Compassion started with me. Three years ago, after my first child was born during the pandemic, I felt like my world had silently imploded around me. Looking back, I am certain now that anxiety and obsessive thoughts have been ingrained in me for most of my life. These dark thoughts, however, became more prevalent, and angrier, in the months after my son was born. This was a fragile and exceptionally emotional time, having a tiny innocent, entirely dependent on me. I would battle intrusive thoughts daily, and often multiple times a day. The hours we spent alone in lockdown felt tainted with the sound of this constant and unrelenting darkness. I pleaded with myself daily, begging me to stop. All I desperately desired was the constant noise in my head to stop. I can recount every single word of that first tearful conversation with my general practitioner, saying the words aloud whilst my husband grasped by hand tightly. Something needed to change for me to function as a wife, as a mother and as me. The journey of healing and recovery started with medication. I was enrolled in regular cognitive behavioural therapy sessions. I was forced to master the art of self-compassion, something which, to be brutally honest, was alien to me. I had hidden behind my illness for so long, subdued by my internal conflict with these toxic, unruly thoughts. I often found myself consumed with shame for the monstrous ideas which would invade my subconscious, both unwelcome and uninvited.

Silence. Sometimes, silence can be comforting. I remember longing for my head to be silent, to stop thinking the unthinkable thoughts I could not stop thinking. During my recovery, I would often sit in silence and instead of suffocating with the thoughts, I would sit with them, acknowledging and accepting their presence. Accepting that this is silence, and these are just thoughts. Remembering in these moments, to show myself some compassion. I shared my silence with others when I knew they needed it most. As my patient lay in the intensive care unit gradually slipping away, we ushered the family into a quiet room. ‘I’m sorry to tell you what we suspected. This is an un-survivable and devastating injury to his brain. He will not wake up; he is reaching the end of his life.’ The father began to scream and sob loudly, the wife echoing his cries with her own. We sat silently, absorbing their horror, as their unrelenting anguish tore through the room, shaking our silence to the core. Compassion is sometimes sitting in silence, observing, and acknowledging the deep pain and suffering that is all-consuming for those in the depths of it. These moments we shared, fraught with such total and inevitable devastation.

I remember the darkest of days, when the intrusive thoughts felt so visceral, as if someone was screaming inside my head. I would bully and shame myself on these days, insisting that I must be weak. I sobbed for hours, not knowing how to stop, wishing desperately to confess these thoughts aloud, but feeling too ashamed to do so, and struggling to show myself the kindness I so desperately deserved. I remember the innate sadness and humiliation I felt, praying in those moments to be anyone else but me. At one of our handovers, my colleague began to sob quietly, tears streaming down her face, with the room around us falling into deafening silence. Once outside in a safe space, she spoke of how she had been cruelly berated. ‘I felt so powerless as she questioned my decision and my level of competence; she demanded to know who my superior was. The whole thing was so humiliating, and I feel so stupid’. Her words are a stark reminder of the bullies we encounter daily, reminding me of my own. I did not want to leave her without reminding her of how valued she was: ‘I’m so sorry, you are right to be upset. I would have felt the same, and I too would have cried'. Now, more than ever, mental health issues and burnout have been highlighted, particularly amongst healthcare practitioners [1, 2]. Recently, we were told of the tragic suicides of junior doctors, working in unsustainable conditions [3]. The news, I am sure is hard hitting for us all. I would urge anyone to seek professional help if they too feel like they are suffocating and feel there is no way out. I felt this way once, not so long ago, and with time and support, things got better.

My journey into discovering self-compassion feels simply incomplete without sharing these experiences. Once I started understanding and allowing self-compassion, I began to see it all around me in my day-to-day life, when we sat in silence absorbing and accepting a family’s grief, when this doctor needed reminding of how much value she adds every day to our team. Compassion felt so natural in the world around me, so why could not I show myself that same kindness? Why could I show strangers more compassion than I could ever show myself? It is all around me where I work: strangers helping strangers. Yet, I could not even support myself and tell myself that I deserved kindness in the darkest of days. It was not until after my recovery that I could unpack these moments and truly recognise that kindness and compassion had been hiding in plain sight. Have these brief, but vital interactions promoted the notion of self-compassion in myself? Could these moments have informed the kindness I have come to show myself more over time? My compassion for me meant I could write these words down and not hide from them, or fear them any longer, for which I will never stop being grateful.

Compassion ends with me. At home, with my almost 3-year-old son, although my illness is better controlled, there are days when the intrusive thoughts seem to be more prevalent and it is difficult to predict when those days will be. However, being able to finally say them out loud seems to make these days feel shorter. My story is inspired by one of my favourite short stories. Whenever I read this story, all that surfaces in my mind is the compassion and kindness I see around me every day and its role in my own journey of recovery. I have come so far on this journey, and this story reminds me of the eternal gratitude I have to my friends, family, colleagues, and patients alike, for showing me how to be kind to myself.

‘I love to share the magic of the shining skies above and think of all the different ways that we can show our love. So, snuggle safely in my arms, our day is nearly done. I love you to the moon and stars, my precious one’ [4].