Compassion Focused Therapy for anxiety and low self-esteem

Compassion Focused Therapy for anxiety and low self-esteem

If you’ve ever been told to “stop acting like a baby”, we have some good news for you. Embracing your inner child, or soothing yourself as you would a distressed baby, can be a way of healing past traumas as well as reducing anxiety and feelings of shame.

Compassion Focused Therapy uses a definition of compassion grounded in Buddhist tradition, which defines compassion as “sensitivity to suffering in self and others, with a commitment to try to alleviate and prevent it”.

It’s based on Compassion Focused Therapy (CFT) by UK-based psychologist Paul Gilbert, who observed that many people, in particular those high in shame and self-criticism, were experiencing difficulties generating kind and self-supporting inner voices when engaging in traditional therapy. He observed that, although these individuals were able to engage with cognitive and behavioural tasks, they still responded poorly to therapy.

Gilbert developed the approach and teachings of CFT, which, put simply, teach people how to feel compassionate to themselves and others by training patients in how to talk to their inner voices with compassion. Initially developed to treat people with high levels of self-shame, this form of therapy has expanded its benefits and it’s now part of a growing global movement that recognises the potential of compassion to benefit a range of sectors, from business, education and healthcare to science, research and the environment. CFT uses a definition of compassion grounded in Buddhist tradition, which defines it as “sensitivity to suffering in self and others, with a commitment to try to alleviate and prevent it”.

Children and adults who receive kindness, gentleness, warmth and compassion are, compared with those who don’t, more confident and secure, happier and less vulnerable to mental and physical health problems.

Gilbert found that children and adults who receive kindness, gentleness, warmth and compassion are, compared with those who don’t, more confident and secure, happier and less vulnerable to mental and physical health problems. “From the very first hours of your life right through to the last moments, kindness, gentleness, warmth and compassion are the things that can sustain you and help you bear the suffering that life will rain on you,” he says.

According to Gilbert, affiliation and affection help stimulate the soothing system, and the sense of contentment, safeness, calm and security that results from this helps to “tone down our threat-based emotions like anger, anxiety, fear. When we’re born we seek care by emitting signals — that is, we cry if hurt or hungry, which signals our needs to our mother,” he writes in his book, The Compassionate Mind. “The cries impact her mind so she’ll provide care; our brain then picks up that care is being given, we’re safe, and we calm down.”

Research shows that this form of therapy works. Studies show that self-compassion is correlated with the severity of a person’s symptoms and can affect their quality of life. Gilbert found that, by increasing self-compassion, there is a noted decrease in psychiatric symptoms and problems with family and external relationships.

“Orientating to your compassionate mind can help you engage with, understand, tolerate and regulate the difficult feelings and troublesome loops associated with your threat-based minds (eg angry, anxious, self-critical),” says Gilbert. “You can learn to be compassionate towards your feelings, rather than fight them or try to avoid them. This is similar to a form of desensitisation, with safeness and grounding in your compassionate mind.”

Gilbert says we all have systems in the brain that make compassion possible, and by developing compassion you can organise your mind in different ways, with the aim of bringing your emotional systems into a helpful balance.

Why even adults need babying

As we get older, while we don’t tend to cry when hungry or upset (although we can), we do still feel cared for when others take an interest in us, use a friendly tone of voice or listen to our needs.

“Your body is designed to respond well to being soothed,” says clinical psychologist James Kirby, co-director of the Compassionate Mind Research Group at the School of Psychology at The University of Queensland. “If a baby is crying your immediate response is to soothe him or her through cuddling, using a gentle tone of voice to reduce their physiological anxiety.”

Yet, as we grow older, we don’t usually receive the same amount of compassion. “We tend to become self-critical if we’re upset as an adult,” says Kirby. “We tend to believe that criticism motivates us to continue to strive and succeed, but actually it can have a negative effect on your emotions and create anxiety and shame.”

Baby talk

CFT is a relatively new form of psychotherapy. A review of it published in Psychological Medicine found that CFT shows promise as an intervention for mood disorders, particularly those high in self-criticism. According to Kirby, one of the key aspects of CFT is your inner tone: “The way you speak to yourself can change the way you feel about yourself. This can be one small step towards changing your inner organisation system to be more compassionate towards yourself, the way you would be towards a child,” says Kirby. “CFT works with people who are highly critical and shame-focused. We consider how we would ideally speak to ourselves if we were a child struggling with this issue.”

As Kirby points out, as we get older, if we’ve made a mistake or deem ourselves a failure, we tend to speak harshly to ourselves rather in the soothing tone you would to a baby or child. “It is not just about soothing; often, that caring voice is also quite encouraging,” he says. “That is the key. When a child fails at doing something — for example, falls off a bike — we often offer encouragement through getting close and checking if they are hurt, speaking calmly to them and maybe giving them a hug. These affiliative behaviours give the child courage to jump back on the bike.”

“Orientating to your compassionate mind can help you engage with, understand, tolerate and regulate the difficult feelings and troublesome loops associated with your threat-based minds (eg angry, anxious, self-critical). You can learn to be compassionate towards your feelings rather than fight them or try to avoid them.”

According to Gilbert, compassion is all about motivation. For instance, if your motivation is to own a house as large as those of your friends, your motivation is “threat-based”. “You’ll tend to feel anxious, fearful or a deep sadness,” says Kirby. That can be because you are comparing your sense of worth to others based on some kind of obtained status — the house. “By changing the focus of your motivation — perhaps you want to have a nice house to feel safe and warm for your family — then your motivation begins to gradually shift towards more caring and compassion-based motivations.”

By opening yourself to receiving care and compassion you’ll be connecting with yourself, your inner child and others. “My research, along with others, has found that those who allow others to soothe them are less likely to suffer from depressive symptoms,” he says. “If you’re a harsh self-critic and have high levels of standards, then you may find it difficult to receive care and compassion from others, as you’re worried that you’re not meeting their standards, as you’re striving to be perfect.”

You can still maintain your high goals. Rather than use self-criticism, though, you might use compassionate self-correction instead.

Baby steps to take

To learn to be compassionate towards yourself, and also receive it from others, Kirby recommends practising the following steps.

  1. Don’t think you have to fix something, as this can be destructive.
  2. Focus on the now. “Humans tend to ruminate, worrying about what ‘could’ have happened rather than what’s really going on,” says Kirby.
  3. Acknowledge that there will be times you may feel sad or angry or disappointed. Accept that that’s life.
  4. Mindfulness can help you allow these thoughts to enter and leave your mind without clinging to them, which may be upsetting.
  5. Engage in some grounding-based exercises, such as soothing rhythm breathing. “Just like the soothing sounds you make to a baby or child, this activates your parasympathetic system,” says Kirby. He recommends breathing in for five seconds and out for five. Keep the breath constant and smooth.
  6. Build your own compassionate self. Use a mantra, or word, to slow your mind and body.
  7. Wake up with intention. “When you wake, spend a minute or two engaging in the soothing rhythmic breathing to welcome yourself to the day like you would a dear friend. Say good morning to yourself with a friendly voice tone. This might feel strange, but a friendly and welcoming voice tone can help with activation of your parasympathetic systems physiology.” Kirby then suggests imagining how you’d like your day to unfold if you were at your compassionate best. “How you would talk, respond to others, how you would act and feel. Imagine that and try to do that as you start the day.”

Finally, don’t worry if you yell at the kids or get anxious about something. “That’s self-criticism kicking off again,” says Kirby. “If that happens, as best as you can, come back to that daily intention. You may need to come back to that 100 times a day — it doesn’t matter how often you do it; it’s just important to remember to do it.”

Other ways to nourish your inner child

Time-Line Therapy

This involves taking the person back before they experienced their trauma, often as a child, taking their adult self to the event to support and be with them as the child. This can alleviate many early issues. Hypnotherapy is also a fast and beneficial way to alleviate numerous issues both from past and present.

Number of sessions: 1–2

Cost: $165 a session



Emotionally Focused Therapy for couples

This therapy is useful for those who wish to embrace EFT as a couple.

Sessions: 8–12

Cost: $220 per session

W: Associated Counsellors and Psychologists Sydney (


Matrix Reimprinting

Heals hurts of the past and clears any limiting self-beliefs, which are usually formed in childhood.

Number of sessions: Dependent on needs. The Melbourne Centre of Healing runs an 8–12-week program.

Cost: $120 per session or $3500–$5500 for the program



Introduction to Buddhism

Self-compassion is a crucial part of self-acceptance, and Buddhist psychology removes the misunderstandings and lack of education on how and why we suffer from self judgement, anger and fear. This is an online interactive course that runs for seven weeks in a dedicated Facebook group, four times a year.



Integrated Massage Therapy

Unique to Gwinganna Lifestyle Retreat, this session combines the best of remedial and deep tissue massage techniques with acupressure, reflexology, polarity energy healing, breathing techniques and passive stretching. The highly experienced therapist works to optimise the various systems of your body using specific balancing techniques, reflex points, slow rhythmic movement, gentle rocking and energy healing. You will be given suggestions as to why the body is exhibiting certain imbalances and symptoms and will receive mindfulness techniques to help you stay in balance. This is highly beneficial for the release of long-term stress from childhood and onwards.

Sessions: 80 minutes

Cost: $250



EFT Clinic

The Melbourne Centre of Healing uses a kind of therapy where the client is in a slight trance state. The subconscious is asked where the client’s current issues are coming from. It usually takes the person back to childhood, which enables both practitioner and patient to go ahead with a healing process focused on healing the inner child.

Sessions: 8- or 12-week programs, 1 therapy session per week (at 2 hours each).

Cost: The 8-week program is $3500 and the 12-week is $5500. The programs also include sensory deprivation or float tank sessions, sauna, nutrition testing and mindfulness/meditation techniques.


Charmaine Yabsley

Charmaine Yabsley

Charmaine is a freelance journalist specialising in health, nutrition, fitness and beauty. She has more than 15 years experience writing and editing magazines and books in the UK and since returning to Australia she has written regularly for Body and Soul, a weekly column for the Sydney Morning Herald's Pulse section, Style magazine, Cosmopolitan, Cosmo Health, Cosmo Pregnancy, Prevention, Good Health, Women's Health, Weight Watchers, Nature and Health, Women's Health and Fitness and of course, WellBeing Magazine.

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