1. COMPASSION-BASED THERAPY
An Introduction

2. Definition of Compassion:
Learning to be sensitive to the suffering of self and others with a deep desire and commitment to try and relieve their and our own suffering.

3. Here are some of the principles that
underpin the practice:
1. Compassionate focussed therapy philosophy recognises that there are many factors in our life that we cannot control and are therefore not our fault. None of us chose to be here at this time, the genes that created us, or to have a brain that is capable of feeling the powerful emotions that it does. We did not choose our family, culture, colour, gender or physical characteristics. So we need to be kind and accepting of the aspects of ourselves we cannot change and focus on our thoughts, attitude, motivation and behaviour which are parts of ourselves that we can change.

4. The next principle is that human beings have three basic emotion regulation systems – threat – which is fight or flight, calm or self-soothing and excitement. 2.
3. The system that causes us the most problems is our threat system or commonly known as fight or flight. If we experienced difficulties growing up as a child, this system is over developed and can be set off very easily. For example, challenging situations can activate feelings of threat. This means that we if we experience difficulties we can become very angry, anxious or run away. Sometimes it can be a minor issue or the thought of a threat can set off our threat system.

5. Compassion Therapy focuses on developing the soothing system to counteract the anxiety system. We can be kind and caring to others because we want to help them with bad feelings, but when it comes to ourselves we can struggle. So we need to learn to be calmer, kinder and more caring to ourselves to overcome the over active flight or fight system.
Although soothing is vital to compassion there is a focus on developing an ability to tolerate and face up to difficult situations and emotions. Sometimes compassion is learning to be with feelings of anger or anxiety. It is by learning tolerance and acceptance that, in the long run, can be soothing.

6. Imagery is the way of stimulating different feelings and things in our brains. For example, if we lay in bed focussing about something that's worrying us, this can make us anxious; if we lay in bed imagining things that make us angry this can make us more angry; if we lay in bed visualising a lovely meal this can start our stomach acids and saliva flowing; if we are thinking about a holiday this can make us excited. So what we think about and what we focus on in our minds will have an effect on brain patterns.

7. Imagery is learning how to utilize this fact and direct our minds to techniques to activate the self-soothing system. Basically, we want to try to develop mindful, compassion brain patterns to offset and counteract those of threat and that can surge us with powerful negative emotions.
So your first step to compassion is making a commitment that you will work to understand yourself and do what you can to help with the painful things you feel.
Just trying therapy here today and finding a way to better understand and look after yourself, is a major compassion step for you. This tells you that you're not ignoring your pain, but would like to do something about it!

8. Creating compassionate feelings, trying to get that brain system going is related to different types of compassion focus, such as:
Compassion for others,
Compassion from others,
Compassion for yourself.
So this is how we relate to, be open to, and feel about –
The compassion you feel for yourself and your desire to help yourself nurture and heal.
The compassion you feel for others, your desires for them to feel happier, The ability to feel compassion from others and their desire to help you.

9. Barriers to Compassion

10. Compassion helps us to develop kindness towards ourselves
Compassion helps us to develop kindness towards ourselves. Sometimes we have barriers to being kind to ourselves as we believe we don’t deserve it. Write down some of the typical fears and thoughts about the fear of being positive. Below are some typical examples:
Ways I resist being compassionate to myself
Tick if present
People only do or say nice things because they want something from you.
Taking your guard down, like taking bricks out of the wall.
Fear of becoming arrogant.
If you let yourself rise up you have further to fall.
To think nice things about myself would seem ‘not me’.
I don’t know what it would feel like, it seems very odd.
Fear of becoming too excited.
Fear that it is not deserved, or is false and will be taken away.
It’s all or nothing. I’m not sure how to start small.
I feel I'm letting myself off the hook, and therefore will feel worse about myself.

11. Can you identify with any of them?
Ways I resist being compassionate to myself
Tick if present
People only do or say nice things because they want something from you.
Taking your guard down, like taking bricks out of the wall.
Fear of becoming arrogant.
If you let yourself rise up you have further to fall.
To think nice things about myself would seem ‘not me’.
I don’t know what it would feel like, it seems very odd.
Fear of becoming too excited.
Fear that it is not deserved, or is false and will be taken away.
It’s all or nothing. I’m not sure how to start small.
I feel I'm letting myself off the hook, and therefore will feel worse about myself.

12. Note:
We also noted in passing, that sometimes the beginning of kindness can spark
feelings of sadness and grief, which can seem overwhelming. However, the expression of grief can also be healing and release unexpressed emotions.

13. Different Types of Techniques

14. Compassionate Attention: It is easy to see a glass as half empty when we feel low, and half full when we feel OK. So how can we learn to focus in on things that are helpful to us rather than get caught up in (understandably, but unhelpfully) dwelling on things that stir our anxiety, anger or other emotions? How can we learn to practice focusing on things that are helpful to us? Similar to mindfulness – it is learning to focus our attention. Try this exercise. Mindful breathing

15. Compassionate Thinking: There are ways of thinking that will stir our anger, anxiety or shame feelings but there are also ways of thinking that can be more calming. These included ideas that if people had been unkind to us then they may not have had our best interests at heart and we should be very cautious about listening to them or accepting their views about us.

16. Although we would hope that everyone’s parents would always be loving, sometimes this does not happen because of problems within them. We can learn to treat ourselves and think about ourselves in the same way we would do if a friend was in the same situation as us. There is no recipe here, and many of you have a wisdom inside of you that can guide your thinking on what is helpful and kind. It takes practice, though, to ask yourself repeatedly, day in, day out, “is my thinking helpful and kind? “Do I really want to be thinking what I am thinking or am I getting caught up in an emotional state?”

17. Although we would hope that one’s parents would always be loving, sometimes this does not happen because of problems within them. We can learn to treat ourselves and think about ourselves in the same way we would do if a friend was in the same situation as us. There is no recipe here, and many of you have a wisdom inside of you that can guide your thinking on what is helpful and kind. It takes practice, though, to ask oneself repeatedly, day in, day out, “is my thinking helpful and kind? Do I really want to be thinking what I am thinking or am I getting caught up in an emotional state?

18. Compassionate Acceptance

19. When we feel unhappy, depressed or angry we can often have the idea that “we shouldn’t feel like this” and there is something wrong with us if we do. This can make us very judgmental and we then start fighting with our feelings or trying to get rid of them. It can help if we learn to accept our feelings. There may well be all kinds of reasons why we are feeling like we are feeling. For example, we may be at a low ebb, things may have reminded us of the past, a lot of things may have all come together or there may have been a lot of stresses and setbacks. Sometimes we can even feel anxious if things are going well. So maybe there are all kinds of reasons for why we feel what we feel.

20. The key, then, is learning how to be compassionate with one’s feelings and learning to be with them in an understanding and kind way. It is always the approach of “given that I do feel what I am feeling (and I am not choosing to feel like this), what would be the most compassionate way for me to work with my feelings or help myself?” So our feelings may not be desirable or wanted, but we can accept them as part of our being rather than fight with them, be self-critical for having them or try to avoid them - which usually makes them worse.

21. Compassionate Behaviour
We all need to find ways of dealing with difficult emotions and one way is by changing your behaviour. For example, sometimes if we are feeling tired or upset, we need chill out, relax or take a “duvet day”.
On the one hand it is important to accept our emotions without blaming ourselves or being over critical. On the other hand, acceptance doesn’t mean that we don’t try to help ourselves.

22. Sometimes, activity and distractions, such as getting up, going for a walk, doing something physical, doing one thing at a time, which breaks up one’s thoughts and feelings, can be helpful. Sometimes acting against a feeling is compassionate. For example, a person who has agoraphobia and is frightened to go out might decide to face their fear little by little each day. In this case it is not trying to overcome the anxiety, but working with it that is compassionate and helpful to us.

23. Compassionate Letter Writing
There is now evidence that it can be a great help to learn 'expressive writing'– that is, writing about difficulties, problems and dilemmas. Compassionate letter writing is a way of doing this. The idea is to help you refocus your thoughts and feelings on being supportive, helpful and caring of yourself, rather than being self-critical. Practising this can help you access an aspect of yourself that will tone down your more negative feelings and thoughts.

24.   Before you begin your letter, try to ensure that you'll have some time when you won't be disturbed. Find a sheet of paper and a pen or pencil; engage in a soothing breathing rhythm. Then, either bring your compassionate image to mind and imagine it writing the letter with you, or put yourself into your compassionate state and imagine yourself as a highly compassionate person writing a letter. Spend a few moments really thinking about this and trying to feel in touch with that ‘kind’ part of you.

25. As you write your letter, try to allow yourself to have understanding and acceptance for your situation, difficulty, feelings or distress. For example, your letter might start with, ‘I'm sad that you feel distressed' or 'Your distress is understandable because…’. If you're writing from the compassion self, you might start with, ‘It's sad that I'm feeling distressed today, but this is understandable because…’. In the next stage, note the reasons for your distress, realizing that it makes sense. This is called 'validation of feelings'. Then perhaps you could continue your letter with, ‘I'd like you to know that…’ – that is, your letter might point out that distress comes with a powerful set of thoughts and feelings, so that how you see things right now may just be the distressed view on things.

26. Any number of ideas might appeal to you to be included in your letter
Any number of ideas might appeal to you to be included in your letter. Do not feel that you have to cover them all. In fact, you might want to tackle different things in different letters to yourself. With all of these ideas, try to avoid telling yourself what you should or should not think, feel or do.

27. Building a Compassionate Image
This exercise is to help you build up a compassionate image for you to work with and develop. Whatever image comes to mind or you choose to work with, note that it is your creation and therefore your own personal ideal, what you would really like from feeling cared for and about:-

28. Qualities of your image - Wisdom, Strength, Warmth and Non- judgemental
In each box below think of these qualities (e.g. wisdom, strength, warmth and non-judgement) and imagine what they would look, sound or feel like. If possible we begin by focusing on our breathing, finding our calming rhythm and making a half smile.

29. Here are some questions that might help you build an image:
Would you want your caring/nurturing image to feel/look/ seem old or young? Male or female (or non-human looking e.g., an animal, sea or light)?
What colours and sounds are associated with the qualities of wisdom, strength, warmth and non-judgement?
Remember your image brings compassion to you and for you.

30. How would you like your ideal caring, compassionate image to look/appear – visual qualities?
How would you like your ideal caring, compassionate image to sound (e.g. Tone of voice)?
What other sensory qualities can you give to it?
How would you like your ideal caring, compassionate image to relate to you?
How would like to relate to your ideal caring, compassionate image?

31. Other Ideas for Images
Use images of real people – some people prefer to use actual people
Pets are great use of therapy – as they often help people to relax and self-soothe. They are often thought of as being loving towards their owners and they don’t answer back and are great at keeping secrets. Don’t underestimate the power of having pets as therapy!!

32. Summary of Compassion Strategies at a glance
SELF-CRITICAL THOUGHT
UNHELPFUL/DISTRESSING FEELINGS
COMPASSIONATE STRATEGIES TO COPE
Thought - I’m such a failure
Feelings of anger, sadness, anxiety, and memories.
Compassion attention: Focus on the present moment - notice and stop, refocus. – mindfulness – maybe describe (speak out) in words what I am feeling.
Making a mistake
Feel sad, angry at myself, very self critical
Compassionate thinking: - what would my best friend say about this to me? What would I say to my best friend?
Am I giving myself a double standard?
I have felt like this before and it passes
I have more courage than I think.
We are all human and we all make mistakes sometime
I can’t do something I should be able to do
Feeling over
whelmed
Compassionate acceptance: It is helpful to accept my feelings without blaming, condemning or fighting with them. The thing that works best for me when I feel like this is to relax, rest and then try again at my own pace
Waking up feeling low – I should be able to cope
Feeling low, anxious
Compassionate behaviour:
Time for a duvet day – let it be – just give myself some space.
Getting out or away is helpful.
Physical activity is helpful.
Trying as best as I can today.
Not letting my feelings dictate my actions can be helpful.
Talking to others – seeing or phoning a good friend
Anxious about dealing with a work task
Anxious, panicky
Compassionate writing: Writing a letter to myself or writing in a diary that is focused on being kind and supportive. Use encouraging words that could be said by a good friend but are written in a kind and accepting manner
Worrying about the future – constantly focussing on negative images
Anxious, worrying
Compassionate imagery: Give yourself just a few moments to take a couple of breaths, bring my compassionate colour or image to mind, and see if that helps to calm and self soothe.

33. Simple, Practical, Quick Techniques

34. The simplest one is to imagine a colour that is associated with compassion for you and imagine this colour bringing feeling of compassion to mind.
Another one we focused on was safe place imagery – going through all the senses and bringing to mind feelings that the place welcomes you; it is your unique place, you created it.

35. The third practice is called becoming the compassionate self (embodiment). This practice is imagining oneself to be a compassionate person. Here you imagine yourself being kind, with wisdom that you have gained from life experiences and having developed certain strengths. You imagine how you think and how you speak when you are in your compassionate mode. You create a compassionate facial expression. You then imagine that you have all of your ideal qualities of compassion. It does not matter if you feel that you really have them or not, just as we can imagine our ideal meal, it is the process of trying to create them in your mind that is important.

36. The fourth practice is to imagine having compassionate thoughts and desires for others that you care about with a genuine wish for “them to be well, be happy, and free of suffering”. This is to try to fill one’s mind with kindness for others.

37. Vision or Sound? There are other chants that you can use such as:
May I be well.
May I be happy.
May I be free of suffering.
These are not just chanted mindlessly, but each time one says them one tries to create compassionate thoughts in the mind and a general feeling of this.

38. Desires to change and improve rather that just self-blame
Once we really understand that then we develop a genuine desire to self improve, rather than sit in self-blame. This is very important because although self-blaming and upset are very understandable, they are not helpful for how your mind is working. We want to develop a genuine desire to improve, to have more control and to be able to stand back in a wiser way, but we will have to work at that.

39. Standing Back

40. Once you've acknowledged your distress, it is useful if, while writing your letter, you can stand back from the distress of your situation for a moment. When you do that, what would be helpful for you to focus on and attend to? For example, you might think about how you'll feel about the situation in a couple of days, weeks or months, or you might recall that distressing feelings can lift and then remember how you'll feel when this happens. It can also be helpful to recall in your letter, thus bringing to your attention the times when you've coped with difficulties before. In your letter, you can let your mind and writing flow with your worries and concerns. Remember to see if the emotional tone can be compassionate and as gentle and understanding as you can.

41. Is my motivation genuinely one of caring, and nurturing; is it helping me?
Am I being sensitive to and observant of my feelings?
Am I allowing myself to be moved by my distress rather than trying to block it out?
Am I being mindful and tolerant, recognizing the human condition?
Am I being empathic, standing back and trying to understand my feelings and the way in which I think?
Am I being non-judgemental?
Am I keeping my emotional tone as focused on warmth and kindness as I possibly can?