Oh Well, first of all, thank you for inviting me to your compassion therapy. And it's always a delight to come and talk to you about compassion-focused therapy. So today, you've invited me to talk about compassion-focused therapy in relationship to trauma and asked me to go through some of the basic background.
So very happy to do that. So the first thing is that these slides are for your information. And we probably won't go through all of them, but we will send them to you.
And then you can have a look at them. We will be doing some personal practices, but not too many because it's only an hour. But the ones that we do do, you're responsible for your own well-being, of course.
And all the material that we are sharing with you is confidential, and it's for the people that are listening to this presentation. So, yeah, the first thing, then, is that all the things I'm going to be talking to you about, you will find in this book. And this book really is a summation of a lot of things that we're going over. for a number of years.
Now in terms of compassion-focused therapy, it's very crucial to root our understanding of mental health and social problems, anti-social problems, in their psychological and social therapies, in the basic sciences rather than the more narrow therapeutic models. You're probably all aware that there are lots of different models of psychotherapy, but what we try to do in CMT is to just think, well, what is the basic science? And what you'll find is a lot of the science we talk about, for those of you who've done psychology as a degree, you'll find it all in your basic psychology books.
So the processes that we utilize in CFT are such as the motives, emotions, cognitive competencies, and behaviors. And we call these the four functions of mind. And as I say, you'll find them in standard textbooks.
So we're not going to actually introduce any new ideas. We're just going to be looking at how these... processes interact. So, GEE is the study of the complex interactions of these four processes and their individual variations. So, people often have different emotives, don't they?
They have different emotional textures and so on and so on, and they will interact together in different ways. So, CFT is really understanding the nature of mind, what we call the map of the mind. CFT focuses on specific guided interventions according to what you're going to target. So whether you're going to target motives or you're going to target emotions or maybe you're going to target physiological systems such as the vagus nerve or frontal cortex or whatever, but you need targeted motivations. Now a little bit of background because Lucy asked me to talk a little bit of background.
Three key books, I think, from 84 through to 92. The first one is called Depression from Psychology to Brain State. Now that's important, I think, because I've always been a brain state theorist, and I'll take you through what that means in a moment. Then in the 80s, I was very interested in the evolutionary nature of mind and how our basic nature, some of our basic dispositions, can set us up for suffering.
And then my research area for many years was depression and the study of how people who are depressed often feel powerless, out of control, defeated, inferior, trapped. And so that book is all about that. So that's important. So what do we mean by a brain state? Well, a brain state actually simply means an interaction of process.
So if you think about a threat brain state, then when you're in a threat brain state, you will be thinking in a certain way, you'll have certain kind of fantasies in you. In your mind, your body and your brain will be firing in a certain kind of way. You'll be experiencing certain emotions, obviously. It could be anger, it could be anxiety.
You're paying attention to certain cues when you're in threat. So you're not paying attention to going out for lunch when you're in threat. You're wanting to do things. You'll be remembering certain things that are linked to threat.
And obviously, you'll be motivated to protect yourself. So basically, what a brain state is then is at any point in time, your mind will be organized in terms of a pattern. of these interactional processes.
We could go into a happy state and if you were in a happy state then very clearly you would be in a very different set of relationships between these things. And of course we can have a compassionate brain state if we're going to look at that in a moment. And the key thing is recognizing that when we're talking about brain states then we are talking about the interaction of these processes. If you're working with CFT, you're not confined to, say, working on schemas or cognitions.
You're not confined to working on the body. You're not confined to working on emotions. All of them and their interactions, particularly the interactions, are important. And having therapeutic ways of dealing with them and how to bring compassion to each of them is what compassion-focused therapy is. So what is compassionate thinking?
How do we create a compassionate body state? How do we get that vagus nerve going? How do we trigger the frontal cortex, which is very important to compassion?
What are the emotions that are associated with compassion? What are the behaviors? If we're going to behave compassionately, what are they?
So compassion then is a way of organizing all of these processes, and they can all be a subject to your work. If, on the other hand, you have a self-critical brain, that's not a compassionate brain. And so you're often wanting to do this, aren't you? You're wanting to switch your brain state from criticism to compassion. And so very basically, then, when you're doing compassion-focused therapy, what you're trying to do is you're understanding brain states that cause problems.
You're understanding the nature of that brain state, how the person is thinking, what they're paying attention to, what their history is, what their motives are, all of those things. And you're then trying to help the person bring a compassionate brain state to help you with this threat state, to help you with the threat state. We also know that there are different ways in which the brain organizes according to whether you're left or right brain, but we won't go into that.
So our brains create all kinds of patterns and it's those patterns that are the cause of brain states. Now, you can help clients understand the importance of brain states by taking them through some pretty straightforward examples, which I'm going to do for you now, because when you're working the CFT, it's all about creating a compassionate mind, a compassionate brain state. That's what we're wanting to do.
Okay, so let's take, let's help us. Our clients understand the nature of a brain state and so you invite them to, you explain to them, let's explore how your brain works and not only how your brain works but how powerful you are in influencing your brain state. You can actually influence your brain state but let's think about what a brain state is first.
So the client agrees, okay. So you say, well the first scenario I want you to think about is you have a small worry, nothing too major. But just bring your mind for a moment to a small worry and just focus on that.
So you let them do that for 20 or 30 seconds, not too long. And then you say, OK, so what did you notice? Let's now pull back and reflect. Let's become mindful of what happened when we did that.
What did you notice? Did you notice what were you paying attention to? Did you notice what you were thinking?
How did that feel in your body? When you were thinking about your small worry, what were you thinking about what you could do? So the client is able to tell you and you say, well, that's an example of a brain state, right? When you're in a brain state of worry, you're thinking, paying attention, you're having feelings in your body, you're planning your behavior, you might be remembering other worries.
You get motivated to transform. Classes, okay. Now imagine, on the other hand, that you are working with anger. You're perhaps sitting there or laying in bed one night remembering somebody you're angry about, and you're thinking, oh, I'm so angry with this person.
Okay, now I'm not going to spend a lot of time on this because you can obviously get the hang of it so you know that you give them a bit of time. And then you say, so pull back now and notice what happened to your imagery? What happened to what you were paying attention to?
What happened to your thinking? How did that feel in the body? How did anger feel in the body?
What did you want to do? And can you see that's very different to the other brain state you just had, which was anxiety, right? Okay.
So you take them through this. And then you say, okay. Supposing you are going on holiday tomorrow, just imagine looking forward to holiday tomorrow, and then you take them through it again. All right, so what were they focusing on? What were they feeling in their body?
What were their thoughts? What were they imagining they were projecting into the future? About what, you know, what's it going to be like?
Will it be okay? Of course, some clients will say to you, Oh, no, I wouldn't look forward to it. I'd be thinking, oh, I've got to get my passports. I've got to make sure I'm packed.
It would just make me very anxious. So you can have a bit of fun with it. Now, for some clients, not for all, you can also use this one. Say, supposing you're laying in bed and you have an erotic fantasy, right? Maybe something you've seen on television or whatever, but you're all alone just having a fantasy.
Can you see then that your attention will be in a certain direction? You'll be imagining certain things. You'll be thinking about certain things.
But what's important is by generating that fancy, you actually would change the blood flow in your body. The blood flow in your body will be changed by your imagery. By what you imagine, you can actually change your blood flow. So have a look at this then. If you imagine a worry, if you imagine somebody you're anxious about, angry about, if you imagine your holiday or you imagine something a bit naughty.
you're actually producing different brain states on purpose and you can switch between them. This is what you can do by using your mind to understand how you can change brain states, right? So this is quite an important process to help clients recognize that when we are in a particular brain state we can switch our attention, we can start to generate other brain states.
So that's quite important. So the next one then is let's have a look at how compassion works in that case. So try and remember a time you were worried or upset about something and you talked to a friend and they were really helpful to you.
So you're just reflecting on how much you liked your friend and how helpful they were to you. So you ask them to do that for a little bit. Can you bring to mind somebody who was really helpful to you? And invite them to focus on the helpfulness, not what they were distressed about.
So can you see what happens in your body, right? What was happening to your thinking? What was happening to your attention? What were you feeling? And then you can do the other one.
Imagine that you were helpful to a friend, and as a result of that, they were helped by you. You helped them. And so what we see is when we do compassion imagery then is that when we receive compassion, when we give compassion, we have a sense of achievement.
We have a sense of something positive. We have positive emotions. And this is because caring and sharing has profound effects on our brain states.
So brain states can be very influenced by being supportive, helpful, and kind, and being open and receiving and being grateful. So you have a discussion a little bit about that, because you're helping clients understand there's nothing overly complicated about compassion, but it is important to recognize that what we focus on has these major impacts on our brain states. Okay?
Okay. So let's just come back a little bit to this, because I promised Lucy I'd talk a bit about the evolutionary stuff. Let's have a look at the other.
book. So that was brain state theory. I've always been a brain state theory. That's why I'm always interested in the interactional processes between attention, thinking, motives, and so on. Now, in the 80s, because I was very lucky to do a little bit of training with Tim Beck, Aaron Beck, and my supervisor was Ivy Blackburn, who was one of the first cognitive therapists in the UK.
She was terrific and taught me a lot about CBT. But I was always an evolutionist. I was always very interested in the motivational processes, which... people are orientated to and which we share with many other animals. And in the 80s, there were a number of basic motivational systems that evolutionary theorists had identified.
There was the caregiving and care-seeking system, which of course was linked to John Bowlby's attachment theory and attachment approach, and that we have a motivation to be caring, particularly of our offspring, obviously, but not only our offspring. And that motivational system... evolved with a whole physiological infrastructure to make it happen, right?
Care-seeking, obviously, you have to evolve care-seeking. If you're evolving caregiving, then you have to have care-seekers that respond. It's no good if you're a parent caring for your child and your child says, well, what are you doing? Why do you keep smiling at me?
What's all this facial expressions? What are you up to? So you need to have that interaction process. And then, of course, cooperating is a really...
important process for humans and humans in particular want to cooperate they want to feel that they can make a contribution uh if you think of the internet most the internet is full of people wanting to show you things teach you how to make you know fairy cakes and paint pictures fix your car play the guitar people love to share and to feel that they have something to offer they're of value right you can't be a value by not having anything you can be a value because you have something that people are interested in and they want. And that's very important because when people become depressed, they often feel worthless. They often feel they have no value.
So the cooperative system is really important. And then, of course, there's the competing system. And that is where we are able to put forward our own views and stand up for our own values and so on.
And then there's the sexual system. Now, the key thing is these are fundamental motivational systems. And what I was interested in, And what you'll see in the book are chapters where we can do this safely, helpfully, and competently. We can care. We can provide care.
We can be cooperative. We can compete in a way that's safe and helpful. And we can have sexuality that's helpful and so on. But equally, we can engage these motivations in ways that are unhelpful, that are threat-focused and incompetent, frankly.
So sometimes like with competing, rather than being assertive and open and respectful, we are aggressive. We become very narcissistic. We're self-promoting.
We would call that an unhelpful and threat-focused way of being competitive. Or if we're cooperating, we're cooperating, but we must have people value us. And if they don't value us or they don't want to do what we want to do, then we move away. Caregiving is very important, but it means it needs to be empathic. Otherwise, we can just impose care.
And parents who impose care, their children struggle with development. So these are important. And the other thing is that when you take an evolutionary approach and you understand that what drives behavior are not just beliefs, they are important, of course, beliefs are very important, but it is the system.
So, for example, guilt, guilt evolved from care. caring and that means guilt is very much linked to issues of causing harm in other words uh not caring very confidently uh causing harm um and being the source of distress and suffering to others but also yourself sometimes and we feel guilty we have the emotions of sadness and remorse and regret and wanting to repair these are very important uh elements and for some clients you want to increase their capacity for experiencing guilt and remorse, particularly people in the prisons. You want to stimulate the care system and you stimulate the care system by working on their own experiences of being cared for.
We now know that people who are a bit on the psychopathic dimension, they often come from rather neglectful and traumatic backgrounds. So their care system has not been particularly well developed. So that's quite a big story. Shame, on the other hand, is very much linked to the rank system, the competitive system. And this is all about feeling inferior, looked down upon, feeling inadequate, and the emotions tend to be ones of anxiety and anger.
It's a totally different motivational system. And although in the cognitive position guilt and shame are distinguished between focusing on the whole self or focusing on behavior, In evolutionary science, we focus on very different motivational systems, and because they're different motivational systems, you have very different therapies for them. So that's just an example of why understanding motivational systems, evolved motivational systems, are really very, very helpful to you.
And the other thing about motivational systems, which I'm going to go through quite quickly, is that evolved motivational systems orientate us to detect important signals. So a motivational system for eating will help us detect food. A motivational system for threat will help us to detect threat.
A motivational system for sexual opportunity will help us detect stimuli of sexual interest. And they're all biologically kind of wired in, right? And the actions of these systems can be both conscious, but we can also have unconscious stimulation.
And the thwarting of our motivational systems can really be problematic. So obviously, if you thwart eating, you starve. But if you thwart the ability to form attachments and be loved, that's not good either. Because these are basic, so they're also linked to basic needs.
Now... The key person for evolutionary stuff is of course Darwin, Robert Darwin, and he highlighted the fact that the process of change is via natural selection. And that natural selection works on the challenges to survival and reproduction.
These are two fundamental challenges to all living things. All living things have these challenges. And that gives rise to the four functions of mind. What comes out of reproduction and survival are what we call the three major life tasks. Now, this is very important in CFT.
The three major life tasks, all living things, need to have systems that will allow them to detect and protect, detect threats to their existence. So, for example, young chicks in a nest, when they see a hawk shape overhead, they crouch in the nest. It's an automatic detection of threat and a response. So threat detection is very important.
And we know the physiology to some degree. It works for your amygdala and your sympathetic nervous system. It activates you to take defensive action.
Even the bacteria in your gut can detect threats to their existence. When plants are threatened, they curl their leaves to protect water loss and so on. So protection.
is a fundamental life task. But so is resource acquisition. You've got to actually, you can't just be protecting yourself.
You've got to go out and get food. You've got to go out and find places to shelter, build burrows or nests or whatever it is. And you have to find sexually reproducing others if you are a sexually reproducing species.
Otherwise, you get to reproduce. So you have to acquire things, right? You have to seek out things.
And sometimes... We seek out things in environments that can be threatening. So we have to keep that system, that threat system on, even while we're seeking. So animals that need to get out and find their own food also need to keep an eye on where the predators are. But when we're not under threat and when we're not needing to get resources, then we can rest and digest.
And again, this is true for most living things. they can rest and digest. Now this is important because for those of you familiar with the CFT, you can look at it this way. You can have these basic life tasks and these life tasks require specific emotions. So the specific emotions then, we talk about the three types of emotions in CFT.
You have three types of emotions, two positive ones, one negative one, and the positive one and the negative one is really about threat. And this is anxiety, anger, disgust. And this is what we call safety seeking. These emotions will be orientated to get out of the threat, get away from the threat, or maybe attack the threat perhaps. And there are different ways in which we can do that, which we don't have time to go into.
But one of the positive emotional systems is, of course, your ability to acquire things, to do things. So when you get stuff that's good for you, you acquire resources. This gives you a bit of a buzz of dopamine. If you win the American lottery tonight or whenever it is, and you're worth $100 million, you'll likely have a big dump of dopamine because you'll get very excited. I'm a millionaire.
It's amazing. All right, so when good things happen to you, it gives you positive feelings. And this is called reward.
In behavioral terms, these are reward systems. The threat system is punishment system. This is the reward system, the positive affect system. And it's activating, tends to be activating.
But... Over time, that activation will wane, so you don't stay in a high state of arousal. Gradually, you've enjoyed the positive reward, and you can gradually now let your arousal slow down a bit, and then you can rest and digest. And rest and digest is when you're not under any threat, you've achieved what you needed to achieve, you've got what you need to get, and you can just be in the state of rest and digest.
And this orientates your brain and your body in a very different way to threat. and activation. And we also know that this system, this ability of calming and soothing and grounding plays a very important part in relationships because there are some forms of relationships that help us to calm, help us to feel soothed and help us to feel safe. So that's quite an important thing because people often talk about three circles, but the three circles are linked to the three basic lines.
challenges. Okay, that's where they come from. They didn't come out of thin air.
They came from challenges. Okay, so that's very important. And here's a slightly more complicated one.
This is when we can see what we call threat-based drive. That is when we're doing things not primarily for the pleasure of doing them, but because we want to stop bad things happening. So sometimes we go to work, but we don't really want to go to work, but we have to go to work because we need the money to pay the mortgage.
Sometimes we do things that we don't really want to do. But if we don't do them, then we can get into more difficulties. Now, sometimes what happens is when you have a lot of threat-based drive, people are doing things that they don't really want to do or they feel overwhelmed by the things they need to do, you can get shut down.
Now, shut down is when you get a kind of anhedonia, you lose interest. That's kind of a depression. But the other emotion you can get with threat-based drive, which is linked to trauma, is when you're getting a lot of trauma, you've experienced a lot of trauma. So your drive system is very much about trying to deal with trauma is you can get numbing.
Now, numbing is different to anhedonia and shutdown. And if you're working with trauma, which we'll have a look at in a moment, do be clear about what numbing is. Now, if you haven't heard of the Pet Shop Boys, then look them up on the internet and look for a song called Numb.
Okay, I want to be numb. It's a brilliant, brilliant song. And sometimes I played it with clients, and they say it captures them.
Absolutely. Now this numbing is when you just want the world to stop. You want to stop feeling. You just don't want to feel pain anymore. You just want it all to stop.
That's a numbing. Whereas in anhedonia, you'd love to feel something, but you're just empty. You just lost it. You know, you've got no energy, you don't want to do anything. So they are different.
So just keep an eye on that. And then over here, we have sadness and grief. And they don't really fit into the three circles anywhere easily, because sadness can actually be quite a useful emotion.
Grieving can really help us go from here to here, help us get back over there. Sometimes when you had a good cry on somebody's shoulder, it helps you feel a lot better. So it's a tricky one, sadness.
These systems are really only designed to be. heuristics for you. Don't try and force every emotion you can think of into the three-system model because that makes it a little bit complicated. In any case, a lot of our emotions are blends.
For example, excitement states you need a little bit of threat. If you do things that are completely and utterly safe, like if you're a skier, you go skiing and you just go on the slopes where the five-year-olds learn to ski, you're probably not going to be terribly excited. So excitement does require some degree of anxiety, but it also requires some degree of safeness and control.
So you get these blends. But these are useful. And sometimes it's important you can help clients think about where they are in terms of what it is that's threatening them in their lives. How do they deal with threat? What is it that gives them positive emotion?
Because we know that in depression, for example, positive emotions have kind of, they've shut down on positive emotions a bit. And there's quite a lot of work now looking at how we stimulate positive emotions and drive emotions, not just deal with threat in depressed people. And certainly this one, the ability to feel content, to feel at peace, to feel safe, to feel connected, this one often needs a lot of work for people who have mental health difficulties.
And that's why compassion is really important here. But compassion will help these two as well. All right. So what happens when we look at the three challenges of life give rise to the four functions of mind? You can have five functions, six functions.
Some people like imagery. Some people like attention as a function. So don't be constrained by this.
This is just a way of thinking for you. So in order for us to keep safe, we have to be motivated. Then we need emotions that will be activated if threat arises.
And then we need to be able to think about it, to reason about it. and we need to be able to behave, we need to be able to run, we need to be able to do things, we need to know what to do. So the four functions of mind are very important in C of T because they're also going to be what you're going to focus on when you're doing your therapy.
And all functions of mind operate through what we call stimulus response algorithms. Now, stimulus response algorithms... It sounds very behavioral and in a way it is, but it's really, really useful for you to get your mind around this, that modus are based on algorithms. Okay.
If a do be, that's basically what an algorithm is, if a do be. So here we go then. If a predator appears, then activate arousal, run and hide.
Okay. So if a predator appears and your system. on the systems of animals are designed to stimulate the threat system so the amygdala will light up the sympathetic nervous system will be activated and you'll be off to run okay if on the other hand it's the opportunity to eat then you don't want this one you don't want this algorithm you want an algorithm that will move you towards that food and that algorithm will start you salivating you'll start creating stomach acids because it's preparing you to eat Very different.
If A, then do that. If on the other hand, it's a sexual engagement, it's reproduction, then the stimulus that triggers you is very different from here and here. They're quite different algorithms.
At this time of year, or actually in spring, the male pigeons fluff up their wings. do a dance to the female because that's a stimulate that's a stimulus for the female to get interest in in my garden a lot of the females are not that interested they just keep flying away but there we are and i've tried this with my wife and i have to say it doesn't work so don't worry about it don't try it but it is an if a then do b we have our own if a then do b ways of activating the sexual system and if it's to do with threat then we know that when animals are threatened by more powerful others, they will submit, they will curl the body, they will go down, they will back off. And again, this is an algorithm that protects them, because if they try to fight somebody bigger than them, another animal bigger than them, or they didn't show submissive behavior, then the dominant would injure them. So dominant submissive behavior is extremely important. It's the way that many of us and many animals avoid getting into trouble.
because we are able to submit in situations and can deter threat. It doesn't always work. There we are. Now, the one we're interested in, of course, is this one.
If an infant is distressed or needing, then we act to alleviate it. Now, this is important because you can see then that compassion has an algorithm. It's an algorithm.
It's a motive, the motive to be helpful and so forth, but you have to be aware of the algorithm because there are many definitions of compassion. that don't help you understand the algorithm of compassion. Okay, so what we can see then, just put this another way, is that these algorithms have particular physiological systems as well. Okay, so the threat detection system has a physiological, the one for sexuality, there is a particular physiological system for sexual arousal.
There are physiological systems which are to do with assertiveness and competitiveness. And there are physiological systems which are evolved for caring behavior. So this algorithm then have detectors and physiological systems.
So let's have a look then. So we can define compassion as a basic motive. And because it's a basic motive, we will look for the stimulus response algorithm. And lo and behold, here it is. Now, this definition is pretty common, although...
It's not always defined in terms of an algorithm, but it's a sensitivity to suffering the self and others with a commitment to try to alleviate and prevent it. Okay, so that's if you encounter suffering and distress in yourself or others, then... Do what you can do to try to alleviate and prevent it.
So that means that the stimulus of engagement is very important because how do you pay attention to suffering? How do you understand suffering? Are you empathic or do you lack empathy?
How do you understand the causes of suffering? So all of the processes of stimulus engagement, all the psychology that goes into stimulus engagement is really, really important. Are you somebody who... denies suffering.
Now you're somebody who dissociates from it. Now once you can engage, then the next part of your algorithm requires you to do something to alleviate and prevent it. And that can take time, you know, that can take skills.
We might have to work out how to do that. We might not know in advance how to do that. So that's important.
And Notice that we have added in the concept of prevention. Now this is important in our definition because many approaches imply prevention. They imply how to address the causes of suffering, not just suffering at any point in time.
So that means you have to have prevention in the definition, that the actions are going to not just respond now, but they're designed to head off suffering in the future. So prevention is important. And here you can see that at the heart of compassion is these three basic dimensions of courage, wisdom, and commitment. Because without courage, you can be very wise, but you won't do it. For example, standing up against injustice or fighting for your moral position, you may know...
How to do that, but without courage, you might not do it because you're worried that other people will attack you or criticize you. Or, you know, if you stand out from a particular group of people because they're being badly treated, that's a courageous thing to be doing, right? But you also need wisdom because we can do things that we can be very courageous, but we rush in. Okay.
So if I see somebody fall into a river and I think I must save them, so I jump. But if I can't swim, I can swim, thankfully, but if I couldn't swim, that would simply be reckless. It wouldn't be helpful.
So we often want to do things, and we don't quite know what we're doing. And that's often the case with people who have mental health problems. They're trying to help themselves, but they don't know what they're doing.
And so they can actually end up making it worse. For example, avoidance. Or what people with anxieties can do is they think, okay, I've got to try and... I've got to try and counter my anxiety.
So what they do is they try and push themselves into anxiety, but they don't do it step by step. They do it until the point that they're over-anxious and they run away. I can't do this.
And then they pull out. So what that happens is we know that if you go to a point of anxiety, which you then leave in a high state of anxiety, actually that makes anxiety worse. It's called incubation. You make the anxiety worse. And so when you...
working with anxiety as you i'm sure or no you must help them pull out before they've got to that point so you do a little bit they learn to cope with that okay that's great fantastic right then they do a little bit more and then that's great so guided exposure gradual exposure in in behavioral work is very very important and that's because it's skilled it's a skilled way of doing it just throwing yourself into something you're anxious about so far always run the risks of being overwhelmed, and then you just make things much worse. So that's just an example, really. Now, the other thing to say to you is also understanding that motivational systems can hide each other. What this means is if you think about competing, the competing motive, so you want to do well, you want to be accepted, you compare yourself with other people, blah, blah, blah.
But then you... you fail and you feel inadequate and you become critical, you could, if you're doing therapy, stop at that point, okay, and start trying to say, oh, what's the evidence you're inadequate? What's the evidence you're incompetent?
Are there other things you're competent at? And that's okay. You can do that.
But what we suggest is that you have to actually get underneath the fear, right? So you always go. In CFT, you always go for the evolutionary strongest fear, right?
And nine times out of ten, it's not always the case, it's to do with social rejection. So if you ask people, why are you worried about being inadequate? What does it matter if you're incompetent?
It's primarily because people will think I'm stupid, they won't bother with me. And it's the social implications of failure that's the problem. And that's what you have to help people see.
Even with perfectionists, John Dunkley has done a lot of work showing that perfectionists are perfectionists. Because they think if they make mistakes, people will reject them. So the social aspect. I mean, you think about tiddlywinks or making fairy cakes. Do you worry about being inadequate?
No, because there's no real implication. And that's why you wanted to be a chef, I suppose. There's no real implications.
Okay, so you're not really good at making fairy cakes. What difference does it make? It doesn't make any difference. There's no social implications.
But if, for example, you were... You felt you were inadequate at making relationships, or maybe sexual behavior, or maybe as a therapist, or maybe as a parent. Now that's a different game, okay? So it's what you are inadequate about, what you are feeling competent about, and the consequences, the implications of it that really are the drivers. So when you're doing CFT, Compassion Vagrant Therapy, then you want to find out what it is that's driving that.
self-criticism, that fear of inadequacy, what is it that's driving it, and usually not always it's to do with the fear of being rejected, being lonely, being pushed out. And so you always get behind self-criticism. That's the key thing. Now let's put all this together for you then in terms of a bit of a model.
So let's start off with our life tasks then. We've got our three basic life tasks, the motives, the acquiring, the resting, and we've got our social mentalities. Caring, the cooperating. So these are basic motivational systems that are wired into the mind. We're going to be pursuing them.
We want to avoid harm, don't we? Of course we do. We want to acquire things.
Of course we do. We want to be able to be content and rest and digest. Of course we do. We also want to be caring and be cared for.
We want to cooperate. So these are all things we want, and we will search them out. But we also need emotions.
And emotions really are the... rapid changes in our body to facilitate our pathway to the motives, right? So emotions guide motives.
That's what they do. So when you're doing well, you tend to have positive emotions. When you feel you're not doing so well, then you tend to have more negative emotions. And these are the three emotion systems that we've just had a look at.
So there they are again. the drive, the rest, and the threat, three basic systems in CFT. So those are your key link between motives. And this is important because when you're working with people's emotional difficulties, always track it back to motives.
Track it back to motives. Track it back to motives. And so sometimes what looks like an emotional problem is actually a motivational problem.
And then we have... Why we are different to other animals is partly because we have these competencies, these brains which allow us to do all kinds of amazing things. So competencies really are the abilities to perform actions, like you need wings to fly and legs to move, but you also need a brain that's going to move those legs and flap those wings. So you need a brain that can actually enact the behaviors competently. And humans have got fantastic cognitive competencies, and there are three basic forms of cognitive competency.
There are more than three, but three is good for us at the moment. Your ability to reason, to use language, to think, metacognition, all of that class of capacities for insight and awareness. Then you have the ability to mentalize.
which is linked to empathy and understanding the mind of others and being able to reflect and think about the nature of your own mind. What is it like to have a motive? What's it like to have an emotion?
Empathy allows you to understand that. Strictly speaking, computers can reason. AI is very good at reasoning and can solve problems, but it doesn't mentalize. Not really, because it doesn't have a conscious capacity for mentalizing. Now consciousness of consciousness is hugely important and this is where we have the ability to observe our own mind, to be aware of having the mind and to be able to observe it and this is what mindfulness is about and that in itself is a huge huge issue as well.
And then we have behaviors And then we have behaviors, and these are your output systems. And we know that changing behavior can have a fundamental impact on changing the other three functions. For example, if you are learning to drive a car, you can be very motivated, you can read it, you can reason about driving a car, you can image driving a car, but you won't get good at it unless you actually get in and drive it. And it's the same, actually, with compassion. People can do all kinds of imagery with compassion, but when you learn to live it in your everyday life, you actually bring it into your life, you practice friendliness with others, you practice empathy with others, you practice developing self-empathy, all of these things, then the practices is really what helps you to engage it.
Now, the other thing is that all of these are related to trauma, and so I want to sort of switch a little bit to trauma. They're all related to trauma because if you've been traumatized, particularly as a child, this will affect your harm avoidance system. It tunes it up, doesn't it?
It'll affect how you go about acquiring resources, how confident you are in the world, and it'll certainly affect how easy it is for you to find peace, to be able to calm down, to be relaxed, to be trusting of others, and so forth. So trauma will affect all of them. depending on the nature of trauma, of course, then trauma will also, of course, affect the emotions and your emotional patterning.
Trauma will affect how you think about yourself and the world, how you mentalize yourself, and trauma will affect what you do, what actions you take, and how you go about engaging the world. So trauma, then, is not one thing that affects one's set of beliefs or whatever. Trauma actually is a way of patterning. your mind. So if you're doing CFT, this is what I want you to try and get your mind around, that CFT is about patterning the mind.
It's not just about self-compassion or compassion to others. It's you pattern the mind with using compassion motivational systems. Okay. Now, the other thing to say briefly about that is that there is a distinction between caring and compassion.
So we know that many animals engage in caring behavior, they care for their offspring and pups and so on and so on. And we know the physiology of caring behavior is related to part of your autonomic nervous system, such as your vagus, the hormones such as oxytocin, and vasopressin, neurocircuits. We also know that caring and receiving care, particularly as children, impacts our epigenetics, the genes that get turned on and off in us.
But caring is caring. What makes compassion compassion is when we bring our new brain competencies to caring, and that is we bring a form of knowing awareness, an empathic awareness, and knowing intentionality. So when we can do that, then we can actually direct our caring behaviors courageously and wisely.
Now, if you think about it, a lion intends to hunt and kill prey. Of course it does. So it has intention and it can do things and it can do things and to some degree it knows what it's doing.
But it doesn't knowingly, in the sense it doesn't realize, it's not able to think, well, you know, all this killing and ripping out throats is pretty cruel, actually. I think I'll become a vegetarian lion. I'm going to set up the Vegetarian Lion Society. I'm going to have the BLS.
That's what I'm going to do. Or I need to train, I need to go down the gym and train because I'm getting very slow, you know. As a predator, I'm not in good shape, really. So they can't do that sort of thinking. It can think in terms of what it needs to do to reach its target, like how to hunt prey, how to kill prey.
But that's about it. Humans have a fantastic ability of metacognition and awareness and insight and all kinds of that, that we can actually understand the nature of suffering. We can recognize what's going on for people when they're suffering. We can develop plans to address suffering.
We can work out how to be helpful. We can develop vaccines against COVID. Now, this is a new game.
This is a completely new game. This is not just caring. This is compassion. So compassion is when we have a deliberate orientation.
We bring our mind to the issue of suffering and the prevention of suffering. And what's also important, is that we bring it to sentience, for sentient beings. So that means that if your garden or your car is damaged, you will be sad about that, but you wouldn't have compassion because they don't have a mind.
They don't have a conscious mind, so they don't suffer. So you care for them, look after them, get them fixed, but you wouldn't have compassion. So compassion is also primarily for sentient minds, for the experience of suffering. That's what it's for. It's not just about caring.
And that's quite important because... You'll see this on the internet all the time. People confuse basic caring motivation with compassion. Compassion is a fantastic capacity to use this awareness of mind, awareness of self, this consciousness of self and so forth, to direct your compassion, your care motivational system. You can also, of course, use these qualities to do the opposite, to be harmful and to hurt people.
So, you know, we don't always use our new brain competencies wisely. So the motivation that we, the way these competencies, these social intelligence work is very dependent upon our motivation. Motivation is crucial, okay? So we have evolved needs.
This is very important in how we meet these needs. And most of these needs, particularly in early childhood, basically compassion needs. We need people who are able to compassionately understand us, be with us, and care about us, and play with us, and share with us.
We are a social species, and our brain and our epigenetic profiles depend upon the quality of caring that we have. Because if we don't get that, if we have a number of unmet needs, particularly linked to overstimulated threat systems like an abuse and neglect, This can orientate the mind to safety first. In other words, always looking for the threat and trying to deal with the threat.
And that can inhibit experiences of safeness. And safeness is when we can just open our mind, we are relaxed, we can explore and so on and so on. Now, when you're developing your compassionate mind, for those of you who have done some training with us, you're going to be wanting to develop compassion motives, compassion emotions, compassion thinking, and compassion behaving.
That's obviously very important. And there are ways in which we can do that. We can do that using the body to support the mind.
We can teach you postural and breathing exercises, dance and movement and yoga, acupuncture. All of these actually can influence the autonomic nervous system and your brain. And you do want to use the body in particular kinds of ways. We can also develop compassionate qualities.
So what we do here is we invite clients to think about compassionate qualities, maybe think about four or five of them. It could be friendliness, it could be trustworthiness, it could be empathy, it could be assertiveness skills, whatever it is. And then you and the client work so that they will practice that skill over the week.
They will practice one skill. So maybe assertiveness would be something, compassionate assertiveness, what's that? compassionate friendliness what's that empathy what's that how does that work um compassionate patience i'm not very patient i i i take on too much and then i get a bit fraught so practicing compassionate patience slowing down grounding in the body that's a practice for me okay so you you identify key qualities and then you practice those qualities then another thing you can do is using imagery where you imagine dialogues and you can imagine interacting with another compassionate mind that's very empathic and caring to you. We do cultivating playfulness and joyfulness. So again, I'm so sorry that I'm whipping through these things very quickly for you, but time is quite short.
But just to highlight the fact that there are lots of ways in which we want to create and develop and harmonize compassionate brain states so that people can pay attention compassionately, can think compassionately, and so on and so on. All right. So now, how do you bring all of this to trauma? Trauma is kind of a key thing.
We've seen that trauma disrupts the patterns of the mind in terms of the motivational systems, the stress system, and so on. It disrupts the... The nature of emotions, emotions can be very, particularly threat emotions, can be very easily triggered.
People can have a lot of difficulty in calming down or feeling safe. And it disrupts the way in which we think and empathize and behave. Okay?
So how does that all figure out in the case of... trauma. So I'm going to dash through a few things here. I'm sorry about that, because I want to get to the... Okay, so I want to share with you something that's extremely important in the way that we work with trauma, which is called mind mapping.
Now, there are lots of different techniques in psychotherapy, as you know. Guided discovery, inference chaining, behavioral planning, reappraisal, therapeutic relationships, all that kind of stuff. Very, very important. But in CFT, we're always interested in what we call multi-mind.
Because if you think about it, a brain state is a multi-mind. A brain state is a mind that's got a lot of things happening at the same time. Paying attention, thinking about what to do.
And... In trauma, you can have lots of different emotions. Trauma is not just about fear. Fear is important, but it's not just about fear.
There are many other things that go with it. And so what you do when you do mind mapping is you then invite the client to explore the multiple experiences of a trauma. So you have to pick on something that they can do okay, right?
So you don't pick on a trauma that at the beginning is too difficult for them to think about or go into. So... Again, it's a step-by-step process. Just pick a small trauma for them to get the hang of it. So this was an example of a client that I saw who had a very hostile, aggressive father who could get into anger quite quickly.
And he had all kinds of problems in being assertive. He was quite a shy person. If he got into conflicts with his... partner he would tend to withdraw and she found that quite difficult because he wouldn't kind of engage very much.
Okay, so let's have a look and see what's happening for him about how his trauma impacts his social relationships and mild depression. Mild is a bad word, but it wasn't severely depressed, but he wasn't happy and his tendency to be quite submissive. So he was able to pick on an example of when he was about six or seven or whatever, they were going out to a wedding or to a party and he'd been dressed up, he got his new clothes on. And as they were going out, his mother gave him an orange juice to drink, give him a drink before they go out.
And he slipped and tipped the door down himself. And he said, And then... My father just, I can just remember, you know, my father just went berserk.
He got so angry. And so the question is, so what were you noticing in your father? It's a mentalizing question.
What were you noticing in your father? What was going on in his mind? Well, he was very angry at me. He was furious. He called me fucking useless, you know.
You're fucking useless, he said, you know. That I'd always been a pain to him. And then he tried to get my clothes off because he just sort of tore them off, really. I see. So you had this experience of your father being very angry, and in that anger, he's also calling you useless and he's tearing your clothes off.
That's pretty scary, right? That's pretty horrible. So what was going on inside of you?
What were you experiencing? Well, I had the feeling that I'd done something terribly wrong, you know. And you did, with dad, you did feel that. Now this with trauma is very, very important, particularly with physical trauma where children are threatened. Because if you're threatened by a powerful parent who's about three times your size or something like that, this is what happens, right?
This is what happens to these kids. And you want to be able to get them to verbalize that. You know, if somebody's shouting at you, you're a fucking useless, you're a fucking useless, you are.
If you've got that in your face, right? Oh my God, what have I done? So you must capture that because that's a crucial aspect of experience or is the internalization of blame, the feeling you've done something terrible.
Very common for kids who have been physically abused, even though later they kind of push it away and deny it. Very, very important. So you capture that emotion. So the first emotion, then the first process is capturing this idea of having done something terrible.
And with mind mapping, you always ask, what else? What else? Anything else? What else can you remember?
What else was part of that experience for you? So mind mapping, you're doing a map of the mind. He was able to say, well, I was obviously very frightened.
When Dad was like that, I'd be really frightened. And anything, yeah, I was sad, I suppose. I was also sad. I think I was probably, probably cried. I felt really sad because I just felt very bad.
And he probably had a sense of shame, although he didn't say that. What else do we feel paralyzed and trapped? As we talked about in just exploring the textures of the experience of the trauma, these gradual nuances and varieties of experience began to become plain.
So there's a sense of paralyzed and entrapment. Now entrapment is incredibly important because if you think about the problem that he's got in his relationship and you understand that... He has a feeling of entrapment when he gets into conflict. That's very important. But you need to capture that, right?
So paralyzed and entrapped was very important for him. And he used to say, you know, when Dad became aggressive, you couldn't get away. There was nowhere to get away to, you know.
Where did you go? Entrapment, and as you probably know, we've done a lot of work on entrapment. Entrapment is very, very important to capture when you're working with Tron. What else?
Okay. And you can ask the question directly. Did you feel there were anybody there to support you, would help you, or did you feel alone or whatever? Okay.
So I asked him the question directly because he didn't volunteer it. And he said, oh, no, no, I felt completely alone. But he hadn't volunteered that. But for CFT, that's really important, the feeling of aloneness. Nobody will come.
Nobody will rescue. You are on your own. You are alone. That feeling, this part of the trauma is incredibly important, right?
And you want him to be able to voice it and remember it and talk about it. Okay. Wanting to hide, try to apologize. I wanted to, just wanted to apologize.
Now it's not, it wasn't his fault that he was given the orange juice and he slipped. I mean, and yet here he is, seven year old, wanting to apologize to his father to stop his father hurting him. And you'll see this in people who have certain types of depression with certain types of self-criticism. That's what they're doing.
They're blaming themselves. It's my fault. I was so stupid. It's my fault.
I was so stupid. I'm so useless. I'm so this.
I'm so that. I'm so this. Where did they get that from? They got that as a submissive effort to protect themselves. I'm so sorry, Daddy.
Please don't hit me. I didn't mean to do it. I'm just so stupid. I know.
You need to capture these experiences when you're working with these clients because they're multi-textured and very complex. And then you can begin to help the client work with them bit by bit. And time and again, when I've worked with trauma clients, when they began to see the pattern, the map of the multiple experiences of being laid down when they were traumatized, they're quite amazed.
And they said, I've never really looked at it like that before. You know, just looked at it like my threat system was there. No, no, it's multiple, right?
You've got feeling down, something terrible. You've got intense fear. The high level of sadness, you're feeling absolutely paralyzed, you're trapped, there's a terrible feeling of aloneness, no one's going to come, you're on your own, you're wanting to hide, you feel that it's your fault, you're going to apologize. So can you see then what's happened is your body is monitoring all this stuff for you in a kind of way, trying to protect you.
So when you're attacked, you tend to do that, you tend to feel blamed. And if you get into arguments with your wife, it's very... Easy for these emotional textures just to begin to texture your experience of feeling something wrong with you or maybe you've done something or you've said something you shouldn't have said and then you want to get away because you want to be alone.
That's the only way you know how to cope with it. You don't want to have to engage with it. And for these clients also, they're very frightened of their own anger.
They're absolutely terrified of retaliation. All right, so that's important. Okay, so I was going to show you a video, but unfortunately I'm running out of time. But just very, very quickly, what you then do is you work with the three basic systems that I talked to you about just now.
And we work with people's anger. When people are traumatized, there'll always be an aspect of anger there somewhere. I mean, whether the trauma you've just been diagnosed with cancer or whether it's remembering trauma from the past, there'll always be a part of you that's angry about what's happened.
Always happens. There'll be a part that's anxious about it, and there'll be a part that's very sad. So when you're doing CFT, you're bringing compassion. to these three aspects.
Working compassionately with your anger, helping clients experience anger towards the abuser or towards the abuse or whatever it is, so they can begin to experience that. Because these clients, when they begin to feel anger, they can feel very unlovable. They can feel even more alone. Anger is not easy for them, okay? There's no point in teaching them to be a surgeon, to be all that stuff, if they're scared.
shitless of their anger. You can't do that. So the first thing then, you have to help them to bring a compassionate ability to the anger, to understand the fear of the anger, the fear that the anger doesn't make them an unlovable person, or they're not going to become like their father, or they're not going to fragment and do something terrible and whatever.
So it's a lot of work to do for some, not all clients, but for some clients around the inhibition of anger. And then of course you've got the trauma, the anxiety, there's a lot of work done on anxiety work, helping people with anxiety. But what's in CFT also we bring compassion to grieving because there's a lot of grieving that goes on, okay, because basically in the grief situation what you're doing is to recognize that all of us are born with basic needs and the need is protection.
The most important need of an infant is is obviously to be fed and click, but also protection, to be protected. Very, very important. That's what the attachment system is all about. I mean, if you're a turtle, you don't get any protection. The moment you hatch, you're off.
But with the attachment, one of the things the parent does is to protect the child from threat and certainly not be a threat itself. So protection is extremely important, and that's what our systems are waiting for, to experience that experience of protection. which then allows us to begin to mature our brains in a way for social relationships and so forth.
So there is always an archetypal desire to have been wanted, to have been loved by a father, to have been seen as a special person, and a mother, of course. And helping the client grieve for the fact that they didn't get there can be very, very important. The ability to grieve for the love you never had.
The father you needed and wanted, but you never had. So you don't just deal with the hostility of the father. You have to deal, you have to grieve for the one that wasn't there as well. Okay?
So then we bring compassion into this capacity to grieve for what wasn't. Okay? So if you've been sexually abused, grieve for the way in which that has influenced your life.
The grieving of the ability to come to terms with what's happened to you is very, very important. So it's not just about... being assertive and blah, blah.
Those are important. But grieving and regenerating the self through a process of acknowledging unmet needs and the ability to work through unmet needs can be incredibly, incredibly moving in therapy when you're working with trauma. Okay, so I've taken up too much of your time. I sincerely apologize. So I'm going to hand back to Lucy now.
So just to say again then that CFT is a model that integrates the basic sciences of mind, the motives, the emotions. We bring that together. Compassion organizes those in a way.
It organizes your attention. It organizes your motives. It organizes your thinking.
When you bring that, you also bring a whole range of physiological systems online, and those systems will help you then work with the threat system and things that you're struggling with. So that is compassion-focused therapy. We use a lot of standard interventions from CBT and other therapies, of course, ACT and all. We use a lot of these therapies. But we always bring that compassion motivation as the basics, as the climate, if you like, as the context in which we do the work.
Okay, so thank you so much for listening to me. And as I say, we will hand you back now to Lucy and see you all next year.