Becoming acceptable and comfortable with ourselves as mental health nurses through self-compassion

In this Blog Senior Lecturer in Mental Health Nursing, Barbara Vincent writes about her work using Compassionate Mind Training  (CMT) as part of Mental Health Nursing practice, including illuminative reflections on the process from third year mental health nursing students.

Working towards becoming a mental health nurse can be tricky when it comes to negotiating our boundaries and it can often feel a very fluid and rather unsafe place to be. Sometimes someone will say or do something which triggers something within us, and we can struggle to know how to respond kindly to that person whilst at the same time manage our own often uncomfortable feelings and thoughts as a person.

Compassionate mind training (CMT) is one way we can learn to manage this tricky balance between our personal self and professional MH Nursing selves. I first introduced the Compassionate Mind Training course last December 2022 to our then 3^rd year Mental Health (MH) nursing students to help prepare them for their transition from MH Nursing students to working as MH Nurses. The 2^nd iteration of the 8-week CMT course was completed last December 2023 again with our 3^rd year Mental Health nursing students and will be evaluated in March 2024 when they return from clinical practice.

As an accredited CMT facilitator with the Balanced Minds foundation, I am also able to issue a certificate of attendance to our students. This can be used as part fulfilment of the training required to be a CMT course facilitator and several of our students have been funded to do their training as facilitators by Sussex Partnership NHS Foundation Trust on becoming registered nurses with them.

The CMT course is an 8-week course run as weekly 2-hour group meeting, which I delivered with support from Lucy, Laetitia, and Michael. The aim of Compassionate Mind Training is to provide you with a range of strategies to help you understand and care for yourself so that you can help others (Irons, Herriot-Maitland, 2020).

CMT and Compassion Focussed Therapy (CFT ) were originally developed by Paul Gilbert (Gilbert, 2009), a clinical psychologist who found that when working with clients taking a Cognitive Behavioural Therapy (CBT) approach that with some people, particularly those who experienced high levels of shame, anxiety, and depression that while they understood CBT at a cognitive level, it made very little difference as to how they felt at a ‘gut’ level.

CFT (therapy) and CMT (strategies to be caring of ourselves) are based on an evolutionary view of our brain’s development, the physiology of the sympathetic and parasympathetic nervous systems and the role of the vagus nerve plus Bowlby’s attachment theory and Buddhist philosophy.

According to evolutionary theory humans have evolved a number of motives, which help us pursue our survival goals. We also have motives to go out seeking things such as food, territory, relationships, status, reproduction. In CMT we focus on 3 types of emotional systems, each system having a specific evolutionary function. These are organised as 3 emotional regulation systems, known as the 3 Circles Model: characterised by their evolutionary function.

Red -Those that focus on threat and self-protection.

Blue – Those that focus on doing and achieving.

Green -Those that focus on contentment and feeling safe.

CFT and CMT looks at ways we can cultivate our compassionate minds by stimulating the parasympathetic nervous system and the vagus nerve in particular, by teaching imagery and breathing practices.

The first CMT 8-week course was evaluated through a creative imagery activity known as intentional reflection through collage (McKay, 2019) and student reflections on the experience. This 2^nd course will also be evaluated by participants completing the ‘Compassionate engagement and action scales’ both before and after the 8-week course (Gilbert et al, 2017).

Collages and reflections examples.

“The woman in the graphic art ascending within two wing-like lungs is about the healing effects of deep, soothing breathing. The octopus suckers talk about the stickiness of the mind and how its nature is to fasten to both positive and negative thinking patterns – but mostly negative! The tunnel and the storms show how compassionate mind practices can help us to navigate through tough and turbulent times” Darren Salt.

“I recognise that my collage is largely consumed by an image of a bed; a clean, uniform, neatly made and perfectly symmetrical bed. This bed represents our opportunity to experience the Compassionate Mind sessions as a place of relief from the bustling, demanding outside world from which we emerged every (often cold and rainy) Monday morning. It is a symbol of a peaceful, easy space; a place of thankful respite and a catch-all of calm” Sophie Davenport.

“It was a challenging course emotionally rather than academically. And now, unexpectedly after several weeks following the end of the course, I find myself missing it. Retrospectively, I can see that some of the exercises we learned will be invaluable to me in both my personal and professional lives” Chris Pestell

References

Gilbert, P. 2009. Introducing compassion-focused therapy. Advances in Psychiatric Treatment 15(3):199-208

Gilbert, P., Catarino, F., Duarte, C., Matos, M., Kolts, R., Stubbs, J, Basran, J. 2017. The development of compassionate engagement and action scales for self and others. Journal of Compassionate Health Care, 4(1), 4

Irons, C. Heriot-Maitland, C. (2020). Compassionate Mind Training: An 8-week group for the general public. Psychology and psychotherapy. 94.

McKay, L. 2019. Supporting intentional reflection through collage to explore self-care in identity work during initial teacher education. Teaching and Teacher Education, Volume 86,