A Brief Introduction to Compassion Focused Therapy Russell L. Kolts, Ph.D. Eastern Washington University Inland Northwest Compassionate Mind Center Spokane, WA USA www.compassionatemind.net

Compassion – being moved by suffering, and motivated to alleviate it. Two psychologies at work: sensitivity to suffering, and motivation to help. Compassion begins by approaching suffering. In Compassion-Focused Therapy (CFT), compassion begins with understanding how our brains and minds work. Looking around – compassion exercise

CFT is based in a few Basic Ideas “Hope Comforting Love in Bondage” courtesy of the Birmingham Museums and Art Gallery Collections, Birmingham, UK Artist: Sidney Harold Meteyard, 1901

Idea #1: Our brains, and the way they influence our minds, are the products of evolution.

As our brains evolved, different strategies, motives and competencies evolved with them: Symbolic thought, self-awareness, empathy, metacognition Kin caring/affection, alliances, play, social communications Fight, Flight, Sex, Hunt, Territoriality Frontal Cortex Empathic brain - key for emotion regulation

Our old, emotional brains are very powerful, but not very wise. The emotional brain isn’t good at distinguishing between input from environment and imagery, thoughts, and fantasies. This is why we can stay angry for hours or days and our dogs don’t… Draw brain-inertia example. Introduce Soothing-rhythm breathing

Understanding our Emotions Emotions evolved to guide us to our goals and respond if we are succeeding or threatened. There are three types of emotion: Those that focus on threat and self- protection Those that focus on doing and achieving Those that focus on contentment and feeling safe

Types of Emotion System The Safeness System The Drive System Safeness kindness Content/Peaceful Soothing Wanting, pursuing, achieving, consuming Excitement, Lust, Ambition Anger, Fear, Anxiety, Disgust The Threat System

Our Old, Emotional Brains are Biased toward Feeling Threatened In species without attachment only 1-2% make it to adulthood. Threats are everywhere. At birth individuals must be able to ‘go it alone’. Our Ancestors’ Survival depended on efficiently detecting and responding to threats.

Motivations and Emotions Organize Our Minds in Very Powerful Ways

Anger Thinking Reasoning Attention Imagery Fantasy Behaviour Motivation Emotions

Anger Threat System Protection and Safety-seeking Body/feelings Tense Heart increase Pressure to act Anger Attention/Thinking Narrow-focused Transgression/block Scan – search Behaviour Increase activity Aggressive displays Attack

Wanting, pursuing, achieving, consuming Drive System Wanting, pursuing, achieving, consuming Activating Excited Body/feelings Activation Heart increase Pressure to act Disrupt sleep Attention/Thinking Narrow-focused Acquiring Exploring Behaviour Approach Engage Socialise Restless Celebrating

Non-wanting/ Connection-focused Safeness-kindness Soothing Well-being Body/feelings Calm Slow Well-being Content Behaviour Peaceful Gentle Prosocial Attention/Thinking Open-focused Reflective Prosocial

CFT helps people work with these emotions -learn to balance them by helping ourselves feel safe…which makes compassion possible

Social Mentalities Our social orientation toward others Social motives can organize the mind in very powerful ways Defensive Competitive Caregiving

Defensive Thinking Reasoning Attention Imagery Fantasy Behaviour Motivation Emotions

Competitive Thinking Reasoning Attention Imagery Fantasy Behaviour Motivation Emotions

Thinking Reasoning Attention Imagery Fantasy Compassionate Behaviour Motivation Emotions

Idea #2: We are powerfully shaped by our early relationships and by social situations (many of which are unchosen).

Early Relationships With Caregivers Shape how we experience others: Kind vs Harsh Consistent vs Unpredictable Available vs Unavailable Trustworthy vs Dangerous Shape how we experience ourselves: Worthy of kindness/love/nurturing?

These early relationships also powerfully influence our ability to feel safe in connection to others (or not).

Idea #3: Shame and self-attacking get in the way of working effectively with our challenges and emotions.

“There’s something wrong with me.” We have unlimited access to our own internal experiences, and very limited access to those of others. (“I feel like a wreck, but they seem to be doing alright!”) Evolution shaped us to be very concerned about how we exist in the minds of others.

So we’re set up to self-shame and self-criticize…but this keeps us stuck in the threat circle.

Idea #4: Cultivating compassion for others and ourselves can help us work with suffering and balance our own emotions.

Research shows that Compassion benefits us: Kind interactions turn down threat responses in the brain. Working for others’ happiness makes us happier than working for our own. Self-compassion is more associated with happiness than is self-esteem. Looking around – compassion exercise

Compassion-Focused Therapy involves a number of factors: Building mindful awareness. Develop capacity to soothe – to help ourselves and others feel safe. Cultivation of compassion toward others and self. Developing courage to take responsibility and work with difficulties. The cultivation of compassionate strengths, and an image of the self as a compassionate person.

Mindfulness “paying attention, in the present moment, nonjudgmentally, and on purpose.” Benefits of Mindfulness Builds capacity to use attention skillfully. Trains us to notice movement in the mind – notice thoughts and emotions as they arise. Reframes thoughts and emotions as mental experiences. Increases distress tolerance – learning to stay.

Hope Comforting Love in Bondage by Sidney Harold Meteyard; Used with kind permission from the Birmingham Museums and Art Gallery, Birmingham, England.

Mindful awareness creates space for compassion to flourish.

Working with the Body: Soothing Rhythm Breathing Slow down the breath: 4-5 seconds on the in-breath, hold for a moment, 4-5 seconds on the outbreath. Focus the attention on sensation of slowing – slowing down the body, slowing down the mind. 30 sec.-1 min, several times per day

Learning to feel Safe Many people may never have truly felt safe. It is crucial that we help them get those brain systems online – to help them learn to feel safe. Frozen shrimp metaphor We can start this process by creating the causes and conditions in which feeling safe is possible – starting with our relationship to the person.

The Compassionate Self Helping to develop a version of ourselves that has deeply compassionate qualities: Kindness The courage and confidence to take responsibility and face difficulties Wisdom This builds compassionate patterns in the brain.

Hope Comforting Love in Bondage by Sidney Harold Meteyard; Used with kind permission from the Birmingham Museums and Art Gallery, Birmingham, England.

Compassion Training in CFT Warmth Warmth SKILLS -TRAINING Imagery ATTRIBUTES Attention Reasoning Sympathy Sensitivity Distress tolerance Care for well-being Compassion Feeling Behaviour Empathy Non-Judgement Sensory Warmth Warmth

Compassion Thinking Reasoning Attention Imagery Fantasy Behaviour Motivation Emotions

The Compassionate Self In Action From this perspective, how would you understand this situation? Feel? Think? Work with it? How would you relate to the other people in this situation? If you could go back to a previous difficult situation and whisper in your own ear, what would you say? What would you want that version of you to really understand? Prompting workable action

Compassionate Motivation: Connecting with the sort of person I’d like to be Compassionate Reasoning: “What sort of person do I want to be?” “What do I want my life to be about?” “If it were my funeral, and I had lived the life I wanted to live, what would I hope that people would say about me?”

Compassionate reasoning: when we observe ourselves or others struggling or acting erratically, Instead of judging and labeling, seek to understand: “How does it make sense that they/I might feel/act this way?” “What might be going on in their/my mind?”

“Given this, what would be helpful?” With compassion, we allow ourselves to soften - to be moved by the pain and suffering of ourselves and others, and ask questions: “Given this, what would be helpful?” “What does she need to feel safe?”

This second question is of vital importance: Compassion tends to flow naturally when we feel safe, and is almost impossible when we don’t.

The key is to keep shifting to the perspective of the Compassionate Self From the perspective of my compassionate self, How would I understand this situation? What would I want to happen? How would I feel about everyone in the situation? How might I empathize with them? With myself? What would I want to do? What would I do? The goal is to gradually establish this shift as a habit, so that the compassionate self gradually becomes a stronger aspect of who we are.

Deepening Compassion: Compassion for Others “Everyone just wants to be happy and to not suffer.” Lovingkindness meditation “Everyone has a story that runs just as deep as mine.” Contemplating the unintended kindness of others. Bring to mind again and again and again – “short periods, many times”.

Hope Comforting Love in Bondage by Sidney Harold Meteyard; Used with kind permission from the Birmingham Museums and Art Gallery, Birmingham, England.