Compassion-focused therapy

What is compassion-focused therapy?

It should first be noted that all talking therapies will involve compassion. The premise of counselling itself involves you being kinder to yourself and taking control of your mental health. What makes compassion-focused therapy different, however, is that it looks at helping you consciously develop your ability to be more compassionate towards both yourself and others. The goal of compassion-focused therapy is to improve mental and physical health. 

The history of CFT

CFT is a relatively new approach. It was founded by Paul Raymond Gilbert, a clinical psychologist, in 2000. It is considered an integrative therapy as it uses tools from other psychotherapies. It also incorporates research and tools from Buddhism, neuroscience and evolutionary therapy. 

Gilbert noticed that many of his clients suffered from very high levels of self-criticism and shame. He found that just cognitive behavioural therapy (CBT) alone didn’t seem to help. While they gained a better understanding of their thinking patterns and how these affected their behaviour, it didn’t help to improve their mental health. 

Gilbert discovered that they needed tools to help soothe themselves too. So, he developed compassion-focused therapy - an approach to help create a positive emotional response for those dealing with low self-worth. The therapy can be used alone, but it can also be used alongside other therapy types, adding another layer of support.

How does compassion-focused therapy work?

Compassion-focused therapy looks at evolution theory and how this affects the way we think. Essentially, as humans, we have two parts to our brains. The primitive or ‘old’ part helps us survive. It ensures we have food, shelter, are loved and are safe. This part is also responsible for the fight, flight or freeze stress response. It tends to be here where concerns like anxiety, and even sadness stem from.

The modern or ‘new’ part of the brain has come about during the evolution process. This part allows us to have a sense of self and lets us imagine and visualise. We can come up with ideas and choose how we want to live.

Sometimes, these new and old parts can often conflict or get confused. Our instincts can take over and create protective emotions (like anxiety).

Cognitive behavioural therapy can help us understand this in greater detail and explain why we feel the way we do. It helps us learn to notice and then change the way we think. Compassion-focused therapy takes this a step further, for those who need it. It helps us let go of the self-blame we can often attach to negative thoughts.

CFT also helps us generate emotions that can help change our thought patterns - like compassion. The brain is designed to create kindness and compassion as well as the more protective emotions like stress and anxiety. CFT helps us learn how to activate this part of the brain.

With this change, our mental and physiological processes shift, we can diffuse negative emotions, feel secure, and then be empowered to make conscious choices which better serve ourselves and others.

Mitchell Osborne PGDip, BSc (Hons) - Self-compassion is meant for you 

The idea of generating compassion to help improve well-being actually stems from ancient Buddhism. Studies have proven its effectiveness too. Research has found that by developing our compassion, we can create positive effects on our brain and our immune system.

The three affect systems

One of the key theories behind compassion-focused therapy is that within our brain there are interconnecting ‘systems’ that need to be managed to improve mental health.

The threat system - This system is protection-focused. This means it will be on high alert for perceived threats and will react with feelings like anger, anxiety and other protective emotions.

The drive system - This system motivates us to get resources and is excitement-focused. As well as focusing on getting basic needs met, like food and shelter, this system is also keen for us to achieve goals like passing a test or succeeding on a date. It’s related to feelings of excitement and arousal.

The contentment system - The ‘soothing’ system. This is triggered when there is no perceived threat or when nothing needs to be achieved. It makes us feel calm, peaceful and safe. This leads to us feeling content, happy and socially connected.

It’s believed that when these systems become unbalanced, it can lead to problems. The aim of compassion-focused therapy therefore is to regain the balance between the systems. The focus is typically on developing the contentment system to help regulate the other two systems.

Techniques used in CFT

There are lots of different tools and techniques used within compassion-focused therapy, some of which are drawn from other therapies. The primary technique used is called compassionate mind training, or CMT. This aims to help people experience compassion and develop non-condemning attributes.

Here are some of the techniques and exercises that may be used: 

Mindfulness - This helps you learn how to pay attention to the present moment without judgement.

Appreciation exercises - These may include making a list of things you like in life, the aim is to help you savour the moment, notice when something enjoyable happens and other positive, rewarding behaviours.

Compassion-focused imagery exercises - These may involve guided memories and fantasies to help stimulate the soothing system.

For those who struggle to experience or express compassion, questioning techniques may be used to help identify (and remedy) what could be causing this.

Who can it help?

Compassion-focused therapy is particularly helpful for those who have the following:

• deep feelings of shame or guilt
• a history of bullying
• a history of physical or emotional abuse
• an unrelenting inner critic
• difficulties trusting
• difficulties (or an inability) to feel kind towards themselves

It can therefore be helpful for those with the following mental health challenges:

• anxiety (including panic attacks)
• depression
• self-esteem issues
• eating disorders
• self-criticism
• anger
• self-harm

The nature of compassion-focused therapy means it can be challenging for some people. For example, if someone is afraid of compassion, doesn’t believe they are worthy of support or is struggling with intense anger or rage.

With the support and guidance of a counsellor, individuals can begin to heal at a pace that suits them. And if you feel that CFT isn’t right for you, that’s OK too. Talking to your GP about your options or exploring other types of therapy can help you figure out what would be best suited to you.