhythm breathing.

2.� Next move into your compassionate self, imagining yourself at your best, at your calmest, at your wisest, at your most caring. Imagine yourself as you would ideally like to be in terms of being powerfully compassionate.

3.� As you focus on it, feel yourself expanding slightly and feeling stronger. Imagine you are a compassionate person who is wise, kind, warm, and understanding.

4.� Think about your kind facial expression.

5.� Remember, it doesn’t matter if you actually feel you are like this, just focus on the ideal you would like to be.

6.� It is this warm, kind, wise part of you that will write the letter.

7.� Don’t worry about how you should or shouldn’t write it, just let it flow as if the pen is writing itself. Just let it flow from the warm, kind part of yourself rather than thinking too much about how you are writing it.

8.� You could start by imagining that you are writing to a very dear friend who is struggling. Later you might begin to think about writing to yourself.

9.� These letters can be difficult to write and can take a number of attempts before they feel warm, kind, and genuinely wanting to help.

B) Compassionate Letter-Writing From Our Compassionate Image or Very Good Friend

1.� Spend a few moments focusing on your soothing breathing and imagine your compassionate image or very good friend appearing out of a warm light in front of you.

2.� It doesn’t matter if this image isn’t clear, just sense your image being with you, focused on helping you and understanding the nature of the difficulty you are struggling with.



3.� Imagine them speaking to you with great warmth and kindness, with wisdom and strength, completely accepting you and looking for a helpful way forward.

4.� Just let your pen write what this compassionate image might say.

5.� Your letter might follow the “NACC” technique for example:

Dear …..

N – Notice: “I can see that this is really hard and upsetting for you.”

A – Accept: “It is understandable that you feel so upset about that this when you think about how important this is to you, and particularly when you consider what has happened to you in the past. You didn’t choose to feel this way.”

C – Compassion: “We have got through difficult times like this before, and together we will work through this one. It feels awful at the moment but I will be with you all the way through this one and we will get through it.”

C – Change: “I guess the immediate thing is to work out what will help right now. You might feel like just curling up in bed, and perhaps this is what you need, but in the past you have found this just makes you sink down further. I remember that what usually helps you more is to take a bit of time, make yourself a hot drink, then phone your partner, or one of your friends. Remember that they might not be able to talk right now, so it might help to have another plan if they can’t. Perhaps it might help to write down now what you might say to your dearest friend to help her move through this. Perhaps think about what might help her in the long term as well.”

Baby notes: When you have had a difficult time with your baby, perhaps for example when you are struggling with your feelings towards your baby, it might be helpful to write a compassionate letter to both yourself and your baby.

•� First spend a few moments getting into the compassionate part of yourself or imaging that your ideal compassionate person or very good friend is writing to you and your baby as in “Dear ----- and -------”.

•� It might start with noticing just how painful this has been for both of you and how you hadn’t chosen to struggle in this way.

•� The letter is written with wisdom about the struggles and upset that both of you might have experienced and a deep and kind understanding of just why it has come to be difficult at this time.

•� It might also suggest what might help at this time and what might help in the future.



Module Eight

Compassionate Behaviour

Compassionate behaviour is about doing things to help when we, or others, are suffering, and helping ourselves to develop, flourish, and improve. It can involve thinking about what would be best for ourselves and making a commitment to carrying on doing what is best. Sometimes we will feel too angry or anxious to even think about how to help ourselves. At these times we could take the opportunity to notice this anger or worry with kindness and take time to let our feelings settle down before returning to the commitment to do what’s best for ourselves.

It can be helpful to think about how we might like to be in six months or a year, or how we would like our children to describe us and then think about some tiny steps we could make that would get us a little closer to how we would really like to be. Think about this with warmth and kindness.

Sometimes it takes a great deal of courage to do what we know would help us to move forward and flourish, such as asking for help when we fear we might be rejected or when we might not be able to return a favour, or go out and talk to people when we feel very shy. At times like this we need the compassionate part of us to help us to get up and have another go.

Here are some specific things that you could try:

1.� Each day do one spontaneous act of kindness to yourself and others.

2.� Each day, where possible, speak to someone – find out a little bit about them.

3.� Do one thing, no matter how small, that you think will help you to reach a longer term goal.

4.� Practise one act of forgiveness to yourself or others each day, no matter how small, especially if you tried and you weren’t as successful as you wanted to be or if you had a relapse of some kind.

5.� Do one thing, no matter how small, which is specifically designed by you to be enjoyable.

6.� Set time aside to practise some of your exercises.

7.� Spend five minutes remembering kindnesses that occurred in the day that went well.



Practice and Practice and Practice

Changing our behaviour can be hard and takes a great deal of practice. Our usual ways of imagining, thinking, feeling, and behaving have often developed over many years and are like well-worn paths. It is easier to carry on walking down these paths and it takes deliberate effort to start to make a new path. With practice this new path will become easier to walk along and will hopefully take us a bit closer to the place we really want to be.



Module Nine

Compassionate Feelings

Compassionate Mind Training exercises are designed to generate particular feelings in us. These are the feelings of soothing, safeness, contentment and peace, when there is nothing that we need (so the drive system is not switched on) and nothing that we are worried or angry about (so the threat system is not switched on). The feeling itself is created when we produce the hormone oxytocin. This is the hormone released when we cuddle our baby, when we are cuddled by our partner, even when we laugh with good friends. It works the other way too. So when we cuddle our baby, we stimulate oxytocin in them too so they feel soothed and safe. When our partner cuddles us it produces oxytocin in them too. So it is a hormone that keeps people connected.

Where people have experienced little soothing as a child then it can be very hard for them even to know what these feelings are like. The soothing system can become much harder to switch on. Even so, it doesn’t shut down completely and under the right conditions, and with practice, it can slowly start to come to life again.

At first though the focus is on getting the conditions right (like getting your garden ready for planting a bulb by weeding, and making the soil rich). In the beginning the focus is therefore on the intention, or wish, to try to feel compassion, warmth and kindness for yourself or others. The feelings will then follow in their own time. This exercise illustrates the importance of focusing on the intention or wish first, which will eventually bring the feelings:

Exercise 1: Growing the Tulip (NACC – “Notice, Accept, Compassion, Change”)

Imagine that you wish to grow a beautiful tulip. You have weeded the soil and put some compost in. You plant the bulb and cover it over. Then each day you focus on growing it with your warmth, kindness, and deep wish that it will grow strong and healthy. Every time you think of it this way you imagine it grows a little more. You may do this for weeks and wonder whether it is doing any good, but one day you are surprised and delighted to see a green shoot

appearing out of the ground. Continue to imagine growing it into a strong, tall, healthy tulip.

Learning Point: It can take a lot of practice before we get the feelings of warmth and soothing. But one day we realise that we have felt them, even if it is just a tiny spark of warmth. All the time our hard work has been paying off; it is never wasted.



Exercise 2: Calming the Horse or “Avatar” Dragon (NACC – “Notice, Accept, Compassion, Change”)

Imagine that you are with a beautiful horse or perhaps a pet that you really care about. The horse or pet has been scared by something and you are trying to calm it down. Notice how you try to calm it. Notice how it responds to how you are feeling inside; as you become calmer, so does the horse or pet. Stay with the horse or pet until it feels completely soothed and safe with you. Notice how you feel inside.

The film “Avatar” used this idea when the characters tamed a dragon. The characters (the Na’vi) “connected” to the dragons using the ends of their long plaits of hair. The dragons then responded to how the Na’vi were feeling inside. When they imagined not been able to fly the dragon, the dragon fell towards the ground, but when they imagined soothing and calming the dragon, and then flying the dragon, it flew upwards and soared through the sky. You can imagine soothing and calming the scared horse or dragon within yourself. The more you soothe it and think of it with warmth and kindness, the more it calms.

Baby note: Like a horse or a pet, babies are also very tuned in to how the people around them are feeling. You may have noticed that the more upset or frustrated you get, the more unsettled your baby becomes. You might also have noticed that as you calm down, your baby calms too. As you try these exercises, notice whether or not they have an impact on your baby, and indeed others in your home.

Exercise 3: “Anchoring” Feelings (NACC – “Notice, Accept, Compassion”)

When you do experience the feelings of warmth, kindness, and soothing, the feelings will inevitably move on, as all feelings do. It can be difficult to get those feelings back again when you want them. One way of making this easier is by “anchoring” the feeling to something such as a word or an object or picture (either real or in your mind). Whenever you experience the feeling you want to remember then hold your chosen object or bring your word or picture to mind. You are then linking the feeling with the object, word or picture. When you look at the picture or touch the object or say the word, with practice, it will bring the feeling to mind. It can even be anchored to a part of your body. This can be done by for example by gently squeezing the soft skin between your thumb and first finger when you notice the feelings arising in you. When you wish to bring up those feelings again then squeeze the soft skin again.



Module Ten

Compassion All Around: Using the Senses

We can use our senses of sight, sound, touch, smell and taste to help us build up the feeling of soothing, safeness, kindness and warmth. This might help us to make changes to our homes or lives that make us feel more soothed, or help us to find things that we can carry with us to help us move more easily into a compassionate frame of mind when we are struggling.

When considering what might make us feel soothed and safe, sometimes it can help to consider for a moment, what makes us feel the opposite ie, angry, anxious, fed up, and then to consider what would make us feel warm, soothed and safe instead.

These are some examples, but what will work best for you will be very specific to you. Over time you might notice what you see, hear, touch, taste, or smell that makes you feel soothed, and safe.

Vision Pictures on the wall Cards/postcards to carry Photos Pictures on your mobile phone Looking at trees and plants Having plants in the house Looking at the baby when it’s asleep Particular films

Write down what would create in you feelings of warmth, kindness, and feeling soothed and safe when you see them:



Touch Soft cushions Stroking the dog or cat Having your nails done Having a hand massage Having your hair done Stroking your baby’s hair Standing under a warm shower Feeling the breeze on your face Putting your hands in the warm washing up water Holding a warm cup of coffee or tea Being cuddled by your partner Having a baby or pet asleep on your lap A smooth stone or object to carry in your pocket

Write down what would create in you feelings of warmth, kindness, and feeling soothed and safe when you touch them:

Sound Particular music Laughing with friends Particular ring tones on your mobile phone The sound of birds The sound of rain on the windows when you are warm and dry in your home Your baby laughing The sound of the sea on a relaxation CD The sound of the kettle boiling or the washing machine going round The sound of the vacuum cleaner Focusing on the sound of your breathing when you are calm



Write down what would bring up feelings of warmth, kindness, and feeling soothed and safe when you hear them:

Smell Scent of particular flowers�A particular perfume or aftershave�A baby’s warm neck�Your partner’s neck�Fresh toast�New coffee when you pop the foil�The smell of your house�Fresh air�Your favourite shampoo�

Write down what would create in you feelings of warmth, kindness, and feeling soothed and safe when you smell them:



Taste Coffee, tea, hot chocolate – especially made by someone else�Your favourite meal for a winter’s day�The first bite of chocolate�

Write down what would create in you feelings of warmth, kindness, and feeling soothed and safe when you taste them:

Baby notes: Babies are very tuned in to their senses and over time you will help them move from being completely dependent on you for soothing, to learning to self soothe as well. One of the ways they do this is by using their senses, just as adults do. What do you notice that makes your baby feel soothed and safe?

Vision:�

Sound:�

Smell:�

Touch:�

Taste:�

How do you help your baby to learn to soothe themselves?�



Part Three: Troubleshooting: Resistance or Blocks to Self-Compassion

Introduction

This part of the learning pack looks at some of the specific struggles that we may have when trying to use Compassionate Mind Training.

We might recognise that we are simply not used to a compassionate way of thinking and it seems odd to us, but we can understand its value and the importance of practice. However, some of us find that we cannot move forward with compassion to ourselves because of the “yes buts…” that start to arise in our mind or uncomfortable feelings that seem to appear when we start to think about being kind and compassionate to ourselves. Until these resistances are addressed then the motivation is likely to be to turn away from compassion. Instead of starting to try to build the soothing system, the motivation may be to protect ourselves from the fear that compassion and kindness to ourselves brings up. This might be noticed as anger, discomfort or panic when thinking about or trying out Compassionate Mind techniques.

Using the “NACC” technique can help in pausing, and noticing the resistance, and then thinking with kindness, warmth and wisdom about what might be the fear behind it. This can help in developing an understanding that this resistance or fear has not been chosen but has arisen for a reason, whether that is because that is how our brains work or because of the need to protect ourselves because of our life experiences. As the fear of compassion becomes clearer we are then better able to think about what might help us to move forward from here.

A number of the struggles that seem to arise for people when using this approach are identified on the following pages, with some suggestions about ways in which these can be approached.

1. I Don’t Deserve to Be Kind to Myself

Some people have a sense that if anybody really got to know them, they would discover that they are not very nice or are bad in some way. Reasons for this are looked at in more detail below. If we have this sense of being unlikeable or bad then it can be difficult to believe that we are worthy of kindness, from anybody else, and certainly not from ourselves.



•� One way round this is to simply note that these beliefs are common, but to practice anyway. It is like taking up running or swimming to keep fit, or gently exercising an injured leg through physiotherapy. We do these things because we need to do rather than because we deserve it. We can adopt the same attitude to being kind to ourselves.

•� Another way is to think about where the idea of not deserving to be kind to ourselves has come from. We all have brains that are designed to need kindness and attachment to others, just like we are designed to pull away from something hot without thinking about it. It isn’t something we choose, it is just how we are made. Exercise 6 in the Compassionate Imagery Module; “Focusing the Compassionate Self on Yourself: Looking From A Distance” is a way of using the wise, kind, accepting part of our minds as if we are looking down from above upon our whole life. We can see ourselves from the time we were in our mother’s womb, right through to now as if watching a speeded up video. This can help us understand how we have come to believe that we do not deserve kindness and then to be able to look at ourselves with kindness and compassion.

Sometimes the belief that we do not deserve kindness has developed as a way of protecting ourselves (a safety strategy); if we don’t expect kindness then we won’t get hurt if we don’t get it, or “I will punish myself before you can” or “you don’t need to attack me, I will do that myself”.

•� Sadly sometimes children can develop a sense of themselves as bad and therefore undeserving of good things. This can feel like it is the absolute truth about them and that they are bad to the core, like the lettering running through seaside rock. Again Exercise 6 can be helpful here; using the wise mind to look down on just how it came to be that a baby grows up to believe he or she is bad. This can sometimes happen to a child living with a parent or caregiver who is scary, neglectful or critical. A child is dependent upon their caregiver for their survival, particularly in the early years. The caregiver is powerful and can withdraw their care so the child has to find a way of surviving this as best they can. It can be dangerous to a child to become angry at their caregiver, and instead a child has to find strategies to try and keep the caregiver as happy and available as possible; this includes taking on the belief that they themselves are bad and undeserving of kindness.

In a strange way, taking the responsibility for bad things happening to us sometimes gives us a sense of some control over an unpredictable situation. We might believe that if our parents treat us badly because we are being bad then all we need to do is be good and they will be loving and kind. However if we believe our parents treat us badly because they are bad then nothing we do will change that: we are powerless. We would rather believe that we are bad than to accept our powerlessness against our ‘bad parents’

The key point here is to understand with kindness and compassion how this very sad position, of believing we don’t deserve kindness, is not something we have consciously chosen to take on, but has arisen out of a way of trying to make ourselves as safe as possible.



•� Another method is imagining that an ideal imaginary compassionate person, even a kind of fairy Godmother, was looking down on your life from birth to now. Notice how they might relate to you, how they speak to you, and what they might say, with kindness, warmth, wisdom, strength and acceptance, about what you need right now, and what you need to help you move forward, develop, and flourish from here.

2. Fear of Kindness Triggering Overwhelming Emotions

For some people kindness can make them feel sad, tearful, full of grief or full of anger. This is because it touches on our inbuilt need to be cared for, cared about, and connected to others. When we feel distressed, depressed, anxious or lonely, being kind to ourselves can open us up to that loneliness and yearning inside to be connected with others. We can feel a great deal of sadness and anger if there wasn’t much in the way of kindness or caring available to us, so that when we do experience this it can sometimes feel like a tidal wave of sadness comes with it. If possible stay with these feeling and allow them to come through. This will be hard to do but you will find that like a tidal wave, the feelings flow through you and then eventually flow away, as all feelings do. A number of the techniques from Part Two can help if the feelings seem too much:

•� Safe Place Imagery – Imagine yourself walking into your safe place where you feel soothed and at peace.

•� Leaves in the Stream – Imagining the feelings and thoughts being placed on leaves and floating past you on a stream.

•� Distancing (Standing Next to Yourself) – Imagine standing next to the very sad, or angry, or worried part of yourself and relating to that part of you with real warmth, kindness and compassion. Notice the expression of kindness on your face as you relate to that struggling part of yourself.

•� Distancing (Noting where you physically feel the emotion) – Scan your body and notice how you know that you feel sad or angry or worried. Notice the physical sensations that indicate to you that you feel tearful or sad, for example “I can feel a prickling behind my eyes and heaviness in my chest”. This can help to feel more separate from the feelings rather than being pulled into them. It also helps to see that although it can feel unbearable and overwhelming, it is in fact just a physical feeling, which will pass in time, just like all other physical feelings.

•� Soothing Breathing Rhythm – Focus on your breathing, and gently bring your attention back to it each time your mind wanders. Notice the gentle rise and fall of your ribs as you breathe and becoming aware of your body settling into its own soothing rhythm.

•� In an hour, a day, a week….. Saying to yourself that like all thoughts, feelings and physical sensations – in an hour, a day, a week you will no longer feel this way.



•� Compassionate Ideal Person – Imagine being held by, or just sat with, your compassionate ideal person for as long as you need to until you feel better.

These techniques can be useful to put on a postcard to have with you for times when you are struggling with your emotion.

3. When Kindness Feels Horrible

Some people find that kindness makes them feel strange, uncomfortable, sick or scared, because when they were children their parents could be kind one minute but horrible the next. Feelings of kindness and horribleness become mixed up together. This is called “emotional conditioning” (see Part One to revisit this). We previously used the example of having a sickness bug after eating pizza and after that always feeling sick at the thought of pizza. This means that as we begin to feel kindness we can also experience the feelings of horribleness coming back as well. Here you just need to keep your focus on the feelings of kindness, notice other feelings creeping in, smile compassionately, and bring the attention back to the feelings of kindness.

The aim is to let the associations between kindness and feeling horrible weaken, like using a path less and less, and creating new paths between kindness and feel soothed and safe. By focusing more and more on these new paths, you use them more and wear them deeper, so making stronger and stronger connections in your brain.



4. Kindness Might Make Me Vulnerable

Where some of us have grown up in a difficult environment, we may have had to develop safety strategies to protect ourselves, such as shutting off and not hoping for or expecting care and kindness. Alternatively, our home life may have been very unpredictable, where if we relax for a minute then we may be caught off guard. Here it can be very scary to start to allow self-kindness or kindness from others. It can feel like taking off your armour.

Kindness and compassion is in fact far from “soft and fluffy”; it also requires courage and strength, for example standing firm when we believe someone is treating someone else unfairly, or deciding that if we are scared to leave the house then the compassionate thing to do is to help ourselves, step by step, to leave the house rather than stay curled up in our duvet.

This involves deciding what part of us we want to grow (think back to the Indian tale of the Grandpa to his Grandson – “there are two wolves in me, anger and compassion”. The Grandson says “which one will win Grandpa?” “The one that I feed” replies the Grandpa. Making the commitment to feed the compassionate part of ourselves takes a great deal of courage, particularly where in the past it has made us feel vulnerable. It is like trying to get back on a horse that has thrown us off, or crossing a road after and accident; it takes lost of tiny steps, courage, determination, but also a kindness and understanding when we struggle (as we probably will) and a kind encouragement and support.

Baby notes: For those of us who have been brought up in a difficult environment, or still live in a difficult environment, it can feel risky to bring up a baby with kindness and love in case they become “soft” and vulnerable. We think that because life is hard and people are not kind it is better for the baby to be toughened up so that she or he doesn’t get hurt.

To discover if we are indeed afraid of making our baby vulnerable, the first thing we need to do is to think about the kinds of things we are teaching our babies about the world and other people. The second is to understand with kindness and compassion why this may be our fear and that it often comes from a deep sense of wanting to protect our children; an attempt to keep our children safe in what can be a scary environment. The third is to think about what makes a child feel strong, confident, and able to cope with difficulties – a withdrawal of kindness, or lots of kindness? It is interesting that research has found that the children who are cuddled more, feel the safer, and are more confident, adventurous, and able to get help from others when they need it.



5. Can I Really Change My Brain?

It used to be thought that our brains became “set” during our childhood and were virtually impossible to change. Now we know that our brains can be changed throughout life. The phrase “use it or lose it” has arisen out of many studies that show that the more we practice something, the stronger the connections made in the brain for that particular skill. When we stop practising the connections eventually whither. It is just the same for kindness and compassion. There are particular areas in the brain connected to kindness and compassion. The exercises throughout this learning pack stimulate and strengthen these specific areas, which is why it is called Compassionate Mind Training. The more we practice feeling, thinking, behaving, imagining in compassionate ways, the more these areas become connected to each other, and the more readily these areas come into play when we need them. Just a few minutes of compassion practice a day can make a difference. It has been discovered that for people who have practiced compassion meditation for hours a day for many years, stay in this state of warmth and soothing most of the time. The soothing system becomes their resting position or set point rather than the threat system.




The Key Steps�This final section of the learning pack is a summary of the key steps of the Compassionate Mind Training.

1. The soothing system can calm the threat system (see “The Three Circles”)

Drive Soothing

Threat

•� Threat feelings (anger, anxiety, disgust) flush through us without our choosing. They exist to keep us safe.

•� Threat can be calmed by the soothing system.

•� We are wired up to respond to kindness. The drive system guides us to our goals of doing well in life and getting what we need. It gives us a “buzz” of excitement as a reward when we do.

2. We switch on our threat system when we criticise ourselves,

3. But we can also switch on our soothing system when we are kind and compassionate to ourselves

(The “Meal-Brain” diagram.)


Emotion Brain

Sexual Bullythreat

Kind, warm and caring

Soothed Safe

Fearful

DepressedArousal

Stomach acid

Saliva

Meal

Meal Sex Bullythreat

Compassion



4. We have an in-built fear of criticism

•� We are still wired up to see rejection, or being ignored, or forgotten by others as terrifying – for millions of years this was a great risk to our survival.

•� We criticise ourselves to keep ourselves safe from being rejected by others.

5. We have developed safety behaviours to keep ourselves safe but these can have unintended consequences. (see formulation)


Angry, violent, unpredictable father.

Other people can be scary. Other people can hurt you.

Watch others closely for any small signs of anger.

Don’t notice your own feelings or what you need. Lose your sense of self eg. what you like/dislike.

Be good, never upset anyone.

Get “walked “over. Don’t get your own needs met.

Keep your own anger in, in case you hurt others.

Never get to learn how to handle your own anger. Scared of getting close to people in case you get angry.

•� From being babies we learn safety strategies to keep us safe from things we fear. But as we get older these safety strategies can cause us difficulties (unintended consequences). They can stop us from developing and moving forward.

•� The way out of this loop is through looking at ourselves with a kind, warm, wise, strong, and accepting mind – The Compassionate Mind.



6. Moving into our compassionate mind takes effort and practice (like imagining preparing the ground, planting a tulip bulb, and growing it using warmth, kindness and compassion). Our threat mind is designed to take hold instantly and keep us there like a magnet. Pulling away from it towards the compassionate mind becomes easier with practice.

7. We can build up our compassionate mind by shifting our focus to compassionate thoughts, feelings, behaviours, images, and using our senses (see “spokes” diagram).

Compassion

Attention

Motivation

Imagery

Thinking

Behaviour

Senses Feelings

“Getting the NACC” Technique

N� Pause, notice what is flushing through you.

A� Accept – these thoughts are not of your choosing, they are often difficult, painful, but understandable.

C� Compassion – think about your struggles with real warmth and kindness.

C� Change – think with wisdom and strength about what would really help in this moment, and in the future.



Exercises for building each “spoke” of the Compassionate Mind


Attention 1. Moving the Torchlight 2. Diary of Compassionate Moments 3. “Zooming in” 4. Mindful eating of an apple 5. Soothing Breathing Rhythm 6. “Leaves in the Stream” 7. Kind faces in magazines/at

supermarket

Motivation 1. “Two Wolves” 2. Preparing Your

Garden 3. Compassionate

teacher

Feelings 1. “Growing the Tulip” 2. Calming the Horse 3. Anchoring

Compassion

Imagery 1. Safe Place 2. Compassionate Colour 3. Developing the Compassionate Self 4. Memories of Compassion

Flowing Out 5. Imagining Compassion Flowing Out 6. Compassionate Self From a Distance 7. Ideal Compassionate Person 8. Compassion Under the Duvet

Thinking 1. Getting the “NACC” 2. Thought Balancing 3. Letter-Writing 4. Voice of a Very Good

Friend

Behaviour Each day: 1. Do one spontaneous act of kindness. 2. Speak to someone and find out a

little about them. 3. Do one thing to reach a longer

Senses term goal. 1. Vision 4. Practise one act of forgiveness to 2. Touch yourself or others. 3. Sound 5. Do one thing designed by you to be 4. Smell enjoyable. 5. Taste 6. Practise compassionate exercises.

7. Spend 5 minutes remembering kindness from during the day.

8. Practice and Practice and Practice.

© Crown copyright 2011 404887 1p 360 April 2011 (BEL) Produced by COI for the Department of Health

www.dh.gov.uk/publications

http://www.dh.gov.uk/publications

Documents

Compassionate Mind Trainingapi.ning.com/.../LP12CompassionateMindV2.pdfCompassionate Mind (For FNP Supervisors and Family Nurses) Team Based Learning Pack 12 ... “We can still be