What is Compassion Focused Therapy?

Compassion Focused Therapy, CFT, was developed by Clinical Psychologist, Professor Paul Gilbert for mental health difficulties which are particularly affected and maintained by self-criticism, self-blame, self-loathing, shame and guilt. It incorporates aspects of CBT, mindfulness, attachment theory, evolution and social psychology.

Professor Gilbert found that while many people benefitted from traditional CBT, there were also those, who did not. Despite CBT helping them to adapt their unhelpful thoughts they did not feel better. Someone might be able to say they know logically they are not a bad person but they still feel like a bad person, or, they know something is not their fault but they still feel it is. We call this mismatch between what someone thinks and feels, a 'head heart lag'. Professor Gilbert's research found such people had very harsh, self-critical internal dialogues. They spoke to themselves in very self-critical ways. Quite often, people don’t even notice they are doing this.

CFT is known as a 'transdiagnostic' therapy which means it can be useful with a range of mental health difficulties where self-criticism and shame are present. It can be used as a stand-alone therapy or, woven into other therapeutic approaches. I find CFT combines very well with both CBT and EMDR and I often use it in this way.

What happens in Compassion Focused Therapy?

In general, CFT combines developing self-compassion with an understanding of how our brains work. That much of the way we automatically respond is not our fault but that we can develop strategies to respond in more helpful ways. The things that have happened to you are not your fault but it is your responsibility to alleviate your suffering. This is done by covering the following topics which I will summarise here.

A Shared Common Humanity - People often feel alone and isolated with their problems. It is helpful to remember, we all just find ourselves here, with similar struggles, doing the best we can to survive. The nature of life and it's impermanence mean it can be difficult and stressful. Imperfection, suffering and struggling are a shared human experience.

Evolution and Our Tricky Brains - We did not choose the brains we have. Our brains have developed over millions of years and were not designed with our happiness in mind. Our 'old' animal brains are hardwired to look out for threat and ultimately driven by the need to 'survive'. Our 'new' human thinking brains, enable us to do amazing things, however they can cause problems with self-monitoring, self-criticism, fearful imagination, fear of feelings, shame and rumination.

Therefore, the combination of the old and new brains can be 'tricky'. For example, we can continually judge ourselves and criticise ourselves (new brain), because of the way we might respond and behave in certain situations (old brain). Feeling anxious at the thought of socialising can lead to self-criticism and avoidance. Self-criticism only serves to retrigger our fight or flight response and makes us feel worse.

In CFT we can learn to notice this, be kinder to ourselves by reassuring ourselves this anxiety is normal and speak to ourselves in a kinder more accepting way. This is more soothing and so helps us to socialise instead of avoiding. We can understand  it is normal to feel anxious when approaching social situations. As mammals it is important for our survival to want to fit in, as mammals don't survive well in isolation.  It is understandable that the prospect of social rejection is threatening and therefore, anxiety provoking. It is not our fault that we automatically respond in this way but we can acknowledge this and use our skills to manage it.

The Lottery of Life and Attachment Theory - this is the understanding that we did not choose who we were born to and we did not choose our genes, this is a lottery. Our individual brains are affected by our experiences and we are conditioned to respond to our environment and our care givers. We develop our responses and coping strategies as children in the best way we can to survive in the relationships and environments we find ourselves in. We develop our beliefs about ourselves, other people and the world, based on this. For one reason or another, these experiences may not be what we needed or deserved. None of this is our fault, but if it is causing us problems, we can develop ways to change and be kinder to ourselves instead of self-blame and self-criticism which only makes us feel worse. 

Three Systems for Managing Emotions - CFT proposes we have 3 systems for managing emotions. It is useful to understand what motivates these systems which help animals seek out what is important to their survival, e.g. safety, food, shelter, relationships, status, reproduction and connection. Emotions guide us towards these motivations and are triggered when we either achieve them or if achieving them is threatened. Our emotions are always telling us something.

Threat System - This motivates us to safety and helps us detect threat and protect ourselves, it has a 'better safe than sorry' approach, it includes our fight or flight response. Feelings include fear, anger, jealousy, envy, sadness and disgust.

Drive System - This motivates us towards resources like food, shelter and relationships. Feelings include excitement, joy, pleasure, energy, arousal and focus.

Soothing System - This motivates us to care giving, managing distress and promote bonding with others. Feelings include contentment, caring, soothing, safety, calmness, nurturing, empathy and trust.

Distress occurs when there is an imbalance between the systems.  Most often this is due to a lack of development of the soothing system due to not acquiring this in childhood which is, no fault of one's own. In addition, one might have an overly developed threat system due to the environment they were brought up in.

Developing Skills of Self-Compassion - The overall aim of CFT is to learn skills to develop self-compassion and the soothing system in order to give ourselves care, alleviate our suffering and allow us to live more comfortably in our own minds. These skills include: mindfulness, non-judgement, strength, warmth, empathy, wisdom and kindness. Learning to engage in activities that calm and soothe you is also key.

MORE ABOUT CFT

ROMINA SCARAMAGLI - PSYCHOTHERAPIST atlantictherapies@gmail.com 07707 876 440

Videos about Self-criticism

 CFT is a powerful therapy. If you have been struggling with feelings of shame and low self-esteem and would like to discuss if CFT can help you, please get in touch.

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