Praxis: Tell us a bit about your journey to learning and eventually teaching Compassion-Focused Therapy.
DT: I’ve been involved with Buddhist meditation since my childhood, when an uncle and mentor had taught me about Zen practice, and compassion is truly the core teaching of all Buddhism. Throughout my young adulthood and education, I had been looking for ways to integrate Buddhism with personal development and psychological science. In fact, I originally pursued a PhD just to better understand the dharma from a scientific perspective.
About twelve years ago, I was lucky enough to strike up a collaboration and deep friendship with Dr. Paul Gilbert, the founder of CFT. Paul and I shared an interest in guitar as well as psychology, and we have had some amazing times developing perspective around compassion while taking extended breaks to jam together and record some tracks.
CFT is more than just a psychotherapy, but a powerful personal practice. Bringing CFT imagery and meditation into the center of my own inner work led to profound changes in my personal and professional life. Experiencing deeper compassion for myself and others has led me to reorganize my relationships and professional aims around what truly matters to me, with greater room for joy and connection.
Praxis: In your opinion, how and where does compassion fit into the psychological flexibility model of acceptance and commitment therapy?
DT: The enduring historical definition of compassion is a sensitivity to the presence of suffering we encounter in ourselves and in others coupled with a motivation and a commitment to do something about it. More than just an emotion or idea, we view compassion as an essential embodied aspect of human intelligence that flows from our motivation for connection, cooperation, and care.
In CFT and Compassion Focused ACT, our central premise involves how human evolution has led to affiliative emotions and human attachment relationships providing a secure base for our development of courage, curiosity and flexible responding. In this way, we see psychological flexibility as a series of interacting processes that emerge from human attachment dynamics.
It is clear that compassion organizes the mind in ways that mirror the psychological flexibility model. In a sense, the entire ACT hexaflex is more of a map of the compassionate mind than it is just a diagram of flexible responding. In our book, The ACT Practitioners’ Guide to The Science of Compassion, we map out a model of Compassionate Flexibility that demonstrates these relationships extensively.
Praxis: Is compassion measurable in clients?
DT: Funnily enough, Buddhist psychology has described compassion, loving kindness, equanimity, and empathetic joy as “the four immeasurable” qualities for centuries, and in truth, compassion has proven somewhat tricky to measure. However, new quantitative assessment measures are being developed that hold great promise.
In the coming months, Paul Gilbert and members of the CFT community will be releasing a psychometrically sound assessment measure that involves all of the attributes of compassion that we focus on in compassionate mind training. Kristin Neff’s measure of self-compassion can be useful, but in CFT we are interested in the transformational power of compassion as a flow between self and others rather than just self-compassion.
In our clinical work at The Center for CFT in New York, we use a clinical interview that directly explores the six dimensions of compassion, and the presence or absence of compassionate behaviors. We integrate this information with a compassion-focused case conceptualization that draws upon the client’s history of attachment relationships and their habitual ways of relating to perceived threats.
Praxis: What does it look like when people begin to develop compassion skills? How does it change their lives?
DT: Often, as clients and students learn to activate their compassionate minds, they become better able to tolerate and make space for challenging emotions. Courage, curiosity, and joy can show up as they gradually let go of the struggle against their experience. When we can regard ourselves and others with kindness in our hearts, in contact with an inner reserve of confidence and willingness to take action, our lives can flourish. When our minds are organized by compassion, we are less dominated by threat-based emotions and behaviors. Often, this means that we can set new compass points for our life’s direction, with greater freedom to pivot towards deeply valued aims, pursuing lives of meaning, purpose, and vitality.
Plus, we know from the research that cultivating compassion transforms our minds and our behaviors, leading to lower levels of depression and anxiety; and greater social engagement and psychological flexibility. There are a host of positive psychological outcomes that have been found to increase with increasing compassion.
Praxis: The evolutionary science behind CFT pretty much implies that many of the things we struggle with are not our fault but simply a result of human evolution. How do we balance this truth with also taking accountability for our actions and living according to our values?
DT: CFT begins with a reality check. Humans live relatively short lives, of perhaps 25,000 to 35,000 days, on average. Our lives also involve many struggles and tragedies, such as aging, sickness and death. On top of this, our brains often set us up to go through all sorts of troubles. We are born with an always-on, better-safe-than-sorry, 24-7 threat detection system that will fire up at a moment’s notice and narrow our available attention and behaviors to focus on solving problems and addressing threats.
To make matters worse still, our human capacity for thinking and imagining places us at the mercy of thousands of imagined challenges and struggles, which can dominate our experience and lead to suffering.
We didn’t choose to be born with a human brain that is hardwired to cause us trouble. Furthermore, we didn’t choose our ticket in the genetic lottery, and what strengths and weaknesses we have. Our parents, neighbors and schools were not of our choosing, and the countless social learning experiences we have had weren’t exactly our choice either. So many of the countless contingencies we experience have not been our choice. What has shaped our behavior and our experiences, and so much of what causes our suffering, is simply not our choice and not our fault. We describe this perspective as “the wisdom of blamelessness.”
A large part of our work in a CFT relationship involves creating a context that is de-shaming, de-stigmatizing, and that activates affiliative emotional bonds. Together with the client, we aim to slow down and activate a more open and receptive mode of processing. We aim to get out from under the dominance of social, threat-oriented, and shame-based experiencing of the present moment.
We know that shame- and avoidance-based functioning that is preoccupied with possible threats does not lead to positive and expansive behavioral change. We don’t punish people into increasing behaviors; that’s just not how human behavioral dynamics operate. If we wish to develop new ways of acting, and cultivate broader and healthier qualities of being and doing in the world, we are much better off realizing the limits of our control agenda and letting go of an endless struggle with self-blame and self-pity.
When we can see things as clearly as possible—letting go of shame and blame as much as we can—we can begin to take deeper responsibility for the consequences of our actions and chart a course towards valued aims. Accountability and responsibility involve empathy and flexible perspective-taking, and even an empathically attuned experience of guilt. All of these processes can contribute to re-building our lives. None of these processes are rooted in shame and self-absorption.
Praxis: Do you think teaching and learning compassion skills can impact social justice issues stemming from racism, discrimination of gender and sexual minorities, sexism, and so forth? If so, how?
DT: We can find the roots of prejudice and hateful expressions of “us vs. them” thinking in our evolved social-rank hierarchical thinking and the tyranny of our social threat-based processing. Our aim in compassion-focused work is to unseat the tyranny of such thinking, and that most definitely extends to addressing internal and external prejudices and hostilities.
Let’s think about how the attributes of the compassionate mind might contribute to taking social action and shifting damaging perspectives involving social divisions. These are the attributes of compassionate flexibility:
- Motivation to care for human well-being
- Present-moment focused sensitivity to the presence of suffering
- Emotional sympathy for the experience of self and others
- Flexible perspective-taking and empathy
- Getting unstuck from judgmental and condemning thoughts
- The ability to tolerate distress and willingly hold difficult emotions and experiences
When we think about what is necessary to address discrimination and polarizing views on one another, we can see that cultivating the compassionate mind can greatly aid us in a journey for social change and social action. As the Dalai Lama has said, it is not enough to just feel compassionate, we must act. Compassion is as much about committed action to alleviate and prevent suffering as it is about sensitivity.
Compassion is not a soft option, it is about moving towards suffering and doing something about it. Compassion involves courage, and we know that compassion is highly correlated with psychological flexibility.
When we aim to enhance the compassion of individuals, groups, organizations and societies, we are aiming to leverage powerful human attachment dynamics to create the conditions necessary for a revolutionary and radical sanity. This sanity involves our recognition of how interconnected and interdependent we all are.
Praxis: Compassion-based therapies are particularly good for working with shame; which is often thought of as a wholly negative emotion. Does shame have a positive function that is activated when we make contact with it?
DT: Humans are an intensely social species, whose chief evolutionary advantages involve cooperation and communication. Just like related emotions such as anxiety, anger and disgust, shame evolved in humans owing to its adaptive functions across the species over deep time. We need to be able to fear the things that could harm us or we would blissfully walk into the metaphorical (and perhaps literal) lion’s den. We need to be able to imagine how we might be held in the minds of others, and to understand what actions could cause us to be shunned and held in contempt.
In this sense, shame is a part of our social monitoring and behavioral correction processes. As evolutionary psychologists say, “a lone monkey is a dead monkey,” and we are hardwired to be sensitive to threats of social exclusion and punishment.
However, we know that shame is a trans-diagnostic process that contributes to a host of psychopathology, exacerbates human suffering, and can confound the effectiveness of evidence-based therapies. Shame can be dealt with in powerful ways when we train our minds in perspective-taking, centering, and self-compassion.
When a person is gripped by shame, they are under the dominance of their perception of social threats, and they are going to function as if they are under excessive threat, even if those threats are completely composed by their own minds. When we are gripped in this way, we are not likely to be able to operate from a place of psychological flexibility and adaptive conduct. Importantly, CFT and compassion-focused ACT give us ways to work directly with shame and self-prejudices; contacting our experience of shame with self-kindness and empowerment, rather than with struggle and avoidance.
Praxis: Why does compassion work so well in helping people work with and transcend shame?
DT: There are so many ways to answer this question, because there are so many levels at which we can examine the powerful healing effects of compassion on our self-condemnation and excessive self-blame. In terms of the growing research on psychotherapy processes and outcomes, we know that compassion can contribute to positive behavioral change that can help us to become free from living under the tyranny of shame.
On a biological level, activating our embodied compassionate motivation allows us to relatively engage our parasympathetic nervous system, engage the oxytocin system, and stimulate and leverage the actions of the polyvagal complex in ways that allow us to experience greater stability, creativity, and courage.
On a behavioral level, a compassionate mode of being leads to greater psychological flexibility and adaptive psychological functioning, with diminishing dominance of anxiety and narrow, rigid, threat-based repertoires.
On an interpersonal level, operating from a place of compassion for self and others can form the foundation for stronger attachment bonds and a more prosocial and cooperative orientation.
Praxis: Clinicians sometimes struggle with knowing how to communicate with their supervisors about compassion-based therapies; they may fear that they won’t be able to explain it in a way that sounds scientific enough, or that they will be unable to articulate clearly why teaching their clients compassion exercises, for example, may be a sound option for healing. What advice would you give to someone in this situation?
DT: The best way to communicate about the underlying science of compassion, and to guide our colleagues towards an understanding of the scientific basis for compassion-focused interventions is to become fluent in our own understanding of this science, and to share resources about the underlying theory, research, and applications.
CFT and compassion-focused ACT are based upon a wealth of work in evolutionary psychology, developmental psychology, behavioral psychology, contemplative traditions, affective neuroscience, contextual science, and integrative psychotherapy. A visit to mindfulcompassion.com will provide a doorway to many resources, videos, audio recordings, books, websites, and primary source articles on the science of compassion.
The New Harbinger series of books on CFT and the science of compassion also provide a deeper and more extensive course of learning in this direction. The compassion training workshops that we provide through The Center for CFT, Praxis, and The Compassionate Mind Foundation are also important sources of further education, as are supervision groups, private supervision, and the workshops led by our compassion-focused colleagues worldwide.
By orienting ourselves to the science, speaking from that space, and sharing resources, we can connect others to the science of compassion. If supervisors and others aren’t willing to be open to the underlying science at that point or seem dismissive, we can simply hold them in compassion and wish them well. If they explore the literature and it doesn’t speak to them, they can simply leave it where they found it, and we can continue on our own compassionate journey as our inner compass guides us.
Editor’s note: This article is an interview with Dennis Tirch, PhD. Dr. Tirch is the founder of The Center for Compassion Focused Therapy in New York City, the first clinical training center for Compassion-Focused Therapy (CFT) in the United States, and author of 6 books, and numerous chapters and peer reviewed articles on mindfulness, acceptance and compassion in psychotherapy. He is co-author of The ACT Practitioner’s Guide to the Science of Compassion: Tools for Fostering Psychological Flexibility.