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Effectively Treating Pathological Self-Criticism in Depressed & Dysthymic Clients
Effectively Treating Pathological Self-Criticism in Depressed and Dysthymic Clients

Section 7
Meditation Intervention for Depression

CEU Question 7 | CEU Test | Table of Contents
Psychologist CEs, Social Worker CEUs, Counselor CEUs, MFT CEUs

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On the last track, we discussed the "Hanging Judge" syndrome in depressed or dysthymic clients and its components, self-hatred, injustice, and a lack of compassion for oneself.

On this track, we will discuss the self-critical pattern of Eternal Penance.

Laura, age 30, came to one session particularly depressed after a trip to visit her younger sister, Caroline. Laura stated, "I always feel so guilty when I go to visit her. When I’m there, I practically wait on her, hand and foot. She tries to stop me, because I’m the guest, but I just can’t help it. I feel like I owe her so much."

After a lengthy discussion about her relationship with her sister, I finally discerned that the reason Laura felt so guilty when she visited Caroline was an incident from her childhood. Laura mentioned that when she was 10, on Caroline’s seventh birthday, she said something very cruel to her younger sister.

Laura stated, "It’s stupid now, looking back, but I was mad because she got the Barbie doll I wanted. When our parents weren’t watching, I took the doll and pulled its head off. Then I told her that she was adopted and our parents didn’t really love her. I said that the Barbie was just a gift because they felt bad for her because her real mom didn’t want her. Caroline started crying. I completely ruined her birthday." Laura explained that since then, she constantly relived the memory and felt a fresh and painful sense of remorse each time. Laura stated, "I’ve never forgiven myself for it!"

Eternal Penace
As you can tell, Laura was displaying the Eternal Penance pattern of self-criticism. Like other depressed or dysthymic   clients mired in this pattern of endless self-recrimination for their past wrongs, Laura continually resurrected this past misdeed and criticized herself anew for it. As a result, she was constantly experiencing the guilt from the situation. I have found that other depressed or dysthymic clients may also feel shame or humiliation.

As you know, our culture has a social practice for atonement. An average social practice for atonement would consist of the transgressor attempting to gain reconciliation by actions such as openly acknowledging their wrongdoing, expressing sorrow or regret for what they’ve done, declaring intent to never repeat the action, voluntarily undertaking penance, or making voluntary restitution for their wrongdoing.

In this situation, the community has an absolutely essential role, which is to scrutinize the transgressor’s behavior and declare that the transgressor is forgiven and the matter is at an end. Clearly, the entire ceremony of forgiveness cannot be completed without the community’s final affirmation.

For a depressed or dysthymic client practicing Eternal Penance like Laura, however, this scenario is often impossible. Clients like Laura play dual roles, both the accuser and the accused.

Have you noticed in your depressed or dysthymic client an unwillingness or inability to forgive themselves as transgressors?

This is a key indication that he or she is practicing Eternal Penance. Depressed or dysthymic clients practicing Eternal Penance are generally unable to make restorative critical appraisals. They are unable to look at themselves and conclude that they subscribe to the transgressed standard in their behavior, are genuinely regretful for their violation, or have made sufficient amends in forms of restitution or penance.

Technique:  Compassion Meditation
I suggested to Laura that she try a technique to help her develop compassion for herself and others, which would help her forgive herself. The technique I suggested is called "Compassion Meditation." As I describe how I explained the "Compassion Meditation" technique to Laura, think of your depressed or dysthymic   client. Would he or she benefit from the "Compassion Meditation" technique?

For the "Compassion Meditation" technique, I asked Laura to get in a comfortable position. I asked her to close her eyes, breathe deeply, and scan her body for tension. I stated, "Relax your muscles, let your breathing slow, and suspend your judgments. Accept whatever images come to you even if they don’t immediately make sense."

I then explained that the "Compassion Meditation" technique was broken into two parts.

Part I.
I stated, "First, imagine your sister, someone you have hurt, in the chair across from you." I then asked Laura to say the following to her sister: "I am a human being, worthy but imperfect. I am like you. When I hurt you, I was just trying to do what seemed best for me at the time. I understand I hurt you, and I want you do know that hurting you was not my goal. Please accept the fact that I hurt you and nothing can change that. Please forgive me. I don’t ask you to approve of what I did or agree with me, but I do ask you to forgive me. Please open your heart to me."

I then asked her to imagine her sister smiling. I stated, "Know that you are understood, you are accepted, and you are forgiven."

Part II.
I then instructed Laura for the second part...
of the "Compassion Meditation." I asked her to imagine herself in the chair across from her this time. I then asked her to say the following to herself: "I am a human being. I am worthwhile just because I exist and try to survive. I correctly take myself into consideration first in all matters. I have legitimate needs and wants. I make choices and I take responsibility for them. I always do my best. Because I’m human, I make mistakes. I accept my mistakes without blame or judgment. When I make a mistake, I learn from it. I am imperfect and I forgive myself for my mistakes. I know that others are equally worthy and equally imperfect."

I then asked Laura to imagine her imaginary self in the chair getting up, coming over to where Laura herself was sitting, and merging into one whole person. I stated, "Relax and rest. When you are ready, open your eyes and get up slowly. Be aware of your new sense of compassionate acceptance." (Self-Esteem p. 133)

On this track we have discussed Eternal Penance in depressed or dysthymic   clients. We have also discussed the "Compassion Meditation" technique.

On the next track, we will discuss assessing ownership of critic behaviors and assessing what clients are trying to accomplish with self-criticism. We will also discuss the eight common reasons depressed or dysthymic   clients engage in self-criticism. Those reasons are to achieve self-improvement, to avoid egotism, to protect themselves from dangers, to atone for past sins, to maintain a needed sense of superiority, to secure reassurance and sympathy, to express hostility, and to reduce the demands and expectations of others.

Peer-Reviewed Journal Article References:
Polizzi, C. P., Baltman, J., & Lynn, S. J. (2019). Brief meditation interventions: Mindfulness, implementation instructions, and lovingkindness. Psychology of Consciousness: Theory, Research, and Practice. Advance online publication.

Shanok, N. A., Reive, C., Mize, K. D., & Jones, N. A. (2020). Mindfulness meditation intervention alters neurophysiological symptoms of anxiety and depression in preadolescents. Journal of Psychophysiology, 34(3), 159–170. 

Stice, E., Rohde, P., Seeley, J. R., & Gau, J. M. (2010). Testing mediators of intervention effects in randomized controlled trials: An evaluation of three depression prevention programs. Journal of Consulting and Clinical Psychology, 78(2), 273–280.

Online Continuing Education QUESTION 7
What causes a depressed or dysthymic client to engage in Eternal Penance? To select and enter your answer go to CEU Test.

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