Compassion Focused Therapy for Complex Trauma

Abstract
Experiences of shame and self-criticism are common for survivors of complex trauma, many of whom have been significantly harmed in the context of important relationships. Shame and self-criticism involve both inter- and intrapersonal processes and contribute to distress, self-blame, low self-worth, and challenges in relationships with self and others. Unfortunately, shame and self-criticism may not always be a primary focus in common evidence-based trauma-focused treatments, which often focus more on fear reduction, cognitive restructuring, and behavioral avoidance. The necessity of additional interventions and adjunctive therapies to address the many impacts of complex trauma is evident. Compassion Focused Therapy (CFT) is a transdiagnostic approach developed to specifically address shame, self-criticism, and unhelpful ways individuals relate to themselves and others. Drawing on evolutionary psychology, affective neuroscience, attachment theory, and Buddhist philosophy, CFT has demonstrated effectiveness in reducing anxiety, depression, shame, and self-criticism, while increasing self-compassion. CFT can help survivors of complex trauma alter the relationship they have with shame and self-criticism, which for many, developed in the context of abuse or neglect by caregivers. In CFT, individuals learn the true meaning of compassion and how to use a range of strategies (e.g., affective regulation exercises like soothing rhythm breathing, mindful imagery, and compassionate embodiment exercises) to manage distress and learn the felt sense of safeness. CFT is not a prescriptive treatment, but rather offers a framework for conceptualization and understanding intra- and interpersonal processes, and a menu of tools that can be used to help individuals discover new ways of relating to themselves and others in times of distress. In this way, CFT is a culturally responsive approach built on a foundation of respect for diverse cultures, identities, and experiences. Common dignity and humanity are at the core of CFT, as one of the primary goals is supporting individuals in connecting, or reconnecting, to themselves or others in the aftermath of trauma (i.e., finding connection, rather than isolation, in experiences of pain and suffering). Participants in this introductory level workshop will gain exposure to the central principles of CFT and develop skills and knowledge to engage with survivors of complex trauma around concepts of shame and self-criticism. Foundational information about CFT will be provided, with particular emphasis on defining compassion and its “three flows.” Additionally, we will discuss how to engage with clients’ fears, blocks, and resistances to compassion – a very important focus for shame-prone individuals. Attendees will be invited to practice multiple experiential exercises that can be implemented with clients (e.g., soothing rhythm breathing, functional analysis of the self-critic and compassionate self, and self-compassionate letter writing). There will be time for reflection and questions about the exercises practiced during the workshop. Presenters are keen to engage attendees in discussions around implementing CFT with individuals who have dissociative experiences, as this is a common symptom for survivors of complex trauma and an exciting new avenue of exploration in the CFT literature.

Timed Outline
45 Minutes - Introduction to Compassion-Focused Therapy (CFT) and core principles
15 Minutes - Introduction to soothing rhythm breathing
30 Minutes - Navigating fears, blocks, and resistances to compassion
30 Minutes - Break
45 Minutes - Exploring shame and self-criticism
45 Minutes - Compassionate imagery and embodiment