How to Practice Self-Compassion: 10 Exercises for Chronic Pain

Estimated reading time: 12 minutesSelf-compassion, the practice of treating yourself with kindness during difficult moments, has been shown in research to reduce stress, depression, and anxiety, with particularly strong benefits for people managing chronic health conditions (1).

This matters especially for those living with Ehlers-Danlos Syndrome (EDS), symptomatic hypermobility, dysautonomia, or other chronic illnesses, where unpredictable symptoms and invisible illness can fuel harsh self-criticism.

Dr. Kristin Neff, a pioneering researcher in this field, describes self-compassion as ‘a practice in which we learn to be a good friend to ourselves when we need it most—to become an inner ally rather than an inner enemy (2).’

More formally, self-compassion involves three things: acknowledging your own suffering, responding to it with kindness rather than criticism, and recognizing that challenges and setbacks are part of the universal human experience (3).

People who implement this treat themselves with kindness and concern when they experience negative events (4).

I have observed, including myself, that when you live with a chronic illness, you tend to be the hardest on yourself. We tend to be harsh with our self-talk and often carry guilt and blame for living with this condition.

There was a recent discussion in The Zebra Club app about experiencing flare-ups in pain and fatigue. Many of the participants felt guilty or blamed themselves for the flare-up.

I have also been guilty of comparing myself to others, beating myself up for not being able to do what my peers are able to do.

Finding self-compassion has been a real game-changer for me and how I relate to myself and my EDS. It can be a hard concept to accept when you have been prone to a harsh approach with yourself, but with practice, it becomes easier and a welcome ally.

The Opposite of Self-Compassion: Self-Criticism

The opposite of self-compassion is self-criticism. According to Paul Gilbert, self-criticism activates the body’s “threat defense system” and triggers a stress response characterized by cortisol and adrenaline release.

As Kristen Neff says, “with self-criticism, we are both the attacker and the attacked (2).”

Research shows that women tend to be slightly less self-compassionate than men, attributed to findings that women are more self-critical and focus more on negative self-perceptions (5).

Those of us living with a chronic illness could really benefit from self-compassion to help manage the stress and anxiety often associated with living with these conditions.

The Neuroscience: What Happens in Your Brain

According to Psychotherapist and repeat The Zebra Club visitor Kim Clayden, self-compassion involves treating oneself with kindness and understanding in times of difficulty. The relationship between our thoughts and our bodies is complex and interconnected.

The way we talk to ourselves has measurable effects on brain function. Here’s what the research shows happens when we practice self-compassion:

• Insula Activation: The insula, a brain region involved in emotional awareness, is affected by self-compassion. Studies suggest that it may enhance emotional regulation by influencing the functioning of the insula (5). In practical terms: This helps you better recognize and respond to your body’s signals.
• Prefrontal Cortex Activation: Mindful self-compassion practices have been shown to increase activity in the prefrontal cortex, a region associated with emotional regulation, decision-making, and perspective-taking (6). In practical terms, this helps you respond to difficult situations more thoughtfully rather than reactively.
• Amygdala Regulation: Self-compassion has been associated with decreased activation of the amygdala, a region linked to the processing of stress and negative emotions. This suggests that practicing this may help regulate emotional responses (7). In practical terms: This means less activation of your stress response system.
• Default Mode Network (DMN): It has also been associated with alterations in the DMN, a network involved in self-referential thinking (7). In practical terms: This may contribute to a more positive and less self-critical internal dialogue.

How Self-Compassion Regulates Your Nervous System

For people with EDS and POTS, nervous system regulation is especially important. Research shows that self-compassion can directly impact the autonomic nervous system response

Research has shown that self-compassion can directly impact the nervous system. One study found that brief self-compassion training impacted physical markers of sympathetic nervous system response (8).

In this study, university undergraduate women were grouped into a placebo group, a no-intervention group, and a group that listened to self-compassion recordings – meditations that focused on cultivating kindness and acceptance towards self and others.

The participants then had to participate in a stress test that involved “an interview-style presentation, followed by a surprise mental arithmetic test, in front of an interview panel who do not provide feedback or encouragement (9).”

Researchers found that in response to the stress test, the group that received training before the test had lower levels of alpha-amylase in their saliva. This is a marker of sympathetic (Fight or Flight) nervous system activation.

Meaning that in the group that simply listened to self-compassion meditations, the sympathetic fight-or-flight response wasn’t as strong.

This group also had a more stable heart rate variability following the stress test compared to the two control groups. The researchers correlated this ability to maintain a higher HRV with greater attentiveness and a better ability to regulate their emotions.

Notably, while anxiety scores increased in all groups in response to the stress test, they increased less in the self-compassion group.

Understanding HRV: Resting vagally mediated heart rate variability (vmHRV) is an indicator of the interplay between the parasympathetic (rest and digest) and the sympathetic (fight or flight) nervous system. Higher heart rate variability – or the variability in beat-to-beat (not the heart rate itself) is associated with a predominantly parasympathetic (10).

So, a higher HRV is a marker of a system trending closer to the rest and digest state.

In another study, a group of students was assessed using questionnaires to determine their level of mindfulness and self-compassion.

Researchers found that higher vmHRV was associated with higher scores of self-compassion (calculated in a way to isolate self-compassion from mindfulness). This was a pilot (small proof of concept) study done in an attempt to tease out mindfulness from self-compassion (10).

Self-compassion seems to directly have an impact on the parasympathetic nervous system! While this study focused on “dispositional self-compassion” (which means they ranked higher on a self-compassion assessment), it can be learned. We will discuss this further.

What this means for you: When you respond to a difficult moment with kindness instead of criticism, you’re not just being nicer to yourself—you’re actually helping your nervous system stay more regulated, which can reduce physical symptoms and improve your ability to cope.

Self-Compassion and Chronic Pain: What the Research Shows

A systematic review analyzed 7 different studies to try and learn more about the impact of compassion with yourself on chronic pain. All of the studies took different approaches to implementing self-compassion interventions and measuring the effect. This made it difficult to draw clear conclusions.

What this review was able to conclude was that across all of these studies, learning self-compassion benefits people with chronic pain (11).

As we often mention, meditation can impact pain. We would like to point out that self-compassion can be another tool in the pain relief toolbox.

Preliminary research has shown that using loving kindness and compassion-based meditation can reduce pain severity, change the impact of pain, and reduce distress from pain (12).

One small study on people with migraines found that after a 20-minute loving-kindness meditation, participants self-reported a decrease in pain by an average of 33% and a decrease in emotional tension by an average of 43% (13).

Why This Matters for Hypermobility and EDS

Living with hypermobility and EDS brings unique challenges where self-compassion can be particularly helpful:

Movement anxiety: Fear of injury or dislocation can lead to avoiding movement altogether. Approaching movement with kindness by going slow, respecting your body’s feedback, helps you stay active without triggering boom-bust cycles. This is a core principle of the Integral Movement Method.

Comparing yourself to the past: It’s easy to be harsh about what you can no longer do. Self-compassion helps you meet yourself where you are now, not where you were before symptoms worsened.

Unpredictable symptoms: When a good day suddenly becomes a bad day, self-criticism (‘What did I do wrong?’) adds suffering. Self-kindness acknowledges the unpredictability without blame. Your body’s behavior isn’t a moral failing; it’s a feature of hypermobile connective tissue.

Medical trauma: Many people with EDS face years of being dismissed before diagnosis. The self-compassion break (which we’ll cover in the practical techniques section) can be especially helpful during and after difficult medical appointments.

How to Practice Self-Compassion: 10 Practical Techniques

These aren’t vague suggestions to ‘be nicer to yourself.’ Each technique is specific, evidence-based, and adapted for the challenges of chronic illness. Kim Clayden, psychotherapist and pain management specialist, helped develop these applications for people with hypermobility and chronic pain. Start with the ones that resonate most

Improving self-compassion involves cultivating a mindset of kindness and understanding toward oneself, especially in times of difficulty or failure. Here are some practical steps:

1. Practice Mindfulness: Become Aware Without Judgment

Engage in mindfulness meditation or other mindfulness practices. Mindfulness helps you become aware of your thoughts and emotions without judgment, fostering a non-reactive and compassionate attitude. This can be a brief pause to notice what is happening, or a mindful movement practice

When to use it: Daily practice, even for 5 minutes, can build your capacity to notice self-critical thoughts without automatically believing them.

2. Replace Self-Critical Thoughts with Supportive Language

Monitor your inner dialogue. Replace self-critical thoughts with kind and supportive language. Treat yourself with the same kindness you would offer to a friend facing a similar situation. It can be useful to ask, ‘What would I say to my best friend if they were in the same situation as me?’

I recently recorded a Heart Meditation on The Zebra Club app, which is designed to promote self-kindness and compassion to ourselves.

For chronic illness: This is especially helpful when you catch yourself thinking “I should be able to handle this” or “I’m letting everyone down” during symptom flares.

3. Remember You’re Not Alone: Common Humanity

Recognise that everyone faces challenges and makes mistakes. Understand that imperfection is a shared human experience. Feeling connected to others in this way can diminish feelings of isolation and self-judgment.

For hypermobility: Remember that millions worldwide live with EDS, hypermobility, and chronic pain. You’re not uniquely broken—you’re part of a community facing similar challenges.

4. Write yourself a compassionate letter

Write a letter to yourself as if you were writing to a friend who is struggling. Acknowledge your challenges, express understanding, and offer words of encouragement and support. Read the letter when you need a self-compassion boost.

If it doesn’t feel easy: Kristen Neff suggests writing this letter to yourself from the perspective of an unconditionally loving imaginary friend

5. Try Guided Self-Compassion Meditations

Explore mindful self-compassion exercises developed by researchers like Kristin Neff and Christopher Germer. These may include guided meditations, exercises, and reflections designed to enhance self-compassion.

Where to find them: The Zebra Club app has guided meditations adapted specifically for chronic illness and hypermobility. You can also find Kristin Neff’s free resources, and Christopher Germer’s Mindful Self-Compassion (MSC) program materials.

6. Set Realistic Goals and Be Kind When Things Don’t Go as Planned

Set realistic and achievable goals. Be kind to yourself when things don’t go as planned. Understand that setbacks and mistakes are part of the learning and growth process.

For chronic illness: With unpredictable symptoms, your capacity changes day to day. What’s realistic on a good day may not be realistic during a flare. Adjusting your expectations isn’t failure—it’s wisdom. Practice saying “I’m doing what I can with what I have today.

7. Prioritize Self-Care Activities That Bring You Joy

Prioritise self-care activities that bring you joy and relaxation. This can include activities like exercise, reading, spending time in nature, or engaging in hobbies. Taking care of your physical and mental well-being contributes to self-compassion.

For hypermobility: Self-care might look like mindful movement practices (like those in the Integral Movement Method), rest when your body needs it, or activities adapted to your current capacity. Remember that rest is a form of self-care, not laziness.

8. Practice Gratitude to Shift Your Perspective

Practice gratitude by reflecting on positive aspects of your life. Focusing on what you are grateful for can shift your perspective and contribute to a more compassionate mindset.

Important note: This isn’t about toxic positivity or pretending everything is fine. You can be grateful for supportive friends AND frustrated about your symptoms. Both can be true at the same time.

9. Reach Out for Support from Others

Reach out to friends, family, or a mental health professional for support. Sharing your struggles with others can provide a sense of connection and understanding.

A note: If self-compassion practices bring up difficult emotions (sometimes called “backdraft”), or if you have a trauma history, working with a therapist can help you approach these practices safely. The Zebra Club community also provides a connection with others who understand living with hypermobility and chronic illness. We strive to make it as supportive and welcoming as possible.

10. View Mistakes as Learning Opportunities

View mistakes and failures as opportunities for learning and growth rather than as reasons for self-condemnation. Embrace a growth mindset and recognise that everyone makes mistakes on the path to improvement.

For chronic illness: This applies to symptom management, too. If you overdid it and triggered a flare, that’s information about your limits—not evidence that you’re failing. Each experience teaches you more about pacing and what your body needs.

Remember that developing this is an ongoing process, and it takes time and practice. Be patient with yourself and celebrate the progress you make along the way, however big or small.

Guided Practice: Self-Compassion Meditation

If you’d like to experience what self-compassion feels like in practice, I’ve created this 25-minute guided meditation specifically for people managing chronic conditions like EDS, hypermobility, and chronic pain.

Find a comfortable position sitting, lying down, or however works for your body today. The guided practice begins at 5:49. If you want to skip ahead, or watch from the beginning for context on how to approach the meditation.

You can return to this meditation whenever you need it—during difficult symptom days, after challenging appointments, or simply as regular practice to build your self-compassion skills.

Remember, developing self-compassion is itself a practice in self-compassion. There will be days when it feels easy and days when it feels impossible. That’s normal and part of being human.

Start with the techniques that feel most accessible to you. You don’t need to master all 10. Even practicing one consistently can make a real difference in how you relate to yourself and cope with chronic illness. This might be monitoring your inner dialogue to replace self-critical thoughts, practicing daily gratitude, or writing yourself a compassionate letter when things are especially hard.

Your condition may limit what your body can do, but it doesn’t limit your capacity for kindness, especially toward yourself.

FAQ

What is self-compassion?

Self-compassion is the practice of treating yourself with the same kindness, understanding, and patience you would offer a good friend in times of struggle. As Dr. Kristin Neff describes, it means becoming “an inner ally rather than an inner enemy” (2). It involves three core elements: self-kindness (vs. harsh judgment), common humanity (recognizing struggles are universal), and mindfulness (acknowledging pain without over-identifying with it).

What are the 3 components of self-compassion?

Dr. Kristin Neff identified three key components that work together: self-kindness (treating yourself gently rather than critically), common humanity (recognizing that struggle and imperfection are part of being human, not personal failings), and mindfulness (being aware of painful thoughts and feelings without getting swept away by them). For people with chronic illness, this might mean acknowledging a flare-up is difficult (mindfulness), recognizing others face similar challenges (common humanity), and responding with care rather than blame (self-kindness).

How can I practice self-compassion with chronic pain?

It can be hard to practice self-compassion when we have chronic pain, but it does take practice. This may involve mindfulness practices, replacing self-critical thoughts with kind and supportive language, and recognizing that you aren’t alone; other people share the experience of chronic pain.

Does self-compassion help with chronic pain?

Yes. Research shows self-compassion can significantly reduce pain intensity—one study found a 33% decrease in migraine pain after just 20 minutes of loving-kindness meditation (13). It also improves nervous system regulation, with studies showing lower stress markers and better heart rate variability (8). For conditions like EDS and POTS where nervous system dysregulation is part of the disease, these benefits are particularly relevant. It’s not a cure, but a valuable tool alongside other treatments.

How can I practice self-compassion with chronic pain?

Start with mindfulness practices to become aware of your pain without harsh judgment. Monitor your inner dialogue and replace self-critical thoughts (“I should be able to handle this”) with kind, supportive language (“I’m doing my best with what I have today”). Remember that you’re not alone—everyone with chronic pain struggles, which is part of our shared human experience. The techniques section above offers 10 specific practices adapted for chronic illness, including guided meditations and gratitude practices available on The Zebra Club app.

How is self-compassion different from self-esteem?

Self-esteem is about how you evaluate yourself compared to others and whether you meet your standards—it fluctuates based on success and failure. Self-compassion is about how you treat yourself, especially during difficult times. It’s unconditional: you deserve kindness whether you’re succeeding or struggling, having a good pain day or a bad one. Self-esteem asks, “Am I good enough?” while self-compassion says, “I’m human, and that’s enough.”

Is self-compassion the same as self-pity?

No. Self-pity involves feeling isolated in your suffering and getting stuck in “why me?” Self-compassion recognizes that suffering is part of the shared human experience—you’re not alone or uniquely flawed. It’s also action-oriented: self-compassion asks “what do I need right now to support myself?” rather than dwelling on how unfair things are. With chronic illness, self-compassion means acknowledging real limitations while still doing what you can, not using your condition as an excuse.

How is self-compassion different from positive thinking?

Positive thinking often means denying or minimizing pain (“Everything’s fine! Think happy thoughts!”). Self-compassion means acknowledging pain is real AND responding to it with kindness. You can think “this really hurts and I hate it” while also thinking “I deserve support and understanding”—both can be true. It’s not about forcing yourself to feel positive; it’s about being kind to yourself, especially when things are difficult. This honesty makes it more sustainable than toxic positivity.

Can you learn self-compassion?

Yes, absolutely. Research shows that even brief training significantly increases self-compassion levels. The studies in this article found measurable changes—reduced stress markers, improved heart rate variability—after just days of practice (8,10). While some people naturally start with more self-compassion due to upbringing, everyone can develop it with consistent practice, similar to learning any skill.

Jeannie Di Bon

Jeannie Di Bon is a movement therapist, educator and author specializing in hypermobility, Ehlers-Danlos Syndrome and chronic pain. She is the founder of The Zebra Club app and the creator of the Integral Movement Method.

Kim Clayden

Kim Clayden HPD, DSFH, MNCH (Reg), CNHC (Reg), AfSFH (Reg) is a Solution Focused Psychotherapist, Clinical Hypnotherapist & Muss Rewind Practitioner. She is a pain management specialist with lived experience in hEDS and POTS.

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