Compassion focused therapy for people with PTSD

Compassion focused therapy for people with PTSD

Post Traumatic Stress Disorder can change the way you see the world and other people. However, it can also create substantial damage in how you see yourself, including causing feelings of shame, self-anger and guilt.

You can shut off external things that distress you, but living with ‘yourself’ with self-compassion and understanding why your body and mind behave the way they do is vital, as it can help regulate mood and lead to feelings of safety, self-acceptance, and comfort.

One of the ways to do this is by engaging with a professional who uses compassion-focused therapy. Or, exploring the ways to train your mind to be more compassionate, and self-managing some of the self-deprecation that can come from trauma.

This article explains what is meant by compassion-focused therapy and how it can be used to address PTSD and C-PTSD issues such as anger management and self-loathing.

What is compassion focused therapy used for?

Compassion focused therapy is usually an aspect of Cognitive Behavioural Therapy (CBT). It is used to address a diverse range of issues, including grief, PTSD, OCD and perfectionism.

This video below by Russell Kolts – a licensed clinical psychologist and Professor of Psychology – provides an explanation of how compassion can be used as a therapeutic tool to address anger issues.

Compassion Focused Therapy has also been used successfully to help people with PTSD to address feelings of shame, guilt and lack of self-belief.

“There is a growing body of evidence within the healthcare community that suggests that developing feelings of compassion for self and others can have a profound impact on physiology, mental health and well-being.”

The success of this is very hard to measure, though various studies have shown improvement not just in mental health, but also in such factors as immune response, blood pressure, and cortisone release.

Compassion is clearly good for you!

The background to compassion-focused therapy

Compassion focused therapy (CFT) was developed by British clinical psychologist Professor Paul Gilbert OBE. He is the founder of the Compassionate Mind Foundation charity.

The core principle of CFT is that it is human nature to care. The Foundation defines compassion as: “a sensitivity to suffering in self and others with a commitment to try to alleviate and prevent it”.

The basis of using this as a PTSD and C-PTSD recovery tool is to focus on fundamental aspects of human nature. We are genetically built with systems that regulate our emotions and actions, which help us to ‘alleviate and prevent’ mental physical and emotional suffering in ourselves and other people.

This particularly involves three emotional regulation systems that impact our decision-making and thinking. Which are:

• Threat protection (fight, flight, fawn, freeze and flop)
• Drive (resource-seeking)
• Caring/soothing.

For some individuals – particularly people with PTSD and C-PTSD – there is an imbalance in these systems.

As an example, PTSD from a childhood trauma may cause you to have an overdeveloped threat system. So, you are quickly stimulated to anxiety and anger, or to seek to fight or run away. CFT would focus on that and help you to lean more on your drive (to find positive solutions) and your self-soothing techniques. Especially your ability to find strength, warmth, kindness, and moral courage.

The way compassion focused therapy is delivered

Treatment using CFT usually involves: learning about human nature, learning skills to develop your own self care-giving, and practising compassion in the way that you perceive other people.

The therapist would guide you towards understanding suffering. Then finding and validating your positive attributes and strengths. They may also use related techniques such as Imagery Rescripting to help you view situations and people in a more positive way, and manage your emotional responses

You may be encouraged to carry out tasks associated with this therapy option, such as letter writing, creating positive mental images or finding examples of compassionate behaviour.

The ultimate aim is to help you to let go of negative emotions and become more understanding and accepting of yourself and other people. So, you replace such emotional responses as anger, shame and self-criticism, with a greater awareness of how to self-soothe – this can then let you feel ‘worthy’ of progressing to treatments such as EMDR, which many avoid as they don’t feel they are ‘fixable’ or feel too guilty to engage with treatment.

Compassion focused therapy can be delivered to an individual or group, or you can learn Compassionate Mind Training to self-regulate and manage your own symptoms. It is sometimes also connected to mindfulness, and staying in the moment, using positive affirmations.

Is it worth trying compassionate focused therapy?

We all know that different therapies and activities work for different people with PTSD and C-PTSD. You can even find an individual’s needs and preferences change over time!

Progress is rarely in a straight line, or and can be difficult to measure.

However, learning to be more understanding and accepting of yourself, can be a key part of the process. It is one of a number of ways to balance your emotional reactions and move towards feeling more resilient.

You can read more about activities and therapies that can help with PTSD and C-PTSD here

NICE guidance updated in 2018 recommends the use of trauma focused psychological treatments for Post Traumatic Stress Disorder in adults, specifically the use of Eye Movement Desensitisation Reprocessing (EMDR) and trauma focused cognitive behavioural therapy (CBT).

Please remember, these aren’t meant to be medical recommendations, but they’re tactics that have worked for others and might work for you, too. Be sure to work with a professional to find the best methods for you.

  • Compassion-Focused Therapy

  • Frostadottir A.D., Dorjee D. (2019) Effects of Mindfulness Based Cognitive Therapy (MBCT) and Compassion Focused Therapy (CFT) on Symptom Change, Mindfulness, Self-Compassion, and Rumination in Clients With Depression, Anxiety, and Stress. Frontiers in Psychology. 2019 May 17;10:1099. doi: 10.3389/fpsyg.2019.01099
  • Gilbert, Paul (2009) Introducing compassion-focused therapy. Advances in Psychiatric Treatment;15(3):199-208. doi: 10.1192/apt.bp.107.005264

Photo by Engin Akyurt from Pexels

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Treatments for PTSD

It is possible for PTSD to be successfully treated many years after the traumatic event occurred, which means it is never too late to seek help. For some, the first step may be watchful waiting, then exploring therapeutic options such as individual or group therapy – but the main treatment options in the UK are psychological treatments such as Eye Movement Desensitisation Reprogramming (EMDR) and Cognitive Behavioural Therapy (CBT).

Traumatic events can be very difficult to come to terms with, but confronting and understanding your feelings and seeking professional help is often the only way of effectively treating PTSD. You can find out more in the links below, or here.