Shame and self-criticism are transdiagnostic problems
People who experience them may struggle to feel relieved, reassured or safe. Research suggests that a specialised affect regulation system (or systems) underpins feelings of reassurance, safeness and well-being. It is believed to have evolved with attachment systems and, in particular, the ability to register and respond with calming and a sense of well-being to being cared for. In compassion-focused therapy it is hypothesised that this affect regulation system is poorly accessible in people with high shame and self-criticism, in whom the ‘threat’ affect regulation system dominates orientation to their inner and outer worlds. Compassion-focused therapy is an integrated and multimodal approach that draws from evolutionary, social, developmental and Buddhist psychology, and neuroscience. One of its key concerns is to use compassionate mind training to help people develop and work with experiences of inner warmth, safeness and soothing, via compassion and self-compassion.
The healing properties of compassion have been written about for centuries
The Dalai Lama often stresses that if you want others to be happy – focus on compassion; if you want to be happy yourself – focus on compassion (Dalai Lama 1995, 2001). Although all clinicians agree that compassion is central to the doctor–patient and therapist–client relationship, recently the components of compassion have been looked at through the lens of Western psychological science and research (Gilbert 2000, 2005a, 2009; Davidson 2002; Neff 2003a,b). Compassion can be thought of as a skill that one can train in, with increasing evidence that focusing on and practising compassion can influence neurophysiological and immune systems (Davidson 2003; Lutz 2008). Compassion-focused therapy refers to the underpinning theory and process of applying a compassion model to psychotherapy. Compassionate mind training refers to specific activities designed to develop compassionate attributes and skills, particularly those that influence affect regulation. Compassion-focused therapy adopts the philosophy that our understanding of psychological and neurophysiological processes is developing at such a rapid pace that we are now moving beyond ‘schools of psychotherapy’ towards a more integrated, biopsychosocial science of psychotherapy