Present Moment Awareness
Coping with Moral Distress: Self-Compassionate Present Moment Awareness
I doubt anyone in the whole world can immediately stay present with compassion and curiosity in the hardest moments of their lives. Yet! Just like a muscle, we can grow our capacity to stay present with compassion, beginning with neutral experiences like our breath, eventually building our practice so that we can present to our moral distress.
Stay Present Even When You Want to Escape or Avoid
If you're feeling overwhelmed, you might pay attention to your surroundings using your five senses. If you are managing the tension of a hurtful conversation, you might focus on your care for this person, instead of what they are saying. You can hone your attention like a laser beam, focusing on the sensation of air moving in and out of your nose, or you can broaden your awareness like a lantern, lighting up all of your internal and external experiences, and allowing them to flow through your awareness without judgment (Hayes, 2019).
The Power of Compassion
Think of the last time you told yourself, "I shouldn't feel this way.” Did this allow emotions to flow through you? Or did you get stuck? Our emotions only amplify when we respond with criticism or judgment. Approach your emotions with compassion, as you would a scared dog crouched in the corner of your limbic system. Notice, with curiosity and kindness, each component of your emotions, including thoughts, sensations, and behavior urges.
Leveling Up
As you get comfortable, you will be able to stay mindful in increasingly distressing emotional situations. This is hard. It's not an overnight achievement but a result of consistent practice in the easier moments.
Practice: Self Compassion Break (Neff, 2011)
Step 1: Notice your suffering (don't fall into the gutters of drowning in it or denying it!)
Step 2: Notice it's human (you are neither so uniquely flawed or good that you are exempt!)
Step 3: Do what you can to relieve your suffering (Can't fix it all, and you aren't completely without agency!)
For Further Exploration:
Do a self-compassion meditation with Dr. Kristen Neff, a leading self-compassion researcher. If you like it, go through her evidence-based workbook:
Neff, K., & Germer, C. (2018). The Mindful Self-Compassion Workbook: A Proven Way to Accept Yourself, Build Inner Strength, and Thrive. New York, NY: Guilford Press.
Practice RAIN for compassion, and learn from a renown psychologist and compassion teacher Dr. Tara Brach: Brach, T. (n.d.). Resources: Self-Compassion and Compassion for Others. Retrieved March 15, 2025, from https://www.tarabrach.com/compassion-others-self/
References:
Evans, W. R., Walser, R. D., Drescher, K. D., & Farnsworth, J. K. (2020). The Moral Injury Workbook: Acceptance and Commitment Therapy Skills for Moving Beyond Shame, Anger, and Trauma to Reclaim Your Values. New Harbinger Publications.
Germer, C. K. (2009). The mindful path to self-compassion: Freeing yourself from destructive thoughts and emotions. Guilford Press.
Hayes, S. (2019). A Liberated Mind: How to Pivot Toward What Matters. New York: Avery.
Neff, K. D. (2003). Self-compassion: An alternative conceptualization of a healthy attitude toward oneself. Self and Identity, 2, 85-102.
Neff, K. D. (2011). Self-compassion: The proven power of being kind to yourself. William Morrow.
Neff, K. D., & Germer, C. K. (2013). A pilot study and randomized controlled trial of the mindful self-compassion program. Journal of Clinical Psychology, 69(1), 28-44.
Smith-MacDonald L., Lusk J., Lee-Baggley D., Bright K., Laidlaw A., Voth M., Spencer S., Cruikshank E., Pike A., Jones C., Bremault-Phillips S. (2022). Companions in the Abyss: A Feasibility and Acceptability Study of an Online Therapy Group for Healthcare Providers Working During the COVID-19 Pandemic. Frontiers in Psychiatry, 12: 801680.