compassion-focused-therapy model and research paul gilbert, kirsten mcewan, corinne gale & jean...

Compassion-Focused-Therapy Compassion-Focused-Therapy Model and ResearchModel and Research

Paul Gilbert, Kirsten McEwan, Corinne Gale & Jean GilbertPaul Gilbert, Kirsten McEwan, Corinne Gale & Jean GilbertMental Health Research UnitMental Health Research Unit, , Kingsway Hospital, Derby UKKingsway Hospital, Derby UK

www: Compassionatemind.co.ukwww: Compassionatemind.co.uk

Talk TodayTalk Today

Outline basic philosophy and model of Outline basic philosophy and model of Compassion focused TherapyCompassion focused Therapy

Note the powerful effects of our self- Note the powerful effects of our self- evaluation systems (self-criticism vs self evaluation systems (self-criticism vs self compassion)compassion)

Explore the main therapeutic work as Explore the main therapeutic work as overcoming the overcoming the fear offear of compassion and self compassion and self compassionscompassions

To understand ourselves we must To understand ourselves we must understand our brainsunderstand our brains

why we have complex brains and minds that are why we have complex brains and minds that are difficult to understand regulatedifficult to understand regulate

1. Old Brain 1. Old Brain Emotions:Emotions: Anger, anxiety, sadness, joy, lustAnger, anxiety, sadness, joy, lustBehaviours:Behaviours: Fight, flight, withdraw, engageFight, flight, withdraw, engageRelationships:Relationships: Sex, status, attachment, tribalismSex, status, attachment, tribalism

2. New Brain2. New BrainImagination, fantasise, look back and forward, plan, ruminateImagination, fantasise, look back and forward, plan, ruminate

Integration of mental abilitiesIntegration of mental abilitiesSelf-awareness, self-identity, and self-feelingSelf-awareness, self-identity, and self-feeling

3. Social Brain3. Social BrainNeed for affection and care Need for affection and care Socially responsive, self-experience and motivesSocially responsive, self-experience and motives

What happens when new brain is recruited to pursue old brain passions?What happens when new brain is recruited to pursue old brain passions?

Sources of behaviourSources of behaviour

Old BrainOld Brain: Emotions, Motives, Relationship : Emotions, Motives, Relationship Seeking-CreatingSeeking-Creating

ArchetypalArchetypal

New BrainNew Brain:: Imagination, Imagination, Planning, Rumination, IntegrationPlanning, Rumination, Integration

Interaction of old and new psychologies

Understanding our Motives and Understanding our Motives and EmotionsEmotions

Motives evolved because they help animals to Motives evolved because they help animals to survive and leave genes behindsurvive and leave genes behind

Emotions guide us to our goals and respond if we Emotions guide us to our goals and respond if we are succeeding or threatenedare succeeding or threatened

There are three types of emotion regulationThere are three types of emotion regulation

1.1. Those that focus on threat and self-protectionThose that focus on threat and self-protection2.2. Those that focus on doing and achievingThose that focus on doing and achieving3.3. Those that focus on contentment and feeling safeThose that focus on contentment and feeling safe

Types of Affect Regulator SystemsTypes of Affect Regulator Systems

Incentive/resource- Incentive/resource- focusedfocused

Wanting, pursuing, achieving, consuming

Activating

Non-wanting/Non-wanting/Affiliative focusedAffiliative focused

Safeness-kindness

Soothing

Threat-focused Threat-focused

Protection andProtection and

Safety-seekingSafety-seeking

Activating/inhibitingActivating/inhibiting

Anger, anxiety, disgustAnger, anxiety, disgust

Drive, excite, vitalityDrive, excite, vitality Content, safe, connectedContent, safe, connected

Self-ProtectionSelf-Protection

In species without attachment only In species without attachment only 1-2% make it to adulthood to 1-2% make it to adulthood to reproduce. Threats come from reproduce. Threats come from ecologies, food shortage, predation, ecologies, food shortage, predation, injury, disease. At birth individuals injury, disease. At birth individuals must be able to “go it alone” be must be able to “go it alone” be mobile and dispersemobile and disperse

Dispersal and avoid othersDispersal and avoid others

Protect and Comfort: Less ‘instinctive Protect and Comfort: Less ‘instinctive brain – post birth learningbrain – post birth learning

The Mammalian Importance of The Mammalian Importance of Caring MindsCaring Minds

Caring as “looking after”. Seeking closeness Caring as “looking after”. Seeking closeness rather than dispersion. Individuals obtain rather than dispersion. Individuals obtain protection, food, and care when ill. Key also is protection, food, and care when ill. Key also is

soothing-calmingsoothing-calming and physiological regulation. and physiological regulation. Few offspring but high survival rate in Few offspring but high survival rate in comparison to species without attachment. comparison to species without attachment. Affection and kindnessAffection and kindness

Co-operative and mutual support can develop as Co-operative and mutual support can develop as we see that our prosperity impacts on that of we see that our prosperity impacts on that of others, sharing and not-exploitingothers, sharing and not-exploiting

Affectionate InteractionsAffectionate Interactions

Secure attachment linked to self-confidence, empathy and use Secure attachment linked to self-confidence, empathy and use of attachment strategies when stressed (Mikulincer & Shaver of attachment strategies when stressed (Mikulincer & Shaver 2005)2005)

Maturation of the brain (e.g. frontal cortex) and affect Maturation of the brain (e.g. frontal cortex) and affect regulation (Gerhardt, 2004; Schore, 1994)regulation (Gerhardt, 2004; Schore, 1994)

Effects of low birth weight (Tully et al, 2004. JCCP, 72, 218-Effects of low birth weight (Tully et al, 2004. JCCP, 72, 218-226)226)

Testosterone and aggression (Booth et al., 2003. Testosterone and aggression (Booth et al., 2003. Developmental Psychology, 39, 85 – 98)Developmental Psychology, 39, 85 – 98)

Self-to-self-relating e.g. self criticism Self-to-self-relating e.g. self criticism vsvs self-reassurance self-reassurance

Internal Threat and SoothingInternal Threat and Soothing

ThreatAffiliative/ Soothing

Calms

Internal representations of helpful others and sources of comfort

Emotional memories of soothing

Neurophysiological networks

Self-affiliation – experiences a lovable self

Internal Threat and More threatInternal Threat and More threat

ThreatAffiliative/ Soothing

Calms

Others are threats or alarming

Emotional memories of no soothing

Neurophysiological networks

No self-affiliation – experiences a ununlovable self

Compassion SolutionsCompassion Solutions

Ancient wisdomAncient wisdom

Compassion is the road to happiness Compassion is the road to happiness (Buddhism(Buddhism))

Evolution Evolution Evolution has made our brains highly Evolution has made our brains highly

sensitive to internal and external kindnesssensitive to internal and external kindness

NeuroscienceNeuroscienceSpecific brain areas are focused on detecting Specific brain areas are focused on detecting and responding to kindness and compassionand responding to kindness and compassion

CompassionCompassion

Compassion can be defined in many ways: Compassion can be defined in many ways: “As a “As a sensitivity to the suffering of self and others with a sensitivity to the suffering of self and others with a deep commitment to try to relieve it”deep commitment to try to relieve it” Dalai Lama Dalai Lama

Eight fold path - represents a multi-modal Eight fold path - represents a multi-modal approach for training one’s mindapproach for training one’s mind

Compassion as FlowCompassion as Flow

Different practices for eachDifferent practices for each

Other Other SelfSelf

SelfSelf OtherOther

Self Self SelfSelf

Non linear empathy for other begins early in lifeNon linear empathy for other begins early in life

DataData• Practice of imagining compassion for others produces changes in Practice of imagining compassion for others produces changes in

frontal cortex and immune system (Lutz et al, 2009)frontal cortex and immune system (Lutz et al, 2009)

• Loving kindness meditation (compassion directed to self, then Loving kindness meditation (compassion directed to self, then others, then strangers) increases positive emotions, mindfulness, others, then strangers) increases positive emotions, mindfulness, feelings of purpose in life and social support and decreases illness feelings of purpose in life and social support and decreases illness symptoms (Frederickson et al, 2008, JPSP)symptoms (Frederickson et al, 2008, JPSP)

• Compassion meditation (6 weeks) improves immune function, and Compassion meditation (6 weeks) improves immune function, and neuroendocrine and behavioural responses to stress (Pace, 2008, neuroendocrine and behavioural responses to stress (Pace, 2008, PNE)PNE)

• Viewing sad faces, neutrally or with a compassionate attitude Viewing sad faces, neutrally or with a compassionate attitude influences neurophysiological responses to faces (Ji-Woong Kim, influences neurophysiological responses to faces (Ji-Woong Kim, 2009, NP)2009, NP)

• Compassion training reduces shame and self-criticism in chronic Compassion training reduces shame and self-criticism in chronic depressed patients (Gilbert & Proctor, 2006, CPP)depressed patients (Gilbert & Proctor, 2006, CPP)

Key Targets of TherapyKey Targets of Therapy

AttentionAttention ThinkingThinkingReasoningReasoning

BehaviourBehaviour

MotivationMotivation EmotionsEmotions

Their pattern gives rise to a certain type of mindTheir pattern gives rise to a certain type of mind

Imagery Imagery FantasyFantasy

Compassionate MindCompassionate Mind


BehaviourBehaviour


Imagery Imagery FantasyFantasy CompassionCompassion

Threatened Mind can block CompassionThreatened Mind can block Compassion

AttentionAttentionThinkingThinkingReasoningReasoning

BehaviourBehaviour


Imagery Imagery FantasyFantasy ThreatThreat

Self-Critical Mind is also Threat-focused Self-Critical Mind is also Threat-focused MindMind


BehaviourBehaviour



Self-Self-CriticalCritical

Meal

Sexual Bully-threat

Emotion Brain

Stomach acid

Salvia ArousalFearful

Depressed

How our own thoughts and images affect our brainsHow our own thoughts and images affect our brains

Kind, warm and caring

SoothedSafe

Meal Sex Bully- threat

Compassion

Pink represents our inner images and thoughts

QuestionsQuestions

How does self-criticism and self-compassion/ How does self-criticism and self-compassion/ reassurance work in the brain?reassurance work in the brain?

Are their individual differences linked to trait Are their individual differences linked to trait self- criticism?self- criticism?

How might compassion training influence How might compassion training influence neurophysiology?neurophysiology?

fMRI Study (Aston University)STUDY Olivia Longe, Gina Rippon, Paul Gilbert & Frankie Maratos

• 2X2 Factorial: 2 X Statement Scenarios, 2 X Imagery Perspectives

• Statements pre-tested (n=12), for imagability (i.e. ease of imagining self-critical or self-reassuring thoughts), 1-7 Likert Scale.

Emotion Scenario(-) Neutral Scenario

“A third job rejection letter in a row arrives in the post”

“The second free local newspaper in a row arrives in the post”.

Self-Reassure

Self-Criticize

Self-Reassure

Self-Criticize

Axial slices displaying left lateral PFC (BA 47, 45,9) and right lateral PFC (BA 46) activation

Longe, et al (2010). Having a word with yourself: NeuroImage, 49, 1849-1856

Self-Criticism during Emotional Scenarios vs. Neutral

Self-Reassurance during Emotional Scenarios vs. Neutral

Whole brain and axial slices displaying left temporal pole (BA 38) and insula activation

Longe, et al (2010). Having a word with yourself: NeuroImage, 49, 1849-1856

Parent recall and SC and SRParent recall and SC and SRIrons Gilbert Baldwin et al., 2006 Br J Clin PsychIrons Gilbert Baldwin et al., 2006 Br J Clin Psych

Rejection

Overprotection

Warmth

Inadequate Self

Hated Self

Reassure Self

Depression

.37

(.30)

-.31

(-.56)

.24

(.31)

.26

(.60)

.15

(.25)

.31

(.33)

.22

(.55)

Imagining a self-critical part of selfImagining a self-critical part of self

197 students from Derby and McGill Universities197 students from Derby and McGill Universities

(with Chris Irons and Mark Baldwin)(with Chris Irons and Mark Baldwin)

Self-criticismSelf-criticism

PowerPower AngerAnger

0.530.53 0.510.51

Self-reassuranceSelf-reassurance

PowerPower AngerAnger

- - 0. 330. 33 - 0.33- 0.33

Imagining a Self-Compassionate Imagining a Self-Compassionate Part of SelfPart of Self

197 students from Derby and McGill Universities197 students from Derby and McGill Universities(with Chris Irons and Mark Baldwin)(with Chris Irons and Mark Baldwin)

Self-criticismSelf-criticismPowerPower WarmWarm

- - 0.540.54 - - 0.340.34

Self-reassuranceSelf-reassurancePowerPower warmwarm

0. 580. 58 0.430.43

Gilbert et al (2005)Gilbert et al (2005)

Compassionate MindCompassionate Mind


BehaviourBehaviour



Self-Self-CompassionateCompassionate

Why a Compassion Focus?Why a Compassion Focus?

People with chronic problems often come from People with chronic problems often come from neglectful or abusive backgrounds, have high neglectful or abusive backgrounds, have high levels of shame, and are often self-critical, self-levels of shame, and are often self-critical, self-disliking, or self-hatingdisliking, or self-hating

Live in a world of constant internal and external Live in a world of constant internal and external threatthreat

Have few experiences of feeling safe or soothed Have few experiences of feeling safe or soothed and are not able to do this for themselves. Often and are not able to do this for themselves. Often do poorly in trialsdo poorly in trials

Self-Criticism

Internal Threat and SoothingInternal Threat and Soothing

Rumination

Worry Threat

Compassionate

Re-focusing

Affiliative/ Soothing

Compassionate imagery

Calms

Fear of CompassionFear of Compassion

Certain types of positive feelings are threateningCertain types of positive feelings are threatening

It is dangerous to feel safeIt is dangerous to feel safe

Compassion feeling are linked to beliefs such that Compassion feeling are linked to beliefs such that it’s an indulgence and weaknessit’s an indulgence and weakness

Activated grief and or abuse memoriesActivated grief and or abuse memories

PROBLEM -Compassion is a threatPROBLEM -Compassion is a threat

Threat

Compassionate

Re-focusing

Affiliaitve/Soothing

Compassionate imagery

Shame-self criticism

Trauma Memory

Meta- beliefsFear of closeness

Mentalizing

Kindness, Attachment and ThreatKindness, Attachment and Threat

Kindness from therapist or imageryKindness from therapist or imagery

Activate attachment systemActivate attachment systemActivate memoriesActivate memories

NeglectNeglectalonenessaloneness

Abuse, shame Abuse, shame vulnerablevulnerable

ActivateActivate learnt and current defences - cortisollearnt and current defences - cortisol

Fight, flightFight, flightshut downshut down

Fight, flightFight, flightshut downshut down

Bowlby: Kindness opens the attachment system and then whatever ever fears, anger Bowlby: Kindness opens the attachment system and then whatever ever fears, anger or despair is coded there will become available and can be intensely threateningor despair is coded there will become available and can be intensely threatening

Study of reactions to Study of reactions to compassionate imagerycompassionate imagery

• Control of the mechanisms for balance between Control of the mechanisms for balance between sympathetic and parasympathetic nervous system have sympathetic and parasympathetic nervous system have been modified and are linked to evolution of mammalian, been modified and are linked to evolution of mammalian, attachment and social engagement systemsattachment and social engagement systems

• This relative balance can be measured in heart rate This relative balance can be measured in heart rate variabilityvariability

• Heart rate variability linked to adaptive balance and Heart rate variability linked to adaptive balance and flexibility, soothing and safeness - low variability to flexibility, soothing and safeness - low variability to relative control/dominance of one over the other - threatrelative control/dominance of one over the other - threat

Sympathetic Sympathetic nerves to heartnerves to heart

Increases HR and Increases HR and stroke volumestroke volume

Parasympathetic Parasympathetic nerves to heartnerves to heart

Slows HRSlows HR

Successive Inter-Successive Inter-beat Intervals beat Intervals

(ms) (ms) 945945

897897858858

799799

821821

846846

851851

858858

879879

879879

Standard Deviation of Standard Deviation of Inter-beat Intervals Inter-beat Intervals over 300 second over 300 second period = SDNNperiod = SDNN

Tasks of studyTasks of study

Relaxation condition was focusing on relaxing Relaxation condition was focusing on relaxing calming images/thoughtscalming images/thoughts

Control condition was to imagine making your Control condition was to imagine making your favourite sandwich and the pleasure you will get favourite sandwich and the pleasure you will get from eating it (control for type of positive affect and from eating it (control for type of positive affect and also the effects of mental imagery)also the effects of mental imagery)

Compassion imagery was to imagine their ideal Compassion imagery was to imagine their ideal compassionate person and how kind, warm and compassionate person and how kind, warm and

caring they were for the selfcaring they were for the self

Compassionate Imagery

Control ImageryBaseline

Condition

65.00

60.00

55.00

50.00

45.00

40.00

Mean

SD

NN

Grp 2 ups

Grp 1downs

SDNN change grouping variable

Diagram showing mean SDNN for each group at baseline & during imagery conditions

CortBCortA

Sample

5.800

5.600

5.400

5.200

5.000

4.800

Mean

co

rtis

ol (n

g/m

l)

Grp 2ups

Grp 1downs

Grouping variabile for SDNN change

Diagram showing mean cortisol for each group at baseline & after Imagery

Correlations between change in HRV Correlations between change in HRV and self-report scalesand self-report scales

SDNNSDNN

Inadequate SelfInadequate Self Anxious AttachmentAnxious Attachment-.54*-.54* -.48*-.48*

Depend AttachmentDepend Attachment Social SafenessSocial Safeness.52*.52* .57**.57**

* p<.05 ** p <.01* p<.05 ** p <.01

Fears of CompassionFears of Compassion

Basic Beliefs and Meta-cognitionsBasic Beliefs and Meta-cognitions

Fear of Compassion Fear of Compassion ForFor Others Others ScaleScale

People will take advantage of you if you are People will take advantage of you if you are too compassionatetoo compassionate

If I’m too compassionate, others will If I’m too compassionate, others will become too dependent on mebecome too dependent on me

I can’t tolerate others distressI can’t tolerate others distress

Fear of Compassion Fear of Compassion FFromrom Others Others ScaleScale

I fear that if I need other people to be kind, they I fear that if I need other people to be kind, they wont bewont be

I worry that people are only kind and I worry that people are only kind and compassionate if they want something from mecompassionate if they want something from me

If I think someone is being kind & caring towards If I think someone is being kind & caring towards me, I put up a barrierme, I put up a barrier

Fear of Compassion Fear of Compassion Towards Towards SelfSelf Scale Scale

I fear that if I develop compassion for I fear that if I develop compassion for myself, I will become someone I don’t want myself, I will become someone I don’t want to beto be

I fear that if I am more self-compassionate I fear that if I am more self-compassionate I will become a weak personI will become a weak person

I fear that if I start to feel compassion for I fear that if I start to feel compassion for myself, myself, I will be overcome with loss/griefI will be overcome with loss/grief

Fear of Compassion DataFear of Compassion Data

Com Com for for others others

Com Com fromfrom OthersOthers

Com Com for for othersothers

Com Com fromfrom OthersOthers

. 47**. 47**

SelfSelf com com . 37**. 37** . 67**. 67**

Fear of Compassion DataFear of Compassion Data

C C forfor OthersOthers

C C fromfrom OthersOthers

Self Self ComCom

AnxietyAnxiety . 22**. 22** . 46**. 46** . 44**. 44**

DepDep . 17*. 17* . 37**. 37** . 40*. 40*

Tentative ideasTentative ideas

To emotional (shame type) events - being self-To emotional (shame type) events - being self-reassuring vs self-critical activates different brain reassuring vs self-critical activates different brain systemssystems

People high in self-criticism seem to struggle to People high in self-criticism seem to struggle to activate soothing system and may find efforts to be self activate soothing system and may find efforts to be self -compassionate a threat – (sadness?)-compassionate a threat – (sadness?)

Question: can we teach self-critics to be self soothing Question: can we teach self-critics to be self soothing and would this ‘training affect’ change physiological and would this ‘training affect’ change physiological responses to threatening-self linked events?responses to threatening-self linked events?

TherapyTherapyLife history and contextual rather than symptom focusedLife history and contextual rather than symptom focused

Background, key threats, safety strategies Background, key threats, safety strategies undesired/unintended consequenceundesired/unintended consequence

High focus on validation, on “not your fault,” courage and High focus on validation, on “not your fault,” courage and doing your best.doing your best.

Clarify three circle model and why we will explore helpful Clarify three circle model and why we will explore helpful behaviour for behaviour for eacheach circles circles

Desensitisation to affiliative positive affect – to be able to Desensitisation to affiliative positive affect – to be able to feel safe and self compassionatefeel safe and self compassionate

TreatmentTreatment

• Attendance one of two programmesAttendance one of two programmes

• Patients invited to take part in a research trial of Patients invited to take part in a research trial of CMT at community meetingsCMT at community meetings

• Criteria for inclusion were mid treatment (six months Criteria for inclusion were mid treatment (six months to one year), well engaged with the service and to have to one year), well engaged with the service and to have self-attacking, negative thoughtsself-attacking, negative thoughts

• Nine patients agreed to take part in the study (five Nine patients agreed to take part in the study (five men and four women)men and four women)

• Three did not complete the study: hence six completed Three did not complete the study: hence six completed

• Twelve two hour sessionsTwelve two hour sessions

• Gradual process of developing compassionate Gradual process of developing compassionate imagery and soothing exercises and then engaging imagery and soothing exercises and then engaging with self critical thinking with self critical thinking

Data From Group StudyData From Group Study

Pre and Post Compassionate Mind Training

10.2

18.8

54.2 56.4

0

10

20

30

40

50

60

Self criticism Self compassion

Sc

ale

Before

After


Functions of Self-to-Self Relating

28(15.79)

17.5(8.62)

21.67(11.74)

9.6(8.45)

0

5

10

15

20

25

30

Self Correction Self Persecution

Sco

re Before

After

Data From Group StudyData From Group StudyHADS

10.33(2.67)

14.67(3.78)

4.3(2.73)

6.83(2.93)

0

2

4

6

8

10

12

14

16

Anxiety Depression

Subscale

Sco

re Before

After


Forms of Self-to-Self Relating

31.33(5.16)

15.17(3.76)

6.17(6.40)

14.5(7.01)

5.67(5.40)

19.83(8.21)

05

10152025

3035

Sc

ore

Before

After

Data From Group StudyData From Group StudyOthers as Shamer

48.5

(17.27)

36.33

(12.13)

0

10

20

30

40

50

60

Others as Shamers

Before

After

Social Comparison

34.83(21.50)

58.67(26.00)

0

10

20

30

40

50

60

70

Socialcomparison

Sco

re Before

After

ReflectionsReflections

I would just like to tell you all here today what (CMT) I would just like to tell you all here today what (CMT) means to me. It seemed to awaken a part of my brain that I means to me. It seemed to awaken a part of my brain that I was not aware existed.was not aware existed.The feeling of only ever having compassion for other people The feeling of only ever having compassion for other people and never ever contemplating having any for myself.and never ever contemplating having any for myself.Suddenly realising that it’s always been there, just that I Suddenly realising that it’s always been there, just that I have never knew how to use it towards myself.have never knew how to use it towards myself.

It was such a beautiful, calming feeling to know it was Ok It was such a beautiful, calming feeling to know it was Ok to feel like this towards myself without feeling guilty or bad to feel like this towards myself without feeling guilty or bad about it.about it.Being able to draw on this when I was frightened and Being able to draw on this when I was frightened and confused, to calm myself down and to put things in confused, to calm myself down and to put things in prospective and say to myself “IT’S OK TO FEEL LIKE prospective and say to myself “IT’S OK TO FEEL LIKE THIS. THIS.

ReflectionsReflections

Having compassion for myself means I feel so much more at Having compassion for myself means I feel so much more at peace with myself. Knowing that it is a normal way of life to peace with myself. Knowing that it is a normal way of life to have compassion for myself and it’s not an abnormal way of have compassion for myself and it’s not an abnormal way of thinking, but a very healthy way of thinking. It felt like I thinking, but a very healthy way of thinking. It felt like I was training my mind to switch to this mode when I start to was training my mind to switch to this mode when I start to feel bad about myself or life situations were starting to get feel bad about myself or life situations were starting to get on top of me.on top of me.

What is striking about this, and what other participants What is striking about this, and what other participants thought, was how much they had (previously) felt that being thought, was how much they had (previously) felt that being self-compassionate and empathic to one’s distress was a self-self-compassionate and empathic to one’s distress was a self-indulgence or weakness and definitely not something to indulgence or weakness and definitely not something to cultivate.cultivate.

Mayhew and Gilbert 2008Mayhew and Gilbert 2008

Three voices hearers with CFTThree voices hearers with CFT

Results showed decreases for all participants Results showed decreases for all participants in depression, psychoticism, anxiety, in depression, psychoticism, anxiety, paranoia, OCD and interpersonal sensitivity. paranoia, OCD and interpersonal sensitivity. All participants’ auditory hallucinations All participants’ auditory hallucinations became less malevolent, less persecuting and became less malevolent, less persecuting and more reassuringmore reassuring

Some other studies

Laithwaite et al., (2010) (University of Glasgow) in a Laithwaite et al., (2010) (University of Glasgow) in a study of group based CFT study for 19 clients in a high study of group based CFT study for 19 clients in a high security psychiatric at Carstairs found security psychiatric at Carstairs found

“… “… a large magnitude of change for levels of a large magnitude of change for levels of depression and self-esteem ….. A moderate magnitude depression and self-esteem ….. A moderate magnitude of change was found for the social comparison scale of change was found for the social comparison scale and general psychopathology, with a small magnitude and general psychopathology, with a small magnitude of change for shame. These changes were maintained of change for shame. These changes were maintained

at 6-week follow-upat 6-week follow-up”.”.

ConclusionsConclusions• CFT linked to evolved and neurophysiological systems : Must CFT linked to evolved and neurophysiological systems : Must

distinguish different types of positive emotion systemsdistinguish different types of positive emotion systems

• Self-to-self relationships are important mediators between early Self-to-self relationships are important mediators between early rearing styles and distressed states rearing styles and distressed states

• CFT focuses on this inner relationship – shifting it to a self CFT focuses on this inner relationship – shifting it to a self compassionate onecompassionate one

• First movements to compassion in self-critics are often aversive so First movements to compassion in self-critics are often aversive so this system needs to be ‘detoxified’ this system needs to be ‘detoxified’

• Takes time and should focus on practice rather than focusing on Takes time and should focus on practice rather than focusing on feelings first upfeelings first up

• Clients like the neurophysiological and Mind Training aspects --Clients like the neurophysiological and Mind Training aspects --like ‘going to the gym’ analogieslike ‘going to the gym’ analogies

compassion-focused-therapy model and research paul gilbert, kirsten mcewan, corinne gale & jean...

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creatingarchetypalnew

old brain emotions

old brain passions

sources of behaviourold

attachment strategies

birth individuals

self compassionsto

integrationinteraction