What is Compassion Focused Therapy?

Compassion Focused Therapy (CFT) is an offshoot of CBT.  It was designed for people with high levels of self-criticism or shame.   It is supposed to be helpful for people who can reason against their fears or beliefs but who find that their feelings don’t change.

The theory behind CFT is that we have evolved a set of mental systems because they helped our ancestors survive.   The relevant ones are the drive and motivation system (search for something, feel rewarded, want to search again), the threat and protect system (recognise danger and activate the fight/flight/freeze response) and the soothing and contentment system.  Due to our genes, our early experiences and our environment some of us have overdeveloped threat systems and undeveloped soothing systems.  CFT teaches us to redress the balance by developing our soothing system.  There are a core set of exercises which include meditations, imagination and imagery and thinking through beliefs and coping mechanisms.

There are self-help resources available and I’ve linked to a few below. CFT exercises can touch on difficult and painful issues and memories so a lot of resources suggest it may be better to work with a therapist.  That was true in my case.

How good is the evidence for CFT?

2014 study says there isn’t enough of the kind of research necessary to consider CFT to be evidence based. Studies have been conducted but they generally have too few people participating in them, or other limitations. This means that we don’t know if CFT is better than existing treatments.

My personal experience with CFT: 

It has been difficult, bringing up some difficult emotions but I feel it is worth it to soften that critical voice in my head and to learn to look after myself better and more kindly.  I started with CFT in one to one high intensity CBT sessions where we talked through some of my early experiences, my beliefs, fears and my feelings about myself.  I’ve found the group therapy sessions I’m currently going to really helpful.  The theory and techniques are introduced gradually and repeated so it’s not too threatening and I’m gradually opening up to a new way of thinking.  I can see there’s an awful lot of work to be done and it’s going to take a lot of time and patience.  But I’m really looking to forward to having a calmer more compassionate way of talking to myself and responding to mistakes and difficulties.

How do I think CFT fits into self-management of chronic illness?

  • A chance to develop new or better coping strategies if our old ones are no longer accessible.  For example, worrying, perfectionism, and over-preparing are not ideal ways of coping but they may have been okay in the past.  But they take up far too much precious time and energy for a chronically ill person.
  • An antidote to criticism and judgement from ourselves, people around us and in the media.
  • Learn to support ourselves in doing what is best for ourselves, even when it is hard.
  • Learn to support ourselves in accepting and coming to terms with the changes to our lives.
  • Learning to alleviate anxiety and fear.
  • Learning to address unhelpful beliefs with understanding and kindness.

Resources

  • Compassionate Mind Foundation
  • Paul Gilbert, Overcoming Depression A long and detailed book that I found really helpful. It’s written clearly, with some memorable turns of phrase and exercises to practise with.  This is my favourite because it strikes the right balance of depth of explanation and practical exercises for me.
  • Mary Welford, A Compassionate Mind Approach to Building Self-Compassion A shorter, easier read than Overcoming Depression with exercises to work through. Some of the exercises on thinking about where my lack of confidence had come from were emotionally challenging. I was glad I had covered some of this with a counsellor before reading the book.
  • Paul Gilbert, The Compassionate Mind (I’m only half way through this book so far) I like reading about the background to how the therapy was developed and where research is going.  However, there may be more detailed theory here than some people will enjoy.  I like that Paul Gilbert acknowledges the role of our culture and social context in producing an environment that isn’t supportive of compassion.
  • Kristen Neff website Meditations and exercises
  • Chris Germer website Meditations and exercises
  • CCI Self-Compassion A series of 7 workbooks (PDF) introducing concepts and exercises for building self-compassion.

Practising… Self-Compassion 1-3

I believe that having self-compassion is essential if I’m going to live a meaningful life with chronic illness.  Unfortunately I’m not very good at it.  I think self-compassion is so important because it’s an attitude that encourages us to take good care of ourselves, to recognise how difficult life with a chronic condition can be, to be accepting of our limitations and appreciative of our efforts. 

For some of us (including myself) self-compassion isn’t something we developed as we grew up.  Instead we have an extremely vocal and opinionated inner critic.  This critical voice is always pointing out our failings, worrying about our weaknesses and generally making life even harder than it needs to be.  Continue reading Practising… Self-Compassion 1-3