Compassion-focused therapy (we will use “CFT,” to avoid confusing it with cognitive behavioral therapy) helps those who struggle with the shame and self-criticism that can result from early experiences of abuse or . CFT teaches patients to cultivate compassion and self-compassion skills, which can help regulate mood and generate feelings of safety, self-acceptance, and comfort.
Psychologist Paul Gilbert developed this therapy in the 2000s to specifically address shame and self-criticism, drawing on evolutionary, social, developmental, and Buddhist psychology and neuroscience.
The technique is similar to mindfulness-based cognitive therapy, which also instructs patients about the science behind the mind-body connection and how to practice mind-body awareness.
Treatment with compassion-focused therapy: when is it used?
CFT has been shown to effectively treat long-term emotional problems, including anxiety disorders, mood disorders, personality disorders, eating disorders, hoarding disorder, and psychosis by addressing patterns of shame and self-criticism, which can significantly contribute to mental health problems.
Research suggests that humans have at least three different emotion regulation systems: a threat and self-protection system, which generates anger, disgust or fear to protect ourselves; a system of drive and enthusiasm, which motivates us to seek external resources such as companions, partners, food and status; and a relaxing and social security system, which is activated when we feel peaceful and content enough that we are no longer forced to seek external resources.
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Mental illness can result, in part, from an imbalance between these three systems. People high in shame and self-criticism may have had not enough stimulation of their calming system early in life, and too much stimulation of their threat system. As a result, they may have trouble being kind to themselves or feeling kindness from others. They may be very sensitive to criticism or rejection, whether real or perceived, and internalize that disapproval. The goal of CFT is to correct this imbalance in emotion regulation systems.
What to expect from this therapy
CFT treatment can be practiced in individual or group sessions, with the overall goal of cultivating compassion for oneself and others. The therapist will teach the patient about the evolution of the brain, the construction of the self, and the systems that regulate emotions.
It will also help the patient develop skills such as compassion, self-compassion, and mindfulness. They generally receive assignments to practice these skills during non-session days.
How does it work?
Shame and self-criticism often arise from abuse, neglect, and bullying. People who experience early trauma may come to feel that their internal and external worlds are almost always on the verge of hostility. According to Gilbert, internal self-criticism and fear of external rejection can become so chronic that they can “literally stalk” people toward depression and anxiety.
CFT overlaps with therapies developed to treat trauma, which address early memories, recognize negative thoughts, and correct misperceptions. But for some people who struggle with shame and self-criticism, being able to counter irrational thoughts is not enough; Without self-compassion, logic does not translate into feeling better.
CFT replaces feelings of hostility and insecurity toward oneself with compassion and understanding, so that patients can begin to calm down, accept relief from others, and generate feelings of satisfaction and security (Chou et al., 2019; Cuppage, Baird, Gibson, Booth, & Hevey, 2018; Frostadottir & Dorjee, 2019; Gilbert, 2009).
The therapist
Look for a mental health professional with specialized training and experience in cognitive behavioral therapy and mindfulness, as well as additional training and supervised experience in compassion-focused therapy. In addition to these credentials, it’s important to find a therapist you feel comfortable with.
References:
Chou, C.-Y., Tsoh, JY, Shumway, M., Smith, LC, Chan, J., Delucchi, K., … Mathews, CA (2019). Treating hoarding disorder with compassion-focused therapy: A pilot study examining treatment feasibility, acceptability, and exploring treatment effects. The British Journal of Clinical Psychology / the British Psychological Society. https://doi.org/
Cuppage, J., Baird, K., Gibson, J., Booth, R., & Hevey, D. (2018). Compassion focused therapy: Exploring the effectiveness with a transdiagnostic group and potential processes of change. The British Journal of Clinical Psychology / the British Psychological Society, 57(2), 240-254. https://doi.org/
Frostadottir, A.D., & Dorjee, D. (2019). Effects of Mindfulness Based Cognitive Therapy (MBCT) and Compassion Focused Therapy (CFT) on Symptom Change, Mindfulness, Self-Compassion, and Rumination in Clients With Depression, Anxiety, and Stress. Frontiers in Psychology, 10, 1099. https://doi.org/
Gilbert, P. (2009). Introducing compassion-focused therapy. Advances in Psychiatric Treatment, Vol. 15, pp. 199-208. https://doi.org/
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