Permission to Be A “Squishy” Therapist: A Mindful Self-Compassion Teacher Reflects on Imperfection and the Clinical Encounter

By: Sean Cook, Psy.D.

The other day, I was changing my shirt and my four-year old daughter offered some uninvited consolation.  “We’re all a little squishy, Dad,” she said in a comforting tone, as she pointed at my belly. Despite being a relatively thin man, I felt a bit stung by her comment, and a few minutes later I caught myself probing the squishiness in question with a disapproving index finger. As I’ve reflected on it in the days since, I think my daughter was speaking from a place of wisdom that we lose as we get older. She was inviting me into the shared human experience. Sadly our culture has already communicated to my daughter that we shouldn’t be squishy (thus her comforting tone); meanwhile she has observed the reality that most of us are at least a little squishy. We strive for culturally-constructed notions of perfection, which are forever at odds with the universal imperfection of the human experience. Even though I’m not a particularly squishy fellow, some part of me heard my daughter’s words and went, “Uh oh…she’s spotted a flaw! Alert!  Alert!”  As I’ve mulled this moment over in my mind, “squishy” has become a stand-in for imperfection in general and I’ve enjoyed mentally repeating, “We’re all a little squishy” in moments when I’ve made a mistake, fallen short, or I feel embarrassed or anxious. For me, this phrase is a doorway into an experience of common humanity—the felt sense of belonging to a global community comprised of imperfect others suffering just like I do.

This experience of common humanity is one of the three components of self-compassion identified by psychological researcher Kristin Neff. The other two are mindfulness and self-kindness. Mindfulness—or present moment, nonjudgmental awareness—allows us to recognize that we are suffering in the moment that we are suffering without over-identifying with our thoughts and feelings. This is a crucial component in self-compassion, because we can’t offer ourselves compassion if we don’t know we’re in pain. Self-kindness is simply treating ourselves in a friendly way—so if we make a mistake, we might respond with comfort and support rather than with harsh criticism or intense pressure to improve.

Self-compassion has been getting a lot of attention recently due to a promising body of research.  Studies by Neff and others have linked self-compassion to trauma resiliency, body satisfaction and appreciation, healthy aging, decreased depression, decreased anxiety, decreased burnout, increased relationship satisfaction, and maintenance of health-related behaviors like diet and exercise. Hundreds of articles on the topic can be found here: http://self-compassion.org/the-research/

For the past several years, my wife, Luana, and I have been co-teaching the 8-week Mindful Self-Compassion (MSC) course developed by Neff and her colleague Christopher Germer. We make no secret about the fact that we teach the course because we need the practices ourselves. These practices have redefined how we experience ourselves as spouses, parents, and human beings. We are particularly excited to be sharing some of the resources from MSC with the SVC-CAMFT community on May 5 because of how much self-compassion has offered us as therapists.

What we all do for a living is hard. To sit across from a human being who is suffering and to allow our own nervous system to resonate with theirs is quite literally painful. In our presentation, we’ll talk a bit more about why that is and how compassion can help with vicarious suffering and the burnout that can follow. Here, I’d like to focus on another aspect of challenge in the therapeutic encounter—making mistakes and feeling badly about it. The therapeutic field is full of uncertainty and ambiguity. Speaking personally, this is part of what I love about it. It is often in the unknown and the unsteady that we feel most alive. At the same time, working to attune to another human being in an ambiguous, ever-changing field means that we are bound to make mistakes. I once attended a talk with psychologist Jessica Benjamin in which she normalized therapeutic misattunement.  I remember her saying, “the essence of therapy is that we make a mess and then we clean it up together.” I find the normalization of the mess so helpful. Although I am now many years post-licensure and have built a successful practice where I offer supervision and consultation to others, I still have moments of feeling like an imposter—like at the base of it all, I haven’t got a clue what I’m doing. In those moments, my chest feels tight, my face feels hot, and my mind is full of shuddering, incomplete thoughts that double-back on themselves even as I try to grab hold of them, hoping for a free ride out of that feeling.

In the past, when those moments happened in session, my inner critic used to rush to my aid—ever the harsh coach, he demanded better of me even as he confirmed my worst fears about myself: “Yeah that last thing you said really didn’t make sense. You really don’t know what you’re doing. You better think of something to say fast or this person is going to discover the terrible truth about you.” As we’ll be talking about in our presentation, the nervous system experiences criticism, whether internal or external, as a threat. So by sending me into a threat response, my go-to coach had a way of making me less creative, less emotionally available, and less skillful.

Since incorporating daily self-compassion practice into my life, I have a new, more compassionate coach. Now when I miss one of my clients and he looks down, jaw tightening in tenderhearted frustration, I hear my coach say to me with a smile, “We’re all a little squishy.” This act of internal kindness brings me back into the fold, and I remember that every therapist knows what it is to miss their client, and that being a therapist is a challenging gig. My body relaxes and I feel less alone in my experience. As any good attachment therapist will tell you, feeling connected is feeling safe, and in the embrace of this safety, my creativity, empathy, and skill begins to come back online. I lean in with safe eyes and a gentle smile—one squishy human silently asking another, “please tell me again…I want to know...what is it to be you right now?”

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