Compassion-Focused Therapy

Compassion-Focused Therapy (CFT) helps those who struggle with the shame and self-criticism that can result from early experiences of abuse or neglect. CFT teaches clients to cultivate skills in compassion and self-compassion, which can help regulate mood and lead to feelings of safety, self-acceptance, and comfort.

The technique is similar to Mindfulness-Based Cognitive Therapy, which also instructs clients about the science behind the mind-body connection and how to practice mind and body awareness.

When It's 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 issues.

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 us; a drive and excitement system, which motivates us to seek outside resources like mates, food, and status; and a soothing and social safety system, which is activated when we feel peaceful and content enough that we are no longer compelled to seek outside resources.

Mental illness can result, in part, from an imbalance between these three systems. People high in shame and self-criticism may not have had enough stimulation of their soothing system early in life, and too much stimulation of their threat system. As a result, they can struggle to be kind to themselves or feel kindness from others. They may be highly sensitive to criticism or rejection, whether real or perceived, and internalize that disapproval. The goal of CFT is to correct this imbalance in the emotion regulation systems.

What to Expect

CFT treatment can be practiced in individual or group sessions, with the overarching goal of cultivating compassion for the self and others. The therapist will teach the client about the evolution of the brain, the construction of the self, and the systems that regulate emotions.

They’ll also help the client develop skills such as compassion, self-compassion, and mindfulness. Clients typically receive homework to practice these skills on days without sessions.

How It Works

Psychologist Paul Gilbert developed Compassion-Focused Therapy in the 2000s to specifically address shame and self-criticism, drawing on evolutionary, social, developmental, and Buddhist psychology and neuroscience.

Shame and self-criticism often arise from abuse, neglect, and bullying. People who experience early trauma can come to feel that their internal and external worlds are almost always on the brink of hostility. Internal self-berating and fear of outside rejection can become so chronic that it can “literally harass” people into depression and anxiety, according to Gilbert.

CFT overlaps with therapies developed to treat trauma, which address early memories, recognize negative thoughts, and correct misperceptions. But for some clients who struggle with shame and self-criticism, being able to counter unreasonable thoughts isn’t enough; without self-compassion, the logic does not translate into feeling better.

CFT replaces feelings of hostility and insecurity toward oneself with compassion and understanding, so that clients can begin to soothe themselves, accept soothing from others, and generate feelings of contentment and safety.

What to Look for in a Compassion-Focused Therapist

Look for a licensed mental health professional with specialized training and experience in cognitive behavioral therapy and mindfulness, as well as further training and supervised experience in compassion-focused therapy. Several organizations, like the Center for Compassion Focused Therapy, offer workshops on the foundations of CFT, but there is no formal certification in the United States. In addition to these credentials, it is important to find a therapist with whom you feel comfortable.

References

  • The Center for Compassion Focused Therapy, New York, NY
  • Chou C.Y., Tsoh J.Y., Shumway M., et. al. (2019) Treating hoarding disorder with compassion-focused therapy: A pilot study examining treatment feasibility, acceptability, and exploring treatment effects. British Journal of Clinical Psychology. 2019 Jul 4. doi: 10.1111/bjc.12228
  • The Compassionate Mind Foundation-USA, New York, NY
  • Cuppage J, Baird K, Gibson J, et. al. (2017) Compassion focused therapy: Exploring the effectiveness with a transdiagnostic group and potential processes of change. British Journal of Clinical Psychology. Jun;57(2):240-254. doi: 10.1111/bjc.12162
  • Gilbert, Paul (2009) Introducing compassion-focused therapy. Advances in Psychiatric Treatment;15(3):199-208. doi: 10.1192/apt.bp.107.005264
  • 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. 2019 May 17;10:1099. doi: 10.3389/fpsyg.2019.01099