Compassion-Focused Therapy (CFT) in Edinburgh

Welcome to Edinburgh Therapy Service. Greetings from me, Cristina—a therapist with a strong passion for compassion-focused therapy (CFT). In our practice, we promote self-compassion not only to help people with psychological difficulties, but as a way of living that anybody can benefit from.  We all have a brain that can be quite self-critical, but nobody has taught us how to be kind to ourselves. Through therapy, we teach tools to increase self-compassion, and we practice together, as compassion is like a muscle that needs to be trained. 

What is compassion-focused therapy (CFT)

Compassion-focused therapy (CFT) is a therapy modality that promotes self-compassion and helps with issues like shame, self-criticism, and self-judgment. It is specially effective for those with high levels of self-criticism, shame, and difficulties in managing strong emotions. CFT developed from various psychological and evolutionary theories, including cognitive-behavioural therapy, evolutionary psychology, and attachment theory.

 

CFT is based on the idea that we have three different emotional systems, each serving different purposes. These systems can sometimes create internal conflicts, leading to emotional distress. Compassion-focused therapy seeks to balance these systems by cultivating a compassionate mind.

 

Clients are guided to develop a kind and understanding relationship with themselves, counteracting the self-judgment and shame they often have. The first step is recognizing that suffering is a universal human experience and responding to one’s emotional struggles with the same empathy and care that one might extend to a friend.

 

CFT also pays attention to the concept of “threat” and how it influences our emotions. It acknowledges that in today’s fast-paced world, our ancient threat detection system can be easily activated, triggering stress and anxiety. Understanding that this is how our brain works, and that there is nothing wrong with us, is essential. Then, clients can learn to respond to these feelings with self-soothing techniques.

 

Through a combination of mindfulness, cognitive techniques, and imagery exercises, compassion-focused therapy helps reframe negative self-perceptions and replace them with more balanced, compassionate perspectives. This shift in attitude has a ripple effect, impacting how clients interact with others and the world around them.

 

CFT offers a safe space for clients to explore their emotions and develop the skills of kindness and compassion. 

CFT model: The three emotion regulation systems

Developed by psychologist Paul Gilbert, CFT developed from the evolutionary psychology, cognitive-behavioural therapy, and mindfulness. One of the basic elements of its framework is the three emotional systems theory.

 

These three systems — the threat system, the drive system, and the soothing system — are the foundation of the CFT model. Each system serves a specific purpose. Becoming aware of the interactions and imbalances within these systems allow us to understand the cause of our distress. With the power or awareness, we can then find ways to balance these system, which often requires self-compassion and emotional regulation techniques.

 

Here we explain each of the three circles model of Paul Gilbert:

 

Threat system

The threat system is a survival mechanism responsible for detecting and responding to potential threats in the environment. When activated, it triggers the fight-or-flight response, preparing us to confront or flee from dangers. The threat system contribute to anxiety, stress, and self-criticism. Understanding how this system operates helps us to recognize when it’s unnecessarily activated and learn techniques, such as mindfulness or self-compassion, to soothe it and calm the threat response.

 

Drive system

The drive system is what propels us to pursue resources, goals, and achievements. It’s the motivational drive that pushes us to strive for success and fulfilment. An imbalance in this system leads to issues like perfectionism, burnout, or self-criticism. In CFT, we manage the drive system by incorporating self-care and self-soothing practices. This doesn’t mean getting rid of ambition, but rather finding a healthier balance between working towards goals and taking time to rest, recharge, and treat oneself with kindness.

 

Soothing system

The soothing system comprises emotions such as compassion, kindness, and a sense of safety. It’s the emotional system that allows bonding, cooperation and a connection with others. To activate this system, we learn  soothing techniques, kindness and self-compassion. Self-compassion is about treating oneself with the same understanding and care that one would extend to a friend in times of distress. A stronger soothing system counteract self-criticism and creates a greater sense of well-being.

 

The core idea of CFT is to balance and harmonize these three emotional systems. We learn to recognise when a system is overactive or underactive and employing appropriate strategies to restore balance. 

How can compassion-focused therapy help

Using self-compassion and the knowledge of the dynamics of the three emotional systems, CFT can provide several ways to promote well-being and personal growth:

 

‣  Addressing self-criticism

‣  Managing anxiety and stress

‣  Enhancing emotional regulation

‣  Fostering self-compassion

‣  Reducing shame and guilt

‣  Promoting mindful awareness

‣  Managing perfectionism

‣  Boosting self-esteem

‣  Reducing negative body image

‣  Enhancing overall well-being

What issues does CFT therapy help with? 

Compassion-focused therapy is a versatile approach that can help individuals dealing with a wide range of emotional and psychological challenges. Some of the issues that it can address include:

 

Low self-esteem

‣ Self-criticism

Anxiety disorders

Depression

‣ Shame and guilt

Stress

‣ Perfectionism

Body image issues

‣ Chronic pain

‣ Emotional regulation

Eating disorders

Grief and loss

‣ Lack of self-confidence

Workplace stress and burnout

‣ Existential concerns

‣ Personal growth

Examples of research showing CFT’s effectiveness

Craig, C., Hiskey, S., & Spector, A. (2020). Compassion focused therapy: a systematic review of its effectiveness and acceptability in clinical populations. Expert review of neurotherapeutics, 20(4), 385–400.

Gharraee B, Zahedi Tajrishi K, Ramezani Farani A, Bolhari J, Farahani H. A Randomized Controlled Trial of Compassion Focused Therapy for Social Anxiety Disorder. Iran J Psychiatry Behav Sci. 2018;12(4):e80945.

Thomason, S., & Moghaddam, N. (2021). Compassion-focused therapies for self-esteem: A systematic review and meta-analysis. Psychology and psychotherapy, 94(3), 737–759.

Gale, C., Gilbert, P., Read, N., & Goss, K. (2014). An evaluation of the impact of introducing compassion focused therapy to a standard treatment programme for people with eating disorders. Clinical psychology & psychotherapy, 21(1), 1–12. 

Carter, A., Steindl, S. R., Parker, S., Gilbert, P., & Kirby, J. N. (2023). Compassion-Focused Therapy to Reduce Body Weight Shame for Individuals With Obesity: A Randomized Controlled Trial. Behavior therapy, 54(5), 747–764.

The Edinburgh Therapy Service is a psychotherapy and counseling practice based in Edinburgh, Scotland (United Kingdom). We offer therapy both in-person in Edinburgh and online, available in English and Spanish.

Contact info

Contact us for more information or to book your first appointment: [email protected]