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Topic

Compassion-focused therapy

Also known as CFT, Compassionate mind training, CMT

Therapy that trains warmth toward yourself, built for high shame and self-criticism.

At a glance

Also on this page: Key facts · Links · Sources · Related pages

Why it matters

Key facts

In short
CBT combined with evolutionary, social, developmental and Buddhist psychology and neuroscience1
Developed by
Paul Gilbert1
Used for
People with high shame and self-criticism; studied in mood disorders, psychosis and eating disorders1
Core idea
Strengthen the soothing system so it can calm the threat and drive systems2
Key technique
Compassionate mind training: exercises that build compassionate attributes and skills1
Evidence
A 2024 meta-analysis (7,875 participants, 17 countries) found it reduced negative mental-health outcomes1

The three emotion-regulation systems

  1. Threat and protection2

    Spots danger fast and fires anxiety, anger or disgust, urging fight, flight or submission. It runs on "better safe than sorry".

  2. Drive and resource-seeking2

    Pushes us toward rewards like food, status and achievement. Linked to threat, it shows up as "shoulds" and the need to keep proving yourself.

  3. Soothing and safeness2

    Contentment, calm and feeling safe with others, a state of "not-seeking". It evolved with attachment and is tied to oxytocin and opiates.

  4. Out of balance2

    In high shame and self-criticism, threat and drive are overactive and soothing is underused, often because early life gave more threat than soothing.

Examples

  1. Threat system in daily life2

    Illustration: a curt message from a manager sets off anxiety and a jump to "I'm in trouble". That is the threat system's "better safe than sorry" and "jumping to conclusions" bias at work.

  2. Drive system2

    Winning a competition, passing an exam or getting to go out with someone you like brings excitement and pleasure.

  3. Drive serving threat2

    Someone whose goal is to be "nice and liked" may pursue it to avoid rejection; when it fails they turn self-critical. Such drive shows up as "shoulds", "oughts" and "musts".

  4. Soothing system2

    A parent's caring, especially being physically close, calms an infant's body. The same system gives contentment: a calm, positive state of not-seeking.

  5. A submissive safety strategy2

    Some people are always aware of others' rank, see themselves as inferior, feel socially anxious quickly and try to appease. CFT treats this as a learned way of staying safe.

  6. Why imagery works2

    Imagining a lovely meal can start saliva flowing just as seeing one does. CFT uses this to explain why imagining compassion can calm the body.

  7. Ideal compassionate other2

    Clients imagine a compassionate figure's face and voice; some prefer an animal, a tree or a mountain, imagined with wisdom, strength and warmth.

  8. A kinder self-statement1

    Clients practise answering "I'm unlovable" with something like "I know for sure that some people love me".

  9. Courage with warmth2

    When facing something frightening, the client builds a warm, encouraging inner tone, the way a parent encourages a child.

How a session works

  1. Not your fault2

    Symptoms are mapped as safety strategies the person needed to develop, which helps lift shame.

  2. Why logic is not enough2

    Clients say "I know I'm not to blame, but I still feel I am"; CFT targets that gap.

  3. Compassion from outside in1

    Clients first learn what compassion is from a third-person view, then turn it on themselves.

  4. Compassionate attention and imagery2

    Refocusing on moments of kindness, given or received, and imagining compassion.

What the research says

  1. Psychosis1

    A 2012 randomized trial found CFT safe and more effective than usual treatment, especially for depression.

  2. Promising but small1

    A 2015 review of 14 studies found promising results; another 2015 review noted small samples and only two of twelve studies individually supported it.

  3. Larger trials needed1

    The 2024 meta-analysis also called for larger, higher-quality randomized trials.

Where to start reading

  1. Introducing compassion-focused therapy (Gilbert, 2009)2

    A free journal article explaining the three systems and the therapy.

  2. The Compassionate Mind (Gilbert, 2010)4

    His book for a general audience.

  3. Compassionate Mind Foundation (opens compassionatemind.co.uk)3

    The charity Gilbert founded in 2006 as CFT's home for training and research.

Connections

Founded by

Related

Sources

  1. Compassion-focused therapy (Wikipedia) (opens en.wikipedia.org)
  2. Introducing compassion-focused therapy (Paul Gilbert, Advances in Psychiatric Treatment, 2009) (opens doi.org)
  3. About the Compassionate Mind Foundation (opens compassionatemind.co.uk)
  4. Paul Gilbert (psychologist) (Wikipedia) (opens en.wikipedia.org)

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