Compassion Focused Therapy

What is compassion?

Compassion is defined as “sensitivity to distress in the self and others combined with a motivation to alleviate the suffering and/or causes of the suffering” (Paul Gilbert). People often think that compassion is pink and fluffy, weak and submissive.  This is not the case at all – compassion is wise, courageous, non-judgemental and involves taking responsibility for acting in accordance with the best interests of the self and others.


Why do we need compassion?

Compassion Focused Therapy (CFT) is a psychotherapy developed by Dr Paul Gilbert.  The basic premise of CFT is that life is hard and having a compassionate approach towards yourself and others helps us to cope with this. As Dr Paul Gilbert highlights, at around age 2-3 years old, we become aware that we are alive and we just have to get on with it.  We don’t chose to be born, or the time in history that we are born in, we don’t choose our bodies or the way they work, we don’t choose our genes, we don’t chose the families we were born into, we don’t choose our emotions or basic temperaments. All of these things just happen to us and we have to cope with them. In addition, we are shaped by our experiences and the culture we are brought up in, neither of which we are responsible for. So in CFT, we acknowledge that life is hard and suggest that developing a compassionate mind can help us manage this reality.


In addition to the above, the human brain developed as a result of millions of years of evolution. In CFT, we talk about the old and new brain.  The old brain is our ‘animal’ brain, the brain that is concerned with basic motives, emotions and behaviours such as protection, food, shelter and sex. The new brain is concerned with higher order functions such as planning, reflecting, imagining and self-monitoring.  This makes it tricky for us humans because we have different parts of the brain that are concerned with different things, and at times these parts of the brain are in conflict. For example your old brain has a desire to ‘see food and eat it’ while your new brain is concerned about how you look. So we need compassion to cope with our tricky minds.


Why do we struggle with compassion?

We are all born with the capacity for compassion.  If a person grows up in an environment that is supportive and nurturing, their compassionate mind will be strengthened by their experiences and they will naturally be compassionate towards themselves and others.  However, if a person grows up in a situation where abuse and neglect are part of their experience, they may understandably struggle to be compassionate towards themselves or others. 


In CFT, emotions are categorised according to their function. Three emotion regulation systems are focused on: the threat system which is concerned with protection from threat, the drive system which is concerned with acquiring things to aid survival and the soothing and affiliative system which is concerned with rest, recuperation and care for wellbeing.  When we have predominately positive experiences in early life, our three emotion regulation systems are balanced.  However, there are many situations where either the threat system or the drive systems become dominant, and this can cause difficulties for the person experiencing this imbalance.  For example abuse, neglect and bullying can all result in a dominant threat system, resulting in difficulties with anger or anxiety, while excessively high standards in a family can lead to a dominant drive system, resulting in difficulties with overworking or an inability to slow down.


What can we do?

Compassion Focused Therapy begins by understanding a person in context – helping them to develop a compassionate understanding of how they got to this point in their lives and why their systems may be out of balance.  Once this is in place, the focus is on re-balancing the three emotion regulation systems via Compassionate Mind Training (CMT).  CMT targets activation of the soothing system so that this system is available to moderate the threat and drive systems.  This is done by engaging in a series of discussions and exercises in compassionate attention and imagery, compassionate thinking and reasoning, compassionate motivation and behaviours.


CFT is about moving away from ideas that there is something wrong with us if we are feeling painful emotions, that emotions are a sign of weakness and that we should be able to get on with it, and towards an understanding that we all experience difficulties in life, that experiencing the full range of emotions is a normal part of the human experience and that by turning towards emotions and working with them, we can all be happier and healthier.


If you would like to read more about CFT, ‘The Compassionate Mind’ (Paul Gilbert) and ‘The Compassionate Mind Workbook’ by Chris Irons and Elaine Beaumont are fantastic reads.


This summary has been written by Lead Clinical Psychologist – Dr Róisín Joyce. If you would like to book an appointment with Róisín or any of the psychology team, you can call the clinic on 091 727777 or get in touch via the contact page.