Interview with
Dr. Christopher Germer
Christopher Germer, PhD
Christopher Germer, PhD, is a clinical psychologist and lecturer on psychiatry (part-time) at Harvard Medical School. He co-developed the Mindful Self-Compassion program with Dr. Kristin Neff in 2010 and they wrote two books,The Mindful Self-Compassion Workbook and Teaching the Mindful Self-Compassion Program. MSC has been taught to over 200,000 people worldwide. Dr. Germer is also the author of The Mindful Path to Self-Compassion; he co-edited two influential volumes on therapy, Mindfulness and Psychotherapy, and Wisdom and Compassion in Psychotherapy and he maintains a small psychotherapy practice in Massachusetts, USA.
Parts of the interview have been edited for clarity and length.
How did you first become interested in contemplative science?
I first became interested in contemplative practice by learning Transcendental Meditation (TM) back in 1976. I had a peak, mystical experience with TM and then I went to India for a year because I didn’t have anybody to talk with about this experience. I traveled the length and breadth of India to meet with saints, sages, yogis, shamans, and other indigenous healers. Between my experiences in India and in meditation, I became convinced that Western psychology was in its infancy compared to the profound philosophical and psychological insights that yogis and meditators were having.
So, after that, in 1978, I went to graduate school for training in clinical psychology. I’ve spent my entire career committed to integrating Eastern contemplative practice with Western scientific psychology. That’s really what I’ve been up to most of my life.
How has your personal engagement with self-compassion benefited you?
Hugely. After I received a PhD in 1984, I moved to Cambridge, Massachusetts where I met colleagues at the Cambridge Hospital who were also on the faculty at Harvard Medical School and were mindfulness meditators. That’s also when I became immersed in mindfulness and began exploring points of intersection between meditation and psychotherapy. In 2005, we wrote a book together, Mindfulness and Psychotherapy, which was the first textbook that made the case for mindfulness in therapy.
From then onward, I was invited to do more public speaking. Unfortunately, throughout my life, I’d always been afraid of public speaking. That was in spite of being considered an “expert” in anxiety disorders as a clinical psychologist. I knew all the tricks of the trade, but nothing seemed to work for me – exposure, systematic desensitization, beta blockers, mindfulness practices—you name it. This problem came to a head in 2006 as I anticipated speaking at a conference on meditation and psychotherapy that some colleagues and I had organized at Harvard Medical School.
In desperation, I went on a silent meditation retreat 4 months before the conference and, following the advice of the teacher, I started practicing loving-kindness meditation, especially for myself. Although I had practiced mindfulness for decades before that, I avoided loving-kindness meditation because I preferred pure awareness practice. Now I started saying to myself “May I be safe,” “May I be peaceful…” and immediately noticed that I felt better and also became more mindful. Four months later, at the conference, the usual panic rose up when I got up to speak, but a new voice also rose up, saying, “May you be safe,” “May you be peaceful…,” and my fear vanished. The fear really hasn’t returned.
That was a huge relief, but the greatest reward was learning about self-compassion. I started looking at psychotherapy through the lens of self-compassion, and eventually met Kristin Neff and we developed the Mindful Self-Compassion course together. After that, there was no turning back.
Do you feel that clinicians and scientists studying self-compassion should deliberately practice self-compassion and mindfulness?
Definitely. Self-compassion and mindfulness are embodied practices. We can’t actually understand mindfulness or self-compassion with a conceptual mind; we need to have direct experience. So, in order to bring mindfulness or self-compassion to our work, we also need to practice.
What are the similarities or differences between mindfulness and self-compassion?
On an absolute level, when mindfulness and self-compassion are in full bloom, they are nearly identical in a moment of suffering. The heart and the mind are open and aware. However, we don’t spend most of our lives either fully mindful or fully self-compassionate. Since we live most of our lives somewhat mindfully or compassionately, it helps to know how to bring these qualities into balance with one another.
There is a key difference between mindfulness and self-compassion: Mindfulness is basically loving awareness of moment-to-moment experience, whereas self-compassion is loving awareness of the experiencer—the sense of self, or a sentient being. Compassion is always directed toward a sentient being. Sometimes that sentient being is oneself, which is self-compassion.
There are some other interesting differences between mindfulness and self-compassion. Mindfulness asks the question, ‘What am I experiencing?’ whereas self-compassion asks the question, ‘What do I need?’ Also, mindfulness dismantles the “self” into moments of experience, whereas self-compassion melts the self with warmth and kindness. In both cases, mindfulness and self-compassion help make the “self” more flexible. Mindfulness and self-compassion also regulate emotion in different ways: mindfulness works by regulating attention—what we’re paying attention to and how we pay attention to it; self-compassion regulates emotions through care and connection.
Mindfulness and self-compassion are really complementary. Perhaps a simple way to describe the complementarity is to consider mindfulness as “space” and compassion as “warmth.” Space creates warmth and warmth creates space. Together, mindfulness and self-compassion are a powerful combination for regulating difficult emotions, especially the kind we find in psychotherapy.
“Mindfulness asks the question, ‘What am I experiencing?’ whereas self-compassion asks the question, ‘What do I need?’”
You developed the Mindful Self-Compassion (MSC) program, along with Dr. Kristin Neff. What brought about its development and what need does it address?
Back in 2008, Kristin and I attended a silent meditation retreat for scientists, hosted by the Mind & Life Institute. I drove her back to the airport and on the way I said to her, “All the research on self-compassion is great but it’s mostly correlational. You should create a training program for self-compassion to study if self-compassion can be learned and actually help people.” Kristin replied that she’s a researcher and doesn’t do that sort of thing, and that I’m a clinician and work with people all the time. So, in that moment, between us, the idea of MSC was born. The first course took place at the Esalen Institute in 2010 and, since then, over 200,000 people around the world have taken MSC. The research is burgeoning, and shows that self-compassion can be helpful in so many ways—for emotional wellbeing, reducing distress, improving relationships, and enhancing physical health. Self-compassion training is going mainstream, close at the heels of mindfulness, and is currently being adapted for education, medicine, psychology, business, athletics, parenting and other areas of life.
“The first course took place at the Esalen Institute in 2010 and, since then, over 200,000 people around the world have taken MSC.’”
Although Kristen and I initially developed this program, MSC is now a project of the international community of teachers. The curriculum is being constantly updated and improved by suggestions from MSC teachers around the world. It’s wonderful to be part of a global community that’s interested spreading compassion, starting with one’s own, inner work.
MSC can be described as “mindfulness-based self-compassion training.” We’re primarily teaching self-compassion with a less explicit mindfulness component. Mindfulness-based Stress Reduction (MBSR) does the opposite; it’s primarily mindfulness training with a less explicit self-compassion component. MSC and MBSR are complementary, and together they provide nicely balanced training in mindfulness and self-compassion.
How is self-compassion a transdiagnostic mechanism of change?
The term “transdiagnostic mechanism of change” means that learning to be more self-compassionate can benefit people in therapy who carry a wide variety of different psychological diagnosis, such as anxiety, depression, substance abuse, personality disorders, and so forth. Generally speaking, research shows that as symptoms decrease during therapy, self-compassion tends to increase. In other words, when a person who is depressed is able to be kind to themselves when things go wrong; is able to recognize they’re not entirely alone when they feel bad; and is open and aware of how they’re feeling in the moment—that person is self-compassionate and probably doesn’t need therapy as much anymore.
Self-compassion as a construct is often separated into two distinct categories of self-warmth and self-coldness. Do MSC or other compassion-based trainings target one versus the other?
Kristin Neff’s scale, the Self-Compassion Scale (SCS), is the most common scale for measuring self-compassion. It is built on a systemic model such that whenever the so-called ‘warmth’ qualities—kindness, common humanity and mindfulness—increase, the so-called ‘coldness’ qualities—self-criticism, isolation and overidentification—decrease. That is built in and assumed in the scale, but some clinicians try to separate the two sets of qualities. That’s understandable since the therapeutic agenda is to decrease symptoms rather than cultivate positive qualities, but trying to separate the two sets of qualities is not how the scale was designed and is not a valid use of the scale.
“…when mindfulness and self-compassion are in full bloom, they are nearly identical in a moment of suffering.”
Your work addresses shame, which is an important aspect of mental health and therapy. What is the relationship between self-compassion and shame?
In many respects, self-compassion is the opposite of shame. If you look at Kristin’s definition of self-compassion, the negative qualities are key aspects of shame—loneliness, self-criticism, and self-absorption. So, theoretically, we can say self-compassion is the opposite of shame, and when we are behaving compassionately toward ourselves, we are automatically reducing shame.
Shame is essentially an attack on our sense of “self.” When we’re being criticized or blamed, our self-worth takes a hit. Self-worth or self-esteem is usually determined by external approval and validation, but self-compassion provides an alternate source of self-worth, namely, inner kindness. Therefore, the self-worth that comes from self-compassion is more stable. We carry it wherever we go. And it dismantles shame.
How can therapists and other providers benefit from integrating self-compassion into their practices?
Let’s face it—caregiving can be difficult. As empathic human beings, we feel the pain of others as our own and, over time, it can be too much to bear. That’s compassion fatigue. Compassion fatigue can be as mild as mind wandering during a session, but it can also lead to physical and mental exhaustion and illness. Luckily, research shows that self-compassion is an antidote to compassion fatigue and burnout. The idea is that when we have no more compassion to give to others, we need to do a U-turn and give compassion to ourselves.
Self-compassion calms and soothes the nervous system and puts us in a caring frame of mind, which can then be extended to others. Self-compassion can also be practiced during therapy itself—we don’t have to go home to replenish ourselves. One elegant way of doing this during therapy is to track our breath going in and out of the body, and make the in-breath for ourselves and the out-breath for our clients.
Self-compassion is also a powerful resource for clients. There are three main levels that self-compassion can be integrated into therapy: (1) compassionate presence of the therapist, (2) compassionate, therapeutic relationship, and (3) compassionate interventions, or home practices. Therapists tend to focus on home practices that they can teach their clients, but home practices should ideally emerge from a compassionate dialogue with a compassionate therapist. When that happens, the client is more likely to practice and also discuss obstacles that may arise during practice.
As the evidence base for self-compassion continues to expand, how do you envision compassion-based training shaping psychotherapy?
It’s now over 20 years since Paul Gilbert in the UK first conceived of compassion-based therapy. Compassion is currently embedded in the “third wave” paradigm of empirically-based therapy, namely “mindfulness-, acceptance-, and compassion-based therapy.” Whereas mindfulness focuses mostly on attention, and acceptance focuses primarily on non-avoidance, compassion-based therapy focuses on goodwill, warmth, caring and connection to oneself and others.
But compassion and self-compassion are not new. Compassion has always been implied in the term “empathy” in psychotherapy, and an empathic therapeutic alliance accounts for the largest portion of positive psychotherapy outcomes. Self-compassion has also been present in psychotherapy under the umbrella of “self-acceptance.” With the advent of mindfulness, however, the focus of “acceptance” shifted to moment-to-moment experience and away from the “self.” Now, acceptance of the “self” is back in vogue and clinicians are integrating both types of acceptance into therapy.
Compassion research is confirming the importance of heart qualities such as loving-kindness and compassion in effective therapy. Freud recommended “evenly hovering attention” as the ideal attitude of the therapist, but he offered no particular way of cultivating it. Now therapists can practice meditation to increase their mindfulness and compassion in the therapy room. We also have a plethora of compassion-based interventions that clients can apply between sessions to cultivate the resources of compassion and self-compassion. Compassion is also being integrated into more traditional therapy techniques. For example, rather than simply exposing oneself to a feared stimulus, clients can learn self-compassion as a tool to tolerate and transform their fear, alongside exposure. Overall, due to burgeoning research, the future is bright for compassion and self-compassion in therapy.
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Michael Juberg
Michael is the Founder & Chief Editor of the Science of Mindfulness.
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