Compassion focused therapy

What is compassion focused therapy?

Compassion focused therapy (CFT) is a talking therapy that helps people work with self-criticism, shame and a harsh inner voice by building a steadier, more supportive relationship with themselves. Developed by clinical psychologist Paul Gilbert, it draws on evolutionary psychology and attachment research, and is often used alongside cognitive behavioural approaches for anxiety and depression.

CFT starts from the idea that human minds evolved with three main systems for managing emotion: a threat system geared to spot danger and criticism, a drive system geared to achieve and strive, and a soothing system that allows rest and calm. People who are highly self-critical often spend most of their time in threat or drive mode, and find the soothing system underdeveloped or hard to reach, sometimes because of difficult early experiences, high personal standards, or growing up in an environment where warmth wasn’t modelled. CFT uses techniques such as compassionate imagery, paced breathing and guided reflection to help build that soothing capacity, alongside the kind of thought work familiar from cognitive behavioural therapy.

When it helps

CFT tends to help most where difficulties are driven by strong self-criticism, shame or a sense of not being good enough, rather than by anxiety or low mood on their own. This might include a pattern of harsh self-judgement after mistakes, difficulty accepting kindness or praise from others, perfectionism that leaves little room for error, or shame connected to body image, eating patterns or past experiences. It can also help people who have made progress with other therapies but still feel undermined by an inner critic that won’t ease off, since CFT focuses specifically on that relationship with the self rather than on the original problem alone. This pattern shows up across many walks of life, from people who are hard on themselves after a difficult diagnosis or health scare, to those who feel they are constantly falling short at work or in relationships despite outward success.

CFT is not a first-line treatment for every difficulty. For conditions such as OCD, panic disorder or post-traumatic stress, other approaches have a stronger and more specific evidence base and are usually tried first. A psychologist can help you work out whether CFT, another approach, or a combination is likely to be most useful for what you’re bringing.

What to expect

CFT sessions are structured but collaborative. Early sessions usually focus on understanding your particular pattern of self-criticism, where it might have come from, and what it’s trying to protect you from, since self-criticism often develops as a way of trying to stay safe or keep standards high. From there, your psychologist will introduce specific compassion-focused exercises, which might include imagery work, self-compassionate letter writing, or noticing and naming your internal “voices” when they show up. These exercises can feel unfamiliar at first, particularly if warmth towards yourself doesn’t come naturally, and a good psychologist will pace this carefully rather than pushing you into anything that feels forced.

The relationship with your psychologist matters throughout. CFT asks people to be honest about difficult feelings towards themselves, and that’s easier to do with someone who is warm, consistent and doesn’t rush the process. Most people notice small shifts before large ones, such as catching a critical thought earlier than usual, or managing a brief moment of self-kindness after a setback, rather than a sudden change in how they feel about themselves overall.

Because this is an online-only practice, sessions take place by video call. Many people find this works well for CFT specifically, since practising compassionate imagery or reflection somewhere familiar, such as your own home, can make the exercises easier to settle into. The number of sessions and how they’re spaced out depends on what you’re working with and is agreed between you and your psychologist rather than fixed in advance.

The evidence for CFT

CFT was developed within an NHS clinical psychology setting and has a growing evidence base, particularly for shame and self-criticism that sit underneath other difficulties such as depression, anxiety and disordered eating. It is not, on its own, a NICE-recommended treatment in the way that cognitive behavioural therapy is for depression and anxiety disorders, or that eye movement desensitisation and reprocessing is for post-traumatic stress. In practice, psychologists often draw on CFT alongside NICE-recommended approaches, using it to address the self-critical patterns that can otherwise get in the way of someone benefiting fully from CBT or other structured treatment.

Research into CFT continues to develop, and a psychologist working with you will be able to explain where the evidence is strongest for your particular situation and how CFT fits alongside other options, rather than presenting it as a stand-alone answer for every presentation.

Compassion focused therapy in Maidstone and Kent

We are clinical psychologists for Maidstone and Kent, working online with adults, including those in Bearsted, Allington, Barming, Loose, Penenden Heath and Tovil. Maidstone is the county town of Kent, and plenty of people living in and around the town already spend part of their week commuting to London from Maidstone East or working remotely, and are used to fitting appointments around a screen rather than a waiting room. People contact us from right across the town and the surrounding villages, often after noticing that self-criticism has started to affect sleep, work or close relationships, rather than because of a single crisis point.

Working online means a psychologist based anywhere in the UK can support you, without the practical demands of travelling across Maidstone at a fixed time each week. For CFT in particular, being able to do imagery and reflection exercises somewhere quiet and familiar can be part of what makes the work land. At the moment all our sessions are online by secure video.