What is compassion-focused therapy (CFT)?

Compassion focused therapy (CFT) was developed by Professor Paul Gilbert OBE. It's a system of psychotherapy that encourages people to be compassionate toward themselves and towards others, and was developed to combat high levels of shame and self-criticism that often come hand-in-hand with mental health difficulties. CFT therefore has enormous potential, as research has shown that high levels of self-criticism can make other talking therapies much less effective. Compassion-focused therapy aims to restore, or even introduce, ideas of safety, compassion and reassurance in individuals who may have grown up in environments where these were lacking, in critical, abusive or neglectful environments.

Gilbert also founded the Compassion Mind Foundation (2008), who explain why compassion is at the centre of their work: "When people hear the word compassion, they tend to think of kindness. But scientific study has found the core of compassion to be courage. A standard definition of compassion is, "a sensitivity to suffering in self and others with a commitment to try to alleviate and prevent it."

The courage to be compassionate lies in the willingness to see into the nature and causes of suffering – be that in ourselves, in others and the human condition. The challenge is to acquire the wisdom we need to address the causes of suffering in ourselves and others.

Compassion is one of the most important declarations of strength and courage known to humanity. It is difficult and powerful, infectious and influential. It is a universally recognised motivation with the ability to change the world."

Compassion-focused therapy integrates techniques from:

Cognitive behavioural therapy (CBT)
Developmental psychology
Evolutionary psychology
Social psychology
Neuroscience
Buddhist philosophy

How does CFT work?

According to CFT theory, there are three emotion regulation functional systems that evolved throughout human history: the threat (/survival), drive (/excitement), and contentment (/social safety) systems. CFT suggests these systems remain active and influence our thoughts, emotions, actions and beliefs today.

The threat system

If we feel under threat we may experience fear, anxiety or anger. As a result of our feelings, we may exhibit particular behaviours, for example fight, flight, freeze. We may also develop cognitive biases relating to future threat stimuli i.e. jumping to the wrong conclusion, assuming the worst, avoiding potentially risky situations.

The drive system

This system directs us towards important goals; it's also the system that developed to enable us to gather resources. This forward-moving system gives us a sense of achievement and pleasure. A balanced drive system is important, people with over-active drive systems may be more likely to seek pleasurable experiences, such as substances and other addictive behaviours.

The contentment system

The contentment system is linked to feelings of calm, typically fostered by a sense of being socially connected, safe, and cared for. This soothing system regulates both the threat and drive systems.

Using CFT enhances the potential of the compassion-based soothing system, and minimises the influence of the threat system. A more enriched contentment system also activates a healthy drive system that encourages us to work towards positive goal-attainment.

The goal of compassion-focused therapy is to achieve harmony between these three systems, as an imbalance between them is often central to poor mental health. When these systems are balanced, we are able to respond appropriately to daily situations.

Techniques and exercises used in compassion-focused therapy

The central therapeutic technique of CFT is compassionate mind training. Compassionate mind training aims to transform problematic thinking patterns related to anxiety, anger, shame and self-criticism. The idea with CFT is that having a cognitive understanding of what needs to change is not enough, the individual also needs to understand what it would be like to feel differently towards themselves. The therapist seeks to foster acceptance, safety, and positive regard from the client, towards others and then towards themselves.

Cognitive mind training aims to develop:

compassionate motivation
sympathy
sensitivity
distress tolerance

People in therapy might learn:

Appreciation exercises: activities that emphasise what the individual enjoys
Mindfulness: fostering the ability to pay attention to the current moment in a non-judgemental manner
Compassion-focused imagery exercises: using guided memories and fantasies to stimulate the mind and the physiological systems. The goal of compassion-focused imagery exercises is the production of a relational image that stimulates the soothing system.

Who benefits from compassion-focused therapy?

Compassion-focused therapy may be highly useful for those who feel stuck by feelings of shame and self-criticism. CFT has been shown to be helpful for long-term emotional problems including anxiety disorders, panic attacks, mood disorders, personality disorders, eating disorders, self-harm, hoarding disorder, and psychosis.

CFT is often used alongside other therapy modalities. It can be a useful addition for any client who has a history of abuse, bullying, neglect or trauma.