Dennis Tirch on Compassion-Focused Therapy
By Lynn Mollick
On Sunday, September 30 seventy NJ-ACT members gathered at Gran Centurions to hear Psychologist Dennis Tirch discuss “Mindfulness and Compassion-Focused Therapy.”
Professor Paul Gilbert developed Compassion-Focused Therapy (CFT) as a treatment for intense shame and self-criticism. CFT can supplement other forms of psychotherapy, or it can stand alone. Based on evolutionary and neuroscientific findings, CFT posits that humans have 3 regulatory brain systems:
1) A threat-focused system that responds with anger, anxiety, disgust and safety seeking behaviors:
2) An incentive-focused system that activates the individual to achieve, consume, and pursue; and
3) An affiliative system that creates calmness and a sense of well-being through soothing connection with other humans. Self-compassion develops from feelings of safety and being cared for by others.
Ideally, these three systems are always in balance. However, the threat-focused system evolved first and it is always active. The affiliative system is sometimes underactive, or poorly accessed because it is often damaged during humans’ long dependence on parents.
“Compassionate mind training” helps patients learn to self-soothe and experience inner warmth and compassion for themselves and others, and to diminish experiences of anxiety, shame, anger, and self-criticism. CFT techniques are drawn from mindfulness, Buddhism, gestalt therapy, and other approaches that target affect.
CFT tells patients “the way you are is not your fault.” No one asked to be born, and no one has control over their genetic endowment or how their parents raised them. Accepting this premise is the beginning of becoming more self-compassionate.
Dr. Tirch described “Soothing Rhythm Breathing” to help patients calm the threat-focused system. Once they are emotionally soothed, patients can develop more accepting and less critical self-cognitions.
CFT Exercises
CFT’s “double chair” technique. The critical self sits and addresses the compassionate self sitting in the empty chair. Then the patient switches chairs, takes a few soothing breaths, assumes the role of the compassionate self, and addresses the critical self.
Mindfulness in CFT. Dr. Tirch asked the audience to recall an incident they felt badly about and to experience the feelings, sensations, thoughts, images, textures, etc. elicited by the experience. These responses form the basis for exploring patients’ “critical selves”.
Letter Writing. Writing a critical letter to oneself also serves to evoke the critical self. Writing a warm, caring letter strengthens the compassionate self.
Soothing Rhythm Breathing Exercise. Research has shown that visualizing compassion evokes compassion. Patients can breathe lovingkindness and warmth into physical and emotional pain which helps to convert pain into discomfort. To hear a demonstration of this and other exercises go to: http://mindfulcompassion.com/Mindful_Compassion_in_New_York/CFT_Practice_Podcast/CFT_Practice_Podcast.html
Communication Among the Selves. A more advanced exercise evokes the critical self, the angry self, and the compassionate self, and then asks the patient to talk about how each “self” views the others. This process strengthens the compassionate self in the presence of anger and self-criticism.
Dr. Tirch also recommended the work of Paul Gilbert, Christopher Germer, and Kristin Neff, as well as his own recently published The Compassionate Mind Guide to Overcoming Anxiety (New Harbinger, 2012).
Author’s note: Some CFT techniques are similar to techniques in other empirically supported treatments. For example, self-compassion bears certain similarities to Beck’s concept of restructuring negative cognitions about the self and the world. However, CFT is described in a warm, emotional style that may be more effective with patients who relate to this kind of humanistic approach.
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