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Compassion Focused Therapy

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Research into the beneficial effect of developing compassion has advanced enormously in the last ten years, with the development of inner compassion being an important therapeutic focus and goal. This book explains how Compassion Focused Therapy (CFT) a process of developing compassion for the self and others to increase well-being and aid recovery varies from other forms of Cognitive Behaviour Therapy.

Comprising 30 key points this book explores the founding principles of CFT and outlines the detailed aspects of compassion in the CFT approach. Divided into two parts Theory and Compassion Practice this concise book provides a clear guide to the distinctive characteristics of CFT.

Compassion Focused Therapy will be a valuable source for students and professionals in training as well as practising therapists who want to learn more about the distinctive features of CFT. "

248 pages, Paperback

First published April 15, 2010

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Paul A. Gilbert

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Displaying 1 - 10 of 10 reviews
Profile Image for Matt.
566 reviews7 followers
October 20, 2012
This is going to have to be a book that I re-read. A lot of the concepts make sense to me. It's embarrassing because I've been so CBT-focused, that when he says that straight CBT won't work unless we focus on the emotions surrounding the cognition, I did a face-palm.
I'm still reading Kristin Neff's book, so I shall continue to try to integrate these concepts into my work.
Profile Image for AJW.
389 reviews15 followers
May 14, 2012
I first came across Compassion Focused Therapy (CFT) from my psychologist who uses it in his work with me. The central focus on compassion and emotional warmth is hugely helpful for me as I was so ashamed of becoming a patient/client in the mental health system. I speak from experience that it is not enough to know intellectually how to become less dysfunctional, there needs to be a felt tenderness and kindness inside to nurture this change as well. CFT provides both the intellectual and feeling tools a person needs to grow in compassion and wisdom.

This particular book is aimed at professional therapists/counsellors explaining the scientific basis for CFT and its distinctive emphases, as well as its commonalities (e.g. mindfulness) with other forms of psychotherapy. There are loads of references to research papers and other psychological text books to show the evidence behind the various theories and practices of CFT.

Finally I would add that I actually prefer another book on CFT by Paul Gilbert entitled 'The Compassionate Mind'. This book is aimed anybody who is interested in CFT and doesn't assume prior psychological knowledge.
5 reviews
February 9, 2023
The book is a nice overview of CFT, with short chapters and diagrams, making it very easy to read.
Profile Image for Evan Micheals.
691 reviews20 followers
September 21, 2023
What a difference 10 years makes. I first read this around 10 years ago, when I became interested in compassion as a concept in my personal and professional life. Recently, I had a client who was hard on themselves and I believed could benefit from self compassion. I suggest we read this together. When I first read this it was revolutionary gold. Ideas that made sense, but were new. This time I had internalised the work and found little fresh or surprising.

“compassion is not about submissive ‘niceness’ – it can be tough, setting boundaries, being honest and not giving clients what they want but what they need” (p 9). This underlies compassion. When I first began studying compassion I needed to understand what it was. All the definitions had two components: A genuine attempt to understand the suffering of another and doing something to alleviate that suffering. Compassion is not about being nice or weak with others or yourself. This leads to a question of time. Which self are you being compassionate towards. The self in the moment (have another drink). Your self tomorrow (don’t have another drink). Your self in a year or ten’s time. We are multiple selves experiencing each other simultaneously. Gilbert goes onto expand his definition too. “1 Being Mindful and open to one’s own suffering; 2 being kind, and non self condemning; and 3 an awareness of sharing experiences of suffering with others rather than feeling ashamed and alone” (p 6).

“CFT is a de-pathologizing approach that focuses more on people’s (phenotypic variations in) adaptive responses to difficult environments” (p 18). CFT approaches peoples problems as problems of existence, rather than disease that need to be eliminated. One of the truths that is reinforced to my through my career is that ‘every suffers’. You can suffer wisely, and stupidly. Wise suffering involves acceptance of your suffering and giving it meaning, stupid suffering involves avoidance of the inevitable and pathologizing it when it arrives as unnatural.

The purpose of Jungian work, is not success or happiness, rather wholeness. Integrating all of our selves. CFT supports this in that “although we often think of ourselves as somehow whole and integrated individuals this is an illusion. In fact, Jung suggested that integration and wholeness are psychological feats – maturational accomplishments. We are made up of many different talents, abilities, social motives, emotions, and so on, and coping with their various pushes and pulls is no easy matter” (p 31). Gilbert acknowledges that our natural state is not integrated, and we live in a ‘multi-mind’ of competing interests. “So given our multi-minds, one thing is clear, we are not an integrated coherent, whole self, but rather made up of a variety of motives and competencies that combine and interact in complex ways” (p 38). This can lead to all sorts of interesting responses and behaviours as we go about our lives. I do not see in myself what Carl Rogers would describe as an authentic self, rather than multiple selves or personas of competing interests, who I have to integrate (then is the question, ‘who it this I, I speak of’.

I have mixed thoughts about ‘safety’ and wonder when does ‘safety’ become ‘safetism?’ Nobody achieves anything worth while without risk. It can be over done. “Safety seeking is linked to the threat system and is about preventing or coping with threats. Safeness is a state of mind that enables individuals to be content and at peace with themselves and the world with relaxed attention and the ability to explore” (p 49). One needs balance in all things.

A lot of people including yours truly have schema’s from childhood, which is a focus of psychodynamic psychotherapy, “therapists often talk about helping clients to recognize that they have often been doing ‘unhelpful thing for good reasons’, it is important to have a very clear emotional and connected understanding of the link between specific safety strategies and early life events” (p 76). CFT provides a number of questions to investigate this: “You felt that mum/dad loved you – how did she/he show this? how did she/he comfort you? how did she/he talk to you about your feelings? In what ways were they physically affectionate: if you were distressed how would they help you?” (p 70).

Work with shame plays an important part of compassion focused therapy. “In shame it is important to emotionally connect with blaming and self-condemnation, and not be vague about ‘good reasons’ for problematic behaviour” (p 78). Shame has a basis in self contempt, “Whelton and Greenburg (2005) showed that it was not the cognitive content of self-criticism as much as the emotions of anger and contempt that were important in the pathogenic effects of self-criticism. One form was identified focuses on feeling inadequate” (p 94). The work around the self critic is important. “If you could take your self-critic out of your head and look at it, what does it appears as (e.g. human or nonhuman) What facial expressions does it have (assuming it has a face)? What emotions is it directing at you? What is its greatest fear/threat?” (p 95). It is amazing how hard people work to maintain their inner critic. “What would be your greatest fear about giving up self-criticism (p 96)?”. Glibert provides suggestions about the root of the self critic. “anger at oneself is really internalized anger towards other one is dependant on or ambivalent about: you are frightened of being angry with them so you take it out on yourself” (p 96).

“The more of a framework clients have for understanding their self criticism – as linked to safety strategies, the more reflective they can be and the more collaborative in engaging with these memories and developing self compassion. Moreover, it helps people to understand why they ‘feel’ (from the amygdala) to blame even thought they logically (cortex) know they are not. There is a mismatch between the two different systems. The amygdala doe not listen to logic very much. I have found clients feel de-shamed by thie explanation. e.g. ‘well it makes perfect sense because your amygdala and threat system cares only about keeping you safe and therefore it will self monitor and self blame as ways to do that (sleeping for example). So your feelings are about safety strategies not about the person you actually are’” (p 98). I can remember how profound I found this for myself. We are not always logically driven, in fact there is a completely unreasonable part of our selves.

Here Gilbert borrows from Psycho-dynamic Psychotherapies, further convincing me that a contemporary therapists need an understanding of both the behaviourists and the analysts. “Alfred Adler (1870 – 1937) argued that people who feel inferior (have an inferiority complex) may strive to compensate and prove themselves to other” (p 109).

Thinking about what your values are is one of the pillars that a healthy psyche is built on. “Value achievers set their achievements to bring pleasures and stretch themselves, whereas need achievers set their standards to impress other” (p 109).

Carol Dwerk and growth mindset anyone? “Growth seekers enjoy challenges and their ability to learn and mature through challenges/mistakes. Validation seekers, however, feel under constant pressure to prove themselves as likeable and acceptable to others” (p 109). More borrowing.

Here Gilbert takes a position I may have supported when I first read this book. Now less so. “Schools, businesses and Western governments over the last 20 years have deliberately infected our societies with beliefs that only the competitive and able can make good – we must all have a ‘competitive edge’ and prove ourselves in the market. It is problematic because it effects our brains and creates higher levels of inequality that are known to be pathogenic and unhelpful to our well being” (p 111). If you want to compete, compete. Do your best, strive for the best version of yourself. Set a goal and aim for it. Go for it. Do not allow the opinions of others to make you week. Gilbert follows it up with “it is useful to distinguish value based achievement striving, from threat based attachment striving, the latter being strongly linked to shame proneness and fears of social exclusion and rejection” (p 111). What are you striving for? I am more with the latter statement, than the former.

Balance in all things. “The main focus of CFT is a balancing of the three affect systems not just stimulating the soothing system. Sometimes it is important to work on the drive and achievement system as well” (p 113). Letting go of jealousy and envy, and being to genuinely able to say ‘well done’, to yourself and others. “Learning to take joy from our and other people’s achievements is also important for balancing our emotions. However, as in other therapies, there is a distinction between taking joy in having and ‘feeling a need and must have’” (p 113).

“The Dalai Lama travels the world trying to promote compassion, in ACT committing oneself to the values and goals is key to personal growth and development” (p 113). I wonder if this book was written today if Gilbert would quote the Dalai Lama. “The Dalai Lama defines compassion as a sensitivity to the suffering of self and others, with a deep commitment to try and relieve it” (p 125).

“Wherever possible CFT asks the clients, ‘What is your intuitive wisdom on the issues’” (p 134).

“Compassion is not at all weak. It is the strength that arises out of seeing the true nature of suffering in the world. Compassion allows us to bear witness to that suffering, whether it is in ourselves or others, without fear; it allow us to name injustice without hesitation, and to act strongly, with all the skill at our disposal. To develop this mind state of compassion, the second of the brahma-vihatas, is to learn to live as Buddha put it, with sympathy for all living beings, without exception” (p 135).

“Typically, we don’t think that we can deliberately practise becoming a certain type of person – but we can, we just have to decide to do it and then put in some time to practise” (p 160). This is the work of knowing yourself, whilst having a vision of the telos of who your are becoming. That vision can change, but the work starts now.

I do not discuss with anyone else, anything that I have not road tested on myself. “It is increasingly recognized that therapists would benefit from some kind of personal practice of the therapy they practice. CFT strongly endorses this and advises CF therapists to practice mindful and compassionate self focusing and meditations as often as possible” (p 164).

Again, compassion is not just being nice. “Sometimes people will develop what looks like compassion, but actually it’s submissive appeasing cultivating ‘niceness’ or wanting to be nice to be liked. While various elements of this exist in all of us, some individuals lack mentalizing abilities, genuine empathy about what other people really need (as opposed to want), and can find difficulties in being assertive or putting down boundaries – a problem sometimes in parenting” (p 177).

Bad is faster and stronger than good. Good is slower, but more resilient and focused, for good evolutionary reasons. “Beck has often pointed out that if we (say) go to ten shops and nine of the assistants are helpful but then one is rude and abusive the likelihood is that when we get home we will ruminate on the rude one and forgets about the helpful ones. This is because our brain is set to be ‘threat sensitive more than reward sensitive’” (p 181).

“Although there have been many studies looking at specific loses in childhood (bereavements), such as the loss of a parent or loss due to illness, there are very few studies looking at loss of what was wanted or needed” (p 202 – 203). Dreams die all the time and this can be traumatic and require a new conception of self. I think Gilbert is onto something here.

This book did not have the same impact the second reading, but I think Gilbert is on to something. He borrows from any thought he finds useful to promote compassion towards one self. Gilbert's background is in CBT behaviourism, but he has well and truly transcended CBT in his conception of compassion focused therapy. This is a useful book to all who want a mature relationship with the therapeutic discourse.
Profile Image for Harriet.
111 reviews8 followers
February 2, 2024
This is a difficult one to review in terms of separating my review on the book and my thoughts on CFT.

The book was well structured and clearly written. I liked that it includes guides in the second section on how to use certain practices with clients. There are lots of elements of compassionate work I appreciate and use including imagery and letter-writing but I’m still not sure I personally would use entirely CFT without other elements - I did like how the book explained crossovers with other modalities.

I struggled more with some of the underlying principles and the Buddhist elements which don’t align with me. I also found the language of “borderline folk” unhelpful but appreciate this is probably to do with the publication date and wasn’t to do with the author’s otherwise clearly compassionate intent.

I do look forward to reading more updated papers about CFT.
Profile Image for Danielle Janzen.
197 reviews3 followers
December 17, 2022
I really enjoyed reading this book. I've been reading it over the past 4 months or so little by little as a sort of self-therapy before I go to bed each night. It was written by a psychologist to teach other psychologists how they can incorporate CFT into their therapy sessions with patients. Because of this, it often says word for word what a therapist might say or ask to their patient to help them utilize CFT to work through their struggles. While it is probably not the same as going to see a therapist, reading this book worked really well for me. It has provided me with the knowledge, tools and methods necessary to begin to overcome several things in my life that have been unknowingly weighing me down for decades. Some of which include:

- Better understanding the mind and a variety of mental states
- Realizing that self-criticism and ruminating over stressful situations actually triggers my threat response and competitive mentality, leading to being more irritable with my kids, less productive, getting worse sleep, etc.
- Learning how to, over time, disengage from shame-based self-attacking and begin a more compassionate self-correction. Being forgiving of myself as I am not perfect at this and probably never will be.
- Better understanding the unmet needs of my past and giving compassion to those around me past and present doing their best.
- Learning that how I experience my relationships (as either caring and accepting or rejecting and abusive) has a major impact on how I experience myself as living in the minds of others. External shame (what I think others think about me) impacts me greatly and causes internal shame (what I think about myself). This was a huge realization for me given that a lot of the external shame I thought I was experiencing was in my own head.
- Remembering that compassion flowing out of me toward others is one of my core tenants as a human being and what brings me the most joy.
- Learning that helpful relationships are physiologically regulating. There is a reason I am drawn to the friends and relationships I hold dear.
- Better understanding the different compensations of achievement (growth and validation) and recommitting to a growth mindset
- Using soothing imagery, breathing and meditation to recenter and create a "safe place"

Honestly, CFT originally sounded a little soft or fake to me. But as I read this book, it was eye opening to see all of the studies cited, and the findings were very interesting to me. I thought it was a concise and easy to read explanation of CFT for the most part. It was a tad dry at times, but overall I really enjoyed it and would recommend to others looking for a self-help book actually rooted in scientific research.
Profile Image for Jaimini Mehta.
135 reviews2 followers
February 16, 2024
Sorry to say this, but not the best book in my view on CFT. Is written in a way that feels difficult to follow and perhaps over complicate some concepts. It doesn’t really feel like a very practical guide, either on treatment or intervention. My preference is for the CFT workbook which feels more user-friendly.
Profile Image for Artjom Aroutounjan.
12 reviews1 follower
May 12, 2019
Gilbert has spolen to me. I think it gives spark to many important thoughts both as a therapist and a client. Really recommendable
4 reviews
September 9, 2021
Enjoyed the theory and techniques, found the writing a bit dry.
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