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Becoming You: Group Therapy Proposal

Kev Holmes

Department of Counseling, California State University – Fullerton

Coun 528-01 Group: Process and Practice

Dr. Ana Reyes

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Becoming You: Group Therapy Proposal

In Gilbert et al.’s (2004) journal exploring self-criticism, they briefly write about an

undergraduate student patient, Clare, who suffered from high self-criticism. They explain how

Clare used self-criticism to motivate her work ethic. However, as her standards became higher,

she struggled to live up to her rising expectations and noticed her self-criticism changed. It

became sadistic and morphed into a form of self-hatred as she told herself that she was a waste of

space and would be better off dead. Even as Clare wanted to heal her self-hatred, she was loath

to let go of her self-criticism because she felt like she could not succeed without it (Gilbert et al.,

2004).

Self-criticism is a type of punishment people experience in response to perceived failure,

especially surrounding contingencies of worth (Gittins & Hunt, 2020). Contingencies of worth

are domains, or values, on which a person stakes their self-esteem. When people with high levels

of self-criticism fail in a contingency of worth, it becomes a reflection of their value as a human

being, leading them to spiral into depression or other psychopathological responses (Crocker &

Wolfe, 2001). People who engage in excessive self-criticism often have an introjected/self-

critical personality, meaning they experience intense feelings of inferiority, guilt, and

worthlessness in response to failing to live up to their standards and evaluate themselves harshly

to avoid disapproval and criticism from others (Blatt, 1974).

Concepts such as self-evaluation, self-criticism, self-blaming, and self-condemnation are

common features in psychopathology (Gilbert et al., 2004). In their research, Gilbert et al. (2004)

highlights the different functions of these traits. Self-condemnation serves to prevent future

errors and maintain standards (Driscoll, 1989), self-blaming and self-criticism originate from and
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create frustration and self-hatred (Gilbert, 1997), and self-devaluation functions to prevent

someone from taking risks, keeping them in a submissive position (Gilbert, 2012).

However, all of these negative self-schemas have a similar alternative: self-compassion.

Unfortunately, people with high self-criticism experience compassion, both generating and

receiving it, as an aversive experience and even grow to fear it (Matos et al., 2017). Even though

compassion effectively shields against depression and other negative psychological symptoms,

this population views compassion as a sign of weakness, a symbol of dependency, and an

experience that highlights their feelings of worthlessness and unworthiness (Hermanto, 2016).

So, despite compassion being an effective intervention to protect against self-criticism and other

forms of self-destructive schemas, it is not something this demographic generally has an easy

time experiencing without guidance and psychoeducation (Gilbert & Procter, 2006).

College students are especially vulnerable to mental health conditions associated with

high self-criticism. In a recent study, The American College Health Association (2016) found

that 64.5% of surveyed students reported feeling extremely anxious, and 44.4% reported

experiencing at least one episode of depression that was so intense they could not function.

Research suggests that individuals with mood and anxiety disorders experience high levels of

maladaptive perfectionism, including self-critical perfection (Antony et al., 1998). Due to the

high stress associated with transitioning to college and the high-paced college experience,

individuals with high baseline self-criticism and self-critical perfectionism are at increased risk

for depressive episodes and self-harming behavior (Levine et al., 2019).

Treatment of the Problem

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This ten-week closed group aims to help college students cope with their self-criticism by

combining aspects of dialectical behavior therapy (DBT) and mindful self-compassion (MSC)

practices. Though cognitive behavior therapy (CBT) is standard when altering behavior and

thoughts in clinical settings, clients in crisis perceive CBT strategies as invalidating because it

implies that a person’s thoughts and behaviors are wrong; this adds to the cycle of self-criticism

(Neacsiu et al., 2012). DBT and MSC have strong roots in mindfulness, a practice that

emphasizes nonjudgmental awareness and acceptance of a person’s current reality. It is a

beneficial tool when teaching clients to cope with their current thoughts (Neff & Germer, 2012).

This group begins by borrowing distracting, and self-soothing skills taught in DBT.

When clients are in crisis or experience spiraling thoughts, they do not have the mental capacity

to use new skills as coping mechanisms. Instead of introducing new skills, distress tolerance

draws awareness to non-harmful pre-existing distraction and soothing activities the client finds

accessible. Engaging in distraction allows a client’s mind to slow down to the point where they

may be able to access more complex coping techniques (Linehan, 1997). This section also

introduces interventions that are immediately helpful for alleviating distress, such as exercising

or ice diving. These skills require no practice to be effective; one only needs to remember to

access them. After introducing distress skills, the group teaches clients about mindfulness in a

general sense. As the group progresses, it introduces more complicated aspects of mindfulness

through the lens of self-compassion. This slow progression is crucial as it gives group members

time to adjust to the new skills before applying them. Individuals who experience high amounts

of self-criticism are likely to reject self-compassion because they may feel it will make them

weak (Matos et al., 2017). By introducing mindfulness and self-compassion as two separate

techniques, group members will hopefully be more likely and willing to explore mindfulness,
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which is a valuable skill on its own, even if they shy away from self-compassion. Before directly

teaching self-compassion, members learn to recognize and name emotions. This steppingstone

between mindfulness and self-compassion is a way to give group members the tools to identify

the emotions they may need to soothe with self-compassion. Being able to name the experiences

and sensations of emotion is necessary because, without awareness, self-compassion lacks

precision and may feel ingenuine.

Self-compassion is only a small part of how DBT addresses emotional regulation. This

group centers it more fully because the group caters to those experiencing high and debilitating

levels of self-criticism. Self-compassion is the difference between reducing self-criticism, or

self-directed hostility, and learning to replace it with something soothing and healing (Gilbert &

Procter, 2006). Individuals who engage in self-compassion have a psychological buffer between

themselves and distressful experiences like anxiety and depression; it involves being patient and

understanding with oneself, exhibiting unconditional acceptance regardless of circumstance and

recognizing that suffering is a universal experience (Neff & Germer, 2012). Finally, the group

experience ends with looking at the larger picture, examining the role values can play in

experiencing self-criticism and distress. Consciously understanding your value systems can help

individuals tolerate difficult situations and help people create a more fulfilling life (McKay et al.,

2019). Though the group is not intended to restructure the members' lives completely, it provides

the tools and resources for group members to continue doing work either on their own or through

individual therapy.

Self-compassion and acceptance work is ideal for group therapy settings. While learning

within a group, people find ways to identify with each other and support one another as they

understand their experiences of self-criticism are shared (Gilbert & Procter, 2006). Though DBT
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groups are typically run as a skills group, this group combines skills and processing to help

members practice compassion. Processing and sharing gives group members a chance to practice

giving and receiving compassion while highlighting the shared humanity of their experience first

hand (Andersen & Rasmussen, 2017). Group therapy settings also offer the unique experience of

receiving validation from peers engaging on a journey together rather than only processing with

an instructor who holds an inherent power over their clients.

Group Development

Population

This group will consist of undergraduate students enrolled at California State University

Fullerton, ideally between the ages of 18 and 22. There will be no restrictions on gender,

ethnicity, or sexuality or other demographic identifiers. All accepted group members must have a

significant struggle with self-criticism that interferes with their mental health.

Screening and Member Selection

The advertisements for this group include a QR code for interested students to scan,

which links to a Google Form. The form contains a more detailed description of the group, an

outline of group topics, contact information for the mental health service’s office, and phone

numbers for crisis hotlines and alternative counseling services. This initial form also collects

information such as the student's name, age, contact information, their preferred mode of pre-

screening interview (phone or in person) and ideal times said interview. There are optional

spaces for students to answer additional screening questions, but section is not mandatory for

application submission as similar questions will be covered in the prescreening interview; it is

just a place to offer more information if desired. Once the form is submitted, students will
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receive a confirmation email as well as a follow-up email containing details about the

prescreening interview

During the phone/in-person interview, the student will be asked about any previous

therapy experience, why they are interested in this group, what they might want to get out of this

experience, and how they feel about sharing and learning in a group setting. They will also be

asked about their experience with self-criticism to assess the severity of their problem and

whether or not this group is the best way to help them. If it is determined that would be better

served working one-on-one with a therapist, those resources will be provided.

After the questioning portion of the interview, the facilitator will go over the details of

the group to make sure the student understands that it is a ten week commitment, members will

be assigned informal homework to practice skills outside of group, and that the process may be

uncomfortable but is designed to benefit the client over time. Finally, the facilitator will discuss

limits of confidentiality with the student to make sure they understand the facilitator’s role as a

mandated reporter and that, while confidentiality will be encouraged in the group, it cannot be

guaranteed.

Once the interviews have concluded, a group of students will be selected based on their

willingness to learn, interact with, and commit to the group procedure. The facilitator must also

assess that each student will be a good fit for group therapy. If there is anyone who is not

accepted into the group, they will be called, and the facilitator and student can discuss next steps

for helping them cope with the self-criticism they experience. This may include, but is not

limited to, individual free therapy through the University, references to other groups in the area,

references to other agencies for individual therapy, and resources such as online forums and

workbooks that the client might find helpful.

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Ethical Considerations

Though this group is not a formal DBT, there is a chance that some group members

might struggle with non-suicidal self-harm (NSSI) or suicidal ideation (SI) as a result of their

high self-criticism, and there is a chance this might be self-disclosed in group. Counselors have a

legal and ethical duty to protect clients from harm, including harm to themselves. Facilitators of

this group must be on the lookout for indications of NSSI and SI and be prepared to offer

additional support to these group members via temporary crisis counseling or getting the student

set up with individual therapy in addition to the group. If the situation is severe enough, a group

member might have to be 5150’d for their safety.

As with all groups, confidentiality is an ethical concern. Confidentiality cannot be

guaranteed in group settings. Because this group includes processing vulnerable and difficult

experiences, the expectation of confidentiality must be explicitly stated for members of the group

while acknowledging that it cannot be fully guaranteed.

Details of the Group

This group will consist of a minimum of eight and maximum of 12 undergraduate college

students. It will meet weekly on Wednesdays for two hours from 6:00-8:00 pm for a total of ten

weeks beginning September 14 and ending November 16, 2022 in the California State University

Fullerton counseling office’s group space. The handouts found in the appendices will be

compiled into a binder for each member to keep and will include blank pages for group members

to track and journal about their skill use throughout the group process.

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Please see Appendix A.

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Group Goals

The goal of this group is to give students the necessary tools to cope with, and eventually

challenge and rewrite self-critical thoughts cause harm and distress. Individuals will hopefully

be more comfortable, accepting and compassionate who they are in any given moment regardless

of their circumstance by using DBT and MSC techniques. Spiraling self-critical thoughts can be

debilitating and learning to be self-compassionate is almost impossible in those situations unless

one has guidance. Hopefully, this group can be that guided starting point.

Session Outlines

Session Theme Outline

Number
1. Getting to know the group members
and introducing the topics of self-
compassion, self-worth, and self-
esteem.
1. Welcome
- Break into dyads and have partners
introduce each other
2. Informed consent and discussion of
group norms/agreements

3. Self-compassion and self-esteem

worksheet (Appendix B)

4. Exploration of group’s feelings towards

self-compassion using the worksheet as
prompt

5. Feeling/processing and group closeout

2. Learn about distraction skills and 1. Introduce using distraction skills when
when to use them experiencing emotional crisis or
ruminating thoughts
- TIP handouts and explain/demonstrate
ice dive skill (Appendix C)

2. Activity: Distraction Skills

- have group members check off what

3. Introduce and learn about self-
soothing skills and explain the
difference between when to distract
versus when to soothe.
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activities they would be willing to engage
in on basic distraction skills worksheet
(Appendix C)
3. Processing:
- What are your feelings towards using
distraction skills? Have you used any of
these in the past and how have they been
effective? How do you think you can use
these skills and will use these skills?
4. Closing check out.
Homework: Make a note of moments
when you use or could use self-distraction
skills
1. Check in: what was it like to use self-
distraction skills?
2. Introduction to self-soothing and brief
talk about when and how to engage in this
skill versus distraction
3. Activity: self-soothing (Appendix D)
-Fill out what skills they would be willing
to engage in
- Create a relaxation plan
4. Activity: Stress Kit
- Provide materials for members to put
together an emergency soothe/distraction
kit (pouches, small candies, cards of
affirmation, worry stones, perfume
samples, etc.)
5. Processing:
- Reflect on the skills learned in this group
- What are your feelings towards using
soothing skills? Have you used any of
these in the past and how have they been
effective? How do you think you can use

4. Introduce the concept of
mindfulness, its benefits, and the
diversity with which it can be
practiced
5. Delve deeper into the concept of
mindfulness and discuss wise mind
and how mindfulness can be used to
combat intrusive thoughts
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these skills and will use these skills?
6. Closing check out.
Homework: Make a note of moments
when you use or could use self-soothing
skills
1. Check in: what was using self-soothing
skills like throughout the week and were
they helpful?
2. Introduce the concept of mindfulness
(Appendix E)
3. Activity: Progressive Muscle
Relaxation
- (Appendix E)
4. Process:
- Brainstorm alternative mindfulness
activities
- What are your feelings towards using
mindfulness? Have you used any of these
in the past and how have they been
effective? How do you think you can use
these skills and will use these skills?
6. Closing check out.
Homework: commit to practicing
mindfulness for at least 10 minutes a day
for the next week and note it in the
mindfulness log (Appendix E)
1. Group check-in and reactions to
mindfulness homework
2. Introduce the concept of wise mind
3. Activity: Wise-Mind (Appendix F)
- Have group members think of a current
issue and break down their thoughts using

6. Discuss the importance of being able 1. Check in and reactions to practicing
to name emotions and understand
the function of different emotions in
the body in a nonjudgmental way.
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reason, emotion, and wise minds
3. Process and Discuss:
-Allow group members to share their
process and discovery through this
activity
- How can mindfulness be used to
nonjudgmentally examine thoughts
5. Closing check out.
Homework: commit to practicing
mindfulness for at least 10 minutes a day
for the next week and noet it in the
mindfulness log (Appendix E; another
will be provided in the workbook)
- Note moments when wise-mind was
used or could have been used
mindfulness and wise mind
2. Activity: Provide a large sheet of paper
with the outline of the human body on it
and have group members use markers to
label where and how they experience
emotions
- have group reference Ways To Describe
Emotions (Appendix G) if needed
3. Introduce the idea of non-judgment
toward feeling and review Mindfulness of
Current Emotions and Managing Extreme
Emotions (Appendix G)
4. Discussion: Perception of emotions and
their roles
- What emotions make you powerless?
What emotions do you enjoy feeling?
What do you think about emotions and
what role do they play?

7. Discuss self-compassion and how to
use meditation/mindfulness
exercises like Loving Kindness to
self-soothe
8. Continue exploring self-compassion
and how to use it when experiencing
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5. Closing check out.
Homework: be aware of your emotions
throughout the week and use the
Emotional Record (Appendix G) to
document your experiences
- If the opportunity arises, use the skills
outlined in the Mindfulness of Current
Emotions and Managing Extreme
Emotions handouts (Appendix G)
1. Discuss reaction to the week’s
homework
2. Review the concept and definition of
compassion (Appendix H)
- Have your feelings towards self-
compassion changed at all in the past few
weeks?
3. Activity: loving kindness (Appendix H)
- Explain the role of phrases in
lovingkindness
- Lead group in loving kindness
meditation
3. Processing:
- How did it feel to give yourself words of
lovingkindness? What emotions came up
for you when asked what you need and
want to hear from others? Are these things
you hear regularly or are they lacking
from your life?
4. Closing check out.
Homework: Engage in at least five
minutes of loving-kindness practice every
day; journaling recommended but not
required
1. Discussion about homework experience

intense emotions and rumination
9. Begin looking at the bigger picture
in the group’s lives by exploring
value systems and understanding the
importance of connecting with these
values.
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2. Review how self-compassion can be
used when experiencing intense emotion
3. Activity: Difficult Emotion Meditation
(Appendix I)
4. Discussion:
- What came up for you during this
exercise? What did it feel like to sit with
that difficult emotion? What can you do to
self-soothe using self-compassion in the
moment?
5. Closing check out.
Homework: Try to find moments when
you can use loving-kindness toward
yourself as a compassionate response to
suffering
- Start or end your day with loving-
kindness phrases and see how it affects
you
1. Group check-in about homework
2. Introduce how explicitly understanding
one’s values contributes to understanding
emotional reactions both in life and during
triggering situations
3. Activity: Prioritizing values
- Pass out notecards and markers
- Have group members use Values
Activity Worksheet (Appendix J) as
guidance and write their values on
notecards
- Have group members go through their
note cards and order them from most
important to least important and finish
values activity worksheet
4. Discuss how values play a role in the

10. Process the journey group members
have had through this program and
plan how to maintain some of the
practices learned in group.
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group members' lives
- Encourage group to share their top
values and how it shapes their lives
- Explore how sticking to or deviating
from values has affecting group members
in the past and present
5. Closing check out.
No Homework
1. Group check-in:
- What has this process been like for you?
- What practices worked for you and
which have not?
2. Activity: Goal planning (Appendix K)
- Have group members complete
individually
- Pair into dyads and have members
discuss their post-group goals
- Reconvene as a group and discuss the
activity and how to maintain practices
post-group
3. Group Discussion:
- Are there any topics you want to review?
- Acknowledgement of progress
4. Provide additional resources.
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References

Andersen, B., & Rasmussen, P. H. (2017). Transdiagnostic group therapy for people with self-

critic and low self esteem, based on Compassion Focused therapy principles. Journal of

Compassionate Health Care, 4(1). https://doi.org/10.1186/s40639-017-0043-1

Antony, M. M., Purdon, C. L., Huta, V., & Swinson, R. P. (1998). Dimensions of perfectionism

across the anxiety disorders1an earlier version of this paper was presented in November

1996 at the meeting of the Association for Advancement of Behavior Therapy in New

York City.1. Behaviour Research and Therapy, 36(12), 1143–1154.

https://doi.org/10.1016/s0005-7967(98)00083-7

Blatt, S. J. (1974). Levels of object representation in Anaclitic and introjective depression. The

Psychoanalytic Study of the Child, 29(1), 107–157.

https://doi.org/10.1080/00797308.1974.11822616

Diamond, S. (2019). Formal mindfulness practice log. MoreThanMindful.com. Retrieved June

27, 2022, from https://morethanmindful.com/wp-content/uploads/Formal-Practice-

Worksheet.pdf

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treatment. Psychotherapy: Theory, Research, Practice, Training, 26(1), 104–111.

https://doi.org/10.1037/h0085394

Gilbert, P. (2002). Evolutionary approaches to psychopathology and cognitive therapy. Journal

of Cognitive Psychotherapy, 16(3), 263–294. https://doi.org/10.1891/jcop.16.3.263.52515

Gilbert, P. (2012). Overcoming depression: A self-help guide using cognitive behavioral

techniques. Read How You Want.

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Gilbert, P., & Procter, S. (2006). Compassionate mind training for people with high shame and

self-criticism: Overview and pilot study of a group therapy approach. Clinical

Psychology & Psychotherapy, 13(6), 353–379. https://doi.org/10.1002/cpp.507

Gilbert, P., Clarke, M., Hempel, S., Miles, J. N. V., & Irons, C. (2004). Criticizing and

reassuring oneself: An exploration of forms, styles and reasons in female students.

British Journal of Clinical Psychology, 43(1), 31–50.

https://doi.org/10.1348/014466504772812959

Gittins, C. B., & Hunt, C. (2020). Self-criticism and self-esteem in early adolescence: Do they

predict depression? PLOS ONE, 15(12). https://doi.org/10.1371/journal.pone.0244182

Hermanto, N., Zuroff, D. C., Kopala-Sibley, D. C., Kelly, A. C., Matos, M., Gilbert, P., &

Koestner, R. (2016). Ability to receive compassion from others buffers the depressogenic

effect of self-criticism: A cross-cultural multi-study analysis. Personality and Individual

Differences, 98, 324–332. https://doi.org/10.1016/j.paid.2016.04.055

Levine, S. L., Milyavskaya, M., & Zuroff, D. C. (2019). Perfectionism in the transition to

university: Comparing diathesis-stress and downward spiral models of depressive

symptoms. Clinical Psychological Science, 8(1), 52–64.

https://doi.org/10.1177/2167702619865966

Linehan, M. (2015). Dbt skills training handouts and worksheets. The Guilford Press.

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and lack of safeness memories, fears of compassion and psychopathology. The Journal of

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McKay, M., Wood, J. C., & Brantley, J. (2019). The dialectical behavior therapy skills

workbook: Practical Dbt exercises for learning mindfulness, Interpersonal Effectiveness,

emotion regulation. New Harbinger Publications, Inc.

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counseling intervention. The Counseling Psychologist, 40(7), 1003–1032.

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mindful self-compassion program. Journal of Clinical Psychology, 69(1), 28–44.

https://doi.org/10.1002/jclp.21923

Neff, K., & Germer, C. K. (2018). The mindful self-compassion workbook: A proven way to

accept yourself, build inner strength, and thrive. Guilford Press.

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https://www.therapistaid.com/worksheets/progressive-muscle-relaxation-script.pdf

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Appendix A

Becoming You Flyer

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Appendix B

My Feelings About Compassion & Self Esteem

Often, people have misgivings about whether it’s a good idea to be self-compassionate or
whether we can be too self-compassionate. Certainly, Western culture doesn’t promote self-
compassion as a virtue, and many people harbor deep suspicions about being kind to themselves.
These misgivings often block our ability to be self-compassionate, so it’s good to take a close
look at them.

 Write down any misgivings that you personally have about self-compassion - any fears or
concerns you have about its possible downsides.

 Sometimes our attitudes are shaped by what other people in our life think about self-
compassion. Write down any misgivings that other people or society at large have about
self-compassion.

When trying to understand self-compassion, it is important to distinguish it from self-esteem.

Self-esteem is a positive evaluation of self-worth. Self-compassion is not a judgment or an
evaluation. Self-esteem tends to be a fair-weather friend, there for us when we succeed and
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deserting us when we need it most -- when we fail or make a fool of ourselves. Self-compassion
is not contingent on success and provides a more stable sense of self-worth. Consider your
relationship with self-esteem.

 How do you feel when you receive feedback that your performance is average in an area
of life that you care about?

 How do you feel when someone is better at doing something you really care about?

 How does it impact you when you fail at something that you care about?

Adapted from Neff & Germer (2018)

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Appendix C
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McKay et al. (2019)

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Appendix D

Self-Soothing Activities and Relaxation Plan

Self-Soothing Using Your Sense of Smell

Smell is a very powerful sense that can often trigger memories and make you feel a
certain way. Therefore, it’s very important that you identify smells that make you feel good, not
bad. Here are some ideas. Check the ones you’re willing to do, and then add any activities that
you can think of:
__ Burn scented candles or incense in your room or house.
__ Wear scented oils, perfume, or cologne that makes you feel happy, confident, or sexy.
__ Cut out perfumed cards from magazines and carry them with you in your handbag or wallet.
__ Go someplace where the scent is pleasing to you, like a bakery or restaurant.
__ Bake your own food that has a pleasing smell, like chocolate chip cookies.
__ Lie down in your local park and smell the grass and outdoor smells.
__ Buy fresh-cut flowers or seek out flowers in your neighborhood.
Other ideas: ___________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________

Self-Soothing Using Your Sense of Vision

Vision is very important to humans. In fact, a large portion of our brain is devoted solely
to our sense of sight. The things you look at can often have very powerful effects on you, for
better or for worse. That’s why it’s important to find images that have a very soothing effect on
you. Here are some ideas. Check the ones you’re willing to do, and then add any activities that
you can think of:
__ Find a place that’s soothing for you to look at, like a park or a museum. Or find a picture of a
place that’s soothing for you to look at.
__ Go to the bookstore and find a collection of photographs or paintings that you find relaxing.
__ Draw or paint an image that’s pleasing to you.
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__ Carry a picture or photograph of someone you love, someone you find attractive, or someone
you admire.
Other ideas: ___________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________

Self-Soothing Using Your Sense of Hearing

Certain sounds can soothe us. Listening to gentle music, for example, may be relaxing. However,
each one of us has our own tastes. You have to find what works best for you. Use these examples
to identify the sounds that help you relax. Check the ones you’re willing to do, and then add any
activities that you can think of:
__ Listen to soothing music.
__ Listen to books on tape or compact discs. Many public libraries will let you borrow
audiobooks via their affiliated apps, so you can try this without financial commitment. You don’t
even have to pay attention to the storyline. Sometimes just listening to the sound of someone
talking can be very relaxing.
__ Turn on the television and just listen. Find a boring or sedate show, sit in a comfortable chair
or lie down, and then close your eyes and just listen. Make sure you turn the volume down to a
level that’s not too loud.
__ Listen to a gentle talk show on the radio. Remember—a gentle talk show, not something that
will make you upset or angry. Stay away from political talk shows and the news. Again,
sometimes just listening to someone else talk can be relaxing. Carry headphones to listen to
when you’re upset or angry.
__ Open your window and listen to the peaceful sounds outside. Or, if you live in a place without
relaxing sounds outside, visit a place with relaxing sounds, such as a park.
__ Listen to a recording of nature sounds, such as birds and other wildlife. You can find
soundscape audios on YouTube or Spotify.
__ Listen to a white-noise machine. White noise is a sound that blocks out other distracting- ing
sounds. You can buy a machine that makes white noise with circulating air or turn on a fan to
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block out distracting sounds. Other white-noise machines have recorded sounds on them, such as
the sounds of birds, waterfalls, and rainforests. Many people find these machines very relaxing.
__ Listen to the sound of a personal water fountain. These small electronic fountains can be
bought in most department stores, and many people find the sound of the trickling water in their
homes very soothing.
Other ideas: ___________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________

Self-Soothing Using Your Sense of Taste

Taste is also a very powerful sense. Tastes can also trigger memories and feelings, so again, it’s
important that you find the tastes that are pleasing to you. However, if eating triggers you, use
your other senses to calm yourself. But if food soothes you, use some of these suggestions.
Check the ones you’re willing to do, and then add any activities you can think of:
__ Enjoy your favorite meal, whatever it is. Eat it slowly so you can enjoy the way it tastes.
__ Carry lollipops, gum, or other candy with you to eat when you’re feeling upset.
__ Eat a soothing food, like ice cream, chocolate, pudding, or something else that makes you feel
good.
__ Drink something soothing, such as tea, coffee, or hot chocolate. Practice drinking it slowly so
you can enjoy the way it tastes.
__ Suck on an ice cube or an ice pop, especially if you’re feeling warm, and enjoy the taste as it
melts in your mouth.
Other ideas: ___________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________

Self-Soothing Using Your Sense of Touch

We often forget about our sense of touch, yet we’re always touching something, such as the
clothes we’re wearing or the chair we’re sitting in. Certain tactile sensations can be pleasing, like
 29

petting a soft dog. Again, each of us prefers different sensations. You have to find the ones that
are most pleasing to you. Here are some suggestions. Check the ones you’re willing to do, and
then add any activities that you can think of:
__ Carry something soft or velvety in your pocket to touch when you need to, like a piece of
cloth.
__ Take a hot or cold shower and enjoy the feeling of the water falling on your skin.
__ Take a warm bubble bath or a bath with scented oils and enjoy the soothing sensations on
your skin.
__ Get a massage.
__ Massage yourself. Sometimes just rubbing your sore muscles is very pleasing.
__ Play with your pet. Owning a pet can have many health benefits. In addition, playing with
your pet and stroking the animal’s fur or skin can provide you with a soothing tactile experience.
If you don’t have a pet, consider getting one. Or, if you can’t afford one, visit a friend who has a
pet or volunteer at your local animal shelter, where you can play with the rescued animals.
__ Wear your most comfortable clothes, like your favorite worn-in T-shirt, baggy sweatsuit, or
old jeans.
Other ideas: ___________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________

Now that you’ve read the suggestions to help you relax and soothe yourself using your five
senses, construct a list of techniques you’re willing to use. Make a list of ideas to try when
you’re at home
RELAXATION AND SOOTHING SKILLS TO USE AT HOME
1. ________________________________________________________________________
2. ________________________________________________________________________
3. ________________________________________________________________________
4. ________________________________________________________________________
5. ________________________________________________________________________
6. ________________________________________________________________________
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7. ________________________________________________________________________
8. ________________________________________________________________________
9. ________________________________________________________________________
10. ________________________________________________________________________

Keep this list in a convenient place that’s easy to remember. You might even want to copy this
list and put it in places where you see it all the time, such as on your refrigerator, above your
desk, on the mirror in your bathroom, or next to your bed. This way, you’ll remind yourself to
relax and soothe yourself as often as possible. It will also make it easier to help yourself when
your painful emotions overwhelm you and prevent you from thinking clearly.

Now create a similar list to use when you’re away from home. Make sure that these skills are
accessible regardless of where you are. For example, don’t list “take a hot bath” because, most
likely, there won’t be a hot bath available to you when you’re not at home.

RELAXATION AND SOOTHING SKILLS TO USE AWAY FROM HOME

1. ________________________________________________________________________
2. ________________________________________________________________________
3. ________________________________________________________________________
4. ________________________________________________________________________
5. ________________________________________________________________________
6. ________________________________________________________________________
7. ________________________________________________________________________
8. ________________________________________________________________________
9. ________________________________________________________________________
10. ________________________________________________________________________

Now copy these last ten ideas on an index card to remind you what to do when you’re away from
home. Keep this list with you, in your car, in your wallet, or in your handbag. Then make sure
you have whatever’s needed with you, such as candy, a portable radio, pictures, and so forth.
 31

This way, you can practice relaxing when you’re not at home, especially when your painful
emotions overwhelm you and prevent you from thinking clearly.

Adapted from Neff & Germer, (2018)

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Appendix E
33
34
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Diamond (2019)
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Appendix F
37
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Appendix G
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40
41
42
43
44
45
46
47
48
49
50
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Appendix H

What Is Compassion?

Self-compassion involves treating yourself the way you would treat a friend who is
having a hard time. Western culture places great emphasis on being kind to friends, family, and
neighbors who are struggling, but this emphasis is lacking when it comes to ourselves. Self-
compassion involves three core elements: self-kindness, common humanity, and mindfulness.
Self-Kindness. When we make a mistake or fail in some way, we are more likely to beat
ourselves up than put a supportive arm around our own shoulder. Think of all the generous,
caring people you know who constantly tear themselves down (this may even be you). Self-
kindness counters this tendency so that we are as caring toward ourselves as we are toward
others. Rather than being harshly critical when noticing personal shortcomings, we are
supportive and encouraging and aim to protect ourselves from harm. Instead of attacking and
berating ourselves for being inadequate, we offer ourselves warmth and unconditional
acceptance. Similarly, when external life circumstances are challenging and feel too difficult to
bear, we actively soothe and comfort ourselves.

Common Humanity. A sense of interconnectedness is central to self-compassion. It’s

recognizing that all humans are flawed works-in-progress, that everyone fails, makes mistakes,
and experiences hardship in life. Self-compassion honors the unavoidable fact that life entails
suffering, for everyone, without exception. When we remember that pain is part of the shared
human experience instead of feeling isolated and alone in our suffering, that moment of suffering
is transformed into a moment of connection with others. The pain I feel in difficult times is the
same pain you feel in difficult times. The circumstances are different, the degree of pain is
different, but the basic experience of human suffering is the same.

Mindfulness. Mindfulness involves being aware of moment-to-moment experience in a clear

and balanced manner. It means being open to the reality of the present moment, allowing all
thoughts, emotions, and sensations to enter awareness without resistance or avoidance.
Mindfulness is essential to self-compassion because we need to be able to turn toward and
acknowledge when we are suffering in order to respond with care and kindness. Mindfulness
counters the tendency to avoid painful thoughts and emotions and prevents us from becoming
absorbed by these experiences.
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Loving-Kindness

Loving-kindness is an element of compassion that entails general feelings of friendliness

to oneself and others. While compassion normally arises in response to suffering, loving-
kindness is experienced in all moments without needing a distressful event to prompt it. Loving-
kindness practices involve evoking feelings of goodwill towards oneself, towards loved ones,
towards people we may find difficult, and towards humanity in general. For the purposes of this
course, we are going to focus on developing loving-kindness towards oneself, but additional
guided meditations can be found at www.guilford.com/neff-materials.
Traditional loving-kindness uses directed phrases to invoke feelings of goodwill towards
oneself. Common phrases include, “May you feel happy,” “May you feel peaceful,” “May you
be healthy,” “May you live at ease.” While you might find that these phrases work for you,
sometimes it is necessary to personalize your practice by developing loving-kindness phrases of
your own. Here are some basic guidelines for creating your own loving-kindness phrases:

 Phrases should be simple, clear, authentic, and kind.

 You do not need to use “May I” phrases if they feel too awkward or too much like
begging
 These phrases are not positive affirmations, such as “I’m becoming healthier every day.”
We are simply cultivating good intentions, not trying to manifest what we want to be true
 these phrases are designed to evoke goodwill, not good feelings. Loving-kindness
practice is not meant to directly change our emotions, they are designed to wish goodwill
upon ourselves and others
 The phrases should be general. For example, “May I be healthy” rather than “May I be
free from my diabetes.”
 Take your time when saying the phrases to yourself; say them slowly
 The phrases should be said warmly, as if you are whispering them into the ear of
someone you truly love.
 You may address yourself with I, you, using your name, or a term of endearment that
speaks to you in your phrases so long as it supports an attitude of kindness and
compassion

Adapted from Neff & Germer (2018)

Loving-kindness Exercise
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This exercise is designed to help you discover loving-kindness and compassionate phrases that
are meaningful to you. If you already have phrases and wish to continue using them, use this
exercise as an experiment and don’t feel pressured to change phrases you know work for you.
We are doing this exercise together as a group, but the instructions are recorded here if you ever
need to return to this practice.

 To start, get into a comfortable position and place a hand over your heart, or somewhere
else that feels comfortable
 Take a moment and allow your heart to open gently, like a flower opens in the warm sun
 Become aware of how your breath moves in your body, and if your attention wanders,
gently move your attention back to the experience of breathing
 Let your breath slip into the background of your awareness and ask yourself, what do I
need? What do I truly need?
o Let the answer be a universal human need, such as the need to be connected,
loved, useful, or free
 Use the words you found and try to transform them into wishes for yourself, such as:
“May I be kind to myself,” “May I know that I belong.”
 Now consider, what do I need to hear from others? What to do I long to hear from others?
 Take those phrases and reframe them as wishes for yourself. “I love you” can become
“May I love myself for who I am.” “You’re a good person” can become, “May I know
my own goodness.”
 Now, using some of the phrases you made, repeat those words over and over and let those
words of love and compassion surround you. If it feels right, allow them to resonate
every cell of your body
 if you find your awareness wondering, allow yourself to feel the sensations in your body
and then offer yourself the words once more.
 Finally, release the phrases and become aware of your breath once more.
 Gently become aware of your surroundings, wiggle your fingers and toes, and when you
are ready, open your eyes

Take a moment to reflect on this experience, and in the space below, write down some of the
phrases you developed and explore how this exercise made you feel:
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Adapted from Neff & Germer (2018)

Appendix I
Working with Difficult Emotions and Shame
Feeling difficult emotions is not easy. When we turn toward difficult emotions, even with
mindfulness and self-compassion, our pain often increases at first, and we feel a natural instinct
to turn away. But if we are to heal, we must face these emotions. There are five stages of
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acceptance when meeting difficult emotions and each stage corresponds to a gradual release of
emotional resistance.

 Resisting: struggling against what comes

 Exploring: turning toward discomfort with curiosity
 Tolerating: enduring and holding steady through the discomfort
 Allowing: letting feelings come and go; making space for them
 Befriending: seeing value in difficult emotional experiences and understanding what we
can learn from it
Shame is a bit of a different story. Shame stems from a desire to be loved and to feel worthy
of affection and belonging, but when we feel it, it is accompanied by a script that says, “I am
bad.” Not “I feel bad,” but, “I am bad.” It is one of the most isolating and lonely emotions a
person can experience, but it is universal and corresponds to a core part of who we are. WE all
have lingering self-doubts, often originating in childhood, that feel objectively true in our most
vulnerable moments. These are our core negative beliefs. Common negative core beliefs include:

 I’m a failure
 I’m unlovable
 I’m helpless
 I’m not good enough
 I’m a fraud

For this next exercise, you will have the option of either working with a difficult emotion or
working with shame. If at any point the discomfort becomes too much, open your eyes or
disengage from the practice in whatever way feels comfortable to you. Learning to sit with these
emotions takes time, and it is not a race. Once again, this is an activity that will be done in group,
and the script is here in case you need to return to the exercise later

 Find a comfortable position, sitting or lying down, close your eyes and take a few deep
relaxing breaths
 Place your hand over your heart or another soothing place and allow kindness to flow
through you in a way that feels safe and natural
 Now, bring to mind one of two events. Option one: an event that made you feel
embarrassed or ashamed, an event that is physically uncomfortable to recall but is only
about a three in intensity on a scale from 1 to 10. Option two: recall a mild to moderately
difficult situation that you are in right now, such as a health problem or stress in a
relationship. Again, choose a problem that generates a little stress in your body when you
recall it but does not cause full distress
 Feel your way into the situation and clearly visualize it. Use all your senses and take note
of what your body feels
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 Label the primary emotion or primary core belief this experience brings out for you. If
there are many, choose the strongest.
 Expand your awareness to the body as you continue recalling the situation. Sweep your
attention from head to toe and stop in areas where you feel tension or discomfort
 Choose a single location in your body where that shame or other emotion (anger,
sadness,, confusion, fear, longing, despair) and feel into that body part
 Softened into the area where you feel that difficult emotion. Let your muscles relax as if
you are sinking into warm water. Remember, we are not trying to change the feeling, we
are just holding it in a gentle, tender way.
 Shift your mind to soothing yourself in response to this difficult situation. You can put
your hand over the part of your body that feels uncomfortable and imagine warmth and
kindness flowing from your hand into your body if that feels comfortable
 Are there comforting words you might need to hear? “I am so sorry you feel this way.”
“This is such a hard emotion.”” I care about you so much.” “You are not broken.” “You
are not your mistakes.”
 Finally, allow the discomfort to just be there. Try to let go of the need to make it go away
and accept its presence in your body however it feels in this moment.
 Allow your mind to scan over the rest of your body as you accept the discomfort. Allow
yourself to feel exactly what you are in this moment.
 Now, soften your attention and take note of your surroundings. Wiggle your fingers and
toes and when you feel ready, open your eyes.
Take a moment to jot down a few words or sentences about this experience with full honesty.
This can be a difficult and uncomfortable experience, and it is normal to struggle with allowing
that type of emotion to be in your body.

Adapted from Neff & Germer (2018)

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Appendix J
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Values activity worksheet (2016)

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Appendix K

Stevenson (2021)
60