BE GENTLE WITH YOURSELF

"Be gentle with yourself" is the phrase that I most frequently say to my patients. It is my intention to counteract what, decades ago, Karen Horney called the "tyranny of the shoulds." They are those inner self-critical and judgmental voices that are so deeply engrained in so many of us that we think that they are simply aspects of human nature.
One of the initial steps of the psychotherapy process is to help our clients become more consciously aware how pervasive and insidious these inner critical voices are. And then begin to explore what are their roots. If you observe young children - in recent years I've had more opportunity to this by interacting with my grandchildren - you will witness that this criticalness is not present. How, then, did our clients inner critical "measuring stick" get internalized?
What life experiences with parents, teachers, coaches, and other significant adults in his/her early life contributed to the formation of this "measuring stick"? Answering this questions common background material that most psychotherapists and counsellors explore. It is also important to consider what are the cultural and sub-cultural influences that have contributed to the inner criticalness? The American culture is a very judgmental one and our clients, often without awareness, have internalized its standards. For example, one of the axioms of American culture is that,"You can do anything that you want to do as long as you put your mind to it and work hard." That notion is absurd nonsense, and is a source of feelings of failure and inferiority for many people. The truth is that we all are profoundly limited by our genetics. One small personal example - it exploring its sources how can we as psychotherapists and counselorswould have been impossible for me with very minimal musical ability to have become a cellist in a classical orchestra. No matter how much I practiced. It is then important for all of us to be gentle with ourselves and to come to a place of loving acceptance of our limitations. This will also help us to be more accepting of the limitations of others.
Some of our clients have inner standards that are idiosyncratic. One of my patients has an internalized image of being a generous person. Whenever he fails to live up to that image he chastises himself as "selfish." I often say to him,"Be gentle with yourself" as I gradually get him to look at the impossibility of living up to that standard. No human being could do it - not even the saints.
Within the limitations of a brief blog it is not possible to discuss in depth all the contributors to this "tyranny of the shoulds."
In addition to exploring its sources how can we as psychotherapists and counselors help our clients to counteract this self-criticalness? One pathway is for us to say,"Be gentle with yourself" whenever this voice shows up in sessions. Initially our clients will struggle with being able to take that in. Gradually what happens ,though, is a kind of 'transmission" wherein they internalize that phrase accompanied by the energy of our compassionate presence.
I also write on an index card,"Be gentle with yourself" and encourage my patients to put that in some place where they will see it often. I recommend that they periodically look at it saying the phrase either out loud or to themselves coupled with some relaxational breathing, imagining with the out breath that they are releasing some of the inner judgment or criticalness.
In addition, I suggest that they consider that the source of their own inner voice saying,Be gentle with yourself" is their own Higher Self or personal Higher Power. For some patients that notion does not fit with their worldview. for them I say,"Imagine that the source is some benevolent relative, or teacher. It may either be someone you personally know or some historical figure. Trust whoever comes into your consciousness at this time. Also the image may change over time." Gradually the potency of the inner critical,judgmental voices diminishes and my patients become more compassionate and loving towards themselves.

I LOVE MY PATIENTS

I love my patients. When I say this it oftentimes makes others uncomfortable.On one occasion I was being interviewed by a psychiatrist on radio and she said,"I read your book and I really liked what you had to say. However, your using the word love made me uncomfortable. I think that I would have preferred the word nurture - I nurture my patients." I responded,"I am aware that it makes people uncomfortable- sometimes it makes me a little uncomfortable too. We need to ask ourselves why does saying'I love my patients' make us feel that way?" One of the reasons is that in our culture the first associations to the word love are usually to sexual or romantic love. Of course,those expressions of love would probably be harmful to our patients. Yet, in other areas there is a wide spectrum of acceptable expressions of that feeling. We can easily say "I love...my children, my wife,boyfriend,friends,animals,home, community etc. Why not include patients?
Another explanation for the internal struggles is that it feels unprofessional to say,"I love my patients." We tend to define professional as objective and not emotionally attached. Yet, in some other cultures that is not true. Several years ago a dear friend,who is a psychotherapist, was on a trip in Cuba sponsored by a social justice organization. On this two week trip she was among a group of health care professionals who were in Cuba to witness how their health care system worked and to interact with Cuban health care professionals. She was very surprised to witness how often and easily the Cubans said,"I love you" and were openly expressive of their love toward their patients. And how openly they expressed that love of their patients at professional meetings. When she returned we had several interesting conversations. We discussed how our training emphasizes this other notion of "professional" as objective and non-attached - more scientific. It led us to recall how important it was for the early leaders of the fledgling fields of psychotherapy to be accepted by members of the medical and scientific community. They felt that in order to establish the legitimacy of this field among the other sciences that it was essential for them to be viewed as objective and emotionally distant. It seemed to both of us that we were still unnecessarily holding on to that earlier model.
When I am asked during interviews how I express my love I reply that, first of all,it is important to state that I am not talking about sexual or romantic or sentimental love. Those expressions of love towards our patients would be unprofessional and harmful. I am talking about open-hearted expressions of praise,encouragement,compassion,acts of loving kindness,warmth,celebrations of growth,consoling touch,non-judgment,caring challenges etc. A common response from other psychotherapists and counselors is,"I do those things too although probably not as often as I feel them and I don't really talk about it with my colleagues. Also, I don't usually think of those things as an important part of the treatment." Yet,according to the research literature about effective psychotherapy, when clients are asked what was most helpful to you in your therapy most frequently people reply that,"My therapist cared about me as a person." Moreover,there is increasing research on brain patterns indicating that compassionate caring over a period of time changes brain patterns in positive directions.
For most of us psychotherapists, counselors, life coaches, pastoral counselors a significant part of our original intentions in doing this work was our heartfelt desire to help people with their problems - to alleviate human suffering. For many of us our training with its emphasis on theories, techniques and professionalism has caused us to suppress those original heartfelt feelings.
A primary motive for me in writing the book,"Working From the Heart:A Therapist's Guide to Heart-Centered Psychotherapy", doing this monthly blog and Twitter, and making my youtube videos is to advocate that we return to our original heartfelt intention by being more openly expressive of our caring. Then our patients benefit not only from our theories and techniques, but also from our open-hearted expressions of love.