Compassion is the act of feeling sympathy, worry, and desire to make others’ pains or misfortunes better or desire to alleviate them. Compassion-focused therapy (CFT) is a therapeutic approach that aims to help those who struggle with shame and self-criticism, often resulting from early experiences of abuse or neglect. In the first decade of the twenty-first century, British psychologist Paul Gilbert created the relatively new discipline of compassion-focused therapy (CFT), which incorporates methods from cognitive behavioral therapy.

According to Gilbert, “One of CFT’s key concerns is to use compassionate mind training to help people develop and work with experiences of inner warmth, safeness and soothing, via compassion and self-compassion.”

Compassionate mind training, which imparts compassion’s qualities and skills, is the main treatment approach used in CFT. Compassionate mind training helps transform problematic patterns of cognition and emotion related to anxiety, anger, shame and self-criticism.

The goal of CFT is to replace 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.

Techniques in CFT :

The primary therapeutic technique of CFT is Compassionate Mind Training (CMT). CMT refers to the common methods for assisting people in feeling compassion and fostering various facets of compassion for oneself and others. Through the use of specialized training and supervised exercises created to aid people in further developing non-judging and non-condemning qualities, CMT seeks to promote compassionate motivation, sympathy, sensitivity, and suffering tolerance.

People in therapy might learn: 

1. Appreciation exercises or activities emphasizing the things an individual enjoys. Making a list of likes, pausing to appreciate the moment when something enjoyable is discovered, and other constructively rewarding activities are a few examples of these exercises.
   
   
   
2. Mindfulness, or the ability to pay attention to the current moment in a non-judgmental manner.
   
   
   

3. Compassion-focused imagery exercises, or the use of guided memories and fantasies to first stimulate the mind and then the physiological systems. The purpose of exercises in compassion-focused imaging is to create a relational image that activates the calming system.
   
   
   
   

   How it works

   CFT is postulates 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.
   
   

   According to CFT, imbalances between these three systems can lead to mental disease as well as/or maladaptive thought patterns and behaviors. Inconsistencies between these three systems, according to CFT, might result in mental illness as well as/or maladaptive thought processes and actions. The aim of CFT is to bring these three affect systems into balance.

People who are prone to guilt and self-criticism may not have received enough soothing system activation in infancy and too much threat system stimulation. As a result, individuals could find it difficult to show kindness to others or to themselves. They may be highly sensitive to criticism or rejection, whether real or perceived, and internalize that disapproval. Therefore, the aim of CFT is to balance out this imbalance in emotion regulating systems.

Issues treated with CFT

People who struggle to comprehend, experience, or express compassion may benefit from CFT because treatment can provide a safe environment in which to identify the underlying causes of this struggle and investigate potential solutions. This style of treatment may be especially beneficial when addressing emotions related to self-attack, but it can also be effective in helping people manage distressing thoughts, behaviors, and feelings of any kind.

Other concerns treated with CFT include: 
Anxiety, shame, self-criticism, depression, disordered eating, anger, self-injury, psychosis, addiction.

Benefits of CFT

CFT deliberately teaches people how to build their compassionate thinking, which heightens sentiments of self-validation and empathy. Greater benefits to one’s mental and physical health are linked to compassion for oneself and others, and it also improves one’s overall quality of life. It enables positive thinking habits, promotes emotional regulation, reduces stress and improves relationship quality. Less self-criticism, despair, and anxiety are also associated with greater compassion. Additionally, compassion can produce healthier immune responses and helps maintain blood pressure and cortisol levels.

Limitations of CFT

While CFT may be effective for those who are comfortable with the concept of being soothed or cared for, not all people share this disposition. Some patients in treatment might fear compassion, while others might believe they don’t deserve to be treated with compassion. Some persons may even find it challenging to understand compassion itself. 

Exercises including mindfulness and compassionate images may potentially cause problems. Some people may find it difficult to enter a state of mindfulness, and failure may lead to self-criticism. Others can find it difficult to concentrate on or even feel empathic imagery.The use of images of known people or events may also bring to mind unwanted associations and negative past experiences. Patients who are exhibiting extreme fury or anger may not respond as well to treatment.

Compassion focused therapy exercises

1.  Soothing Rhythm Breathing
   
   Make sure that you are sitting comfortably with both feet flat on the floor and roughly shoulder-width apart before beginning the relaxing rhythm breathing exercise. Close your eyes or stare down at the ground while placing your hands on top of your legs. Let yourself have a gentle facial expression, like a small smile.
   
   Begin to focus on your breathing. Allow the air of each breath to come down into your diaphragm and feel it move in and out as you breathe. Play with the speed of your breath until you find a comfortable, soothing rhythm of breath.
   
   You’ll probably discover that your relaxing breathing pattern is roughly three seconds of inhalation, a brief pause, and three seconds of exhalation. Continue focusing just on your breathing, through your nose, and in your peaceful rhythm.
   
   Next comes a grounding moment. Turn your focus within and feel the weight of your body as it rests on the chair and the ground underneath you. Let yourself feel held and supported by the chair.
   
   Keep in mind that it’s alright for your thoughts to wander; just pay attention to where it goes and gently bring it back to being aware of your body. Feel the air flowing in and out of your nostrils, and simply allow yourself to “be.”
   
   If you find yourself stuck on noticing your breathing, let yourself focus on an object instead. You can grip something comfortable to hold, like a softball or a smooth stone. Keep your attention on the object and your breathing while taking note of how the object feels in your hands.
   
   When you’re ready, slowly open your eyes and bring yourself back to the present moment. A small stretch and a deep breath can help you ready yourself for the rest of your day.
   
   
2. Compassionate Flowing Out
   
   To try this exercise, choose a peaceful place where you won’t be bothered, then start to paying attention to your breathing. Consider a time when you felt very compassionate and kind toward a person or a pet that you cherished.
   
   Try not to choose a time when that person or animal was very distressed because then you are likely to focus on that distress instead of the kind, compassionate feelings for him or her.
   
   Focus on your desire to assist the individual or animal, as well as the feelings of kindness that will motivate you to do so. Remember that in this exercise it is your intentions that are important, not how the person or animal responds.
   
   Bring to mind a specific time when you felt compassionate towards him or her. Imagine yourself expanding, as if you are becoming calmer, wise, stronger, and more responsible, and able to help him or her.
   
   As you recall how it felt to be nice, pay attention to how you feel in your body. Spend some time expanding with warmth in your body. Notice the genuine desire for this person to be free of suffering and to flourish.
   
   Think for a moment or two on the way you spoke, the things you said or did or wished to do to help, and the tone of your voice.
   
   Spend another minute or two on thinking about how good it felt to be kind to him or her.
   
   Finally, focus only on your desire to be helpful and kind: the sense of warmth, feelings of expansion, your kind tone of voice, the wisdom in your voice and your behavior. When you have finished this exercise, you may want to take some notes about how this felt for you.

Reference

Ackerman, C. (2017). 16 Compassion Focused Therapy Techniques & Exercises (+ PDF). PositivePsychology.com. Retrieved 11 October 2022, from https://positivepsychology.com/compassion-focused-therapy-training-exercises-worksheets/.

Blain, T. (2022). What is Compassion-Focused Therapy?. Verywell Mind. Retrieved 11 October 2022, from https://www.verywellmind.com/cft-definition-techniques-and-efficacy-5213936.

Compassion–Focused Therapy (CFT). Goodtherapy.org. (2018). Retrieved 11 October 2022, from https://www.goodtherapy.org/learn-about-therapy/types/compassion-focused-therapy#:~:text=Compassion%2Dfocused%20therapy%20(CFT)%20aims%20to%20help%20promote%20mental,essential%20aspect%20of%20well%2Dbeing.

Compassion-Focused Therapy. Psychology Today. (2022). Retrieved 11 October 2022, from https://www.psychologytoday.com/us/therapy-types/compassion-focused-therapy.

Gilbert, Paul (2009). “Introducing compassion-focused therapy”. Advances in Psychiatric Treatment. 15 (3): 199–208. doi:10.1192/apt.bp.107.005264