” If you want others to be happy, practice compassion. If you want to be happy, practice compassion ” – Tenzin Gyatso (Dalai Lama).
The theory based on compassion has been growing within psychotherapeutic practices for a few years and is getting a lot of attention. That’s why this article offers you a zoom on this new emerging therapy.
What is compassion-based therapy?
Compassion-Focused Therapy, or CFT, was proposed by Paul Gilbert in the United Kingdom and is notably carried by Pascal Delamillieure and Francis Gheysen in France. This therapy is multidimensional : it is based both on cognitive-behavioral therapies (therapies supported by a scientific approach) but also on evolutionary psychology (which explains psychology based on the theory of evolution), Buddhist philosophy (which includes meditation practices) and neuroscience (study of the nervous system). mindfulness, compassion and acceptance are central to CFT.
Compassion-based therapy – for what audience ?
This therapy is primarily for people who feel hurt and self-criticism, often stemming from trauma : experiences of abuse, harassment, emotional shortcomings… These are people on whom other therapeutic approaches do not necessarily work, as blocked by shame. CFT offers emotional safety and focuses on more positive thoughts, focused on compassion and caring for oneself moving from ” I know it’s not my fault but I still feel guilty ” to ” I can be loved for who I am “.
Individual or group, this therapy would also apply to depressive, anxiety, bipolar, eating disorders or personality disorders and finally would promote stress and emotional management.
The objectives are as follows :
- Find soothing strategies
- Access a position of safety
- Take a caring look at oneself, instead of shame and self-criticism
In CFT, compassion is enacted first by the therapist in his or her attitude and then, over the course of the therapeutic work, by the patient toward himself or herself. But what is compassion ?
For Paul Gilbert, it is the ” development of sensitivity to one’s own suffering and that of others with a deep commitment to try to salve it and prevent ” It requires courage to confront that suffering and then seek to remedy it.
Good news : compassion is cultivated ! In CFT, it is seen as a set of specific attributes that are worked on. The skills related to compassion are thus :
- Well-being-seeking : the motivation to alleviate distress ;
- Sensitivity : being able to recognize the emotions and needs of the target person of compassion ;
- Sympathy : being emotionally affected by that person’s feelings and suffering ;
- Tolerance of distress : being able to tolerate fairly intense levels of emotion rather than avoiding them, seeking to distract oneself from them or being in denial ;
- Empathy : feeling and understanding the person’s emotions and thoughts, this is worked on ;
The target of compassion may be someone else or, simply…oneself.
Theoretical foundations of therapy
According to evolutionary theories, there are 3 systems of emotion regulation, linked to specific hormones, that interact :
- The threat-centered system : it prompts safety-seeking through rapid decision making to escape danger and thus promotes species survival (adrenaline, cortisol). It has an activating or inhibiting effect.
- The conduits system: it drives the search for rewards and the satisfaction of needs such as food, reproduction, pleasure… (dopamine). It has an activating effect.
- The system focused on soothing and affiliation : related to kindness and safety, connection with others, it has a calming effect.
TFC focuses on the latter system, which allows for well-being and soothing, and focuses more on ” being “. This may involve mindfulness exercises.
Associated with mindfulness
Mindfulness, or mindfulness, comes down to bringing your attention to the present moment, without judgment. It is a way of being present and observing one’s own thoughts, emotions and physical sensations, but also what is happening in the outside world. The objective is to leave the ” autopilot ” mode of daily life : to become aware of our ruminations (rehashing the same thoughts over and over again that are not necessarily appropriate or true) and to choose what to focus our attention on.
As said earlier, it is part of CFT and can be incorporated into exercises. Attention is encouraged to focus on more positive elements: self-acceptance and self-kindness, with a willingness to help oneself. This does not mean that the negative elements will be ignored, but simply recontextualized and diminished. This will allow the patient to view his or her self-image with more compassion, rather than constant self-criticism, and move toward change.
To summarize, compassion-based therapy aims to develop and cultivate compassion for oneself but also for others. It is based on mindfulness techniques and can thus be part of ” toolbox ” of some psychologists. So, if you ever come across a psychologist who proposes this therapy, you will have an idea of what it is !
- Delamillieure, P., & Gheysen, F. (2017). Compassion-Based Therapy (CBT) : From concept to practice. French Association for Behavioral and Cognitive Therapy. Retrieved from https://www.aftcc.org/therapie-fondee-sur-la-compassion-tfc-du-concept-la-pratique
- Delamillieure, P., & Gheysen, F. (2020). Practicing Mindfulness based on Compassion and Insight (MBCI) in 34 cards. Elsevier Health Sciences.
- Gheysen, F. (2020). TFC : compassion-based therapy. Francis Gheysen. Retrieved from https://www.francis-gheysen.com/therapie-compassion-tfc
- Gilbert, P. (2009). Introducing compassion-focused therapy. Advances in psychiatric treatment, 15, 199-208. doi: 10.1192/apt.bp.107.005264