In advance of our one day online CPD event: Embracing Compassion Focused Therapy – Theory and Practice with Dr Erin Hope Thompson on 4th February 2023, we have put together an article exploring the question:
What is Compassion Focused Therapy?
Compassion Focused Therapy (CFT) is a modality of therapy that aims to help clients become more compassionate towards themselves and others, in order to promote greater emotional and mental wellbeing.
In her talk as part of the Perspectives On Bereavement And Grief ThEO video, Dr Erin Hope Thompson explains that CFT: “rests on the principle that developing acceptance and compassion for ourselves and others is both deeply healing, strengthening and soothing.”, Dr Erin Hope Thompson explains that CFT: “rests on the principle that developing acceptance and compassion for ourselves and others is both deeply healing, strengthening and soothing.”
It also helps us address many of the challenges we encounter in being human.
It’s Founder: Dr Paul Gilbert
“If you want one recipe to make you unhappy, it would be to focus on the things you criticize or don’t like about yourself.”
Paul A. Gilbert, The Compassionate Mind
Influenced by philosophy, psychology and religion that recognise the power of compassion, CFT was founded by Dr Paul Gilbert, Professor of Clinical Psychology at the University of Derby. Along with colleagues, he founded the Compassionate Mind Foundation in 2006 (which is the home of Compassion Focused Therapy). The charity’s mission statement is: “To promote wellbeing through the scientific understanding and application of compassion”
Paul Gilbert was a member of the team for the UK Governments’ NICE guidelines for depression in 2002. He has also written and edited over 20 books and 200+ papers. In 2010, he published The Compassionate Mind (Compassion Focused Therapy). In 2011, Paul was awarded an OBE (Order of the British Empire) for services to mental health.
This YouTube video: Compassion Focused Therapy with Dr Paul Gilbert (10:47) features an interview where Paul explains more about his focus on reducing self-criticism:
“The key issue with self-criticism is the emotion that goes with it… What goes through your mind is very powerful and how it affects your emotions and your body”
“It is very important to recognise that what you think about and the fantasies and images you dwell on, have a very powerful influence on how your brain works and how your body works.
“By analogy then, if you are focusing on yourself as being no good or inadequate or you are generating quite a lot of anger or disappointment to yourself, that is going to be stimulating your stress system.
“And the problem with people who are self-critical is that day in, day out, they’re stimulating their threat stress system. And if you keep doing that sooner or later you’re going to just feel beaten down, harassed, no good, worthless, useless, inadequate.”
2 Types of Self Criticism
He goes on to make a distinction between two types of self-criticism:
- Criticism based upon frustration, anger, annoyance, and punishment.
- Compassionate self correction
The latter, self correction, involves embracing mistakes as much as possible and focusing on what we can learn from them. This is in contrast to the first, which involves punishing ourselves and beating ourselves up.
So we can ask ourselves: “When things go wrong, how do we treat ourselves?” and “How would we like to learn to treat ourselves?”
It can be useful to recognise that if you get very angry and critical, you are going to be pushing your stress system into overdrive, on top of still having to deal with the initial challenge or problem that triggered the response.
Paul also identifies the damaging situation where someone actually hates themselves, and the self criticism isn’t targeted at a mistake but at themselves. This form also includes different emotions such as contempt and aggression, which are very likely to lead to anxiety and depression. This is also impacted by greater social comparison through media, society etc, and the “increasing emotional tone of not being good enough”.
An Evolutionary Model of Psychology
Drawing on a range of influences, Compassion Focused Therapy is rooted in an evolutionary model of human psychology.
This helps explain the difficulties we experience when older evolutionary motivation and emotional systems interact with more recently evolved cognitive competences and intelligence. Self-monitoring is one example of this. It has been hugely useful in our human evolution but can also be the source of anxiety, depression and shame.
In this model, humans have 3 emotional regulation systems:
- Evolutionary fight/flight/freeze response and fall-back system
- Over eager protection system that results in anxiety
- Reward and resource seeking looking for pleasure and vitality
- Achieving and activating energies
- Can be used to avoid uncomfortable feelings (such as grief)
- Relaxed, safe, and kind space which helps regulate the other 2 systems and find balance between wanting /striving
- Releases endorphins in brain
- Can be triggered by others and also by ourselves.
These are also summarised in this infographic from NICANM:
Our early life experience can shape the organisation of our emotional regulation systems. In the ideal scenario, babies learn to self sooth as a result of good parenting. If the parents weren’t able to do this, this can result in a greater disposition towards threat awareness and threat-based emotions in later life, which are at the root of many mental health challenges. Indeed, when we are in threat or in drive states, the soothing system can’t be online. And so this is where CFT comes in to help us develop the skills in compassion to bring the soothing system online.
What is Compassion?
The online Merriam Webster dictionary defines compassion as the:
“sympathetic consciousness of others’ distress together with a desire to alleviate it”
3 Components of Compassion
There are 3 components of compassion:
- The noticing of suffering
- Which leads to feeling moved to do something to help
- Acknowledging that this suffering is part of a shared human experience that unite us (therefore making it distinct and separate from pity).
Compassion is similar to empathy but has the added impulse of a desire to take action in order to help. It also invites us to recognise that our struggle may be what connects us to others, rather than separating and isolating us which is what many of us fear.
In practice, compassion is not easy, it is not fluffy, and can be very challenging. Especially when it comes to self-compassion; the noticing of our own suffering and feeling moved to help ourselves.
3 Flows of Compassion
There are 3 Flows of compassion:
- Self to other
- Other to self
- Self to self
For many people having compassion for another (self to other) may be easier than self compassion (self to self). In this case it could be worth asking:
“What would I/you say to a friend?”
There may also be therapeutic value and insight in exploring what resistance maybe in place.
How to develop compassion?
The good news is that compassion is a skill that can be developed. It is a way of thinking and focusing our attention. Instead of trying to avoid or get rid of suffering and uncomfortable feelings, the intention is to gently meet the suffering (in ourselves or others) and offer kindness and support.
The Simple Secret to Self Compassion – Professor Paul Gilbert OBE (5:26)
In this YouTube, Paul Gilbert, reflects on the truth “that no living thing chose to be what it is”… The problem is when we fuse with our emotions. If I have rage I must be an angry person and a bad person. The reframe is to see that this is a programme in our mind which has been placed there by nature (and perhaps influenced to some degree by our upbringing).
The invitation to to then stand back from our difficult emotions, observe them and then decide what you want to do about it. And this is where mindfulness comes into its own, in terms of helping us to become aware of what is happening in our minds and observing, without fusing, and without naming and shaming ourselves.
We remember that it isn’t our fault that we have all these programmes running, we didn’t choose them: “My brain has been built for me, not by me”. While these programmes and emotions aren’t my fault, I can still take responsibility for how I move forward and behave: asking “How can I start to use my mind to help myself and others?”.
Further Ideas for Developing Compassion
Further ideas for developing compassion include:
- Guided visualisations
- Developing and drawing on supportive imagery
- Building a compassionate language and kinder inner voice that understands what it is like to be human and to suffer
- Soothing breathing exercises (such as soothing rhythm breathing)
Dr Kristin Neff, is also a leader in working with compassion, and offers an impressive range of exercises on her website: https://self-compassion.org/category/exercises/.These include using writing, touch, changing critical self talk, and identifying what we really want.
Her colleague Chris Germer, also offers a range of meditations and practices on his website: https://chrisgermer.com/meditations/. These include: guided meditations (with the option of written instructions), exercises for working with difficult emotions, labelling emotions, walking meditation, and writing a compassionate letter to myself.
When working with clients it can be useful to start with simple practices and then build up to more challenging exercises (which may involve addressing suffering more directly) as resilience grows.
It is also useful to be aware of the possibility of “backdraft” as a result of experiencing greater compassion. This can occur when compassion triggers difficult memories and feelings that are overwhelming. With the help of another, the work maybe to normalise these feelings and work to allow and accept them as well.
None of these offer quick fixes. They are all practices, and it is worth noting that even a few seconds of felt compassion and release can be beneficial. And of course meeting it all, willingness and resistance, with compassion.
Interested in exploring Compassion Focused Therapy further? Join us for our one day online CPD event: Embracing Compassion Focused Therapy – Theory and Practice on 4th February 2023, with Dr Erin Hope Thompson.
Erin will be running a full day workshop that covers the theory behind CFT as well as a number of reflections and exercises that can be used in practice. The workshop will include case studies from Erin that help illustrate how CFT can be used in formulation and practice, as well as some experiential exercises that delegates can get involved in during the workshop.
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