Month: November 2024

Most humans have a natural capacity for compassion, a natural and automatic response that ensures survival. Louis Cozolino pointed out, “We are not the survival of the fittest. We are the survival of the nurtured.” He further added, “Those who are nurtured best survive best.”

Compassion is fundamental to our basic nature and enhances our everyday experience of being human at a personal, interpersonal, organisational, and social level’s. An increasing body of research indicates that cultivating a compassionate mind for oneself and others has significant benefits, such as promoting well-being, resilience, and social connection (Neff & Germer, 2017).

Compassion is defined as the feeling that arises when we notice the struggles in ourselves, and others associated with the commitment to alleviate and prevent suffering. Cultivating compassion for ourselves and others helps us develop the strength to cope with suffering, take compassionate action, and to avoid burnout.

Cultivating Compassionate Mind Training practices, therefore, enables the building of an internal secure base and safe haven. The intention is always to be helpful, and not harmful to ourselves.

Compassionate Mind Training is a crucial part of Compassion-focused Therapy because many of us may not have the capacity to recover and flourish. Compassionate Mind Training, in its various forms, produces changes in the autonomic nervous system. The various forms of Compassionate Mind Training include a number of practical exercises and techniques,

This includes mindfulness, breathing exercises, imagery exercises, setting compassionate intentions and taking compassionate actions, and deploying compassion itself to bring compassion to aspects of ourselves and others, especially in order to relieve suffering.

Compassionate resilience
In today’s fast passed and pressured working environments. Be that in delivering health, educational, welfare, or commercial services for any organisation with compassion increases satisfaction and engagement and reduces the threat of burnout.

However, over time, for various reasons, professionals may start showing symptoms of empathic distress fatigue, compassion fatigue, secondary trauma, and burnout, all of which negatively impact the quality of their productivity and profitability, and the level of service offered to their clients.

Providing a continuous flow of delivery, in the absence of self-compassion, can lead to depletion and burnout. Professionals greatly benefit from compassionate mind training where they actively engage with the three flows of compassion.

The Three Flows of Compassion
•    Compassion for others (compassion flowing out), which involves an awareness of the experience of compassion in ourselves, and then directing compassion towards other people. For example, towards a work colleague who is struggling or making a connection with a client.
•    Compassion from others (compassion flowing in), which refers to the experience of receiving and accepting compassion from other people.
•    Compassion from our self to our self (self-compassion), where we attend to ourselves with sensitivity and understanding to support and care for ourselves (not always easy).

Each of those abilities has its obstacles and can be cultivated through visualisations, meditation and intentional actions. Compassionate Mind Training, which focuses on each specific aspect of the three flows of compassion, will strengthen the overall capacity to attend to ourselves and others with compassion and build increasing resilience.

There is a growing body of research indicating that cultivating self-compassion helps us deal with our distress and trauma in the workplace and promotes our ability to deliver services. Often, professionals are more comfortable offering support to others than themselves and find it difficult to receive care and compassion from others. Cultivating the three flows of compassion provides a more sustainable approach.

The following two exercises aim to cultivate the three flows of compassion, beginning with cultivating an image of an inner compassionate self that offers compassion to others. We can also receive compassion from others but also offer compassion to the self (self-compassion), where one attends to and receives compassion from the self to the self.  

Visualisation of practising a chosen flow of compassion
First, identify a flow of compassion where you notice inner resistance and where you would like to cultivate more ease.

Affirm your intention to cultivate this flow such as:
May I receive compassion from others with ease?
May I be compassionate to others?
May I give myself the compassion that I need?

Second, visualise a situation from your past where this flow was required or a future event where this flow will be required.

During the visualisation, notice the resistance and the discomfort, and let it be as it is. Explore how you can bring acceptance and kindness to the unease, allowing yourself to be as you are. In your way, at your pace, re-affirm gently your intention in your visualisation. Visualise yourself making progressive steps in engaging in some way in the practice of this flow of compassion as best as you can.

For instance, if it is difficult for you to receive compassion from others, recall a past situation in which someone praised you or was kind, understanding, or helpful to you.

Notice the initial resistance and possibly avoidance, with acceptance and kindness, letting yourself be as you are.

Then, imagine allowing yourself to receive this praise and kindness with calm and appreciation.

Visualising yourself smiling and accepting the kindness with delight. 

What would you like to have said to this person in return? How would you like to express your gratitude? Can you imagine yourself saying “thank you” to this person? Then, let go of the scene and notice what is here for you, reaffirming your intention.

You may need to practice this visualisation many times before the situation becomes easier for you.

Explore how you can also change your behaviour in such a situation where you become more relaxed and expressed gratitude.

Loving-kindness meditation
The practice of loving-kindness meditation can help us to cultivate the three flow of compassion.

We send out loving-kindness to a loved one,
May you be happy
May you be well
May you be healthy
May you have peace
May you have ease of being

We imagine our loved one in return wishing us well (receiving goodwill from others), saying:
May you be happy
May you be well
May you be healthy
May you have peace
May you have ease of being

We offer ourselves loving-kindness phrases (self-compassion)
May I be happy
May I be well
May I be healthy
May I have peace
May I have ease of being

If you wish, you could also offer similar loving-kindness phrases to a neutral person or a difficult person.

If you are interested in exploring this further, we offer an eight-session course.

Session One

Defining compassion, how and why we suffer and the role of our tricky brains and the old brand new brain loops that we get caught up in.

Session Two

Looks at the three circles model of emotions: threat, drive and soothing.

Session Three

It goes a little deeper, discussing the idea that we’re made up of multiple parts and that one of these parts is compassion itself. Cultivating this compassionate self is at the heart of CMT.

Session Four

Starts to explore the three flows of compassion,

Beginning with the flow of directing compassion to others.

The compassionate self helps with this, offering compassion to others.

In this session, CMT also looks at fears, blocks, and resistances to compassion, particularly to this first flow.

Session Five

Discusses the second flow of compassion, how we can open ourselves up to receiving compassion from others. This is a tricky one. So, CMT explores fears, blocks, and resistances, identifying opportunities to notice and accept compassion from others in our lives.

Session Six

It focuses on self-compassion, bringing the compassionate self to ourselves, exploring practical skills and strategies, and examining the fears, blocks, and resistances that may also arise for this flow.

Session Seven

Looks at another important part, the critical self. We also explore the forms and functions of self-criticism and how to direct compassion to this part of ourselves.

Session Eight

It brings in a range of other parts, especially the big three: the angry self, anxious self, and sad self, and how we can extend our compassion to these evolutionarily significant yet sometimes very difficult emotional selves.

Session Nine

In this last session of CMT, we also explore how to maintain it all, living a compassionate life inside and out.

Importantly, throughout these sessions are lots of practical exercises and techniques,

things like mindfulness, breathing exercises, imagery exercises, setting compassionate intentions and taking compassionate actions, deploying the compassion itself to bring compassion to aspects of ourselves and others, especially in order to relieve suffering.

And there is home practice, audio recordings, building self-awareness, behavioural tasks and little experiments to help move from learning about compassion to practicing it and eventually embodying that compassionate self.

The Three System Model – sometimes called the Three Circle Model – is an important part of Compassion Focussed Therapy and can play a helpful role in someone understanding themselves and their emotional lives. It’s something that we spend time introducing in therapy, but also in the self-help use of the Compassionate Mind model. 

Scientists have many theories about how many emotion ‘systems’ we have. Some have tried to separate these between ‘positive’ (e.g. excitement, joy) and ‘negative’ (e.g. shame, fear) emotions. This doesn’t mean ‘good’ or ‘bad’, but just how they feel when we experience them. Others have split emotions by their energy, with ‘high’ energy emotions like excitement and fear, and ‘low’ energy emotions like types of sadness, and contentment. And then other psychologists have split emotions by the direction they take us in. So, ‘towards’ emotions like excitement and anger, and ‘away’ emotions like disgust and fear. 

In Compassion Focused Therapy we have a different approach to this. Here, we suggest that it’s useful to consider how our emotions can be grouped together based on their function – that is, what they evolved to help us to do.

For example, if you’re threatened in some way you might experience feelings of fear or anxiety. Or maybe, if this threat involves you (or someone you love) being treated unfairly, then it might be anger you experience.  In contrast, if you’re achieving things, you might have pleasant emotions such as joy, excitement and happiness.  However, we can also have pleasant emotions that are calming and soothing, for example, when we feel safe and cared for.

With the three-system model in CFT, we suggest that evolution has shaped our emotions to have different functions, all of which have been helpful in facilitating our chances for survival and reproduction and ultimately, passing our genes on.  In this sense, these emotion systems are fundamentally tied to three important life tasks:

• threat detection/harm avoidance
• acquiring things for our survival (e.g. food, shelter, reproductive opportunities)
• resting and conserving energy

From this perspective, the three emotion systems you’re going to read about below link to each of these tasks. They emerged to facilitate, guide and give energy to each of them

Understanding the Three System Model

Given that it’s referred to as ‘the three circle’ model, it’s probably not surprising that the model has three circles, or systems! Each of these has a colour ascribed to it, as after a while, people use this as a simple way of communicating things. For example, “I’ve been in my red system all week, it’s been so difficult”, or “I’ve been trying my best to get in to my green system, but I’ve found this almost impossible. 

So, what are the names of each of the three circles? Well, they are:

1. Threat System, with emotions like anger, fear and disgust, this system evolved in all animals with the function to help us identify and respond to threats in the world. Once activated, this system directs physiology, attention, thinking, behaviour and emotion to reach safety.

2. Drive System, linked to higher energy pleasurable emotions like excitement and joy, which motivate us to move towards resources and goals that might be helpful to us, and leave us feeling good when we achieve them. This system is important in motivating people to get things that are useful to them and others, and is highly rewarding. 

3. Soothing System, linked to feelings like contentment, calmness and safeness, which helps us to engage in periods of rest and peacefulness when we are not threatened or trying to achieve things. This system is also associated with giving and receiving care from others.

We show this model visually like this (a copy of this can be downloaded here):

Visual of Three Circle Model

Whilst each of these systems are biologically primed, these are also learning systems. This means that through our lives, our experiences – for example, with other people – shape how these three systems develop. For some people, this might mean that their threat system (for example) is triggered very quickly, or that one part of it (e.g. anger) is primed to respond to potential difficulties in their environment. This isn’t anyone’s fault when this happens, but using the three system model can be a helpful way of supporting people to understand themselves and ultimately, think about how they can get more balance within the three circle model.

Of course, we can have a different balance to the three circles in different parts of our lives. For example, at work, it might be that there’s a lovely balance between threat, drive and soothing, but at home with our partner, they are massively out of balance. Here, it might be threat system is dominant, and the other two are small. It can be useful to get familiar with these different contexts. The more aware we are of their balance and functioning, the more likely we are to do something different, to bring change in a helpful way.

A key part of CFT and Compassionate Mind Training is how to bring change to the three-circle model. If in therapy, this is in part done via a safe, caring and empathetic therapeutic relationship. But CFT also utilising a number of exercises and interventions that can support this, that can change how our three-system model is balanced. 

In a simple way, CFT and CMT – and compassion and self-compassion more generally – aims to reduce threat system, build the drive system (in a healthy, sustainable way) and cultivate the soothing system so people feel safer inside themselves and with others. 

There’s lots of ways to answer this. CFT (Compassion Focused Therapy) is a psychological therapy which aims to help reduce distress and psychological difficulties, as well as increasing happiness, wellbeing and flourishing.  CFT does this by helping people to cultivate their compassionate minds, which in turn, allows them to engage with the difficulties they are facing in a wise and helpful way.

Ultimately, this approach helps people to become more compassionate in three directions:

• to others
• from others
• to themselves (self-compassion)

What is Compassion?

To understand “What is Compassion Focused Therapy?”, we first need to think about what compassion is. 

There is a long history of compassion being held as a powerful way of relieving suffering and human distress.

In CFT, we define compassion as “…a sensitivity to suffering in self and others, with a commitment to relieve and prevent it.”

A useful way of understanding this definition is to see how it holds two related but separate parts: 

1. Being able to notice, engage with, tolerate and understand difficulties, distress or suffering 
2. Being able to take wise action to manage, reduce, relieve and prevent difficulties, distress or suffering

Although people sometimes think that compassion just involves being nice, kind and warm, it’s important to recognise that it often also requires courage and strength.

For example, compassion to others could be observed when a firefighter enters a burning building to save someone trapped inside.  

The firefighter is aware of the trapped person’s distress (1^st part of compassion), and has trained to take wise steps to rescue them (2^nd part of compassion). Clearly here their compassion is not soft or gentle, but instead, is underpinned by courage and strength to move towards danger in order to alleviate someone’s distress. 

Similarly, self-compassion, particularly when it involves engaging in painful internal experiences, like shame, fear and trauma, needs a big dose of strength and courage to enable us to tolerate painful feelings in order to find ways to alleviate our pain. 

The Three Flows of Compassion

CFT is unique in compassion-based approaches, as it highlights the importance of three key flows of compassion:

• compassion to others
• compassion from others
• self-compassion

Each of these flows are important, and are related to psychological distress and wellbeing in different ways. And whilst self-compassion is a significant focus, we’re interested in how to cultivate all of the flows. 

Alongside understanding the three flows of compassion, it’s also useful to consider the fears, blocks and resistances (FBRs) to compassion. These are common for many people, and can be a major focus of therapy and Compassionate Mind Training. Research has found that following therapy and CMT, the fears of compassion are (on average) significantly reduced.

How did CFT develop?

CFT was developed over a number of decades by Professor Paul Gilbert, a clinical psychologist based in the UK. He developed CFT in part as a response to the realisation that some people – particularly those high in shame and self-criticism, who often had difficult or traumatic early life experiences – didn’t benefit from standard therapeutic interventions as other people with less severe difficulties tended to.

Part of Paul’s insights linked to a recognition that many of his clients had an internal voice that was highly self-critical, hostile and angry, and that this seemed to block the potential helpfulness of therapy. So CFT emerged as a way of understanding our internal, self-to-self relationship, and finding ways to shift this from self-criticism to self-compassion.?

What ideas and theories does CFT draw from?

At its heart, CFT is a highly integrated, biopsychosocial approach. This means it draws upon and from a wide range of therapeutic and scientific ideas, including:

• Attachment theory
• Developmental psychology
• Social psychology
• Evolutionary theory and evolutionary psychology 
• Cognitive Behaviour Therapy (CBT)
• Psychodynamic approaches and ideas
• Neuroscience and neurophysiology
• Social psychology
• Buddhist principles and practices

Although CFT was initially developed for people with difficult and sometimes traumatic backgrounds, who often struggled with high levels of shame and self-criticism, many studies now show that CFT is an effective approach to working with a variety of psychological and mental health difficulties.

What’s involved in a CFT session?

CFT is similar to other therapies, in that the therapist will spend some time getting to know the client, the difficulties they’ve been experiencing, and how they might have developed (for example, by thinking about someone’s experiences in life, and how these might have impacted what they are going through today).  They’ll do this in part by asking questions and bringing this understanding together in something called a formulation a bit like a map to help both therapist and client understand what led to some of the difficulties being experienced, but what direction therapy might take to relieve these. All of this will be done whilst establishing a safe, trusting and warm therapeutic relationship. 

As a part of some of the early sessions, the therapist will introduce some ideas that are central to the approach, like the tricky brain and the three system model, and help their client to understand how these apply in their lives. The therapist will then go on to help the client to cultivate their compassionate mind. This means learning about the different skills that help us to be compassionate to ourselves and others, and also how to find it easier to receive compassion and care from others. As part of this process, clients will be introduced to varies types of skills training known as Compassionate Mind Training (CMT). These may may include various guided exercises and practices like:

• Attention training
• Mindfulness practice
• Breathing and body practices
• Imagery practices
• Compassionate action
• Chair work
• Expressive writing (compassionate letter writing)
• Appreciation and gratitude practice
• Working with multiple parts
• Balancing thoughts

Depending on the type of difficulties that clients might be having, there may be a particular focus on working with common difficulties like high levels of shame and self-criticism and various fears of compassion. CFT has a variety of techniques and interventions to help people with this.

Outside of therapy sessions, clients will have the opportunity to practice the exercises and meditations often through guided audio files, the Self-Compassion App or self-help books (for example, The Compassionate Mind Workbook).

But of course, all of this will happen within a kind, caring and compassionate atmosphere. The therapeutic relationship is central to the process of CFT, so the therapist will strive to create a safe and empathetic space for the client, in which difficulties and distress can start to be shared in a way that feels helpful, and not overwhelming. 

CFT is primarily a ‘human’ approach, in that we recognise that all of us have been bestowed with a tricky brain that easily gets caught up in loops; that we have a threat system that comes pre-packaged with emotions like anger, grief and shame that can be difficult to manage and can cause us and others pain; that all of us have been shaped by experiences in like, many of which we had little or no control over. And that this applies to the therapist, just as much as it does to the client. So the therapeutic relationship is crucial in creating the conditions for positive change and improved emotion regulation. 

What issues are treated by CFT?

Whilst we’ve been looking at ‘What is Compassion Focused Therapy?’, it’s also important to think about what difficulties it can help with. 

CFT was originally described as a transdiagnostic approach to working with psychological and mental health problems. There are now published studies showing CFT’s effectiveness working within clinical and none clinical settings

From a clinical perspective

• Depression
• Burnout
• Anxiety
• Obsessive Compulsive Disorder (OCD)
• Trauma/Post Traumatic Stress Disorder (PTSD)
• Eating disorders (like anorexia or bulimia)
• Bipolar disorder
• Psychosis
• Personality difficulties
• Suicidal thoughts and self-harm
• Psychological problems in health conditions (like head injury, chronic pain and cancer)
• Sexual difficulties
• Intellectual difficulties 
• Psychopathic traits

It’s also worth noting that it’s not just mental health diagnoses that CFT has been shown to be helpful for. There’s also lots of evidence that it helps to reduce:

• Shame
• Self-criticism
• Worry
• Rumination
• Perfectionism
• Difficult emotions
• Attachment insecurities
• Feeling inferior

And recent research has found that CFT isn’t just about reducing difficulties or problems. Studies have found that CFT helps to increase wellbeing, positive emotions and of course, the three flows of compassion – compassion to others, compassion from others, and self-compassion.

How does CFT work?

Key to the research has been establishing it as an evidenced based therapy, but that the evidence is across multiple levels. There’s lots of ideas about this, including:

• through the supportive and healing aspects of the therapeutic relationship, collaboration and human connection
• by helping us to understand that the way our brains have evolved means they can be very ‘tricky’ to manage, as they easily get caught up in thinking-feeling ‘loops in the mind’
• that we have been shaped by many things in life (e.g. our genes, our relationships, experiences and environments), many of which we had little control of
• through bringing change to our three emotion systems, and in particular, by changing our experience with our threat system, giving us a more balanced and sustainable connection to the drive system and crucially, helping us to experience and use the soothing system
• by helping us to improve the three flows of compassion – to others, from others and to ourselves
• by reducing the fears, blocks and resistances of compassion
• by reducing shame and self-criticism
• by helping us to cultivate a new identity
• by turning the compassionate mind towards common human difficulties

Interestingly, a variety of research studies have found that using the skills and practices in CMT also bring important changes to our brains and bodies, for example, through stimulating the vagus nerve.