How Compassion-Focused Therapy Can Support People With Depression

What is Compassion-Focused Therapy, and how can it support your clients through depression?

Compassion-Focused Therapy (CFT) is a system of psychotherapy that works by encouraging people to show compassion towards both themselves, and the people around them. It’s particularly useful for anyone experiencing feelings of shame and self-criticism around their mental health.

It can be incredibly difficult for people to feel the benefits of talking therapies when shame or self-criticism is at play: through CFT, the themes of compassion, reassurance and safety can be restored (or introduced) to those struggling to be kind to themselves.

So, who is CFT most beneficial for?

When someone has been raised in an abusive or neglectful environment, or in a home where compassion, reassurance or safety were lacking, CFT can help to redress the imbalance and restore the courage of compassion. So if one of your clients has grown up in or been exposed to this sort of environment, CFT could be particularly valuable.

What is CFT?

CFT isn’t only about kindness: it’s about a commitment to easing and preventing suffering in the self, and others; seeing into the cause of that suffering, and developing the courage to address it.

Integrating techniques from Cognitive Behavioural Therapy (CBT), developmental psychology, evolutionary psychology, social psychology, neuroscience and Buddhist philosophy, CFT focuses on the three emotional regulation systems that are believed to have evolved throughout human history, and still influence our emotions, actions and thoughts today.

These are the ‘threat’, ‘drive’, and ‘contentment’ systems, and this is how they work:

• The threat system: We’re all familiar with the notion of ‘flight or fight’; that’s our threat system in action. If we perceive ourselves as being under threat, it can trigger feelings of anxiety, anger and fear – leading us to exhibit fight, flight or freeze behaviours. Under the influence of the threat system, people can adopt avoidance techniques (particularly to risky situations), engage in catastrophic thinking, or form inaccurate (and potentially damaging) conclusions.

• The drive system: Our drive system is incredibly useful for keeping us motivated, and spurring us on to reach our goals; in fact, it’s this system that first enabled humans to gather resources. But while we can derive a sense of pleasure and achievement from our drive system, it needs to be balanced. An overactive drive system can lead to substance abuse or other addictive behaviours in the pursuit of pleasure.

• The contentment system: CFT is particularly concerned with the contentment system. Associated with feelings of calm, connectedness and safety, the soothing nature of the contentment system is capable of regulating our threat and drive systems. Through CFT, its potential for compassion can be enhanced – minimising the threat system, and activating a healthier drive system.

CFT centres on harmonising these three systems, as any imbalance can very quickly lead to the development of mental health issues. A healthy balance allows people to think clearly and respond appropriately to different daily stimulus.

How does CFT work?

There are lots of different techniques and exercises used in CFT, but compassionate mind training is at the core. This form of mind training is designed to develop sympathy, sensitivity, compassionate motivation, and distress tolerance in people who may be lacking them.

This approach can involve:

• Mindfulness: Helping your clients to be present in the current moment, without judging that moment, is extremely beneficial in CFT.
• Appreciation exercises: Encouraging your clients to identify and focus on activities that they enjoy helps to stabilise the three emotional regulation systems.
• Compassion-focused imagery exercises: Enabling your clients to use fantasies and guided memories can produce a relational image capable of soothing the system, and stimulating the mind.

The practice of compassionate mind training, when employed correctly, will help your clients to overhaul problematic thought patterns connected with shame, self-criticism, anger and anxiety.

CFT works on the notion that your clients need more than just a cognitive understanding of what has to change in order for them to feel better: they also need an understanding of what it would actually feel like to experience compassion towards themselves. Therefore, your job as a therapist is to work closely with your client to foster feelings of safety, self-acceptance, and positive regard towards themselves and others.

Moving forward with CFT

CFT may not be the right approach for every client who walks through your door, but it could be extremely beneficial for those experiencing shame, and high levels of self-criticism. It can also be effective alongside other therapies for people with a history of trauma, neglect, abuse or bullying.

With a focus on the emotional regulation systems, CFT is powerful in the support of long-term emotional problems – such as psychosis, self-harm, panic attacks, anxiety disorders, personality disorders, eating disorders, mood disorders, and even hoarding disorder.

For more help with supporting your clients through the challenges of depression, discover my new online course: Working With Depression.