Tuesday, June 30, 2020

Developing Self Compassion as an Essential Part of Trauma Recovery

Learning to develop self compassion is an essential part of overcoming emotional trauma.  At the same time, it can be challenging for most adults who experienced childhood trauma to feel self compassion because part of the trauma involved developing a harsh, critical attitude towards themselves (see my article: Self Compassion: Loving Yourself in the Places Where You Feel Broken).

Often, these are individuals who found themselves in impossible situations where they had to function as adults even though they were young children. These situations include children who were in a role reversal situation at home where they took on the role of being the "parent" in a dysfunctional family. The term for this role is a "parentified child" (see my article: Children's Roles in Dysfunctional Families).

Self Compassion as a Part of Trauma Recovery


Many of these individuals have childhood stories of making heroic efforts at home to take care of their parents and siblings despite formidable odds.  Anyone who heard these stories would feel an outpouring of compassion for these people, and yet, these individuals are often hypercritical of themselves for "not doing enough" for their families.

These feelings of either "not doing enough" or, worse, "not being enough" often develops early in childhood and continues through adulthood.  These feelings often permeate their relationships, including their romantic relationships, friendships and work relationships (see my article: Overcoming the Emotional Pain of Feeling Unlovable).

These same individuals often feel a lot of compassion for others who had similar experiences as children, but they struggle to give themselves even one iota of compassion.  When they begin therapy, they might see the incongruity of this logically but, on an emotional level, they struggle when they attempt to feel compassion for themselves.

Clinical Vignette: A Traumatized Adult's Struggle to Feel Self Compassion
The following fictional vignette is a typical scenario of an individual's initial struggle in therapy to feel self compassion and how I use trauma therapy to help the client:

Nina
Initially, when Nina sought help in therapy she said the presenting problem was, "I have low self esteem." Although she was aware of her feelings of low self worth, she didn't see how harsh and critical she was of herself.

Since she wasn't aware of her inner critic, she was also unaware of the relationship between the inner critic and her feelings of low self worth and how this dynamic was connected to her traumatic experiences in childhood (see my article: Overcoming the Internal Critic).

Her self criticism extended to her inability to overcome her low self esteem. She felt that, as an adult, "I should be able to pull myself up by my bootstraps" (an expression her father often used when Nina was a child) to overcome her low self esteem. In fact, there was hardly an area in her life where she didn't experience herself as "weak."

As a trauma therapist, I'm aware that this inner critic can pose a significant challenge in trauma recovery and needs to be approached with care so traumatized clients don't leave therapy prematurely to protect this critical aspect of themselves (see my article: When Clients Leave Therapy Prematurely).  

You might wonder why someone would feel so protective of an internal part that is causing them so much emotional pain. Looking at this situation on the surface, logically, it might seem that they would want to overcome the internal critic.  

But, on an emotional level, it's important to understand that the internal critic was part of their survival strategy as children.  Even though the internal critic was harsh, it also pushed them to overcome obstacles as children.  Without the internal critic as a defensive strategy, these individuals would have fared much worse in their childhood homes (see my article: Understanding the Different Aspects of Yourself That Make You Who You Are).

Getting back to Nina's story: When asked about her childhood, Nina recounted how, as a young child, she pushed herself (through her internal critic) to keep the household going. As the oldest of four children, she took on a parentified role with her parents and siblings. 

At the age of 10, not only did she get alcoholic father up and out in the morning so he could get to work on time, but she also made breakfast for the whole family (while her depressed mother stayed in bed) and got her younger siblings dressed and took them to school.

As she talked about this time in her life, Nina said she often said to herself, "You'd better get dad up because if you don't no one else will and then he'll lose his job and we'll all starve" or "You have to get your brothers and sisters to school everyday or the school might contact the authorities and then we'll all be taking away from mom and dad."

During the initial part of therapy, Nina believed it was her responsibility, as a child, to take on the role of her parents because neither of them could function as parents. And, even though she was correct that there was no one else to help and the family would have fallen apart if she didn't take on this role, she didn't see the high price she paid in doing it.

Initially, as Nina talked about her childhood best friend, Anna, who was in similar role as a child, Nina expressed enormous love and compassion for Anna for the challenges she faced in her childhood. She understood that Anna functioned above the capacity of most children and that Anna sacrificed their childhood to do so.  

During the initial stage of therapy, when I tactfully tried to point out her compassion for Anna as compared to her lack of compassion for herself, Nina would shut down emotionally.

Her protective feelings towards her inner critic were so strong that she couldn't see the similarity between her childhood experience and Anna's.  It was as if her internal critic was her savior, and she couldn't tolerate being open and curious about it.

So, as Nina developed more of an awareness of her inner critic, I talked to Nina about the important function that her inner critic served when she was a child.  Nina agreed and told me, "That part of me pushed me to keep the family going, to do well at school and to do whatever was necessary to keep the household going. If I didn't have that part of me, I think I would have fallen apart and then my family would have fallen apart.  I couldn't allow that."

Over time, Nina felt safe enough in therapy to begin to go beyond appreciating the useful function that her internal critic served so that she was able to take small steps to explore the negative impact this internal part had on childhood, "I was often so exhausted. I could barely keep my eyes open in school. I see now how this part pushed me relentlessly and why it was so exhausting."

This realization didn't come like a lighting bolt. Instead, it evolved gradually over time as Nina saw that I appreciated the internal critic as the only survival strategy that she had as a child.  And, even as this initial realization developed, Nina was often quick to defend this part.  

Gradually, as Nina seemed ready for it, I helped her to tolerate seeing both the "good and the bad," as she put it, with regard to her internal critic.  This was a major breakthrough for Nina because, before this, she was only able to tolerate seeing the positive aspects of her internal critic rather than seeing the whole picture.

As we developed a positive therapeutic relationship, Nina felt safe enough with me to explore the more tender feelings that she had suppressed as a child so that she could take on an adult role.  She began to feel a sense of compassion for her younger self and, over time, she mourned for her lost childhood.

Parts work, which is also called Ego States therapy or Internal Family Systems (IFS), was helpful in allowing Nina to open up to those suppressed tender feelings.  By then, she had developed the emotional wherewithal to tolerate exploring the loneliness and emotional neglect she experienced as a child, and she allowed herself to grieve.

As Nina looked at her younger self, she began to feel a sense of love and compassion for that part of herself. During parts work in therapy, she was able to have a dialogue between her adult self and her child self where the child self was finally able to ask for what she needed and the adult self was protective of the younger self and helped to soothe her.  

This was an important turning point in therapy because as her adult self expressed compassion and love for her child self, the role of Nina's inner critic diminished.  Rather than pushing herself with harsh, critical messages, Nina nurtured her younger self in ways that she was never nurtured as a child.

At that point in therapy, I provided Nina with psychoeducation about EMDR (Eye Movement Desensitization and Reprocessing) therapy as a trauma therapy (see my article: Experiential Therapy, Like EMDR Therapy, Helps to Achieve Emotional Breakthroughs).

After learning about EMDR therapy, Nina agreed to try it with me.  The work was neither quick nor easy, but EMDR therapy, along with parts work, helped Nina to work through her traumatic experiences.

By the time Nina completed trauma therapy, she was a much more psychologically integrated person.  Her traumatic experiences no longer had a negative impact on her life.  She experienced self compassion. And, in addition, she was able to form a healthy relationship with a man she began dating, and her friendships grew and deepened.

Conclusion
Self compassion is often sorely missing for individuals who grew up with childhood trauma. Although they might feel compassion for others in similar situations, they have difficulty feeling self compassion.  

A harsh inner critic is often part of a maladaptive survival strategy for people who experience trauma.

If the therapist doesn't appreciate role of the inner critic in terms of the client's survival, the therapist risks alienating the client and the client leaving therapy prematurely as a way to protect that part.

Before the negative impact of the inner critic can even be broached, the therapist needs to establish a strong therapeutic alliance with the client for the client to feel safe enough to explore the negative aspect of the inner critic (see article: The Creation of the Holding Environment in Therapy).

Parts work, also known as Ego States work or IFS, is helpful for clients to begin to see that their internal world is made up of many different aspects, including an internal critic.

When clients can begin to feel compassionate and nurturing feelings for the younger self, the internal critic often begins to soften and diminish.

EMDR therapy, which is a trauma therapy, helps traumatized clients to reprocess and reconsolidate their traumatic memories so that these memories no longer have a negative impact on them.  

Getting Help in Therapy
It's often difficult for traumatized individuals to seek help in therapy because many of them weren't able to form loving, trusting relationships in their family, so they're reluctant to reveal the more vulnerable parts of themselves to a therapist.

Finding a therapist that you feel comfortable with is essential. It might take a while before you feel comfortable enough to reveal the more tender parts of yourself, but most people get at least a sense of whether they feel a connection with a therapist during the first few sessions.

If you're feeling overwhelmed by unresolved trauma, you're not alone. Trauma therapy can help you to work through traumatic experiences so that these experiences no longer create obstacles for you, and you can live a more fulfilling life.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR, AEDP, EFT and Somatic Experiencing therapist (see my article: The Therapeutic Benefits of Integrative Therapy)

I work with individual adults and couples.

One of my specialties is helping clients to recover from trauma (see my article: What is a Trauma Therapist?).

During the COVID-19 pandemic, I am providing teletherapy, which is also known as online therapy, telehealth or telemental health.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.