Compassion-Focused Therapy

Core idea

CFT draws on evolutionary psychology, neuroscience, and Buddhist practice. Gilbert proposes three primary affect-regulation systems: threat (red), drive (blue), and soothing/affiliation (green). High-shame clients have over-developed threat systems and under-developed soothing systems — often because early attachment did not install the soothing system. CFT uses imagery, body practices, and compassionate-mind training to develop the soothing/affiliative system directly.

Key concepts

Three-circles model

Threat, drive, and soothing systems — imbalance drives suffering.

Tricky brain

We didn't choose our genes, early experiences, or many emotional reactions — reduces shame about shame.

Compassionate self

Cultivated through imagery and posture — wise, strong, warm, committed.

Fears, blocks, resistances (FBRs)

Why compassion feels unsafe — addressed before deepening practice.

Soothing rhythm breathing

Slow diaphragmatic breath that activates the parasympathetic system.

What a session looks like

1. 1
   Formulation

   Map threats, safety strategies, and unintended consequences.
2. 2
   Psychoeducation

   Three circles, evolved brain, why self-criticism developed.
3. 3
   Body-first practices

   Soothing rhythm breathing, friendly facial expression, grounded posture.
4. 4
   Compassionate-mind training

   Imagery: safe place, compassionate self, compassionate other.
5. 5
   Compassionate work with parts

   Compassionate self addresses self-critic, anxious self, angry self.

Signature techniques

Evidence base

Growing RCT evidence for depression, eating disorders, psychosis (adjunct), and trauma. Particularly effective for shame-driven and self-critical presentations where standard CBT can intensify self-attack.

Common pitfalls

• ▸Skipping FBRs — pushing compassion onto someone who finds it threatening backfires.
• ▸Doing CFT without body-led practice — it's a somatic therapy.
• ▸Confusing self-compassion with self-pity or letting-off-the-hook.
• ▸Therapist's own unaddressed shame leaking into the work.

Where to go next