Written by Dr Sara Tookey
As a psychologist who integrates Compassion Focused Therapy (CFT) into my practice and compassion into my own life values-system, I've witnessed firsthand the transformative power that developing compassion can have on a person's overall well being, mental health and in enabling us to heal wounds from our pasts.
Compassion Focused Therapy Approach
Compassion Focused Therapy (CFT) is a modern therapeutic approach, developed by psychologist Dr Paul Gilbert in the 1990s. The approach emphasises cultivating compassion to alleviate human suffering, and is grounded in evolutionary psychology, affective neuroscience, psychology, and Buddhist traditions. CFT is considered a "third-wave" cognitive-behavioural therapy, emphasising mindfulness, acceptance, and emotional awareness.
CFT's core objective is to cultivate self-compassion, compassion for others, and the ability to receive compassion. It views compassion as a deep sensitivity to suffering coupled with a commitment to alleviate and prevent it. By intentionally nurturing compassion towards ourselves, others, and receiving it, we can skilfully respond to pain in transformative ways. Critically, CFT recognises that our difficult experiences have impacted us through no fault of our own. With a compassionate understanding that we've done our best, it supports finding new ways to reduce these impacts and respond to ourselves with greater care.
Theoretical Basis of CFT
The Evolutionary Roots of Compassion
From an evolutionary perspective, our capacity for compassion and caring for suffering enabled early humans to band together, increasing chances of survival. Tribes high in compassion traits like empathy and reciprocity outlasted less cooperative groups (Wilson et al., 2014).
Humans have an innate, biological predisposition toward forming connections and social bonds - we are literally wired to connect. In present times, substantial evidence demonstrates that lacking compassion for ourselves and others exerts major tolls on our mental and physical health.
Emotion Regulation Systems
CFT is based on the idea that our well-being is influenced by three emotional regulatory systems (Gilbert, 2014):
The Threat System (focused on detecting threat to keep us safe), centred in the amygdala
The Drive System (focused on resources and incentives), located in midbrain regions
The Soothing System (focused on connection and comfort), involving the prefrontal cortex, vagus nerve, and oxytocin release
Many mental health struggles reflect having an overactive threat system which over-detects threats, telling us we’re not safe when we are. The key components of CFT include education on the concept of compassion, understanding the human mind's evolutionary perspective, exploring the roles of shame and self-criticism, and learning to balance these three emotional regulatory systems.
How our Brains Regulate Emotions
At birth, our brains are wired with a "threat-protection system" located in the amygdala and other limbic system structures. This emotional regulation system detects threats and responds with instincts like fight, flight, or freeze responses to ensure survival.
In childhood, our caretakers ideally help us develop a "self-soothing system" - where the sound of their caring voice and touch calms our distress. However, for many, we weren’t properly soothed as a child, and so did not learn how to do this for ourselves. Early attachment trauma, neglect, or abuse means our threat system becomes over-developed while our ability to self-soothe fails to develop.
We can then face an imbalance between the inner critic voice - constantly scanning for danger and flaws - and an inner nurturing voice. Strengthening our self-compassion muscle through CFT exercises is akin to learning to speak to ourselves as a caring parent would, quieting inner distress.
The Costs of Self-Criticism and Isolation
Research shows high self-criticism strongly predicts increased depression (Kim et al., 2011; Kim et al., 2020), anxiety disorders (Cox et al., 2004; Thakur and Baumann, 2022), suicide risk (O'Neill et al., 2021), addiction relapse (Snoek et al., 2021), and inflammatory disease (Trindade et al., 2021).
Brain imaging studies found that self-critical neural patterns light up areas linked to threat response rather than reasoning centres - showing that when we are self-critical, we are actually attacking ourselves (e.g. Longe, 2009).
A global review found chronic social isolation increases mortality risk over 15 years as much as smoking 15 cigarettes a day (Hold-Lunstad et al., 2015). Our biological health suffers without compassionate connections.
The Benefits of Self-Compassion
One of the most important things we can do in therapy is help people learn to be compassionate towards themselves. As children, we're often taught to be kind, courteous, and generous to others. Rarely are we taught that extending kindness inwardly, to ourselves is equally as vital. Many of us are conditioned by family and society to view self-compassion as selfish, indulgent, or weak - failing to recognise its inherent value and strength for wellbeing. Self-compassion is also exceptionally difficult to do, partly due to these ingrained messages and partly because our wiring for social connection makes compassion for others easier. Yet cultivating self-compassion is essential for healing and growth.
By intentionally building self-compassion skills through practices like supportive self-talk (Tod et al., 2011), writing compassionate letters to ourselves (Swee et al., 2023), or loving-kindness meditation (Hoffman et al., 2011; Hutcherson et al., 2008), we can strengthen neural circuits that evoke the caring presence of our "compassionate self." (Stevens et al., 2018)
Additional well-documented benefits of self-compassion include:
Reduced depression (MIllard et al., 2023)
Lower addiction relapse rates (Craig et al. 2020; Chen et al., 2019)
Buffered emotional reactivity to stress (Cosely et al., 2010; Kirby et al., 2017)
Increased motivation toward self-improvement goals (Breines and Chen, 2012)
Deeper self-insight and life satisfaction (Frank et al., 2021)
Reduction in physiological pain perception (e.g. Maratos et al., 2020).
You can read more about the importance of the compassion focused approach in our recent article: Men’s Mental Health: Challenging stigma, learning vulnerability and giving compassion.
Developing the Compassionate Self
CFT founder Dr. Paul Gilbert uses the metaphor of developing our “compassionate self” to represent accessing wisdom, strength, warmth, and the drive to care for wellbeing in the face of suffering - our own and others’.
When we engage in practices like loving-kindness meditation, self-compassion journaling, or soothing touch, we activate and reinforce neural pathways of emotional resilience and connection. We re-pattern self-relating in ways that support coping, healing, taking responsibility, and living deeply.
Who Can Benefit from CFT?
CFT is beneficial for those struggling with high self-criticism, shame, low self-esteem, mood disorders, trauma, and more. At its core, CFT works by accessing and strengthening our innate capacity for compassion.
The CFT approach recognises that often, lack of self-compassion reflects early childhood attachment patterns and difficult life events that have trained our threat system to respond to safe situations with a threat response, detect threats where there is safety and to attack us (Kim et al., 2020). With compassion focused exercises, we can retrain our brains to respond to ourselves with the same care and kindness we might show a good friend.
Experiencing CFT in a session:
In CFT the compassionate therapist models compassion skills and nurtures the development of compassion within the client. The therapist guides the client through mindfulness practices, vivid imagery exercises, and behavioural techniques. The goal is to help activate the client's self-soothing system, which can counterbalance excessive reactions driven by threat perception or unhelpful urges. This allows us to care for ourselves in harder moments with the warmth of compassion, quieting inner distress. In turn, drive system energy can flow toward meaningful pursuits (the things that really matter to us) rather than an unending strive for perfectionism.
CFT enables clients to cultivate an "inner ally" - a compassionate inner voice that can replace the harsh "inner critic" that often fuels shame, self-blame and negative self-talk. By relating to themselves and others with greater kindness and empathy, clients can improve self-esteem, reduce anxiety, and boost motivation for positive personal growth.
The therapy provides a toolkit of compassionate mind/body exercises that clients can use to emotionally navigate life's challenges. The supportive inner ally acts as a psychological safety net during difficult times, countering negative thought patterns with a soothing, understanding perspective. This compassionate self-to-self relating helps create a sense of emotional security and resilience.
Conclusion & Summary
Compassion Focused Therapy offers a powerful approach to alleviating human suffering by helping individuals cultivate greater self-compassion, compassion for others, and the ability to receive compassion. By intentionally strengthening our "compassionate self" through practices like compassionate imagery, letter writing, and mindfulness, we can counteract harsh self-criticism, reduce anxiety and shame, enhance emotional resilience, and foster deeper connections with ourselves and others. CFT can be particularly beneficial for those struggling with low self-esteem, mood disorders, trauma, perfectionism, or excessive self-blame and inner conflict. At its core, CFT helps retrain our minds to respond to personal suffering with the same kindness and care we would offer a loved one, enabling us to navigate life's challenges with greater self-compassion, motivation, and overall well-being.
Note: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified mental health professional for personalized guidance.
WANT TO LEARN MORE?
Below are recommended readings if you're interested in learning more about Compassion Focused Therapy and how you can implement skills of compassion to improve your mental health and support wellbeing.
The Compassionate Mind Workbook: A step-by-step guide to developing your compassionate self - By Elaine Beaumont and Chris Irons
The Compassionate Mind -By Paul Gilbert
The Compassionate Mind Approach to Difficult Emotions: Using Compassion Focused Therapy Paperback - By Chris Irons
Book an initial 30 minute consultation with one of our Compassion-Focused-Therapy Psychologists Today
Initial Therapy Consultation
We welcome your thoughts and reflections on this therapeutic perspective.
Subscribe to our newsletter to keep up to date on the latest news, events, resources and features from True North Psychology
References
Breines, J. G., & Chen, S. (2012). Self-compassion increases self-improvement motivation. Personality & Social Psychology Bulletin, 38(9), 1133–1143. https://doi.org/10.1177/0146167212445599
Chen, Y., Bai, Y., Kalatharan, M., Chen, Z., Guo, T., Lu, J., Wang, W., & Hu, J. (2019). Effect of a mindfulness-based relational intervention on women with medical assisted reproduction: A randomized controlled trial. Journal of Psychosomatic Research, 123, 109739. https://doi.org/10.1016/j.jpsychores.2019.109739
Cosley, B. J., McCoy, S. K., Saslow, L. R., & Epel, E. S. (2010). Is compassion for others stress buffering? Consequences of compassion and social support for physiological reactivity to stress. Journal of Experimental Social Psychology, 46(5), 816–823. https://doi.org/10.1016/j.jesp.2010.04.008
Cox, B. J., Fleet, C., & Stein, M. B. (2004). Self-criticism and social phobia in the US national comorbidity survey. Journal of Affective Disorders, 82(2), 227–234. https://doi.org/10.1016/j.jad.2003.12.012
Craig, C., Hiskey, S., & Spector, A. (2020). Compassion focused therapy: a systematic review of its effectiveness and acceptability in clinical populations. Expert Review of Neurotherapeutics, 20(4), 385–400. https://doi.org/10.1080/14737175.2020.1746184
Frank, T., & Banner-Lukaris, D. (2021). The benefits of knowing and caring about oneself: The role of self-insight and self-compassion in identity and well-being. https://doi.org/10.24124/2021/59221
Gilbert P. (2014). The origins and nature of compassion focused therapy. The British journal of clinical psychology, 53(1), 6–41. https://doi.org/10.1111/bjc.12043
Hoffmann, S. G., Grossman, P., & Hinton, D. E. (2011). Loving-kindness and compassion meditation: potential for psychological interventions. Clinical Psychology Review, 31(7), 1126–1132. https://doi.org/10.1016/j.cpr.2011.07.003
Holt-Lunstad, J., Smith, T. B., Baker, M., Harris, T., & Stephenson, D. (2015). Loneliness and social isolation as risk factors for mortality: a meta-analytic review. Perspectives on Psychological Science, 10(2), 227–237. https://doi.org/10.1177/1745691614568352
Hutcherson, C. A., Seppala, E. M., & Gross, J. J. (2008). Loving-kindness meditation increases social connectedness. Emotion, 8(5), 720–724. https://doi.org/10.1037/a0013237
Kim, J. J., Gerrish, R., Gilbert, P., & Kirby, J. N. (2021). Stressed, depressed, and rank obsessed: Individual differences in compassion and neuroticism predispose towards rank-based depressive symptomatology. Psychology and Psychotherapy, 94(S2), 188–211. https://doi.org/10.1111/papt.12270
Kim, J. J., Kent, K. M., Cunnington, R., Gilbert, P., & Kirby, J. N. (2020). Attachment styles modulate neural markers of threat and imagery when engaging in self-criticism. Scientific Reports, 10(1), 13776. https://doi.org/10.1038/s41598-020-70772-x
Kim, S., Thibodeau, R., & Jorgensen, R. S. (2011). Shame, guilt, and depressive symptoms: a meta-analytic review. Psychological Bulletin, 137(1), 68–96. https://doi.org/10.1037/a0021466
Kirby, J. N., Day, J., & Sagar, V. (2019). The 'flow' of compassion: A meta-analysis of the fears of compassion scales and psychological functioning. Clinical Psychology Review, 70, 26–39. https://doi.org/10.1016/j.cpr.2019.03.001
Longe, O., Maratos, F. A., Gilbert, P., Evans, G., Volker, F., Rockliff, H., & Rippon, G. (2010). Having a word with yourself: neural correlates of self-criticism and self-reassurance. NeuroImage, 49(2), 1849–1856. https://doi.org/10.1016/j.neuroimage.2009.09.019
Maratos, F. A., & Sheffield, D. (2020). Brief Compassion-Focused Imagery Dampens Physiological Pain Responses. Mindfulness, 11, 2730–2740. https://doi.org/10.1007/s12671-020-01485-5
Millard, L. A., Wan, M. W., Smith, D. M., & Wittkowski, A. (2023). The effectiveness of compassion focused therapy with clinical populations: A systematic review and meta-analysis. Journal of Affective Disorders, 326, 168–192. https://doi.org/10.1016/j.jad.2023.01.010
O'Neill, C., Pratt, D., Kilshaw, M., Ward, K., Kelly, J., & Haddock, G. (2021). The relationship between self-criticism and suicide probability. Clinical Psychology & Psychotherapy, 28(6), 1445–1456. https://doi.org/10.1002/cpp.2593
Snoek, A., McGeer, V., Brandenburg, D., & Kennett, J. (2021). Managing shame and guilt in addiction: A pathway to recovery. Addictive Behaviors, 120, 106954. https://doi.org/10.1016/j.addbeh.2021.106954
Stevens, F.L. et al. (2018). The brain that longs to care for itself: The current neuroscience of self-compassion. In E. Seppälä et al. (Eds.), The Oxford Handbook of Compassion Science. Oxford University Press.
Swee, M. B., Klein, K., Murray, S., & Heimberg, R. G. (2023). A Brief Self-Compassionate Letter-Writing Intervention for Individuals with High Shame. Mindfulness, 14(4), 854–867. https://doi.org/10.1007/s12671-023-02097-5
Thakur, N., & Baumann, N. (2022). Breaking the anxious cycle of self-criticism: Action orientation buffers the detrimental effects of a self-critical personality style. Journal of Affective Disorders, 301, 30–35. https://doi.org/10.1016/j.jad.2022.01.014
Tod, D., Hardy, J., & Oliver, E. (2011). Effects of self-talk: a systematic review. Journal of Sport & Exercise Psychology, 33(5), 666–687. https://doi.org/10.1123/jsep.33.5.666
Trindade, I. A., & Sirois, F. M. (2021). The prospective effects of self-compassion on depressive symptoms, anxiety, and stress: A study in inflammatory bowel disease. Journal of Psychosomatic Research, 146, 110429. https://doi.org/10.1016/j.jpsychores.2021.110429
Wilson, D. S., Hayes, S. C., Biglan, A., & Embry, D. D. (2014). Evolving the future: toward a science of intentional change. The Behavioral and Brain Sciences, 37(4), 395–416. https://doi.org/10.1017/S0140525X13001593
Comments