ONEBird: Integrating Mindfulness, Self-Compassion, and Art Therapy (ONEBird : intégration de la pleine conscience, de l'autocompassion et de l'art-thérapie)

ABSTRACT

This review article explores the interface between art therapy and the growing field of self-compassion. The term ONEBird refers to a model that integrates mindfulness, compassion, and creative expression in an educational, experiential, and therapeutic process. Background information is provided on the integration of self-compassion and mindfulness into effective training programs and a contemporary approach to psychotherapy. Empirical evidence for the protective role of self-compassion is also included. The model provides a framework for discussing the proposed mutual benefit of Mindful Self-Compassion and compassion-focused therapy to the field of art therapy, and the inherent suitability of art therapy for fostering the cultivation of non-judgmental awareness and a desire to alleviate personal suffering. The unique contribution of creative expression is discussed and a rationale for adopting an integrative art therapy model is presented.

RÉSUMÉ

Cet article de synthèse explore l'interface entre l'art-thérapie et le domaine en pleine expansion de l'autocompassion. Le terme ONEBird fait référence à un modèle qui intègre la pleine conscience, la compassion et l'expression créative dans un processus éducatif, expérientiel et thérapeutique. Des informations générales sont fournies sur l'intégration de la compassion et de la pleine conscience dans des programmes de formation efficaces et dans une approche contemporaine de la psychothérapie. Des preuves empiriques du rôle protecteur de l'autocompassion sont également fournies. Le modèle offre un cadre pour discuter du bénéfice mutuel de l'autocompassion pleinement consciente et de la thérapie axée sur la compassion dans le domaine de l'art-thérapie, ainsi que de la pertinence inhérente de l'art-thérapie quand il s'agit de favoriser la conscience sans jugement et le désir de soulager la souffrance. La contribution unique de l'expression créative est discutée et une justification de l'adoption d'un modèle d'art-thérapie intégrative est présentée.

Introduction

The proposed beneficial and reciprocal relationship between art therapy and a mindful approach to self-compassion is encapsulated in a model called ONEBird (Williams, 2016). In the Buddhist tradition, mindfulness and compassion are considered equally important, like two wings on one bird (Morgan & Morgan, 2005, p. 81). This model expands on the metaphor of a bird by adding creativity as a third element—the symbolic heart of the bird. The heart is traditionally understood to be an integrative center and the seat of emotion (Odorisio, 2014). The capacity of the creative process to support integration and regulation of emotion is also at the heart of ONEBird. ONEBird offers theoretical support for combining mindfulness and self-compassion with art therapy and argues that the creative process is inherently suitable as a means of deepening the acquisition of the skills and resources associated with self-compassion. In keeping with the metaphor of a bird, it is a fledgling concept requiring research and a more comprehensive description. ONEBird is a call to examine the burgeoning field of self-compassion research and reflect on its potential value to art therapy. Because it is not a prescriptive model, ONEBird is an opportunity for art therapists to exercise creative agency in the design of a novel and integrative approach. It is an invitation to capitalize on the unique properties of art therapy to cultivate compassion in art therapists and their clients.

The concepts of mindfulness and compassion are described in the context of contemporary psychology. Kristin Neff's pioneering research in self-compassion and the model of Mindful Self-Compassion, developed with Christopher Germer, are presented. While Germer and Neff's (2013) training model is focused on resilience and skill building, Paul Gilbert's (2010) compassion-focused therapy is presented as an example of the integration of mindfulness and self-compassion into psychotherapy. Empirical support is provided for the role of self-compassion in preventing professional burnout. The unique contributions of the creative process of art therapy are examined, including the role of both process and product, the capacity of creative expression to make explicit that which is implicit, and the powerful ability of images to communicate complex ideas, in part because they are free of the constraints of spoken language. Finally, a rationale for integrating art therapy with mindfulness, compassion and self-compassion approaches is provided.

In contemporary psychotherapy (Gilbert & Choden, 2014), and in the field of personal development (Germer, 2009; Neff, 2011a), self-compassion has emerged as an important, measurable, and empirically supported concept. For this reason, it is worthy of the attention of art therapists. Art therapy has a long history of adapting to or integrating other approaches to psychotherapy, from the early influence of psychoanalytic theory to cognitive behavioral therapy, attachment theory, positive psychology, and art therapy as social action (Gussak & Rosal, 2016). The field has also integrated relevant findings from modern neuroscience (Hass-Cohen & Findlay, 2015). Examining the current research related to the efficacy of self-compassion is in keeping with art therapy's openness to other approaches and advances in related disciplines. In addition to the value that self-compassion may bring to the field of art therapy, this review article proposes that art therapy has inherent benefits for the cultivation of self-compassion for art therapists and their clients.

Mindfulness

Kabat-Zinn (2005) defines mindfulness “as moment-to-moment, non-judgmental awareness, cultivated by paying attention in a specific way, that is, in the present moment, and as non-reactively, as non-judgmentally, and as openheartedly as possible” (p. 232). This systematic and intentional practice and cultivation of a mindful state leads to the emergence of insight and sympathetic focus (Kabat-Zinn, 2005). In the early 1990s Kabat-Zinn conducted research at the Stress Reduction Clinic at the University of Massachusetts Medical Centre and developed a structured, empirically supported, eight-week program known as “mindfulness-based stress reduction” (Kabat-Zinn, 2011, p. 289). Since his seminal work there has been a proliferation of related research and treatment interventions including the integration of cognitive behavior therapy resulting in mindfulness-based cognitive therapy (Sipe & Eisendrath, 2012). A meta-analysis of 24 studies showed the usefulness of mindfulness-based approaches to reduce stress, anxiety, and depression (Regehr, Glancy, & Pitts, 2013).

Compassion

Compassion literally means, “to suffer with,” and although there are various definitions, Gilbert (2009) says “its essence is a basic kindness, with a deep awareness of the suffering of oneself and of other living things, coupled with the wish and effort to relieve it” (p. 35). It acknowledges our common humanity; we all suffer and we all wish to be happy. Compassion has an active quality to it and requires the use of two separate abilities—being empathetically receptive to suffering and being motivated to act with kindness to alleviate it (Gilbert & Choden, 2014). The concept of compassion is central to many of the world's great religious traditions, including Buddhism and Christianity (Gilbert & Choden, 2014). It is also foundational to contemporary psychotherapy, which emphasizes compassionate qualities in the therapeutic relationship such as respect, kindness, authenticity, affirmation, and empathy (Gilbert, 2010).

Self-compassion

Kristin Neff is a pioneer in the relatively new but burgeoning field of self-compassion research. She operationally defined self-compassion and designed the widely used “self-compassion scale,” which provides a valid and reliable way to measure the concept and its six basic elements (Neff, 2003a; 2003b; 2015). Neff (2015) defines self-compassion as having three major components, “each of which has a positive and a negative pole that represents compassionate versus uncompassionate behaviour: self-kindness versus self-judgment, a sense of common humanity versus isolation, and mindfulness versus over-identification” (Neff, 2015, p. 2). A person's ability to recognize the human condition of suffering, combined with the offering of kindness toward their own pain, develops self-compassion.

Training in self-compassion increases the number of self-kindness responses and reduces the number of critical responses to suffering (Neff, 2015). Neff and Vonk (2009) demonstrated how self-compassion offers the same positive effects as global self-esteem (optimism, happiness, and positive emotions) with fewer negative effects (social comparison, contingent self-worth, and narcissism), which predict more stability in self-worth with less dependency on specific outcomes. A meta-analysis by Zessin, Dickhäuser, and Garbade (2015)) also concludes a causal relationship between self-compassion (a caring and positive attitude toward the self when faced with failure and personal shortcomings) and well-being. Another meta-analysis by MacBeth and Gumley (2012) shows a large effect size for the relationship between compassion and psychopathology, whereby higher levels of self-compassion are associated with lower levels of mental health distress. Self-compassion is empirically correlated with reduced anxiety and depression, and greater life satisfaction, psychological well-being, and social connection (Allen & Leary, 2014; Barnard & Curry, 2011). For individuals with problematic alcohol use, increased self-compassion is significantly correlated with decreased anxiety and depressive symptoms, and a significant reduction in alcohol consumption (Brooks, Kay-Lambkin, Bowman, & Childs, 2012). After a one-year follow-up, life satisfaction was significantly increased for individuals trained in Mindful Self-Compassion, suggesting that ongoing self-compassion practice enhances quality of life over time (Germer & Neff, 2013).

Mindful Self-Compassion

Developed by Germer and Neff, Mindful Self-Compassion is an eight-week, empirically supported program designed to cultivate self-compassion skills (Germer & Neff, 2013). Laypeople and professionals learn to: understand the scientific base of self-compassion; practice it in their daily life; motivate personal change; decrease self-criticism; address challenging emotions; transform difficult relationships; reduce the risk of compassion fatigue; and teach basic self-compassion skills to others (Neff, 2018). Mindful Self-Compassion has the potential to transform a core sense of self and one's relationship to the world as it addresses shame and self-judgement related to a lack of self-worth (Germer & Neff, 2013). There is also empirical research that demonstrates how Mindful Self-Compassion reduces body shame and contingent self-worth, while enhancing body image (Albertson, Neff, & Dill-Shackleford, 2014); improves the quality of romantic relationships (Neff & Beretvas, 2013); and increases intrinsic motivation (the ability to persist with healthy pursuits, such as exercise) (Neff & Dahm, 2014).

Compassion-focused therapy

Self-compassion is part of what MacBeth and Gumley (2012) call the “third wave” of cognitive behavioral therapies, all of which emphasize the powerful therapeutic value of positive emotions (p. 546). The third wave cognitive therapies emphasize mindfulness, kindness, and the importance of developing a compassionate or non-judgmental attitude toward one's problems as a means of reducing distress. A key figure in the third wave is Paul Gilbert, who developed “compassion-focused therapy”—a multimodal therapy that integrates cognitive behavioral interventions with a wide array of other therapeutic strategies (Gilbert, 2010, p. 5). Gilbert's (2010) therapeutic model is designed for individuals with complicated, often abusive and chronic mental health backgrounds, characterized by shame and self-criticism. While the model borrows from Buddhism, it is primarily based on neuroscience, evolution, and social psychology and emphasizes the importance of positive feelings of care (for self and others), affiliation, and belonging (Gilbert, 2010).

According to Gilbert and Choden (2014) humans are regulated by three primary systems of emotions: our threat and self-protection system; our drive and resource-seeking system, and our soothing and affiliation system (Gilbert & Choden, 2014). Evolution, genetics, and our early attachment experiences play a large role in determining how these systems interact. If our relationships have not supported access to the soothing and affiliation system, then regulating the threat system can be difficult. Compassion-focused therapy clients are taught that although it is not their fault that their brain is dominated by the threat system, it is their responsibility to change it. Gilbert (2010) says, “clients find this very de-shaming and reassuring at the beginning of therapy because many of them felt that they were either bad or mad or had odd brains; that there was something very wrong with them for having the problems they had” (p. 62). Compassion-Oriented Art Therapy is a modification of Gilbert's approach proposed by Beaumont (2012) to reduce shame and build self-soothing skills using mindfulness, breathing, guided imagery, and art. The client creates images of a safe place, an inner critic, and compassionate metaphors through a variety of expressive art activities designed to promote self-acceptance and self-compassion.

Professional burnout and compassion fatigue

A benefit of developing personal self-compassion is that it provides protection from professional burnout and compassion fatigue (Baum, 2016; Thompson, Amatea, & Thompson, 2014). Professional burnout is “a state of physical, emotional, psychological, and spiritual exhaustion” that results from chronic work with vulnerable populations in negative working conditions, such as excessively large caseloads and lack of supervisory support (Newell & MacNeil, 2010, p. 61). Compassion fatigue is a broad term, often used interchangeably in the literature with “secondary traumatic stress” and “vicarious trauma” (Newell & MacNeil, 2010, p. 61). Burnout is closely related to systemic problems in the work environment, whereas compassion fatigue is linked to the emotional demands of working with trauma (Thompson et al., 2014).

Research shows mindfulness-based interventions that focus on increasing self-compassion may reduce the risk of compassion fatigue and enhance the clinical care that healthcare workers deliver (Ho, n.d.; Raab, 2014). Research with students studying counselling and psychotherapy found that those with high levels of self-compassion report lower levels of compassion fatigue and burnout (Beaumont, Durkin, Hollins Martin, & Carson, 2016) and higher levels of perceived self-competence (Ying, 2009).

Art therapy and creative expression

Art therapy is an approach to psychotherapy that uses the creative process of art making and the resulting product to help clients find meaning, resolve conflict, and alleviate distress (Malchiodi, 2007). The images form an enduring visual record of the client's therapeutic process. Art therapists may also create mindful empathic art in response to client imagery and affective state (Franklin, 2010). While verbal processing is typically involved, there is value attributed to the non-verbal, sensory, kinaesthetic, imagistic and symbolic aspects of art therapy.

Although art therapy can be integrated into many theoretical frameworks, most art therapists agree that images are external representations of internal reality (Moon, 2006). Sometimes the images that arise are from the unconscious mind, or from early traumatic experiences that have not yet been integrated into consciousness (Malchiodi, 2007). Although cognitive therapies are predicated on the idea of conscious changes, research shows that “rapidly communicated nonconscious social emotional information is primarily processed and acted upon at the implicit rather than the explicit level,” and the primary changes that occur in psychotherapy are in “implicit relational knowledge and unconscious internal representations” (Schore, 2003, p. xv). The creative process makes that which is implicit explicit. Art can also utilize shape, color, and line to communicate paradoxical, confusing, or ambiguous ideas within the same image because creativity is not bound to the rules, structure, or organization of language (Malchiodi, 2007). Art therapy offers unique potential for expressing and regulating emotions: “colours and textures easily arouse affectively laden limbic memories while purposeful art-making provides a here and now opportunity to express, understand and integrate emotional reactions” (Hass-Cohen & Carr, 2008, p. 31). This is reflected in Clark's (2016) approach to art therapy which highlights the incorporation of dialectical behavior therapy techniques to encourage emotional regulation, distress tolerance, and positive self-regard.

ONEBird: Rationale for an integrative model

ONEBird combines mindfulness, compassion, and creative expression in an experiential and therapeutic process that is proposed to be synergistically greater than the sum of its parts. It offers theoretical support for the integration of mindfulness and self-compassion into art therapy and argues that the creative process is inherently suitable as a means of deepening the acquisition of the skills and resources associated with self-compassion. ONEBird supports the acquisition of compassion-based skills through psycho-educational, experiential, and creative processes. For example, after a brief check-in, a typical session opens with discussion regarding a mindful or self-compassionate concept, and is followed by a direct experience of a related practice. Then a creative activity based on the experiential component is completed. Finally, if appropriate, verbal processing of the image and entire experience is conducted. The approach is similar within both individual and group work.

ONEBird combines elements of compassion-focused therapy (Gilbert, 2010) and Mindful Self-Compassion training (Center for Mindful Self-Compassion, 2018), with creative activities drawn from art therapy (Table 1). Psycho-education exercises assist with understanding the role of evolution in shaping the human brain and the interaction of emotional regulation systems, which help to reduce shame. (Gilbert, 2009, 2010; Gilbert & Choden, 2014; Kolts, 2016). Education regarding the nature of mindfulness and self-compassion are integrated with direct experiences of the concepts. Creative expression can take many forms (spontaneous or directed) and use a range of media. Integration typically involves verbal processing of the image and the overall experience.

Table 1. Elements of ONEBird.

Psycho-education	Mindfulness	Self-compassion	Nature of the mind
While the focus is on mindfulness, self-compassion, and the nature of the mind, clients also benefit from learning ways to integrate creative expression as a home practice.	Discuss the nature of mindfulness and potential benefits of practice in relation to the client's presenting issues. Describe the creation of mindfulness cards to support home practice that include an inspirational quotation on one side of the card and a client's artwork on the other.	Describe self-compassion and the benefits of practice. Offer support for formal (loving-kindness meditation) and informal (Self-Compassion Break) home-based practices to evoke mindfulness, common humanity, and self-kindness. Explore the value of a home altar dedicated to symbols, images, objects, and client artworks that serve as reminders to be self-compassionate during times of personal suffering.	Discuss the three circles model of emotion—the threat, drive and safeness emotion-regulation systems in the brain (Gilbert & Choden, 2014). Help client understand their attachment history in light of the three circles model. Encourage self-soothing touch when the threat system is activated (hand over heart, hand on cheek, self-hug, etc.).
Experiential aspect	Lead client in basic mindfulness practices in the session.	Lead client through a Self-Compassion Break.	Lead client to visualize and feel into situations where each of the emotional systems is predominating.
Creative expression
May be directed or spontaneous, incorporating either a single art material or combination of available media. For example, creating a simple wrapped doll with a variety of textiles and embellishments can become a powerful symbol of the self. Reminiscent of bandaging, wrapping is a mindful act that often suggests self-care and healing. The imperfect nature of the doll is a reminder to be compassionate and self-accepting.	1. Contemplative string art involves dipping cord in ink and very slowly and mindfully lowering and spreading it across paper.2. Clay manipulation (with eyes closed or soft-focused) facilitates tactile awareness.3. Watercolor mandalas to aid moment-by-moment, non-judgmental attention. The mandalas are soothing to create and a reminder to pursue mindful interludes.4. A home-based visual journal provides an opportunity for written and creative art expressions.	1. Invite art making based on the contrasting experiences of self-criticism and self-kindness. It is often beneficial to explore the somatic aspect of each experience and invite the client to translate each into an image using their preferred media (refer to Figure 1 and Figure 2).2. Decorate a small stone with words/images as a reminder to treat the self like a good friend who is suffering. Place the stone in the home as a visible cue for self-kindness.3. Clients may photograph their artworks for use on their phone screens, as an on-the-go reminder of self-acceptance.	1. Invite client to draw the three circles model, where the size of the circle represents how dominant each emotional system is for them. Clients are often surprised at how big they depict their threat circle and how underdeveloped their safeness circle is.2. Clients can be invited to draw the relative size of their circles as a check-in at the beginning of each session. It can be a working diagram, with therapist and client altering it, adding notes, etc. Reinforce ways clients can activate their soothing system to regulate emotional threat system.
Verbal integration	The way in which the mindful art process and product are discussed is very dependent on the needs of the client and the personal style of the art therapist.	Clients are often moved by the stark contrast between their self-critical and self-compassionate images, which may spontaneously lead to further discussion regarding how they can integrate self-kindness into their daily life.	The image naturally leads to a discussion about how compassion is a way to work with suffering—the client understands how self-criticism activates the threat system and how important the safeness circle is in soothing emotional distress.

ONEBird reflects the author's core belief that a therapist's personal and professional development are inextricably connected, and that embodying mindfulness and self-compassion personally is an important factor in successfully sharing it professionally. While there is no direct empirical support showing that it is necessary for therapists to be mindful or have self-compassion, Davis and Hayes (2011) state, “research suggests that mindfulness practices offer psychotherapists a way to positively affect aspects of therapy that account for successful treatment” (p. 198). In Spirituality and Art Therapy: Living the Connection, editor Farrelly-Hansen (2001) observes that every contributor in her book emphasizes mindfulness and its supportive role in their work. Rappaport (2014c) acknowledges her personal commitment to meditation training over a period of 30 years and recognizes, along with Kalmanowitz, how mindfulness training is essential for art therapists interested in this approach (Rappaport & Kalmanowitz, 2014).

Mindful approaches to art therapy are supported by quantitative and qualitative research methods (Peterson, 2015; Rappaport, 2014a; Thompson, 2018) and used with diverse populations, including cancer patients (Peterson, 2015), refugees (Kalmanowitz, 2016), adolescents (Weiner & Rappaport, 2014), and psychiatric outpatients (Isis, 2014). Mindfulness-focused art therapy is also applied to a variety of settings: schools, prisons, hospitals, and community contexts (Gussak & Rosal, 2016). Although mindfulness is widely integrated into art therapy, self-compassion is given less formal attention. For example, in the book Mindfulness and the Arts Therapies: Theory and Practice edited by Laury Rappaport, mindfulness is mentioned over 1,000 times, while compassion and self-compassion are referred to only six times (Rappaport, 2014a). Similarly, Mindful Art Therapy: A Foundation for Practice by Barbara Jean Davis (2015) mentions compassion 12 times and self-compassion once. Given that self-compassion has been identified in a variety of mindfulness-based therapies as a mechanism of action distinct from mindfulness, it warrants attention in the field of art therapy (Germer & Neff, 2013). This is not to suggest that the concept of being kind to the self during times of suffering is a foreign concept in contemporary mindful approaches to art therapy. For example, both Franklin (2010) and Kalmanowitz (2016) highlight self-kindness and empathy for the self and others. Although other similar terms are used in the literature, self-compassion as an operationally defined, measurable, and empirically supported concept is not often explicitly integrated into the field of art therapy. Beaumont (2012), however, offers a specific example of self-compassion within art therapy in her article describing its application with gender variant individuals.

A key rationale for integrating art therapy with compassion-focused approaches is that it provides a buffer against what Germer (2009) calls “backdraft”—an intense, negative, and often angry reaction to self-compassion that occurs in some individuals with deep feelings of worthlessness and shame (p. 150). Neff (2011b) remarks,

…it is as if their sense of self has been so invested in feeling inadequate that this ‘worthless self’ fights for survival when it's threatened. The way to deal with backdraft…is to mindfully accept the experience and have compassion for how hard it is to experience such intense negativity. (p. 131)

The sensory aspect of art therapy supports a balanced attitude toward intense emotions, such as fear and shame. Given that the amygdala is involved in both fear responses and sensory motor processing, art therapy can link fear with positive sensory experiences, facilitating better coping and integration of strong emotions. (Hass-Cohen & Carr, 2008, p. 33). This example of affect regulation is central to what Schore (2003) calls the “repair of the Self” (p. xiii). Beyond the specific experience of backdraft, the majority of individuals with early developing psychopathology struggle with emotional dysregulation, often as a result of early relational trauma and attachment disruption (Bowlby, 1980; Dozier, Stovall-McClough, & Albus, 2008). Schore (2003) considers affect dysregulation to be operative in all psychiatric disorders and affect regulation to be a key goal of therapy.

Emotional intensity lends meaning to experience and Corbett (2000) suggests that it is important to pay attention to both the affective and the imaginal aspects of a client's experience. If either image or affect are attended to, at the exclusion of the other, the therapist risks contributing to a defensive reaction that splits off the meaning of the experience (Corbett, 2000, p. 111). As art therapy brings the image from imagination into concrete reality, the client encounters the image directly, which reduces the risk of neglecting it, while simultaneously rendering the affective aspect more tolerable. Rappaport (2014b) shares a powerful example of a client who transforms debilitating grief by mindfully connecting with her emotions while also communicating with her terrifying image of loss. Through the process the client recovers a belief in her ability to live beyond grief through a cultivation of meaning and wisdom.

Compassion-focused therapy, Mindful Self-Compassion and art therapy incorporate imagery and visualization. For example, the compassion-focused adaptation of the Buddhist loving kindness meditation is based on the tradition of sequentially bringing to mind an image of the self with loved ones, friends, acquaintances, and eventually the entire world of sentient beings, while offering and receiving kindness, compassion, and love (Gilbert, 2010). Many art therapists also use guided visualization on its own to bring to mind a detailed image of a safe place during trauma work (Cohen, Barnes, & Rankin, 1995) or as a starting point for creating an actual art image (Beaumont, 2012; Capacchione, 2015; Malchiodi, 2007; Oaklander, 1988).

Art therapy and compassion-based approaches also share an understanding of the importance of personification. Therapists in both traditions call on clients to engage in a dialogue with aspects of the self. Neff (2011b) suggests moving among three different chairs to systematically give voice to three aspects of the self that are often in conflict—the criticizer, the criticized, and the compassionate observer. In Gilbert's (2010) work, a dialogue with the compassionate ideal focuses on the deep intention and desire of the client to be well, free from suffering, and profoundly understood through benevolent associations. In Mindful Self-Compassion and compassion-focused therapy the images remain in the imagination. Bringing the image into a concrete form through an art therapy creative process may deepen the client's integration of an inner commiserative self. McNiff (2004) suggests that because images spring from within, personifying them allows us access to emotions and concerns that are not otherwise easily accessible, and just as “in relationships with other people, dialogue takes us into a deeper, more intimate and creative exchange” (p. 91).

The following example illustrates the powerful capacity of creative expression to deepen integration and access to compassionate self-acceptance. The Self-Compassion Break is a five-minute exercise that can be practiced whenever difficult emotions arise as a result of self-criticism or other difficult life circumstances (Neff, 2018). It encapsulates the three parts of self-compassion: mindfulness of one's suffering; an experience of one's common humanity with regard to suffering; and self-kindness (reinforced by placing hands over the heart or another soothing place). Figure 1, “Self-Criticism,” is a client's representation of her experience when asked to bring to mind a mistake or failure that makes her feel inadequate. The self-critical image is of hard, blue-black, metallic claws over her heart, which she described as “harsh.” Figure 2, “Self-Compassion,” represents her experience following the Self-Compassion Break. She said there was “a palpable shift…a wave within me that was a sense of soft pink and tenderness and warmth…embodied. Very physical.” More than a year after the workshop, the client keeps the self-compassionate image on her wall. The tangible nature of the piece means:

There is another option. If I'm feeling bad or self-critical, I can look at this and I have a different choice…there's something else I can access even if I just bring the image to mind. For me it seems to be an easier way than thinking or talking. I found it very powerful.

Figure 1. Self-Criticism.

Figure 2. Self-Compassion.

The addition of an art activity to a core Mindful Self-Compassion exercise was transformative in the moment and resulted in a concrete image that serves as an enduring reminder for the client on her journey to self-compassion.

Conclusion

Art therapy is a field characterized by an openness to contributions from other disciplines and theoretical frameworks. With mindfulness and compassion as its wings, and creative expression at its heart, ONEBird is an integrated approach. While mindfulness has a well-established place in art therapy, self-compassion is much less explicitly acknowledged in the literature. Self-compassion in general, and Mindful Self-Compassion in particular, have been empirically shown to significantly improve mental health and well-being across a broad spectrum of issues, including many client issues commonly addressed in art therapy (anxiety, depression, self-worth, shame, and emotional regulation). The primary theoretical argument for integrating compassion-focused practice with art therapy hinges on the unique properties inherent in the creative element of the art therapy process. Engaging with art materials—facilitates emotional regulation; creates an external image of that which is internal; makes explicit that which is implicit; integrates affective and imaginal experience; and supports communication not bound by the conventions of verbal language. By promoting greater ease in expression and regulation of difficult emotions such as unworthiness, self-criticism and shame, art therapy strengthens the innate capacity of self-compassion to transform one's core sense of self and relationship to the world.