第二章 同情心概览

第二章 引入同情

在CFT中，我们从一个与词典和达赖喇嘛一致的同情定义开始：对痛苦的敏感，以及伴随而来的缓解或预防痛苦的动机。在CFT的背景下，同情不仅仅是我们来访可能追求的众多价值观之一——尽管它当然可以作为指导生活追求的价值观（这也是我们显然会鼓励的）。首先且最重要的是，CFT中的同情是一种对待痛苦的态度——一种赋予我们能力，以有益的动机去面对痛苦并处理和缓解它的态度。让我们花点时间来剖析这个定义。

在同情的背景下，我们可以将敏感理解为能够意识到痛苦，以及愿意被痛苦触动。如果我们的心智失衡，强烈地陷入威胁或驱动力的体验中，我们可能会对痛苦视而不见。这并不意味着我们不在乎，而是因为我们可能过于专注于感知到的威胁或追求目标，以至于他人的痛苦（甚至我们自己的痛苦）都不会出现在我们的雷达上。

此外，如果我们的来访在世界中生活，其心身被威胁体验所主导，开放自己去感受痛苦可能会令人难以承受。在这种情况下，我们可以理解他们为什么会采取回避策略来减轻强烈的痛苦。另一方面，如果情绪平衡，威胁和驱动力的情绪被体验安全感和观察情绪而不推开它们的正念能力所缓和，我们的来访可以学会注意到他们的痛苦，并以温暖的态度被触动而不至于被压垮。回避可以转变为愿意的、正念的、同情的觉知：“我现在真的很难过。我和配偶的争吵真的激起了我被抛弃的恐惧。这对我来说真的很难。”

在考虑这种可能性时，我们可以看到，我们将帮助来访发展的同情的一个主要方面是情感勇气——即愿意接近和连接非常困难的情感，以帮助自己处理这些体验。

同情的第二个组成部分涉及帮助缓解和预防痛苦的善意动机。虽然看起来当面对痛苦时，我们自然会想要帮助缓解它，但这并不总是如此，特别是对于有广泛羞耻和自我批评历史的来访。对于这些来访来说，对他们挣扎和痛苦的观察可能不是帮助的前兆，而是自我攻击的前兆，因为他们将这些体验解读为更多证据表明“我有问题”——他们不好、有缺陷或不值得。其他来访可能会与这些体验融合——过于陷入沉思和基于威胁的思考和情感循环中，以至于无法脱离这些体验并考虑他们能为自己的痛苦做些什么。

在这里，我们再次看到了帮助来访以非责备的方式对待他们的体验的重要性，正念观察何时威胁反应开始带走他们，并与安全感的感受相连。当这一切发生时，它为同情的理性出现铺平了道路，沉思的念头“我无法忍受这个”让位于同情的问题，如“在我处理这个困难体验时，什么会有帮助？”此外，为了帮助来访保持这种有益的动机，去接近和处理痛苦，我们还需要帮助他们建立信心，相信他们能够采取有益的行动——这种信心根植于一套有用技能的储备中。我们需要给他们提供有效的工具、策略和实践。

同情的属性

既然我们已经探讨了同情的工作定义，让我们花些时间进一步探讨CFT中如何具体化同情。这种具体化在图9.1的《同情之圈》中以图形方式展示。在该图中，同情被描绘为一系列属性，这些属性通过各种同情技能的训练来培养，所有这些都在一个充满温暖的治疗环境中进行。

在CFT中，同情涉及培养各种属性，这些属性有助于以熟练的、面向处理的态度对待痛苦、挣扎和苦难。贯穿这些属性的是帮助来访培养同情的勇气——使他们能够面对和处理真正困难的事情，尤其是他们可能倾向于回避的挑战性情感。让我们简要探讨这些属性。

（摘自Gilbert, 《同情之心》[2009]，经Little, Brown Book Group许可重印。）

敏感性

如前所述，敏感性是我们对同情定义的核心组成部分。在这个背景下，敏感性指的是帮助来访打开对痛苦、苦难、挣扎和困难体验的意识。这种开放性可能与他们惯常的应对方法中的回避形成鲜明对比。敏感性涉及注意到这些体验，使它们进入意识。我们帮助来访学会积极而有目的地关注生活中的困难事物，而不是回避，这使他们有可能被这些事物所触动。

同情

同情的敏感性不仅仅是冷冰冰地意识到事情不如我们所愿。它充满了温暖——包含与受苦者的内在联系，无论这个受苦者是自己还是他人。同情涉及对受苦者的些许心痛——我们被他们的苦难所触动。这种同情非常重要，与来访常常带入治疗中的自我批评和羞耻形成鲜明对比。同情涉及自我与自我、自我与他人的关系的柔和化。当来访能够停止自我攻击，允许自己被自己的苦难（或他人的苦难）所触动时，这有助于他们有动机面对和处理这些苦难，即使知道这样做不会容易。有了同情，我们被触动，并且我们想要帮助——这引出了下一个属性。

同情的动机

同情涉及真诚地帮助预防或缓解苦难的动机。有了同情，我们接受并自愿地与苦难打交道，但不会沉溺其中。在帮助来访培养同情的动机时，我们是在帮助他们培养面对苦难的具体意图——理解苦难及其成因和条件，以便采取有益的行动来帮助缓解或预防苦难。我们试图帮助来访增强并学会转换到一种照顾者的社会心态（稍后我们会讨论社会心态），这样他们就不会被威胁感所消耗，而是将注意力、思维、动机和行为集中在帮助自己和他人上。这种关怀的动机可以激发面对困难的勇气。这种关怀的动机并不是我们从零开始制造的——我们是在唤醒来访与哺乳动物祖先一起进化的天然照顾和抚育能力，使他们能够在确保后代生存的同时面对巨大的艰难和危险。

忍受痛苦的能力

正如我们在其他疗法模型中看到的，例如辩证行为疗法（Linehan, 1993），CFT也包含了忍受痛苦的能力作为需要培养的一种能力。为了直接而积极地处理痛苦及其成因，来访和治疗师都需要能够忍受由此带来的不适。CFT中的忍受痛苦能力不仅包括愿意忍受不适，还包括培养自我安抚的能力——帮助自己感到安全，使生活变得更容易，尤其是在接近和处理痛苦时必须忍受的疼痛。

非评判性

正如我们将看到的，CFT中的同情还包括帮助来访发展正念觉知。除了上述的敏感性——即注意到——同情还涉及以接受和非评判的方式对待自己的体验。在培养同情的过程中，来访学会用同情的觉知取代伴随困难体验的评判、贴标签和自我责备，这种同情的觉知旨在理解这些体验。这引出了最后一个同情的属性：同理心。

同理心

同情涉及被痛苦所触动，而同理心则涉及努力从受苦者的角度理解痛苦的存在。我们希望帮助来访深入观察自己和他人内心产生的一系列情感。我实际上在感受什么？我这样感受有什么道理？在暂停评判后，同情力求理解正在穿越的情感景观——无论是治疗中还是生活中。

综合起来，这些同情的属性形成了一个强大的对待痛苦的导向，从意识到行动。有了同情，我们注意到痛苦，被它所触动，并且想要帮助。为了做到这一点，我们必须努力忍受痛苦，并以非评判和同理心的方式理解导致痛苦和困难的原因和条件。凭借这种动机和理解，来访和治疗师能够充分利用多种强大的技术来解决心理痛苦——这就是为什么CFT可能成为那些主要在其他模式下工作的治疗师的有益补充。

同情心训练

在帮助来访培养上述同情的属性时，CFT专注于协助他们发展一系列同情的技能。让我们来看看我们将在帮助来访培养上述同情属性时针对的技能训练领域。

同情的思维和推理

CFT中的同情思维工作分为两个方面。首先，它涉及帮助来访以正念的方式对待思维——非评判地注意到和接受他们的思维作为心理活动，而不被这些思维所束缚或推开。其次，它涉及有目的性地培养同情的思维方式、推理和理解——这些思维方式是验证性的、安抚性的、鼓励性的，并且熟练地专注于处理痛苦。在CFT中，同情的思维方式以有益性为定义。这些思维方式将在本书采用的多层次方法的多个领域中体现。首先，我们帮助来访发展对其心智、情感以及生活中现状的理解。稍后，我们将重点帮助来访具体培养同情的思维方式。

注意力和感官聚焦

CFT的一个主要目标是帮助来访以熟练的方式处理他们的注意力。首先，我们将通过培养正念来帮助来访发展同情的觉知，这在第七章中有所介绍。正念在CFT中占据核心地位，既增加了来访对思维和情感如何在他们心中产生和发展的意识，又帮助他们以接受和非评判的方式对待和处理这些心理活动。

CFT治疗师还利用特定的感官聚焦练习，帮助来访以能够帮助他们缓解威胁情绪的惯性、平静身体并为同情的心态做准备的方式集中注意力。最常见的练习之一是舒缓节奏呼吸，这在第四章中有所介绍。

想象

CFT广泛使用想象，既帮助来访处理困难的情绪状态，也在他们的生活中发展和应用同情。后者最好的例子是在第九章中介绍的“同情自我”练习。这是一种基于想象的方法表演练习，旨在帮助来访培养一个同情的、适应性强的自我版本，为发展一系列同情的力量提供组织框架。我们还将使用想象练习帮助来访学习自我安抚和创造安全感。

感受和情感

或许将CFT与其他认知行为方法区分开来的一个因素是我们对处理情感的高度重视。像其他疗法一样，CFT中的许多治疗工作都围绕帮助来访处理困难的情感展开。然而，CFT还特别注重有目的性地培养同情的感觉——温暖、友善、勇气、归属感（对自己和他人）以及安全感。这些工作的两方面跨越了许多前面提到的治疗层次——治疗关系作为发展关系安全感的基础，同情的理解和对我们情感及其在我们身上如何表现的正念觉知，以及通过椅子工作、暴露练习和想象培养同情技能，用于情感安抚和处理困难的情感和体验。

行为

同情的第二个组成部分——帮助解决和预防痛苦的动机——如果没有同情的行为则是不完整的。在CFT中，重点在于帮助来访发展一系列同情的行为。CFT中的行为工作不仅帮助来访理解和熟练处理痛苦的来源，还帮助他们构建充满意义、满足感和良好关系的生活。在这项工作中，CFT治疗师利用行为学习理论来理解来访困难的历史根源和维持这些困难的条件，并帮助来访以同情的方式对待这些挑战——作为由他们无法选择或控制的社会力量塑造的习得反应和应对策略。此外，CFT治疗师根据来访的需求，利用广泛的经验支持的行为干预措施——包括行为激活、暴露工作和社会技能培训。

在CFT中，所有这些策略都嵌入在一个以同情的动机和理解为中心的组织框架内。目的是使这些技术变得温暖，目的是软化它们的威胁性方面，潜在地增加来访的动机和利用率。我们希望来访体验这些行为和策略时，不是觉得“我不得不做（其实我根本不想做）”，而是作为同情的动机努力，关心自己并发展力量和能力，以实现美好生活。

总结

在本章中，我们介绍了同情的工作定义，并探讨了CFT如何在来访需要培养的属性和治疗中具体发展的技能方面具体化同情。正如我们在引言中所见，《简单CFT》采用了一种多层次的治疗方法：治疗关系、同情理解的发展、正念觉知的培养，以及同情的具体发展和应用。每一层都围绕为来访在其生活中展现同情奠定基础：创造一个由关系安全感定义的治疗环境；帮助来访理解那些不由他们选择的生物和社会力量如何塑造了他们的体验，这些体验并非他们的错；培养对体验的接受和非评判性觉知；有目的地努力发展一系列同情的力量。在下一章中，我们将探讨这些层次中的第一层：CFT中的治疗关系。

知识点阐述

进一步阐述的知识点

1. 同情的定义

• 敏感性：同情包括对痛苦的敏感性，即能够意识到痛苦并愿意被痛苦触动。
• 缓解和预防痛苦的动机：同情还包括帮助缓解和预防痛苦的善意动机。

2. 情绪平衡与痛苦的意识

• 情绪失衡的影响：当情绪失衡时，人们可能过于专注于感知到的威胁或追求目标，而忽视了自己或他人的痛苦。
• 情绪平衡的作用：当情绪平衡时，威胁和驱动力的情绪被体验安全感和观察情绪的正念能力所缓和，人们可以更好地注意到痛苦并以温暖的态度被触动。

3. 情感勇气

• 接近痛苦的勇气：情感勇气是指愿意接近和连接非常困难的情感，以帮助自己处理这些体验。
• 避免与正念的对比：回避策略可能会暂时减轻痛苦，但正念的同情觉知可以帮助人们更好地面对和处理痛苦。

4. 同情的动机

• 帮助与自我攻击：对于有广泛羞耻和自我批评历史的来访，对痛苦的观察可能引发自我攻击，而不是帮助。
• 非责备的方式：帮助来访以非责备的方式对待他们的体验，正念观察威胁反应，与安全感的感受相连，有助于培养同情的理性。

5. 技能和信心的建立

• 有用的技能：帮助来访建立信心，相信他们能够采取有益的行动，这种信心根植于一套有用技能的储备中。
• 工具和策略：提供有效的工具、策略和实践，帮助来访处理生活中的痛苦。

总结

在CFT中，同情不仅仅是价值观之一，而是一种对待痛苦的态度，赋予我们能力以有益的动机去面对和处理痛苦。通过帮助来访建立情绪平衡、情感勇气、非责备的方式对待体验，以及提供有效的工具和策略，CFT旨在帮助来访更好地处理生活中的痛苦，提升他们的心理健康和生活质量。

进一步阐述的知识点

1. 敏感性

• 定义：敏感性是同情的核心组成部分，指帮助来访打开对痛苦、苦难、挣扎和困难体验的意识。
• 作用：敏感性使来访能够注意到这些体验，而不是回避，从而有机会被这些事物所触动。

2. 同情

• 定义：同情不仅仅是冷冰冰地意识到事情不如我们所愿，而是充满温暖，包含与受苦者的内在联系。
• 作用：同情涉及对受苦者的些许心痛，帮助来访停止自我攻击，允许自己被自己的苦难（或他人的苦难）所触动，从而有动机面对和处理这些苦难。

3. 同情的动机

• 定义：同情涉及真诚地帮助预防或缓解苦难的动机。
• 作用：同情的动机使来访能够接受并自愿地与苦难打交道，而不是沉溺其中。它帮助来访增强面对苦难的具体意图，理解苦难及其成因和条件，采取有益的行动来帮助缓解或预防苦难。

4. 社会心态

• 定义：社会心态是指个体在社会互动中表现出的心理状态和行为倾向。
• 作用：帮助来访增强并学会转换到一种照顾者的社会心态，使他们能够将注意力、思维、动机和行为集中在帮助自己和他人上，而不是被威胁感所消耗。

总结

在CFT中，同情被具体化为一系列属性，这些属性通过各种同情技能的训练来培养。敏感性和同情是同情的核心，帮助来访打开对痛苦的意识，被苦难所触动，并有动机面对和处理这些苦难。同情的动机使来访能够接受并自愿地与苦难打交道，而不是沉溺其中，从而采取有益的行动来帮助缓解或预防苦难。通过这些方法，CFT旨在帮助来访更好地处理生活中的困难，提升他们的心理健康和生活质量。

进一步阐述的知识点

1. 忍受痛苦的能力

• 定义：忍受痛苦的能力不仅包括愿意忍受不适，还包括培养自我安抚的能力。
• 作用：帮助来访和治疗师直接而积极地处理痛苦及其成因，使他们在面对痛苦时能够更好地应对。

2. 非评判性

• 定义：非评判性是指以接受和非评判的方式对待自己的体验。
• 作用：帮助来访用同情的觉知取代伴随困难体验的评判、贴标签和自我责备，从而更好地理解这些体验。

3. 同理心

• 定义：同理心涉及从受苦者的角度理解痛苦的存在。
• 作用：帮助来访深入观察自己和他人内心产生的一系列情感，理解这些情感的合理性，从而更好地处理痛苦。

4. 同情的思维和推理

• 正念对待思维：帮助来访以非评判的方式注意到和接受他们的思维，而不被这些思维所束缚或推开。
• 培养同情的思维方式：帮助来访发展验证性的、安抚性的、鼓励性的思维方式，专注于处理痛苦。

5. 注意力和感官聚焦

• 正念觉知：帮助来访通过培养正念来发展同情的觉知，增加对思维和情感的意识。
• 感官聚焦练习：利用特定的感官聚焦练习，帮助来访缓解威胁情绪的惯性，平静身体，为同情的心态做准备。

总结

在CFT中，忍受痛苦的能力、非评判性、同理心、同情的思维和推理以及注意力和感官聚焦构成了一个强大的对待痛苦的导向，从意识到行动。通过这些方法，CFT不仅帮助来访更好地处理生活中的困难，还提供了多种强大的技术来解决心理痛苦。这些技能和方法的结合使CFT成为其他治疗模式的有效补充，有助于提高来访的心理健康和生活质量。

进一步阐述的知识点

1. 想象

• 定义：CFT广泛使用想象，既帮助来访处理困难的情绪状态，也在他们的生活中发展和应用同情。
• 作用：通过“同情自我”练习，帮助来访培养一个同情的、适应性强的自我版本，为发展一系列同情的力量提供组织框架。通过想象练习帮助来访学习自我安抚和创造安全感。

2. 感受和情感

• 定义：CFT对处理情感高度重视，不仅帮助来访处理困难的情感，还特别注重培养同情的感觉。
• 作用：通过治疗关系、同情理解、正念觉知和同情技能的培养，帮助来访更好地理解和处理自己的情感。

3. 行为

• 定义：同情的动机需要通过具体的同情行为来实现。
• 作用：帮助来访发展一系列同情的行为，不仅处理痛苦的来源，还构建充满意义、满足感和良好关系的生活。利用行为学习理论和经验支持的行为干预措施，帮助来访以同情的方式对待挑战。

总结

CFT通过多层次的方法帮助来访在其生活中展现同情。这些层次包括治疗关系、同情理解、正念觉知和同情技能的培养。每一层都旨在为来访在日常生活中展现同情奠定基础，最终帮助他们实现更好的心理健康和生活质量。

CHAPTER 2 Introducing Compassion In CFT, we begin with a definition of compassion that is consistent with both the dictionary and the Dalai Lama: sensitivity to suffering with an accompanying motivation to alleviate or prevent it. In the context of CFT, compassion isn’t simply one of any number of values our clients might seek to pursue—­although it certainly can be chosen as a value to guide one’s life pursuits (one which we would obviously encourage). First and foremost, compassion in CFT is an orientation to suffering—­one that empowers us to approach suffering with the helpful motivation to work with it and alleviate it. Let’s take a moment to unpack this definition.

In the context of compassion, we can consider sensitivity as referring to the ability to become aware of suffering, as well as the willingness to be moved by it. If our minds are unbalanced and powerfully caught up in experiences of threat or drive, we can find ourselves oblivious to suffering. It’s not that we don’t care, necessarily. It’s that we can become so powerfully focused on perceived threats or caught up in pursuing our goals that the suffering of others (or even ourselves) just doesn’t show up on the radar.

Additionally, if our clients are going through the world with mind and body dominated by experiences of threat, opening themselves to suffering can be overwhelming. In such a situation, we can understand why they might resort to avoidance strategies in the effort to alleviate intensely felt distress. On the other hand, if things are balanced, with threat and drive emotions tempered by the ability to experience safeness and the mindful capacity to observe emotions without pushing them away, our clients can learn to notice their suffering, and to be warmly moved by it without becoming overwhelmed. Avoidance can give way to a willing, mindful, compassionate awareness: I’m really hurting right now. This argument with my spouse has really activated my fears of being abandoned.

This is really hard for me. In considering this possibility, we see that a primary aspect of compassion we’ll be helping our clients develop is emotional courage—­the willingness to approach and connect with very difficult feelings, in the service of helping themselves work with these experiences. The second component of compassion involves the kind motivation to help alleviate and prevent suffering. While it may seem obvious that when presented with suffering, we’d want to help alleviate it, this isn’t always the case, particularly for clients with extensive histories of shame and self-­criticism. For such clients, observations of their struggles and pain may serve as anteced- ents not for helping but for self-­attacking, as they interpret these experiences as more evidence that there is something wrong with me—­that they are bad, flawed, or unworthy. Other clients may become fused with such experiences—so caught up in rumination and cycles of threat-­based thinking and emotion that they are unable to disengage from the experience and consider what they might be able to do about their pain.

Here again, we see the importance of helping clients relate to their experience in nonshaming ways, to mindfully observe when threat responses begin to carry them away, and to connect with feelings of safeness. When this happens, it paves the way for compassionate reasoning to emerge, as ruminative thoughts like I can’t take this give way to compassionate questions, such as What would be helpful as I work with this difficult experience? Additionally, If we’re to help our clients maintain this helpful motivation to approach and work with suffering, we also need to help them develop confi- dence that they can engage in helpful action—­confidence rooted in a repertoire of useful skills for working with the pain of life. We need to give them tools, strategies, and practices that work.

COMPASSIONATE ATTRIBUTES Now that we’ve explored a working definition of compassion, let’s spend a bit more time exploring how compassion is operationalized in CFT. This operationalization is depicted graphically in the Circle of Compassion in figure 9.1, below. In this figure, compassion is depicted as a collection of attri- butes, which are cultivated via the training of various compassionate skills, all of which occurs within a therapeutic context defined by warmth. Compassion in CFT involves the cultivation of various attributes that facilitate a skillful, approach-­based orientation toward pain, struggle, and suffering. Woven throughout these attri- butes is a focus on helping clients develop compassionate courage—­so that they can approach and work with the really difficult things, particularly the challenging emotions they may be inclined to avoid. Let’s briefly explore these attributes.

Warmth Warmth SKILLS TRAINING Imagery Attention ATTRIBUTES Sympathy Sensitivity Care for well-being Feeling Compassion Nonjudgment Reasoning Distress tolerance Empathy Behavior Sensory Warmth Warmth

Figure 9.1: The Circle of Compassion—­Compassionate Attributes and Skills. (From Gilbert, The Compassionate Mind [2009], reprinted with permission from Little, Brown Book Group.)

Sensitivity As we’ve mentioned previously, sensitivity is a core component of our definition of compassion. In this context, sensitivity refers to helping clients open their awareness to experiences of pain, suffering, struggle, and difficulty. This openness may stand in stark contrast to the avoidance that may characterize their habitual coping methods. Sensitivity involves noticing these experiences, so that they show up on the radar. Rather than avoiding the difficult things in their lives, we help clients learn to actively and purposefully attend to them, which allows the possibility of being moved by them.

Sympathy The sensitivity of compassion isn’t a cold awareness that things aren’t as we’d prefer them. It is infused with warmth—­containing a felt connection to the being that suffers, whether that being is us or someone else. Sympathy involves feeling a bit of heartbreak for the being that is suffering—­we are moved by their suffering. This sympathy is important, and it stands in stark contrast to the self-­criticism and shame that our clients often bring to therapy. Sympathy involves a softening of self-­to-­self and self-­to-­other relating. When clients can stop self-­attacking and allow themselves to be moved by their own suffering (or that of others), it helps them be motivated to face and work with this suffering, even knowing that doing so won’t be easy. With compassion, we are moved, and we want to help—­which brings us to the next attribute.

Compassionate Motivation Compassion involves a sincere motivation to help prevent or alleviate suffering. With compas- sion, we accept and engage willingly with suffering, but we don’t wallow in it. In helping clients develop compassionate motivation, we’re helping them develop the motivation and courage to approach suffering with a specific intent—­to understand the suffering and the causes and condi- tions that lead to it, so they can engage in helpful activity to help alleviate or prevent it. We’re trying to help clients strengthen and learn to shift into a caregiving social mentality (we’ll discuss social mentalities a bit later), so that rather than being consumed by feelings of threat, their atten- tion, thinking, motivation, and behavior are focused on helping themselves and others. This moti- vation can give rise to the courage to face difficulties head-­on. This caring motivation isn’t something we’re manufacturing from scratch—­we’re working to awaken our clients’ natural capacity for caregiving and nurturance that evolved with our mammalian ancestors, enabling them to face tremendous hardship and danger to ensure the survival of their young.

Distress Tolerance As we see in other therapy models, such as dialectical behavior therapy (Linehan, 1993), CFT incorporates distress tolerance as a capacity to be cultivated. In order to work directly and actively with suffering and the factors that lead to it, both clients and therapists need to be able to tolerate the discomfort that comes with doing so. Distress tolerance in CFT involves both the willingness to endure discomfort and the cultivation of the ability to self-­soothe—­to help ourselves feel safe and to make life a bit easier when there is pain that must be endured as we approach and work with suffering.

Nonjudgment As we’ll see, compassion in CFT also involves helping clients develop mindful awareness. In addition to the sensitivity—­the noticing—­described above, compassion involves the ability to relate to one’s experience in accepting, nonjudgmental ways. In cultivating compassion, clients learn to replace the judging, labeling, and self-­blame that may accompany difficult experiences with a com- passionate awareness that seeks to understand these experiences. This leads us to the final compas- sionate attribute: empathy.

Empathy Whereas sympathy involves being moved by suffering, empathy involves making efforts to understand the suffering as it exists from the perspective of the being that suffers. We want to help clients look deeply at the range of emotions arising within themselves and others. What am I actually feeling? How does it make sense that I might be feeling this way? Having suspended judgment, compassion seeks to understand the emotional landscape that is being traversed—­in therapy, and in life.

Taken together, these compassionate attributes form a powerful orientation toward suffering, which unfolds from awareness to action. With compassion, we notice suffering, we are moved by it, and we want to help. In order to do this, we must work to tolerate distress, and to nonjudgmentally and empathically under-stand the causes and conditions that contribute to the suffering and difficulty. Armed with this motivation and understanding, clients and therapists are well equipped to draw upon a wide variety of powerful technologies to address psychological suffering—­which is why CFT can potentially be a helpful adjunct for those whose therapeutic work is rooted primarily in other modalities.

COMPASSIONATE MIND TRAINING In helping clients cultivate the compassionate attributes described above, CFT focuses on assisting them in developing a number of compassionate skills. Let’s take a look at the skill-­training domains we’ll be targeting in helping our clients cultivate the compassionate attributes described above.

Compassionate Thinking and Reasoning Compassionate thought work in CFT is twofold. First, it involves helping clients relate to thoughts mindfully—­nonjudgmentally noticing and accepting their thoughts as mental activity without getting caught up in clinging to them or pushing them away. Second, it involves the pur- poseful cultivation of compassionate ways of thinking, reasoning, and understanding—­ways of thinking that are validating, soothing, encouraging, and skillfully focused on working with suffer- ing. In CFT, compassionate ways of thinking are defined by helpfulness. These ways of thinking will be represented in multiple areas of the layered approach we’re taking in this book. First, we help clients develop compassionate understanding of their minds, emotions, and how things came to be the way they are in their lives. A bit later on, we focus on helping clients specifically cultivate com- passionate ways of thinking.

Attention and Sensory Focusing A primary goal in CFT involves helping clients to work with their attention in skillful ways. First, we’ll help clients develop compassionate awareness through the cultivation of mindfulness, introduced in chapter 7. Mindfulness occupies a central role in CFT, both in increasing client awareness of how thoughts and emotions arise and play out in their minds, and in helping them relate to and work with these mental activities in accepting, nonjudgmental ways.

CFT therapists also utilize specific sensory-­focusing exercises in training clients to focus their attention in ways that can help them soften the inertia of threat emotions, calm the body, and prepare the way for compassionate states of mind. One of the most common of these exercises is soothing rhythm breathing, introduced in chapter 4.

Imagery CFT utilizes imagery extensively, both in helping clients work with difficult affective states and in developing and applying compassion in their lives. The latter is best exemplified by the Compassionate Self practice, introduced in chapter 9. This practice is an imagery-­based method-­ acting practice aimed at helping clients cultivate a compassionate, adaptive version of the self that provides an organizational framework for the development of a repertoire of compassionate strengths. We’ll also use imagery exercises to help clients learn to self-­soothe and create feelings of safeness in themselves.

Feeling and Emotion One factor that perhaps distinguishes CFT from other cognitive behavioral approaches is the high premium we place on working with affect. Like other therapies, much therapeutic work in CFT is anchored around helping clients work with difficult emotions. However, CFT also involves a very intentional focus on the purposeful cultivation of compassionate feelings—­warmth, kindness, courage, affiliation (to self and others), and safeness. Both sides of this work cross many of the layers of therapy mentioned earlier—­the therapeutic relationship as a basis for the development of relational safeness, compassionate understanding and mindful awareness of our affects and how they play out in us, and the cultivation of compassionate skills for emotional soothing and for working with difficult emotions and experiences via chair work, exposure exercises, and imagery.

Behavior The second component of compassion—­the motivation to help address and prevent suffer- ing—­is incomplete without compassionate action. In CFT, there is a strong focus on helping clients develop a repertoire of compassionate behaviors. Behavioral work in CFT is focused both on helping clients understand and work skillfully with sources of suffering and on building lives that are filled with meaning, fulfillment, and good relationships. In this work, CFT therapists draw upon behavioral theories of learning to understand the historical roots and conditions that maintain client difficulties, and to help clients relate to these challenges in compassionate ways—­as learned responses and coping strategies that were shaped by social forces they didn’t get to choose or control. Additionally, CFT therapists make use of a wide range of empirically supported behavioral interventions—­including behavior activation, exposure work, and social skills training—­depending upon the needs of the client.

In CFT, all of these strategies are couched within an organizing framework of compassionate motivation and understanding. The idea is that we’re warming up the techniques, with the goal of softening their threatening aspects and potentially increasing client motivation and utilization. We want clients to experience these behaviors and strategies not as something I have to do (that I’d really rather not do) but as compassionately motivated efforts to care for themselves and develop strengths and competencies in the service of having good lives.

SUMMARY In this chapter, we’ve introduced a working definition of compassion, and have explored how CFT operationalizes compassion in terms of attributes we help clients cultivate and specific skills we’ll be working to develop in therapy. As we saw in the introduction, CFT Made Simple takes an approach defined by layers of treatment: the therapeutic relationship, the development of compassionate understanding, the cultivation of mindful awareness, and the specific development and application of compassion. Each of these layers is centered around laying the groundwork for clients to mani- fest compassion in their lives: creating a therapeutic environment defined by relational safeness; facili- tating our clients’ understanding of the unchosen biological and social forces that have shaped their experience in ways that were not their fault; cultivating accepting, nonjudgmental awareness of their expe- riences; and purposefully working to develop a repertoire of compassionate strengths. In the next chapter, we’ll explore the first of these layers: the therapeutic relationship in CFT.