Compassion-based CBT, as described by Paul Weber, could be straight out of a manual of Buddhist teachings, or from Holy Scriptures. I use a lot of CBT with my clients, but in cases where the client is overly focused on self-criticism and shame, actually believing the “alternative healthy thoughts” is a struggle. Conceptually they understand the logic of Socratic dialogue, but they don’t integrate the rational thoughts, maybe because they lack a key ingredient crucial to recovery: self-compassion. This is when I use more compassion-based interventions. Finding and developing self-compassion is a lot easier with religious clients. Here’s why:

Clients who practice religion based on Abrahamic traditions tell me that the essence of the “compassionate self” goes back to the spirit of God which was blown into Adam and is the source of goodness in all humans. They acknowledge self-compassion as a tool for challenging the devil – who misleads and tricks us through negative self- talk. They equate the automatic negative thoughts associated with our inner voices (the critic, worrier and perfectionist), as a device of evil. Challenging and minimizing evil thoughts is part of their religious belief system anyway. These clients can more easily cultivate self confidence as well. Why? Because they believe that God has a purpose for them – so since it is Divinely ordained, they must have the ability to carry out that purpose. Behavior activation, behavior experiments, and finding evidence to support core beliefs are easier to engage in when they are in harmony with spiritual teachings. The compassionate self fits in well with both science as an emotion regulation system and with religion, as a source of spiritual strength.

Sometimes, though, I see the opposite. Clients who had very insecure attachment to their mothers specifically, or who were emotionally or physically abused by mothers, tend to abandon spiritual faith. It’s unfathomable to them that a God would allow what happened to them, to happen. With no inspiration for self-compassion and no lived experience of it either, it’s an uphill journey to help them cultivate good feelings out of nothing. Nurturing the compassionate self does not appeal to their intellect, as it isn’t linked to anything they can actually relate to. The emotion regulation system that is most active in these cases is the fear and danger system – clients are hyper vigilant and conditioned to be reactive. These are the difficult cases. This is when Rogerian style unconditional positive regard and empathic listening are the keys that help in the process of recovery. This is when ideas don’t heal, the therapeutic relationship does.

*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA