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Introducing compassion-focused therapy
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Summary: Shame and self-criticism are transdiagnostic problems. People who experience them may struggle to feel relieved, reassured or safe. Research suggests that a specialised affect regulation system (or systems) underpins feelings of reassurance, safeness and well-being. It is believed to have evolved with attachment systems and, in particular, the ability to register and respond with calming and a sense of well-being to being cared for. In compassion-focused therapy it is hypothesised that this affect regulation system is poorly accessible in people with high shame and self-criticism, in whom the ‘threat’ affect regulation system dominates orientation to their inner and outer worlds. Compassion-focused therapy is an integrated and multimodal approach that draws from evolutionary, social, developmental and Buddhist psychology, and neuroscience. One of its key concerns is to use compassionate mind training to help people develop and work with experiences of inner warmth, safeness and soothing, via compassion and self-compassion.
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“CFTis grounded in a theoretical assumption that we have three affective systems (threat, drive and soothing) and that enhancing the soothing system helps us manage negative thoughts and emotions through promoting social bonding and positive self-repair behaviours (Gilbert 2009).”
From Effectiveness of Self-Compassion Related Therapies: a Systematic Review and Meta-analysis (2019) · cites this paper as Gilbert 2009
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“Compassion-focused therapy (CFT; Gilbert, 2009, 2014), for example, relies on the same evolutionary stress systems, helping people to reduce their own stress levels and experience (self-) connection, warmth, safety, and reassurance by developing a supportive inner voice.”
From A theoretical exploration of polyvagal theory in creative arts and psychomotor therapies for emotion regulation in stress and trauma (2024) · cites this paper as Gilbert, 2009
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“The issue of self-acceptance is central for the compassion-focused psychotherapeutic approach to the treatment of pathological shame [23,24,47,48].”
From Shame or What Makes Irrational Social Anxiety Rational. (2025) · cites this paper as [23]
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“Contemporary or traditional models of formulation such as CBT (Beck 2019), Psychodynamic (Malan 1979) or Compassion Focussed Therapy (CFT) (Gilbert 2009) have historically underemphasized cultural identity, value systems, expressions of distress, aspects of intersectionality or language considerations which resoundingly echo the profound absence of multicultural training and competencies and colon”
From Person‐Centered Case Formulation: A Culturally Responsive and Trauma Informed Reconceptualization for Psychotraumatology Practice (2026) · cites this paper as Gilbert 2009
In the citing paper
“The method was employed to enable them to indirectly give compassion to themselves40. In the virtual reality while embodied in a (non-lookalike) adult virtual body they saw a virtual crying child and delivered a previously learned compassionate speech to the child, that then gradually stopped crying.”
From Conversations between self and self as Sigmund Freud—A virtual body ownership paradigm for self counselling (2015) · cites this paper as [40]
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Prospective prediction of first-onset generalized and social anxiety disorders in adolescent girls
Liu, J., Yao, N., Perlman, G., Klein, D. N., Kotov, R., & Mu, W. (2026) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2026.103153 · Cited by 1
Ito, Y., Iwasaki, Y. K., Asano, K., Toshimitsu, M., Sakakibara, E., Yumura, H., Kanamori, Y., Kamo, S., Doi, S. K., Sasaki, N., et al. (2026) · Psychiatry and Clinical Neurosciences Reports · doi:10.1002/pcn5.70293 · Cited by 2
Hynes, M., Finucane, F. M., Collins, C., O’Brien, T., McAnena, O., O'Shea, G. E., Pilch, M., & McGuire, B. E. (2026) · PLoS ONE · doi:10.1371/journal.pone.0342744 · Cited by 1
Metadata
- Authors
- Gilbert, P.
- Affiliations
- University of Derby (GB)
- Corresponding author
- Gilbert, Paul
- ORCID
- Gilbert, Paul
- Venue
- Advances in Psychiatric Treatment
- Publisher
- Cambridge University Press (CUP)
- Published
- 2009-05
- Volume
- 15
- Issue
- 3
- Pages
- 199-208
- ISSN
- 1355-5146 (ISSN-L)
- 1472-1481
- OpenAlex
- W1994387760
- Cited by
- 1,435
- References
- 56
- Citations by year
- 2026: 114 · 2025: 137 · 2024: 145 · 2023: 144 · 2022: 154 · 2021: 150 · 2020: 115 · 2019: 94 · 2018: 73 · 2017: 94 · 2016: 62 · 2015: 55 · 2014: 39 · 2013: 25 · 2012: 15
- FWCI
- 10.99
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Advances in Psychiatric Treatment (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- compassion-focused therapy, shame, self-criticism, emotion regulation, reassurance, safety, self-compassion, compassionate mind training, attachment, Buddhist psychology, evolutionary psychology
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