前言

前言

在这本写得既优美又技巧高超的书中，罗素·科尔茨利用自己的经验概述了同情聚焦疗法（CFT）的关键主题。人们很容易认为，同情在心理治疗中的方法只是帮助人们对自己和他人友好。实际上，同情的核心——特别是在治疗领域——是勇气。罗素本人曾在监狱中与有愤怒问题的囚犯合作，并开发了一种他称之为“真实力量”的CFT方法，强调同情是勇敢地面对我们自己的痛苦以及他人的痛苦的力量。

我必须承认，对于“简化疗法”这一概念我曾持怀疑态度，因为这很容易被视为将疗法简化为浅显易懂。需要注意的是，同情聚焦疗法在某些方面是非常复杂的：它基于对基本科学建立的心理过程的考虑；情感、动机和认知是如何运作的；以及人类如何通过社会关系深深嵌入并组织起来。因此，当你读到“简化”这个词时，不要认为罗素是在说这种疗法是“简单的”。相反，他是在概述CFT的一些关键概念，希望这些概念对你有用，或许能激发你去了解更多。

我很高兴地说，罗素以一种我永远无法做到的方式出色地实现了他的目标。我是那种倾向于看到复杂性而非简单性的人之一。所以这里有一本极好的指南，可以引导你了解CFT的现实——它的艰难、困难和复杂性——但正如罗素所说，是以相对直接和简单的方式来构建层次和基础。

正如本书所述，CFT始于1980年代，以一种相对简单和直接的方式开始。它最初只是注意到理解人们在试图帮助自己时，在脑海中创造的情感基调的重要性。例如，想象一下你在感到抑郁时尝试产生一些有益的想法。但是，想象一下以非常敌对的方式“听到”和体验这些想法，仿佛你即使在心中说出它们时也感到烦躁和轻蔑。那会是什么感觉？即使是像“你可以做到”这样鼓励的话语，当以敌对的内心“语调”传达时也会变得恶毒。你可以试着以轻蔑、有些敌意的方式对自己说这句话，注意这种感觉。观察你是否感到受到鼓励。

然后想象你可以真正专注于话语中的温暖和同理心的理解，专注于这种感受——也许就像你听到一个真心希望你摆脱抑郁的人用一颗关怀的心说它一样，或者就像听到自己的声音支持、友善且肯定，怀着同样的愿望。实际做这样的练习是有帮助的，因为在CFT中，通过亲自实践获得个人经验是发展你的治疗技能的关键。

多年前的发现

多年前我发现，尽管人们可以在“认知”层面上学会产生新的视角和应对思维，但他们通常是以轻蔑或敌对、烦躁的语气来做这件事。事实上，他们常常很难体验到涉及两个现在被认为是同情核心的重要方面的应对思维。首先，他们难以将这些思维导向自己，带着基于同理心的关注来解决困难的根本原因（同情动机）。许多患者实际上责备自己，或者认为自己不值得同情，或者认为同情是某种软弱的表现——太柔和了！有时，他们非常回避造成自己痛苦的原因——例如，不愿面对导致他们抑郁的创伤经历，或者不愿承认他们需要做出生活改变。开始处理这些问题需要勇气。其次，当他们在脑海中实际产生这些思维时，往往难以生成支持性的、友善的、理解的和认可的情绪（同情行动）。

因此，CFT始于思考如何帮助客户产生同情动机和关怀导向的情绪，并在这一动机中创造心灵中的某种情感平衡。正如罗素所说，我们使用一个标准的同情定义——即渴望痛苦停止，愿意培养“对自己和他人痛苦的敏感性，并承诺努力减轻和预防这种痛苦。”预防部分很重要，因为我们的培训旨在减少当前和未来的痛苦。因此，同情的心理学首先是关于我们如何开始应对我们的痛苦并真正开始理解它。正如罗素在此概述的，我们需要许多能力，例如我们如何集中注意力，如何体验接触痛苦，如何忍受痛苦，以及如何在没有评判或批评的情况下同理心地理解痛苦。

同情的第二重心理学

同情的第二重心理学实际上是关于培养真正有用的智慧。真正的助人需要智慧的发展——我们必须理解痛苦的本质，才能有效地应对它。心灵非常复杂，充满了冲突的动机和情感。虽然温暖和温柔可以是同情的一部分，但同情也需要一定的坚定、果断和极大的勇气。父母会因为想保护孩子而与他们在饮食或晚归问题上争论，即使这可能会引起冲突。在某些治疗过程中，客户害怕他们的愤怒、焦虑或悲伤。治疗师可能需要鼓励这些客户体验这些情绪，即使客户不愿意这样做，即使这样做当时并不愉快，因为这是帮助客户学会体验和应对这些困难情绪所必需的。这是一种治疗技能和智慧，使治疗师知道如何以及何时这样做。事实上，几年前的研究显示，一些最温暖的治疗师竟然是行为主义者！这合乎逻辑，因为行为疗法经常需要鼓励客户面对他们不愿接触的事情。

CFT还使用进化功能分析来帮助我们理解情绪是如何工作的。正如Russ明确指出的，我们从功能上将情绪分为三种类型的情绪调节系统：有用于应对威胁和保护我们的感情，有激励我们外出、实现目标和获取资源的感情，还有产生满足感、安全感和放松感的情绪——这些有时与副交感神经系统的休息和消化功能有关。许多客户在这些情绪上严重失衡，几乎无法获得满足感和平静的感觉。副交感神经系统的研究表明，许多精神健康问题患者的情绪平衡和调节系统功能失调。在这种情况下，我们必须帮助他们恢复这些安全感觉。通过这种方式，建立和培养减缓、扎根、体验安全感、联系和归属感的能力成为CFT的核心治疗目标。这为客户提供了应对恐惧材料的能力——无论是外部世界中需要做的事情，还是内部世界中的事物。

鉴于CFT是一种基于进化的疗法，它借鉴了依恋理论及其广泛的研究基础也就不足为奇了。依恋理论告诉我们，与关爱他人的关系可以提供一个安全基地（可以作为平台，使我们能够外出尝试新事物、冒险）和一个避风港（一个安全和稳定的基础，在遇到困难时可以得到安慰、帮助和支持）。CFT帮助客户开始体验和发展这个内在的安全基地和避风港。

一旦理解了这三种不同情绪的本质，很多事情就迎刃而解了

一旦一个人理解了我们之前讨论过的三种不同情绪的本质，很多事情就会迎刃而解。例如，当士兵接受训练时，他们的安全基地和避风港会从家庭转向战斗伙伴——因为这些伙伴确实是他们在战斗中感到安全的来源。当他们出任务时，会处于高度紧张的状态，而当他们返回时，会平静下来，在战友的陪伴中找到那个避风港。因此，他们的安抚系统已经被重新编程，以回应这些战斗伙伴。当他们回家后，可能会失去大脑已经适应的安全基地和避风港，因此会有更少的强烈“多巴胺激增”。即使他们现在回到了家中，与家人在一起，处于物理上的安全环境，但由于家人不再是他们安全基地和避风港的来源，这可能会非常困难，甚至压力重重。

CFT清楚地概述了这些过程，因为它包含了一个能够处理这种复杂程度的情绪模型。这个例子反映了CFT的一个常见方面：CFT治疗师非常关注患者如何平静和扎根自己，感受到与安全基地和避风港的连接，并发展出必要的勇气去应对恐惧和回避的经历。同样重要的是发展内部的归属关系；也就是说，学会以友善和支持的方式对待自己，而不是以批评的方式继续刺激威胁系统。

优秀的治疗师希望了解他们使用的疗法背后的证据。鉴于本书的目的，罗素并没有用过多的证据来压倒读者，但他明确表示，CFT的许多证据是过程证据。也就是说，我们没有很多理论概念，而是试图理解和利用科学告诉我们的关于动机和情绪的知识——例如，我们对前额叶皮质在童年时期的发展或受创伤影响的重要性了解多少。我们知道，归属动机（如依恋或群体归属）和情绪在哺乳动物的进化中，尤其是在人类智力的进化中，发挥了非常重要的作用。我们也知道，归属关系是动机和情绪的强大调节器。因此，这些应该是治疗干预的目标。

CFT的核心在于详细理解我们的大脑是如何形成的，理解情绪的进化功能，理解动机的核心调节过程以及动机如何与自我身份相关联，理解如何在治疗过程中培养自我身份。如今，全世界都在开始认识到，人类的大脑充满复杂的情绪和冲突，部分原因是其进化设计——这一认识甚至反映在流行文化中，如迪士尼电影《头脑特工队》（2015年）。人类的大脑非常复杂，容易被引诱去做伤害他人的坏事和伤害自己的事。然而，同情的动机有助于带来和谐，减少这些风险。

CFT是一种综合疗法

CFT是一种综合疗法，利用了许多基于证据的干预策略。这些策略包括苏格拉底式对话、引导发现、识别安全行为、关注回避和暴露、推理链、重新评估、行为实验、正念、身体/情绪意识和呼吸训练、意象练习、支持成熟等。然而，CFT还具有一些独特特点：

• 关于我们进化出的“复杂”大脑的心理教育
• 情绪调节模型，特别关注归属感和副交感神经系统
• 特别关注自我批评和自我意识情绪的复杂功能和形式，突出不同类型羞耻和内疚的区别
• 建立以同情为中心的动机、能力和身份作为内在组织系统
• 利用自我身份作为组织和培养同情动机和能力的手段
• 应对同情、积极情绪尤其是归属情绪的恐惧、障碍和抵抗

CFT的一个关键方面是动机是我们心智的主要组织者。动机与表型之间的复杂联系超出了当前讨论的范围。但例如，想象你被邀请参加一个派对，你的动机是竞争性的社会地位。你希望给那里的人留下深刻印象，避免犯错或被拒绝，并且希望抓住任何机会来识别群体中的主导成员并给他们留下深刻印象。现在让我们改变这个动机，假设你的动机是关注关爱或友谊。这时，你的注意力不再集中在谁是主导者或你能给谁留下深刻印象（或如何留下深刻印象），而是更多地了解他们。你对分享价值观感兴趣，也许希望发展友谊。你会根据是否喜欢某人和是否愿意花时间与他们相处来考虑他们。我们思考、关注和行动的方式都由动机引导。当然，信念和组织图式也与此有关——实际上，这些都与动机相连——但关键问题是动机。当我们看到这些动机在组织我们心智方面的强大作用时，就明白了为什么同情和亲社会动机在CFT中占据核心地位。

研究揭示了许多心理健康问题患者的动机

研究揭示，许多心理健康问题患者主要通过竞争性的社会等级系统来驱动自己的行为，这表现为严厉的自我评判、自我批评和担心被看作是低人一等或无能，从而被排斥，常伴有强烈的孤独感。这些人可能常常觉得自己被困在低等级、低地位或不受欢迎的位置。当然，也有另一些人过度专注于获得主导地位，无论这对他人有何影响，都一心想着出人头地和掌控局面。对于这些患者来说，转向关爱或同情的动机可能是一个启示，但也可能相当令人恐惧。不同类型的人在培养同情和亲社会动机时，可能会遇到阻力，而不是继续专注于竞争性的社会等级。CFT教人们如何思考不同的动机和情绪状态，并练习在这些状态之间切换。当我们学会在内心创造一种明智、坚强、同情的动机，并将其锚定在自我感知的中心时，我们会发现它带来了应对生活危机的智慧，以全新的方式关注自己的痛苦和他人的痛苦。我们发现，这是一种从痛苦中解放自己的方式，学会容忍那些无法改变的事物。一个简短的影片《为声音赋予同情》展示了为什么培养同情的自我意识很重要：https://www.youtube.com/watch?v=VRqI4lxuXAw。

罗素引导读者关注自己的身体，学习如何识别哪些情绪动机系统在我们身上运作（这些动机可以自动激活，对我们的情绪和行为产生很大影响，除非我们培养更多的正念意识），并使用来自标准疗法、冥想传统和表演传统的多种技术，培养关爱的动机、情绪和自我身份。正如罗素所指出的，CFT的细节确实很复杂，但这里介绍的层次化方法有助于以简单明了的方式组织这些复杂性。我很高兴看到罗素以如此清晰、易于理解、循序渐进的方式撰写这本书。我希望它能吸引你了解更多——也许接受更多的培训，甚至激发你在内心培养日益深厚的同情动机。正如罗素所指出的，没有什么比个人实践和洞察更能让人理解这些过程是如何运作的。

现在我能做的就是将你交给才华横溢且能力出众的作者，并希望这能激发你更多地了解同情的本质，以及如何将其带入治疗，当然，也带入我们生活的各个方面。 — Paul Gilbert, PhD, FBPsS, OBE

进一步阐述的知识点

• 同情聚焦疗法（Compassion-Focused Therapy, CFT）

  • CFT是一种心理治疗方法，旨在帮助个体学会如何以更加同情的方式对待自己和他人。该方法特别关注于培养个体的内在同情力，从而促进心理健康和福祉。

• 同情与勇气的关系

  • 在CFT中，同情不仅仅是情感上的共鸣或对他人的关心，而是一种需要勇气的行为，特别是当面对自己或他人的痛苦时。这种勇气体现在能够直面内心的负面情绪，并采取积极行动来缓解这些情绪带来的影响。

• CFT的复杂性

  • 尽管CFT的目标是以简单易懂的方式呈现，但它实际上建立在复杂的心理学理论之上，包括情感、动机、认知等多个方面的知识，以及对人类社会关系的深层次理解。这意味着CFT不仅关注表面的症状，还深入探讨了症状背后的心理机制。

• 实践的重要性

  • 在CFT中，实践不仅是学习的一部分，也是治疗过程的关键。通过实际操作来体验和内化同情的概念，可以帮助个体更好地理解和应用这些技巧。例如，通过特定的练习来培养自我同情的能力，可以使个体在面对困难时更加坚韧和积极。

• CFT的发展历程

  • CFT从1980年代起，经历了一个从简单到复杂的发展过程。最初，它只是注意到理解人们在试图帮助自己时，在脑海中创造的情感基调的重要性。随着时间的推移，CFT逐渐形成了一套系统的理论框架和实践方法，旨在解决人类心理和社会生活中的各种挑战。

进一步阐述的知识点

• 认知与情感的分离

  • 尽管人们可以在认知层面学会新的应对策略和思维方式，但在实际应用中，这些策略往往伴随着负面的情感，如轻蔑、敌对或烦躁。这种分离表明，仅仅改变思维模式是不够的，还需要在情感层面上进行调整。

• 同情的两个核心方面

  • 同情动机：这是指带着基于同理心的关注，解决自己和他人痛苦的根本原因。许多患者由于自责、认为自己不值得同情或认为同情是软弱的表现，而难以产生这种动机。
  • 同情行动：这是指在实际产生这些思维时，能够生成支持性的、友善的、理解的和认可的情绪。许多患者在这方面也遇到困难。

• 勇气的重要性

  • 开始处理深层次的痛苦问题需要勇气。这些问题可能涉及创伤经历或需要做出重大生活改变，患者往往倾向于回避这些问题。

• CFT的目标

  • CFT旨在帮助客户产生同情动机和关怀导向的情绪，并在这一动机中创造心灵中的情感平衡。这包括培养对痛苦的敏感性和承诺减轻和预防痛苦的能力。

• 预防未来的痛苦

  • CFT不仅关注当前的痛苦，还强调预防未来的痛苦。通过培训，个体可以学会如何在当前和未来减少痛苦。

• 必要的能力

  • 在CFT中，个体需要培养多种能力，包括：
    • 集中注意力：学会如何将注意力集中在重要的事情上。
    • 体验痛苦：学会如何体验接触痛苦而不被其压倒。
    • 忍受痛苦：学会如何忍受痛苦，而不是逃避。
    • 同理心理解：学会如何在没有评判或批评的情况下同理心地理解痛苦。

进一步阐述的知识点

• 智慧与同情的关系

  • 真正的助人不仅需要同情，还需要智慧。这种智慧包括理解痛苦的本质，才能有效地应对它。心灵非常复杂，充满了冲突的动机和情感，因此需要深刻的洞察力和智慧来指导同情行为。

• 同情的多维度

  • 温暖与温柔：虽然温暖和温柔是同情的一部分，但同情还需要一定的坚定、果断和勇气。例如，父母为了保护孩子，会在饮食或晚归问题上与孩子争论，即使这会引起冲突。
  • 坚定与果断：在某些治疗过程中，客户可能害怕自己的愤怒、焦虑或悲伤。治疗师需要鼓励客户体验这些情绪，即使客户不愿意，即使这样做当时并不愉快。这是帮助客户学会应对困难情绪所必需的。

• 治疗技能与智慧

  • 治疗师需要具备特定的技能和智慧，知道如何以及何时鼓励客户面对和体验这些困难情绪。研究表明，一些最温暖的治疗师竟然是行为主义者，因为行为疗法经常需要鼓励客户面对他们不愿接触的事情。

• CFT中的情绪调节系统

  • CFT使用进化功能分析来理解情绪的工作原理。情绪被分为三种类型的情绪调节系统：
    • 威胁应对系统：用于应对威胁和保护自己。
    • 激励系统：激励我们外出、实现目标和获取资源。
    • 安抚系统：产生满足感、安全感和放松感，与副交感神经系统的休息和消化功能有关。
  • 许多客户在这些情绪上严重失衡，几乎无法获得满足感和平静的感觉。副交感神经系统的研究表明，许多精神健康问题患者的情绪平衡和调节系统功能失调。

• CFT的核心治疗目标

  • 建立和培养减缓、扎根、体验安全感、联系和归属感的能力是CFT的核心治疗目标。这为客户提供了应对恐惧材料的能力，无论是外部世界中需要做的事情，还是内部世界中的事物。

• 依恋理论的应用

  • CFT借鉴了依恋理论及其广泛的研究基础。依恋理论认为，与关爱他人的关系可以提供一个安全基地和一个避风港。CFT帮助客户开始体验和发展这个内在的安全基地和避风港，从而增强他们的心理韧性和支持系统。

进一步阐述的知识点

• 三种不同情绪的本质

  • 威胁应对系统：用于应对威胁和保护自己。
  • 激励系统：激励我们外出、实现目标和获取资源。
  • 安抚系统：产生满足感、安全感和放松感，与副交感神经系统的休息和消化功能有关。
  • 一旦理解了这三种情绪的本质，很多心理和行为现象就能迎刃而解。例如，士兵在战场上的行为和回归家庭后的适应问题。

• 士兵的适应问题

  • 当士兵接受训练时，他们的安全基地和避风港会从家庭转向战斗伙伴，因为这些伙伴是他们在战斗中感到安全的来源。出任务时他们会高度紧张，返回时则在战友的陪伴中找到避风港。回家后，他们可能会失去大脑已经适应的安全基地和避风港，因此会有更少的强烈“多巴胺激增”，即使在物理上安全的环境中，也可能感到困难和压力。

• CFT的情绪模型

  • CFT包含了一个能够处理复杂情绪的过程模型。治疗师关注患者如何平静和扎根自己，感受到与安全基地和避风港的连接，并发展出必要的勇气去应对恐惧和回避的经历。同时，发展内部的归属关系，学会以友善和支持的方式对待自己，而不是以批评的方式继续刺激威胁系统。

• 治疗的证据基础

  • 优秀的治疗师希望了解他们使用的疗法背后的证据。CFT的许多证据是过程证据，而不是理论概念。这些证据基于科学对动机和情绪的研究，例如前额叶皮质的发展和创伤的影响。

• 进化心理学的视角

  • 归属动机（如依恋或群体归属）和情绪在哺乳动物的进化中，尤其是在人类智力的进化中，发挥了非常重要的作用。归属关系是动机和情绪的强大调节器，因此这些应该是治疗干预的目标。

• CFT的核心内容

  • CFT的核心在于详细理解我们的大脑是如何形成的，理解情绪的进化功能，理解动机的核心调节过程以及动机如何与自我身份相关联，理解如何在治疗过程中培养自我身份。

• 人类大脑的复杂性

  • 人类的大脑充满复杂的情绪和冲突，部分原因是其进化设计。这一认识甚至反映在流行文化中，如迪士尼电影《头脑特工队》。人类的大脑非常复杂，容易被引诱去做伤害他人的坏事和伤害自己的事。然而，同情的动机有助于带来和谐，减少这些风险。

进一步阐述的知识点

• CFT的综合性质

  • CFT是一种综合疗法，结合了多种基于证据的干预策略，如苏格拉底式对话、引导发现、识别安全行为、关注回避和暴露、推理链、重新评估、行为实验、正念、身体/情绪意识和呼吸训练、意象练习、支持成熟等。这些策略旨在从多个角度帮助患者应对心理问题。

• CFT的独特特点

  • 心理教育：关于我们进化出的“复杂”大脑的心理教育，帮助患者理解大脑的复杂性和情绪的起源。
  • 情绪调节模型：特别关注归属感和副交感神经系统，帮助患者调节情绪，恢复心理平衡。
  • 自我批评和自我意识情绪：特别关注自我批评和自我意识情绪的复杂功能和形式，区分不同类型羞耻和内疚，帮助患者更好地理解自己的情绪反应。
  • 建立同情动机：建立以同情为中心的动机、能力和身份作为内在组织系统，帮助患者发展积极的自我形象和行为模式。
  • 利用自我身份：利用自我身份作为组织和培养同情动机和能力的手段，帮助患者在心理治疗中找到内在的动力。
  • 应对恐惧和障碍：应对同情、积极情绪尤其是归属情绪的恐惧、障碍和抵抗，帮助患者克服心理障碍，建立积极的心理状态。

• 动机在CFT中的核心地位

  • 动机是我们心智的主要组织者，影响我们的思考、关注和行动方式。例如，如果一个人参加派对的动机是竞争性的社会地位，那么他的注意力会集中在如何给人留下深刻印象、避免犯错或被拒绝上。而如果动机是关爱或友谊，那么他的注意力会集中在了解他人、分享价值观和发展友谊上。
  • 动机与表型之间的复杂联系超出了当前讨论的范围，但关键在于动机对心智的组织作用。CFT强调同情和亲社会动机，因为这些动机能够帮助患者建立积极的心理状态，改善人际关系，提高生活质量。

• 动机与行为的关系

  • 动机不仅影响我们的行为，还影响我们的认知和情绪。通过改变动机，可以从根本上改变一个人的思维方式和行为模式。例如，从竞争性动机转变为关爱动机，可以显著改善人际关系和社会互动。

• CFT的治疗目标

  • CFT的治疗目标是帮助患者建立积极的动机和行为模式，提高情绪调节能力，减少心理障碍，提升生活质量。通过综合运用多种干预策略，CFT能够全面地帮助患者应对心理问题，实现心理健康的提升。

进一步阐述的知识点

• 竞争性社会等级系统的动机

  • 许多心理健康问题患者主要通过竞争性的社会等级系统来驱动自己的行为。这种动机表现为严厉的自我评判、自我批评和担心被看作是低人一等或无能，从而被排斥，常伴有强烈的孤独感。这些人可能常常觉得自己被困在低等级、低地位或不受欢迎的位置。
  • 例如，一个在工作中总是担心被同事看不起的人，可能会不断自我批评，努力表现得更好，但这种努力往往伴随着巨大的压力和焦虑。

• 获得主导地位的动机

  • 也有一些人过度专注于获得主导地位，无论这对他人有何影响，都一心想着出人头地和掌控局面。这种动机可能导致他们忽视他人的感受，只关注自己的成功和地位。
  • 例如，一个在社交场合总是试图成为焦点的人，可能会不顾他人的感受，只为了展示自己的优越感。

• 转向同情动机的挑战

  • 对于这些患者来说，转向关爱或同情的动机可能是一个启示，但也可能相当令人恐惧。不同类型的人在培养同情和亲社会动机时，可能会遇到阻力，而不是继续专注于竞争性的社会等级。
  • 例如，一个长期依赖竞争性动机的人可能会觉得转向同情动机意味着放弃自己的优势，这让他们感到不安。

• CFT的治疗方法

  • CFT教人们如何思考不同的动机和情绪状态，并练习在这些状态之间切换。通过学会在内心创造一种明智、坚强、同情的动机，并将其锚定在自我感知的中心，患者可以发现它带来了应对生活危机的智慧，以全新的方式关注自己的痛苦和他人的痛苦。
  • 例如，通过正念练习，患者可以学会识别和管理自己的情绪，减少自我批评，培养同情心。

• 具体的技术和方法

  • 罗素引导读者关注自己的身体，学习如何识别哪些情绪动机系统在我们身上运作，并使用来自标准疗法、冥想传统和表演传统的多种技术，培养关爱的动机、情绪和自我身份。
  • 例如，通过身体意识练习，患者可以更好地理解自己的生理反应，通过冥想练习，可以培养内心的平静和同情。

• CFT的复杂性和层次化方法

  • 尽管CFT的细节确实很复杂，但这里介绍的层次化方法有助于以简单明了的方式组织这些复杂性。罗素以清晰、易于理解、循序渐进的方式撰写这本书，帮助读者逐步掌握CFT的核心理念和实践方法。
  • 例如，书中通过具体的案例和练习，逐步引导读者理解如何在日常生活中应用CFT的原理和技术。

• 个人实践的重要性

  • 个人实践和洞察是理解这些过程如何运作的关键。通过实际操作和体验，患者可以更深刻地理解同情的动机和情绪，从而在日常生活中更好地应用这些技巧。
  • 例如，通过持续的正念练习和情感调节训练，患者可以逐渐减少自我批评，培养更多的同情心和积极情绪。

希望这些知识点能帮助你更全面地理解CFT的核心理念和实践方法，激发你进一步探索和应用这些技巧的兴趣。

Foreword In this beautifully and skillfully written book, Russell Kolts uses his experience to outline the key themes in compassion-­focused therapy (CFT). It’s very easy to think that compassion approaches to psychological therapies are just about helping people be kind to themselves and others. In reality, the center of compassion—­particularly in the therapeutic arena—­is courage. Russell himself has worked with anger problems in prison inmates and has developed a CFT approach that he calls the True Strength program, highlighting compassion as the strength and courage to turn toward our suffering, and that of others. I must confess that I was dubious about “making therapies simple” because this can easily be seen as dumbing them down. It’s important to note that compassion-­focused therapy is in some ways very complex: based in consideration of basic scientifically established psychological pro- cesses; the ways in which emotions, motives, and cognitions operate; and the manner in which humans are deeply socially embedded and organized through their social relationships. So when you read this in terms of “made simple,” don’t think that Russell is saying the therapy is “simple.” Rather, he is outlining some of the crucial concepts of CFT in the hope that they will be useful to you, and perhaps excite you to learn more. I’m delighted to say that Russell achieves his goal brilliantly and in a way I never could. I am one of those people who tend to see complexity rather than simplicity. So here is a wonderful guide to introduce you to the realities of the toughness, difficulties, and complexities of CFT—­but, as Russell says, creating the layers and building blocks in relatively straightforward and simple ways. As explained in this book, CFT began in a relatively simple and straightforward way in the 1980s. It started with just noticing the importance of understanding the emotional tone people created in their heads when they tried to be helpful to themselves. For example, imagine you are trying to generate helpful thoughts when you’re feeling depressed. But imagine “hearing” and experiencingCFT Made Simple these thoughts in a very hostile way, as if you are irritated and contemptuous even as you say them in your mind. How will that be? Even an encouraging phrase like You can do it becomes venomous when communicated in a hostile mental “tone of voice.” You might try saying that to yourself in a contemptuous, sort of hostile way and notice how that feels. Notice whether you feel encouraged. Then imagine that you can really focus on warmth and empathic understanding in the words, focusing on the feeling—­maybe as if you were hearing somebody who really cared about you say it with a heart that wishes for you to be free of your depression, or maybe as if hearing your own voice as supportive, kind, and validating with the same intention. Actually doing exercises like this is helpful, because in CFT getting personal experience by doing the practices yourself is key to the development of your therapeutic skills. What I found all those years ago was that while people could “cognitively” learn to generate new perspectives and coping thoughts, they often did so with a contemptuous or hostile, irritable tone. Indeed, they often found it very difficult to experience coping thoughts that involved two important aspects that are now recognized as being core to our understanding of compassion. First, they struggled to direct these thoughts toward themselves with a heartfelt motivation that is based on empathic concern to address the deeper causes of the difficulties (compassionate motiva- tion). Many patients actually blamed themselves, or thought they did not deserve compassion, or that compassion was weakness in some way—­just too soft! Sometimes they were very avoidant of the causes of their suffering—­for example, not wanting to address the traumatic experiences underpinning their depression, or the fact that they needed to make life changes. It takes courage to begin working on these difficult issues. Second, they tended to struggle with generating sup- portive, kind, understanding, and validating emotions when they actually created those thoughts in their mind (compassionate action). So CFT began with trying to think about how to help clients generate compassionate motivation and care-­orientated emotions, and also within that motivation, to create certain kinds of emotional balancing within the mind. As Russell says, we use a standard definition of compassion—­one that captures the heartfelt wish for suffering to cease, a preparedness to develop “sensitivity to suffering of the self and others with a commitment to try to alleviate and prevent it.” The prevention part is important, because the training that we do is aimed at reducing suffering both in the present and in the future. So the first psychology of compassion is about how we begin to address our suffering and really start to understand it. As Russell outlines here, there are many competencies that we are going to need, such as how we pay attention, how we experience being in contact with distress, how we tolerate our distress, and how we empathically understand it without being judgmental or critical. The second psychology of compassion is really about developing the wisdom of knowing how to be genuinely helpful. True helpfulness requires the development of wisdom—­we must under- stand the nature of suffering before we are well equipped to work with it. Minds are very tricky and are full of conflicted motives and emotions. Also, although warmth and gentleness can be part of compassion, compassion requires a certain toughness, assertiveness, and a great deal of courage as well. Parents are prepared to argue with their children over their diets or going out late at night viiiForeword because they want to protect them, even though this may cause conflicts. In some therapy encoun- ters, clients are frightened of their anger or anxiety or grief. Therapists may then need to encour- age these clients to experience such emotions, even when a client is reluctant to do so, and even when doing so may not be pleasant at the time, because that is what’s required to help this client learn to experience and work with these difficult feelings. It’s a therapeutic skill and wisdom that allows the therapist to know how and when to do this. Indeed, some years ago, studies showed that some of the warmest therapists were behaviorists! That makes sense, because behavior therapy often has to encourage clients to engage with things they’d rather not connect with. CFT also uses evolutionary functional analysis to help us understand how our emotions work. As Russ clearly outlines, we consider emotions in terms of three functionally distinct types of emotion-­regulation system: there are emotions for dealing with threats and trying to protect us, emotions that are stimulating us to go out and achieve and acquire resources, and emotions that give rise to feelings of contentment, safeness, and slowing down—­which are sometimes linked to the parasympathetic functions of rest and digestion. Many of our clients are very out of balance with these emotions, and the capacity for contentedness and peaceful feelings can be almost impos- sible for them to access. Studies of the parasympathetic nervous system have shown that this system is out of balance in many people with mental health problems, with the major emotion-­ balancing and regulating systems not operating appropriately. In such cases, we have to help them get these feelings of safeness online. In this way, building and cultivating the capacity for slowing down, grounding, and experiencing safeness, connectedness, and affiliation are central treatment targets for CFT. This creates the competencies and strengths for people to then engage with feared material—­be these things they need to do in the outside world, or in the internal one. Given that CFT is an evolutionary-­based therapy, it will not be surprising to hear that it draws from attachment theory and its extensive research base. Attachment theory tells us that relation- ships with caring others can provide a secure base (which can be the platform to enable us to go out and try things, take risks) and a safe haven (a safe and secure base where we can be soothed, helped, and supported when we’ve gotten into difficulties). CFT helps clients begin to experience and develop this internalized secure base and safe haven. Once a person understands the nature of those three different types of emotion we visited earlier, then a lot of things fall into place. For example, when soldiers are trained, their secure base and safe haven can shift away from their families and toward their combat buddies—­because that is indeed the source of their safeness in combat. When they go out on sorties they will be in high-­ stakes arousal, and when they come back they will calm down and find that safe haven within the company of their buddies. So the soothing systems have been rewired to respond in connection with these combat buddies. When they come home, they can then lose the secure base and safe haven that their brains have gotten wired up for, and there will be fewer intense “dopamine rushes.” Even though they are now at home with their families in a physically safe environment, it can be very difficult and even stressful, because those families are not now the source of the secure base and safe haven. ixCFT Made Simple CFT outlines these kinds of processes clearly because it contains an emotional model capable of dealing with that degree of complexity. This example is reflective of a common aspect of CFT: the CFT therapist is very interested in how patients are able to calm and ground themselves, feel connected to a secure base and safe haven, and then develop the courage necessary to engage with feared and avoided experiences. Key too is the development of the internal affiliative relationship; that is, one learns to relate to oneself in a friendly, supportive way rather than in a critical manner that will continue to stimulate the threat system. Good therapists want to know the evidence behind the therapies they utilize. Given the purpose of this book, Russell has not overwhelmed it with evidence, but makes clear that a lot of the evidence for CFT is process evidence. That is, we don’t have many theoretical concepts, but rather try to understand and draw upon what the science tells us about things like motivation and emotion—­for example, what we know about the importance of the frontal cortex and how that develops during childhood or is affected by trauma. We know that the affiliative motives (such as attachment or group belonging) and emotions played a very major role in mammalian evolution and in particular the evolution of human intelligence. We also know that affiliative relationships are very powerful regulators of motives and emotions. It follows, therefore, that these would be targets for therapeutic intervention. The backbone of CFT is found in detailed knowledge of how our brains have become the way they are, understanding the evolutionary function of emotions, understanding core regulating pro- cesses of motives and how motives are linked to self-­identity, and understanding how self-­identity can be cultivated in the therapeutic process. All over the world now, we are beginning to recognize that the human mind is full of complex emotions and conflicts partly because of its evolved design—­an awareness that is increasingly reflected even in popular culture, such as the Disney movie Inside Out (2015). The human brain is very tricky, easily pushed into doing bad things to others and harmful things to ourselves. Compassionate motives, however, help to bring harmony and reduce the risks of both. CFT is an integrative therapy, which makes use of many evidence-­based intervention strate- gies. These include Socratic dialogue, guided discovery, identification of safety behaviors, focus on avoidance and exposure, inference chaining, reappraisal, behavioral experiments, mindfulness, body/emotion awareness and breath training, imagery practices, supporting maturation—­and more besides. However, CFT also features a number of unique features: • Psychoeducation about our evolved “tricky” brains • Models of affect regulation with special focus on affiliation and the parasympathetic nervous system • A specific focus on the complex functions and forms of self-­criticism and self-­conscious emotions, highlighting distinctions between different types of shame and guilt • Building compassion-­focused motives, competencies, and identities as inner organizing systems xForeword • Utilizing self-­identity as the means for organizing and developing compassionate motives and competencies • Working with fears, blocks and resistances to compassion, positive feelings, and espe- cially affiliative emotions One of the key aspects of CFT is the idea that motives are major organizers of our minds. They are linked to phenotypes in complex ways that are beyond the scope of the current discussion. But for example, imagine that you are invited to a party and you are motivated by competitive social rank. You want to impress the people there, and avoid making mistakes or being rejected, and you want to take any opportunity you can to identify the more dominant members of the group and impress them. Now let’s change that motivation and imagine you have a motivation that’s focused on caring or friendship. Now your attention is not on who is dominant or whom you can impress (or how you can impress them), but on finding out more about them. You are interested in sharing values, and perhaps developing friendships. You will be considering people in terms of whether you like them and want to spend time with them or not. The ways we think, pay attention, and act are guided by motivations. Of course, beliefs and things like organizing schemas come into it—­in fact, these are linked to motives—­but the crucial issue is motivation. When we see how powerful these motives can be in organizing our minds, it becomes clear why compassion and prosocial motivations are central in CFT. Research has revealed that many people with mental health problems are motivated primarily through competitive social rank systems which play out in terms of harsh self-­judgments, self-­criticizing, and worries of being seen as inferior or incompetent in some way and rejected, often with intense feelings of loneliness. These individuals may often feel they are stuck in low-rank, low-status, or undesirable positions. Of course, there are others who are hyper-­focused on attaining dominance; focused on getting ahead and taking control regardless of the impact it has on others. Switching to caring-­focused or compassionate motivations can be a revelation to such clients, but can also be quite frightening. Different types of clients can experience resistance toward cultivating compas- sionate and prosocial motives rather than competitive social rank–focused ones. CFT teaches people how to think about different motivational and emotional states and to practice switching between them. When we learn how to create within us a wise, strong, compassionate motivation and then to anchor that motivation at the center of our sense of self, we discover that it brings with it a wisdom for how to deal with life crises, orienting us to our own suffering and those of others in very different ways. We discover that it’s a way of liberating ourselves from suffering and learning how to tolerate that which can’t be changed. A very simple depiction of the essence of why devel- oping a compassionate sense of self is important can be seen in “Compassion for Voices,” a very short film about how people who hear voices can develop a compassionate self: https://www .youtube.com/watch?v=VRqI4lxuXAw. Russell guides readers through the processes by which we need to pay attention to our bodies, learn how to identify which emotion motivational systems are operating through us (motives which can be activated quite automatically and exert considerable control over our thoughts and xiCFT Made Simple behaviors unless we develop more mindful awareness), and cultivate care-­focused motives, emo- tions, and self-­identity using a range of techniques drawn from standard therapies, contemplative traditions, and acting traditions. As Russell makes clear, the details of CFT can indeed be complex, but the layered approach presented here helps to organize these complexities in a straightforward, understandable way. I’m delighted to see Russell write this book in such a clear and easy-­to-­ understand, step-­by-­step way. I hope it will entice you to learn more—­perhaps to get more train- ing, and perhaps even motivate you to cultivate an ever-­deepening compassionate motivation within yourself. As Russell points out, there’s nothing like personal practice and insight to see how these processes work. All that I can do now is to leave you in the talented and capable hands of your author and hope this inspires you to learn more about the nature of compassion and how we can bring it into therapy, and of course, into all aspects of our lives. —­Paul Gilbert, PhD, FBPsS, OBE xii