Compassion focused therapy (CFT)

Compassion really is an antidote to cruelty

It also explores the possibility of being with distress and developing greater tolerance to uncomfortable feelings, while also developing a compassionate sensitivity, sympathy and motivation towards the experience, for ourselves and others. It can be useful for people struggling with self-criticism and shame ^[1].  There are many facets to CFT but in brief it strives to support clients to develop an inner compassionate capacity (for self and others) via exploration and techniques.

CFT integrates various notions rooted in some of the following domains: science of human nature, evolution, attachment, neuropsychology and eastern and western philosophy.

Working compassionately in therapy is not a new phenomenon and is espoused in many therapeutic approaches. However, alongside the therapist’s attitude of compassion and lack of judgement towards clients, CFT highlights the significance of supporting clients to cultivate a compassionate attitude for themselves, and others, as a way towards alleviating suffering ^[2].

“Compassion isn’t just this nice feeling, it’s the preparedness to turn towards difficulty and the commitment to try to work it out by taking action.” ^[3]

• Compassion is about understanding the features of our suffering with kindness, and being inspired to sensitively master our responses to it.
• Compassion helps us to understand, tolerate, validate and normalise experiences for ourselves and others.
• Compassion can function as a way of grounding and balancing our experiences.

In therapy clients may be asked to explore and focus on:

• Creating a greater awareness and compassionate understanding of how and why they may be avoiding positive experiences and emotions, and focusing on negative biases and threats. This might include exploring how emotions are being regulated from a physiological level.
• Considering their responses to disturbing aspects in their mind including traumatic memories and strong emotions (such as avoiding, self-blaming or shaming).
• Building tolerance to being with difficulties.
• Exploring their experiences of positive emotions: for instance, are they noticed, permitted, assimilated and experienced fully.

Techniques may include:

Fostering more mindfulness in the everyday – the practice of being aware and observing what is happening both within and outside yourself, in a non-judgmental and objective way.

Appreciation exercises – these may include encouraging clients to explore and recognise enjoyable activities. Cultivating ways for clients to invite and experience more space for themselves that allows experiences of fun, pleasure and wonder.

Compassion-focused imagery exercises – using guided imagery to stimulate a healthy response to self-soothing.

What happens during CFT?

Your first session

Your first session in compassion focused therapy may bring a mix of relief and anxiety. During your initial consultation, your therapist will assess whether they can work with you and your issue. This is also the time to determine whether you feel comfortable sharing your inner world with them. It’s important at this time that you ask any questions you may have and reflect on the session and how you feel before deciding if this is right for you. A usual therapy session lasts around fifty minutes; however, this may vary. The time of your session will be agreed upon beforehand.

Confidentiality in therapy

Confidentiality is an essential practice in therapy which means that everything you discuss stays between you and them. However, there are rare instances where it may be broken, such as if the therapist feels there is a risk to yourself or others. Your therapist will discuss confidentiality in your session if it arises.

The frame

In the world of psychotherapy, there is a term called ‘the frame’. This term refers to the physical and contractual boundaries that make compassion focused therapy possible. The frame covers when and where you meet, confidentiality, fees, and also consistency in how your therapist interacts with you.
Starting CFT means starting an intimate relationship with your therapist that you may not have experienced before. The boundaries that the frame creates is what makes this relationship possible and safe.

Ongoing CFT sessions

Many who come to us for compassion focused therapy either agree on a set number of sessions, or they enter into an ‘open-ended’ contract where there is no end date to the therapy, but you keep going until you mutually agree to an ending. It’s not uncommon for people to engage in therapy for months or even years once they get into the rhythm of therapy, due to the deep relationship in which they’re able to explore their inner world and make significant changes to their lives to reach their goals.

In summary, CFT offers a safe and confidential space to explore your inner world in an attempt to make changes to your life. Therapy is a unique, intimate relationship between you and your therapist governed by boundaries to make it possible and safe. It’s important to ask as many questions as possible during your first session and reflect on how you feel. Therapy is a process and finding the right therapist is a crucial step in your journey.

Compassion focused therapy is offered by Susanna Petitpierre.

If you are unsure of the type of therapy you need, you can search for a therapist here.

References –

• [1] Gilbert, P. (2009) Advances in psychiatric treatment, vol. 15, 199–208 doi: 10.1192/apt.bp.107.005264
• [2] Gilbert, P. (2009) Advances in psychiatric treatment, vol. 15, 199–208 doi: 10.1192/apt.bp.107.005264
• [3] Gilbert, P. (2018) Compassion is an antidote to cruelty.

The Psychologist article, Vol.31 (pp.36-39), doi: https://thepsychologist.bps.org.uk/volume-2018/february-2018/compassion-antidote-cruelty