What do you do when a client says something self-critical in session?
How can you teach your client to respond to self-criticism with self-compassion?
Self-criticism is a problem for most people I know – not just my clients — but my friends, colleagues and at times I catch myself sliding into negative self-talk, too. Being a high-achiever and striving for excellence can be a good thing, but many of us are expecting too much from ourselves – we’re expecting perfection. And then when we mess up or fall short, we feel frustrated and discouraged and start to call ourselves names and berate ourselves for our imperfections and mistakes.
Often, we say things to ourselves that we’d never dream of saying to our friends. Obviously, this isn’t a healthy pattern. Self-criticism tends to demotivate people, diminish their self-esteem, and perpetuate rigid, all-or-nothing, perfectionist thinking. Therefore, it’s important for us as social workers and therapists to support our clients in changing their critical inner voice and replacing negative self-talk with self-compassion.
How to Help Your Client Use Self-Compassion to Reframe Self-Criticism
So, what do you do when a client says something self-critical in session?
If your client makes a self-critical statement during a session, you can help them practice self-compassion with these three steps:
- Acknowledging and naming the statements as self-critical or distorted thoughts.
- Inviting your clients to explore whether they are accurate.
- Modeling and teaching your clients to say something more accurate and compassionate to themselves.
Here’s an example of what this might sound like with a fictional client who, after many months, left her emotionally abusive boyfriend, Mark.
Client: I know I need to make a clean break, but I can’t stop thinking about Mark. I promised myself I wouldn’t, but I caved and spent all of Monday stalking his Instagram and Facebook. I’m so weak. I promised myself I wouldn’t, but I texted him. I’m so stupid. And I immediately regretted it. I’m weak and I caved in.
Therapist: It sounds like you’re pretty upset with yourself. I heard a lot of self-blame and self-criticism in what you said and I wonder how accurate those thoughts are. Would you be willing to explore that a bit with me?
Client: I guess.
Therapist: Despite the setback of texting him, can you see how you made some steps in the right direction? Do you see some progress this week in detaching from Mark? Can you think of some ways you used your strengths?
(Note: You can find additional questions to help challenge cognitive distortions in my book, The CBT Workbook for Perfectionism.)
Client: Well, I only texted him once even though I thought about it every day. And I didn’t get pulled back in. I cut it off immediately and blocked him again.
Therapist: Does it seem fair or accurate to call yourself stupid and weak given what you’ve just told me?
Client: Not really.
Therapist: Exactly. So, what could you say to yourself that would be more accurate and more compassionate?
Client: I had a moment of weakness and I made a mistake – and I was really strong the rest of the time. It’s hard for me to block him, but I did!
Therapist: Yes, and making mistakes is part of the process. We can learn more from them when we aren’t stuck in self-blame and criticism.
Help your client practice self-compassion between sessions
You can use this intervention each time your client makes a self-critical statement during a session. This will help develop a new way of thinking. But, of course, they will need to practice in between sessions as well.
I encourage my clients to pay attention to their self-talk, write down any self-critical statements and a compassionate response. This will continue to bring awareness to their distorted thoughts and rewire their brain to focus on their strengths and to see themselves in a more positive light.
You can also suggest other self-compassion practices from Dr. Kristin Neff’s website and book. I also like the simple self-compassion exercises in The Self-Compassion Deck: 50 Mindfulness-Based Practices.