Compassion Focussed Therapy (CFT)

What is Compassion Focussed Therapy?

CFT is a relatively new form of therapy, developed to help people who are struggling with significant levels of shame or self-criticism. It is modified from CBT, but also draws on evolutionary, social and developmental psychology, neuroscience and mindfulness.

CFT is based on the premise that our brains (and our bodies) are the product of evolution, and have not been designed for modern day living. The oldest “reptilian” part of brain is focussed on survivial; the “mamalian” part of the brain is focussed on living in groups, status, caring and hierarchies; whilst the newest part of the brain is focussed on attachment and higher level thinking and planning. Furthermore, the way in which our brains have developed affects our everyday experiences.

CFT Model

The CFT model proposes that we have three different systems, each associated with different bits of the brain and with differenet neurochemistry.

The “threat system” has developed via evolution to keep us safe. It is highly responsive and will trigger a threat response (fight/flight or freeze) whenever there is a real or perceived threat. This is through the release of cortisol and adrenaline, which encourage action, historically ensuring our safety (e.g. running away or fighting a dangerous creature). However, the sensitivity of the system means it can be triggered when there is no actual threat, and the fight/flight/freeze response is not always a useful respone in todays environments.

The “drive system” has developed to get things done and motivates us towards things we need (or think we need). Its link to the reward system in the brain (the dopaminergic system) means we experience a flood of dopamine (experienced as a sense of pleasure) whenever we feel that we have achived our goal. This can be productive, but can also result in us becoming overly focussed on one goal, contributing to difficulties such as addiction or obsessive thinking.

The “soothing system” is crucial to human development. It focusses on nuturing and care-giving, warmth and forgiveness, driven by the need to rest and digest, to connect to others, and to manage emotions. It is associated with neurochemicals such as oxytocin, endorphins, and opiates, and typically balances the drive and threat system.

CFT suggests that when people have not experienced sufficient warmth, safety and nuturing during childhood, they will have an under-developed soothing system. This means that they are being driven primarily by the drive and threat system - constantly seeking out achievement and constantly scanning for threat, resulting in exhaustion, anxiety, shame, anger, self-criticism, and hopelessness. Their use needs to be balanced via the soothing system.

The aim of CFT is to help people develop skills in self-compassion: strengthening the soothing system, helping to regulate mood and enhancing feelings of safety, self-acceptance and comfort.

How does CFT work?

CFT helps people develop practical skills to bring balance to the brain’s three emotional systems so they can self-soothe and deal with difficult emotions including shame, anxiety and fear. This involves enaging in skills training, both in and between sessions, to practice skills of compassion (including imagery work, letter writing or challenging self-critical thoughts). Central to this are experiential exercises which draw on mindfulness techniques, such as safe place imagery, soothing-rhythm breathing, and compassionate mind imagery - helping people activiate the soothing system. However, CFT also works with the fears, blocks and resistances to working with compassion.

Fears, blocks and resistances (FBRs) are seen as understandable but outdated protective strategies which were developed in childhood to help manage but which no longer work effectively. In CFT you are supported to make sense of what is blocking you from engaging in compassion focussed therapy techniques, to understand where these FBRs have come from, and to find alternative ways of being.

The goal of CFT is to replace feelings of self-criticism and fear with compassion and understanding, so that you can begin to soothe yoursef, accept soothing from others, and generate feelings of contentment and safety.

You can find out more about CFT on the Compassionate Mind Foundation website.