第十一章 运用同理图像技术

第十一章

运用同情心意象

为了让同情心对患者变得真实，它需要在体验层面上被感受到。 越来越多的研究发现，意象是一种有效的促进来访体验工作的方法（Hackmann, Bennett-Levy, & Holmes, 2011）。在“同情自我”练习中，我们利用意象帮助来访转换视角，并以同情的方式处理困难情况。在本章中，我们将探讨如何使用意象来帮助来访管理痛苦并平衡他们的情绪。

意象的介绍

由于CFT（同情聚焦疗法）经常使用意象，让我们考虑如何有效地向来访介绍想象工作。通常，当来访听到“想象”或“意象”时，他们认为这意味着“在脑海中创造生动的画面”。这个观念可能成为障碍；虽然一些来访能够轻松地创造出如此生动的心理画面，但许多其他人则会为之挣扎。克服这一障碍的关键在于让来访意识到，想象工作并不是关于制造生动的画面——而是关于创造心理体验（Gilbert, 2010）。让我们探索一种向来访介绍这种实践的方法，该方法由Paul Gilbert开发：

治疗师：珍妮，正如我在上一次会谈中提到的，今天我们将介绍一些意象练习，以帮助你在威胁系统高度活跃时唤起安全感，从而平衡你的情绪。我认为在开始之前讨论一下如何使用意象将是有益的。你觉得怎么样？ 珍妮： 听起来不错。 治疗师：除了我们一直在做的“同情自我”练习外，你是否曾经使用过心理意象？比如闭上眼睛尝试想象一些事物？ 珍妮： 去年我参加了一个瑜伽班，有时老师会让我们想象一些事情——比如置身于海滩，或者想象自己是一棵树，生命从脚下的大地流向我们。类似这样的事情。 治疗师：真好——你对此感觉如何？ 珍妮： 我喜欢，但有时效果比其他时候更好。我应该再参加一个瑜伽班，因为它真的让人放松。 治疗师：听起来是个好主意——瑜伽很棒，与我们正在做的事情非常契合。你有使用意象的经验很好。有时人们在意象工作中会遇到困难，因为他们认为这涉及到在脑海中创造非常生动的画面。有些人能做到，但其他人则很难做到。 珍妮： 我想我知道你的意思。我不太擅长这个。 治疗师：（微笑。）我也不行——我并不善于‘在脑海中看到东西’。但是重点是：我们追求的不是创造生动的心理画面，而是创造心理体验。我们可以做一个简短的练习来说明我的意思吗？ 珍妮： （感兴趣地点点头）当然可以。 治疗师：太好了。让我们先调整到我们做练习时使用的那个舒适、挺直的位置……双脚平放在地板上，背部挺直，眼睛闭上。让我们进行大约三十秒的平静节奏呼吸，放慢呼吸速度，专注于减缓的感觉。让身体和心灵都慢下来。 珍妮： （闭上眼睛，慢慢呼吸。） 治疗师：（等待三十秒。）接下来我会提示你短暂地想象几种不同的场景。当我这样做时，只需让自己想象我描述的情景即可。 珍妮： （点头。） 治疗师：首先，回想你今天早上来这里的方式——想象你开车、乘车或步行时所走的路线。（等待三十秒。）现在，回想你最喜欢的甜点。（等待三十秒。）最后，回想你最近的一次度假，如果记不起来，就想象你想要去的度假地。（等待三十秒。）当你准备好了，轻轻地睁开眼睛。 珍妮： （稍等片刻，然后缓缓睁开眼睛，动了动，微微一笑。）嗯。 治疗师：你能对所有我提到的事物形成心理上的感知吗？ 珍妮： 我能。感觉很好。我不想停下来。 治疗师：很好！听起来你能够对那些事物产生心理体验——你走过的路线、甜点、假期——并且似乎也产生了某些情感？ 珍妮： 是的。想象自己像去年夏天那样沿着海滩行走感觉很好。 治疗师：太棒了！这就是心理意象。它是关于将一种体验带入心中，使我们对其有一个清晰的感受。听上去你已经注意到了意象的一个好处——我们的古老情绪大脑会对意象作出反应，产生不同的情感，就像你因想象自己回到海滩而产生的那种愉悦感一样。 像这样的练习可以让来访了解意象工作是什么样的，并给予他们信心，相信自己能够做到。我们希望创造一个心理环境，在其中来访能够专注于意象练习，尽量减少因担心是否做得正确而引起的自我评价性想法造成的干扰。

创建安全空间

创建安全空间是CFT（同情聚焦疗法）的一个目标，旨在帮助来访学会利用三个圈（自我保护、自我驱动、自我同情）来平衡他们的情绪。特别是当他们发现自己进入威胁模式时，这时采用更平衡的方法会更有帮助，或者当他们注意到自己通过反复思考或威胁性的意象加剧了威胁感时。意象可以是一个强大的工具，帮助启动安全系统，而实现这一目标的一种方法是通过安全空间意象。（有时，对于不喜欢“安全空间”一词的来访，它被称为“安抚空间”意象。）

在这个练习中，来访想象自己处于一个能产生安全感、平静、宁静和归属感的环境中。许多治疗师都会以这种方式使用意象。与其他类似的练习一样，我们让来访关注这个安抚空间的各种感官细节。在CFT中，我们在典型的“安全空间”练习中加入了一个亲社会的维度，通过具体的指导语，如：“如果在这个地方有其他生物，想象它们欢迎你、重视你，并且很高兴见到你。事实上，想象这个地方本身也很重视你的存在——仿佛你让它完整了，它很高兴你在这里。”

让我们看看如何在治疗过程中引入和促进这一练习：

治疗师：珍妮，既然我们已经探讨了意象的含义，我想介绍一个特定的练习，旨在帮助你的安全系统发挥作用——帮助你在注意到自己的威胁系统高度活跃时，连接到平静和宁静的感觉。你觉得怎么样？ 珍妮： 为什么不呢？ 治疗师：太好了。某种程度上，你在这方面已经有了一个良好的开端。刚才你说你喜欢想象自己回到假期中的海滩——以至于你不想停下来。你喜欢那里的什么？ 珍妮： 我喜欢海滩。我喜欢它的所有一切——气味、脚下的沙子、看着和听着海浪、阳光。我喜欢在海滩上漫步数小时。那里非常宁静。 治疗师：那确实很美妙。 珍妮： 是的。这是我最喜欢做的事情。 治疗师：这是一个完美的过渡到我们下一个练习。这个练习叫做“安全空间练习”。我们将想象自己处于一个让你感到安全、舒适、平静和安慰的地方。目的是创造一个关于这个空间及其伴随感觉的心理体验。有时需要时间来确定使用什么样的地方——但听起来你可能已经有一个很好的选择。你觉得海滩适合这个练习吗？ 珍妮： 海滩完美极了。 治疗师：太好了。那么我们开始吧。我们将从一些平静的节奏呼吸开始，以减缓我们的身体和心灵。然后我会提示你想象海滩。我会让你描述海滩上的情况——就像它真的在发生一样——以便我们创造一个深刻的心理体验。然后我会安静下来，让你沉浸在意象中约五分钟。如果你的思绪开始游离或被其他想法打扰，没关系——就像我们做正念呼吸时那样，注意到自己分心了，然后温柔地将自己带回海滩。准备好开始了吗？ 珍妮： 让我们开始吧。 治疗师：坐在一个舒适的位置，眼睛轻轻闭上。 珍妮： （稍微移动了一下，闭上了眼睛，放慢了呼吸。） 治疗师：让呼吸变得缓慢而舒适。专注于放慢的感觉。（等待五秒钟。）放慢身体，放慢心灵。（等待三十秒到一分钟。） 珍妮： （慢慢呼吸。） 治疗师：现在，想象自己在那美丽的海滩上。开放自己，感受那里的安抚体验。当你有了画面，描述你在做什么和体验到什么。想象自己在海滩上，感受你喜爱的所有声音、气味和景象。 珍妮： （暂停了五到十秒钟。）我在海滩上散步，能感觉到脚下的沙子挤压着我的脚。我喜欢这种感觉在我的脚趾上。 治疗师：太完美了，珍妮。你还注意到什么？感觉如何？ 珍妮： 温暖而宁静。阳光照在我的脸上，微风轻轻吹拂着我的头发。我听到了海浪声和海鸥的叫声。（停顿了几秒钟。）我能闻到大海的味道。 治疗师：让自己充满在这个美妙地方的安全感、宁静感和喜悦感。也许可以让你的脸上浮现出温和的微笑，享受在这里的时光。 珍妮： （微笑。）嗯。 治疗师：想象你听到的海鸥很高兴你在这里与它们在一起。同样，如果这里还有其他人或其他生物，想象它们欢迎你。它们重视你，很高兴你在这里。（等待二十到三十秒。）想象这个地方本身也欢迎你。它重视你的存在，几乎像是你让它完整了。它很高兴你在这里。 珍妮： （平静地呼吸。） 治疗师：让我们花些时间想象自己在这个地方，充满安全感、平静感和满足感。想象所有与这个空间相关的感受。 珍妮： （继续平静地呼吸。） 治疗师：（等待五分钟。）当你准备好了，轻轻地将注意力转移到缓慢的呼吸感觉上，然后慢慢睁开眼睛。 珍妮： （等待二十秒左右，然后逐渐睁开眼睛。微笑。） 治疗师：感觉怎么样？ 珍妮： 非常好。非常宁静。 治疗师：你有没有对这个地方及其相关感受产生心理体验？ 珍妮： 有。感觉非常舒适和宁静。 治疗师：你能想象这个地方和这里的生物欢迎你吗？ 珍妮： 是的。有点像那些儿童电影中的动物做滑稽的事情。我想象海鸥在我旁边飞，或者从海滩上站着的地方抬头看我。想象起来很有趣。 治疗师：海滩上还有其他人吗？ 珍妮： 一开始没有，但你说了之后，我想象有几个人躺在沙滩上的毯子上，晒太阳，享受自己。非常宁静。 治疗师：这正是它应有的效果。你愿意在未来一周内练习两到三次吗？目的是让你习惯在脑海中访问这个地方，激活那些帮助你感到安全、满足和宁静的大脑部分。 珍妮： 我很乐意。 治疗师：太好了。最好在你已经感觉相当平静的时候开始练习，以便熟练地唤起意象。一旦感觉可以掌控，尝试在你的威胁系统活跃时使用意象，通过连接到安全感来平衡情绪。明白了吗？ 珍妮： 明白了。

事情进展顺利

在上面的案例中，事情进展得非常顺利，因为珍妮在之前的意象练习中已经找到了一个可能的“安全空间”（使用“最喜爱的假期”作为引导意象的一个偶然优势），她也非常擅长与海滩的意象联系起来。她能够迅速进入意象并在治疗中描述它。但并非每次都会这么顺利。有些来访记忆中没有这样的地方，因此我们需要与他们一起考虑这样一个地方可能会是什么样子。有时，我会简要提及几个我自己喜欢的地方——比如在西北部海滩散步、坐在松树林中，甚至在一个最喜欢的英国酒吧里，周围是笑脸和300年的橡木，鼻子里充满了桌上的牛排和啤酒派的舒缓香气。

对于那些不像珍妮那样容易进入意象的来访，我们可以提供感官锚点，利用我们对来访可能感到舒缓的事物的知识：“想象阳光照在你的脸上，海洋的气味和声音……” 我们要说得恰到好处，以促进意象和随之而来的平静感和舒缓感，然后轻轻地退后，让来访沉浸在自己的意象中。有些来访可能需要尝试几个不同的“地方”，才能找到一个适合他们的。最后，身体的工作也很重要——通过舒缓的节奏呼吸设置舞台，并提示一个温和的微笑，可以帮助来访更充分地进入体验，为情感大脑提供另一个舒缓的隐性输入。

我真的无法过多强调这种练习的重要性。虽然没有一种练习适合所有人，但我见过因暴力犯罪而入狱的男性，他们在与愤怒斗争了几十年后，使用这种练习来平息自己的怒气。这些人通过意象平衡了自己的情绪，并重新参与到有效和果断地处理以前可能导致言语或身体攻击的情况中。

理想的同情心意象练习

英国心理学家黛博拉·李开发了一种称为“完美养育者”或“理想同情心意象”的练习（Lee, 2005）。这种练习旨在帮助自我批评的来访学会自我安抚和发展被接受和关心的感觉，通过想象一个理解他们、对他们有同情心并给予关爱、支持和鼓励的理想人物。在这个练习中，治疗师与来访合作，识别出他理想的养育者会具备的特征——可能是接受、善意的关心和爱——以及对来访所经历的一切的深刻理解。与来访可能在生活中经历的人不同，这个养育者是支持的、养育的和鼓励的，永远不会对来访进行评判、批评或羞辱。治疗师还将帮助来访发展出这个养育者的形象、声音，以及他们可能如何互动。与上面的安全空间练习一样，目的是帮助来访尽可能生动地创造心理体验。如果来访生活中有一个人体现了这些品质（或他想象中的人，如一个精神人物），他可以在可视化中使用这个人。

有些来访可能最初会抗拒这个练习，抗议说他们从未在生活中遇到过这样的人。如果这种情况发生，我们可以强调实际上没有人拥有这样的人——一个完全理解、支持和非评判的人。关键是要想象这样一个存在的样子，并想象这个人对我们表现出关爱、理解和接受。让我们看看这个练习在治疗过程中可能的样子：

治疗对话

治疗师：珍妮，我很高兴你上一次喜欢我们介绍的安全空间意象。这周练习得怎么样？

珍妮：非常好。这是我最喜欢的作业。这周我做了三次。

治疗师：太棒了！反复练习确实是关键。在练习过程中，你有没有发现什么有帮助或阻碍的因素？

珍妮：嗯，如果有一个安静的地方练习会更好。我的宿舍晚上很吵，那是我有时间的时候。我最终戴上耳机，试图让周围安静一些，然后我想到我可以下载一段海洋的声音。于是我去网上找到了，现在当我做练习时，我会听海洋的声音，这让一切变得更加真实。

治疗师：哇！你应该来教这个！这是同情思维的一个完美例子，珍妮——发现问题或障碍后，不是陷入其中放弃，而是问自己“有什么办法可以解决这个问题？”你不仅解决了障碍，还找到了一种更好的练习方法——连你的治疗师都没有想到这一点。

珍妮：这确实很酷。

治疗师：确实很酷。顺便说一句，我要借用你这个海洋mp3的想法。这简直是金点子！

珍妮：（笑）随便用吧。

治疗师：我想我们再尝试一个意象练习。你觉得怎么样？

珍妮：好的。

治疗师：正如我们讨论过的，自我批评一直是你的一大难题，你也曾经历过被他人批评和欺负的情况——这些经历非常痛苦。

珍妮：（表情有些痛苦，低头，说话缓慢）是的。

治疗师：我能感受到这些记忆——这些你心中的经历——仍然给你带来很多伤痛。我们希望通过意象帮助你获得完全不同的体验——被关心、接受和理解的体验。

珍妮：（抬头看着治疗师）

治疗师：我们要想象一个完美的呵护者——一个绝对关心你、接受你、深刻理解你并希望你最好的人。一个永远不会评判或嘲笑你的人。你觉得怎么样？

珍妮：很难想象。我从未遇到过这样的人。

治疗师：其实我们谁也没有。现实中的人无法完美地支持我们——而且你的同情意象不一定是人。它可以是一只动物，或者其他类型的生物。我知道有人使用了一棵古老的树作为意象。关键是想象一个能让你感到安全、接受、理解和支持的存在。我们先从想象这个呵护者的特质开始。你觉得这个存在会是什么样的？它会怎样对待你？

珍妮：嗯，他们会对我很好，永远不会让我觉得自己愚蠢。他们会接受我现在的样子。

治疗师：很好。所以他们会很友善，接受你。还有其他的特质吗？

珍妮：他们不会评判或批评我。他们只是喜欢我。

治疗师：他们不会评判你。或许他们还会完全理解你，理解你的背景……真正喜欢你，并在你挣扎时希望帮助和鼓励你。

珍妮：是的，这听起来很好。

治疗师：我们就从这些特质开始：友善、接受、理解和鼓励。让我们想象这样一个慈爱的存在——无论是人类还是非人类，是否有性别，长什么样子等等。你觉得你的完美同情意象会是什么样的？

珍妮：我不知道……（停顿，思考）

治疗师：（沉默等待）

珍妮：我觉得她会是一个女人。一个年长的女人，经历过这一切，知道作为一个女性成长和经历这一切的感受。

治疗师：一个真正理解你的人，因为她自己也经历过。

珍妮：没错。她可能会看到我身上的某些影子，并知道如何帮助我，因为她自己也经历过。

治疗师：她会长什么样子？听起来像什么？会怎么行动？

珍妮：她会有灰白的头发，一个非常友善的微笑。她的声音很温柔，经常笑。她很有幽默感。

治疗师：听起来她很像你内心的同情自我——友善、智慧、自信，能够帮助你应对任何挑战。

珍妮：没错。

治疗师：我觉得我们有了一个很好的起点。你现在想开始练习吗？

珍妮：好的。（调整姿势，闭上眼睛，放慢呼吸）

治疗师：先进行一两分钟的舒缓节奏呼吸……（等待二十到三十秒）放慢身体，放慢心灵……（等待二十到三十秒）

珍妮：（轻声呼吸）

治疗师：想象这个慈爱、智慧、自信的女人，她深深地关心你，理解你，并在那里支持你。

珍妮：（脸庞放松了一些，轻声呼吸）

治疗师：想象她与你在一起，对你友善地微笑。想象她喜欢你，希望你感到被理解。想象她以最有益和安慰的方式向你表达善意和同情。想象她可能会做什么或说什么。想象自己被她的善意、理解和接受所包围。

珍妮：（继续轻声呼吸）

治疗师：（等待五分钟）如果你感到焦虑或其他困难的情绪，想象她在你身边，理解和支持你。想象她在你挣扎时支持你，相信你。她理解这有多难，而这并不是你的错。想象她在你面对这些挑战时向你表达善意和支持。

珍妮：（轻声呼吸）

治疗师：（等待五分钟）当你准备好时，轻轻地睁开眼睛，带着被接受、理解和支持的感觉回到房间。

珍妮：（停顿片刻，然后慢慢睁开眼睛）

治疗师：感觉怎么样？

珍妮：我非常喜欢。这真的非常美好。

治疗师：你能告诉我更多吗？

珍妮：我能看见她，她就在我身边……在某个时刻，我意识到她是我的未来自我。她完全理解我正在经历的一切，而且……（开始轻声哭泣）

治疗师：（静静等待，面带友善的微笑，眼中含泪）

珍妮：（仍在哭泣）……她希望我快乐。她知道我会好起来的。我知道我会挺过来的。（微微一笑）

治疗师：（靠前，温柔地说）你会挺过来的，珍妮。

珍妮：（微笑）我开始相信这一点了。

在上述例子中，我们可以看到这个练习有多么强大。有几个要素展示了如何加深练习的体验方面。首先，注意在引入练习之前，治疗师会跟进其他意象练习，看看是否有需要关注的障碍。珍妮，像许多来访一样，能够解决问题并深入练习——治疗师热情地肯定了这一点。在进入练习时，治疗师提到了一个潜在的障碍——即珍妮生活中没有人像这样——通过将其普遍化（“我们都没有真正有这样的人”），并详细说明了照顾者的品质。

在进入意象练习之前，治疗师引导了一次合作探索，了解珍妮希望她的照顾者具备哪些品质——包括情感品质和对珍妮的态度，以及促进意象的物理品质。在练习过程中，治疗师提示珍妮首先想象照顾者支持她的情景，然后设想如果焦虑或其他困难出现时，这种情况会如何发展。像往常一样，治疗师在练习后进行检查，从珍妮的理想同情形象中得到启示，了解如何支持她。

最后，你会注意到，治疗师在听到珍妮的意象体验时深受感动。虽然这不是CFT计划的一部分（这样做不真诚），但我还是包括了这一点，因为我写这段情景时流泪了，回想起治疗中的类似经历。当然，治疗师的情感不应以任何方式干扰或削弱治疗，转移焦点从来访到治疗师。然而，我发现偶尔让来访看到治疗师被他们的治疗工作深深打动，可以是一次强大的体验。治疗师应该是一个真实的人，有真实的情感，偶尔展示这一点可以创造有意义的时刻，深化治疗体验。这也可以为来访树立勇气和接受的榜样，特别是那些难以体验或表达自己情感的来访。

正如你可能猜到的，这个练习并不总是像与珍妮的那次一样顺利。与所有练习一样，如果明显练习对来访不起作用，我们不想强迫进行（尽管我们也不应在遇到第一次抵抗时就放弃）。例如，我有一位来访，每次进行这个练习都会引发与从未有人对她表现出真诚关怀的深刻痛苦相关的记忆——尝试想象有人如此善良地对待她，会以非常威胁的方式激活她的依恋系统。对于这位来访，使用自我同情练习来向自己表达同情更为有益——这不会触发相同强烈的情感记忆——同时努力发展现实生活中的关系，为她提供真实的接受和支持体验。

其他意象练习 虽然我主要介绍了安全空间和理想的同情形象练习，但CFT中还有许多其他常见的意象练习。这些练习的一个重要主题是同情的流动——从外部到自我，从自我到自我（或自我的某个方面，如痛苦），以及从自我到他人。在每个练习中，都强调尝试创造接收或给予同情的体验，包括动机方面（扩展或接收同情），感受到充满同情或温暖地将其延伸给他人，意象成分（如被同情充满或它从自我流向他人），有时还包括重复的短语（例如，愿你幸福、和平、轻松）。有许多资源详细描述了同情聚焦的意象练习的例子（例如，Germer, 2009; Kolts & Chodron, 2013）。我将简要描述其中的一些练习。

对痛苦、威胁感和痛苦的同情

在这个练习中，来访转变为同情自我的友善、智慧、自信的视角，并想象将同情发送到正在经历痛苦、疼痛或威胁感（如焦虑、愤怒或悲伤）的自我部分（Gilbert, 2009a; Kolts 2012; Gilbert & Choden, 2013）。来访想象同情和温暖的感觉在内心升起，并想象将这种同情延伸到痛苦或不适中。这可以涉及一个可视化过程，其中同情被想象成一种暖色调的光（来访选择颜色），围绕、安抚并亲切地包裹住处于痛苦中的自我部分。

对自我的同情

在这个练习中，类似于许多佛教练习，来访想象自己被来自外部或内部来源的同情充满。一种变化是想象同情从宇宙或外部来源（如自己的同情形象）以彩色光线的形式通过心脏或头顶流入身体，充满全身，随着它的流入和充满，产生安全和轻松的感觉。 另一种变化（我们在前面提到过）是来访转变为同情自我的视角，并想象自己向一个挣扎的自我版本延伸同情。在这个练习中，在短暂的同情自我诱导之后，想象一个脆弱的自我版本（焦虑的自我、自我批评的自我、愤怒的自我等），可能处于困难情境中。从同情自我的视角，来访想象向挣扎的自我延伸温暖、同情的感觉——被这个脆弱的自我所经历的挣扎所触动。也许她会连接到挣扎背后的感受和善意。（例如，对于珍妮来说，焦虑可能是她非常想与他人建立联系的反映）。然后，她想象以最有助益、安慰和安心的方式向这个脆弱的自我版本延伸同情。这个练习还可以包括大声或想象中重复温暖语气的短语，根据最有助益的内容进行定制。在慈悲和慈爱冥想中常用的短语（其中慈悲是希望生物免受痛苦，慈爱是希望她幸福）包括：

• 愿你免受痛苦，（名字）。
• 愿你幸福，（名字）。
• 愿你繁荣，（名字）。
• 愿你找到和平，（名字）。（Gilbert & Choden, 2013, 247） 这些短语的变化可以专注于向经历特定类型困难的自我版本延伸同情，包括焦虑（愿你免于激动和焦虑。愿你感到安全），愤怒（愿你免于激起你的愤怒和挫败感），或自我批评（愿你免于导致这种自我批评的痛苦）（Gilbert & Choden, 2013）。涉及“免于”困难情绪状态的陈述应理想地嵌入一个整体练习中，该练习涉及建立安全、和平和平衡的感觉。

对他人抱有同情

越来越多的研究表明，专注于他人福祉的慈悲和慈爱冥想练习，不仅在提升幸福感方面，还在正念、生活目标、社会支持和减少疾病等方面，对自我产生了可测量的好处（例如，Frederickson, Cohn, Coffey, Pek, & Finkel, 2008）。虽然CFT强调自我同情的发展，但培养对所有人的同情，包括自我在内，是非常重要的。鉴于安全系统是进化设计用来响应连接的，通过增加对他人的同情而产生的社会收益对来访显然是可取的。此外，深化对他人的同情在治疗那些可能伤害他人的行为（如问题愤怒）的来访时可以发挥重要作用（Kolts, 2012）。

有许多练习可以用于培养对他人的慈悲和慈爱，其中许多练习改编自佛教来源（例如，Salzberg, 1995）：

• 慈爱冥想：想象将同情发送给另一个人——一个亲人、一个正在受苦的人，甚至是一个来访正在斗争的人。（通常从来访关心并希望帮助的人开始更容易。）转变为同情自我的视角，来访想象自己向另一个人发送善良、温暖和慈悲的愿望。这可以包括来访想象自己的善良和同情以光的形式延伸到另一个人身上，使那个人充满和平、轻松和幸福。这也可以包括说出“对自我的同情”部分中描述的短语，这次是针对另一个人。这些短语可以根据接收者的具体需求进行调整，重点放在温暖、同情和希望帮助对方的感受上。
• 来访可以想象另一个人（或实际看着这个人），提醒自己这个人和其他所有人一样，只想幸福而不受苦。 这个简短的练习可以在走路时、等红灯时或任何时候有其他人出现时进行。目的是反复养成以同情方式意识到他人的习惯。
• 作为前一练习的扩展，来访可以想象另一个人，意识到就像每个人一样，那个人的生活同样深邃，充满了希望、梦想、胜利、悲剧、失望和人类经验的全部范围。 可以想象另一个人从出生到死亡的生命循环，作为一个无助的孩子出生，成长成熟（包括所有这一切），变老，死去，冥想者想象在整个过程中向个体延伸慈悲和慈爱。这个练习可以通过反思“如果我能为这个人的生活做出贡献，我希望他们过什么样的生活？”来强调，连接到自己深切的愿望，希望他人能找到幸福和摆脱痛苦（Kolts, 2012; Kolts & Chodron, 2013）。

有许多其他慈悲和慈爱练习，有动力的来访可以用来深化对自己和他人的同情体验。除了书籍（例如，Kolts & Chodron, 2013; Gilbert & Choden, 2013; Germer, 2009; Neff, 2011），快速的互联网搜索“慈悲和慈爱冥想”会带来许多书面和指导音频练习，可用于培养对自己和他人的同情。我建议与个别来访合作，找到适合他们的具体练习。关键是找到方法帮助来访在面对自己和他人的痛苦时感到温暖的同情而不是严厉的批评，并发展温暖的感受和帮助他人的善愿。

本章知识点阐述

知识点阐述

• 同情心意象的作用

  • 定义：同情心意象是一种心理技术，通过引导个体进入特定的心理状态，帮助个体以更加积极、理解和支持的态度面对自身的情绪和经历。
  • 目的：旨在缓解负面情绪，提高个体的心理韧性，增强自我同情能力。
  • 应用场景：常用于心理咨询和治疗中，特别是在处理焦虑、抑郁和创伤后应激障碍等情绪问题时。

• 心理意象的误解

  • 常见误解：许多人误以为心理意象必须是视觉化的，即在脑中形成清晰的图像。
  • 实际含义：心理意象更多是指心理体验，包括感官、情感和认知层面的综合感受。例如，一个人可以通过回忆某个愉快的时刻，不仅在脑中“看到”当时的场景，还能感受到当时的情绪和身体感觉。
  • 应对策略：治疗师需要向来访解释这一点，帮助他们理解心理意象不仅仅是视觉上的，而是多维度的体验。

• 引入意象的方法

  • 简单练习：通过简单的练习，如引导来访回忆过去的经历或想象未来的场景，可以帮助他们更好地理解和接受心理意象的概念。
  • 具体步骤：
    1. 调整姿势：让来访坐得舒适且挺直，双脚平放在地上，闭上眼睛。
    2. 深呼吸：进行几分钟的深呼吸练习，帮助来访放松身心。
    3. 引导想象：逐步引导来访想象具体的场景或经历，如早晨的通勤路线、最喜欢的甜点、最近的假期等。
  • 目的：通过这些练习，帮助来访建立对心理意象的信任和信心，使其更容易在治疗中应用。

• 减少自我评价

  • 重要性：在进行意象练习时，创造一个无评判的环境至关重要。这样可以让个体自由地体验而不受自我评价的干扰，从而更深入地参与其中。
  • 具体做法：
    • 正面反馈：治疗师应给予积极的反馈，鼓励来访继续练习。
    • 减少压力：强调没有“正确”或“错误”的方式，每个人的经历都是独特的。
    • 心理准备：在练习前，帮助来访做好心理准备，提醒他们专注于体验本身，而不是结果。
  • 效果：通过减少自我评价，个体可以更自然地进入心理意象的状态，从而达到更好的治疗效果。

知识点阐述

• CFT的目标：

  • 平衡情绪：CFT的核心目标之一是帮助来访学会利用自我保护、自我驱动和自我同情三个圈来平衡他们的情绪。
  • 应对威胁：特别适用于当来访发现自己进入威胁模式时，通过更平衡的方法来应对，或者当他们通过反复思考或威胁性意象加剧了威胁感时。

• 安全空间意象的作用：

  • 创造安全感：通过想象一个安全、平静、宁静和有归属感的空间，帮助来访在心理上建立安全感。
  • 多感官体验：来访需要关注这个空间的各种感官细节，如视觉、听觉、嗅觉和触觉，以增强心理体验的真实感。
  • 亲社会维度：在CFT中，加入了亲社会的维度，让来访想象在这个空间中的其他生物或人欢迎他们，重视他们，从而增加情感支持和归属感。

• 实践方法：

  • 准备阶段：让来访坐在一个舒适的位置，闭上眼睛，进行几次深呼吸，以放松身心。
  • 引导想象：治疗师引导来访逐步想象自己在安全空间中的各种细节，如环境、声音、气味等。
  • 情感连接：让来访感受在这个空间中的安全感、平静感和满足感，甚至可以让他们想象自己受到欢迎和重视。
  • 持续练习：建议来访在未来一周内练习两到三次，以便更好地掌握这项技能，并在日常生活中应用。

• 效果与意义：

  • 情绪调节：通过安全空间意象，来访可以在心理上获得安全感，从而更好地调节情绪，减少焦虑和压力。
  • 自我同情：这项练习有助于培养来访的自我同情能力，让他们在面对困难时更加温和地对待自己。
  • 长期影响：持续的练习可以激活大脑中与安全、满足和宁静相关的部分，从而在长期内改善来访的情绪状态和生活质量。

创建安全空间的目的

• 平衡情绪：
  • CFT的一个重要目标是帮助来访平衡他们的情绪，尤其是在他们发现自己转向威胁模式时。
  • 当来访通过沉思或威胁意象加剧了威胁感时，创建安全空间可以帮助他们恢复平衡。

意象的力量

• 激活安全系统：
  • 意象是一种强有力的工具，可以帮助激活大脑中的安全系统，从而减少威胁感。
  • 安全空间意象通过视觉、听觉、嗅觉等多感官体验，帮助来访进入一个放松和宁静的状态。

安全空间练习的步骤

• 选择合适的环境：
  • 来访可以选择一个他们觉得安全、舒适、宁静和有归属感的地方，比如海滩。
• 关注感官细节：
  • 引导来访关注这个环境中的各种感官细节，如声音、气味、触感等。
• 加入社交成分：
  • 在CFT中，除了传统的安全空间练习，还会加入一个社交成分，让来访想象自己在这个地方受到欢迎和重视。
  • 例如，想象其他生物或人欢迎你，重视你，甚至这个地方本身也欢迎你。

实践建议

• 定期练习：
  • 建议来访在接下来的一周内练习两到三次，以熟悉这个练习。
  • 最初在已经相当平静的时候练习，有助于熟练地唤起意象。
• 在需要时使用：
  • 一旦熟练，可以在威胁系统活跃时使用这个练习，通过连接到安全感来平衡情绪。

治疗师的角色

• 引导和支持：
  • 治疗师在练习过程中起到引导和支持的作用，帮助来访逐步进入放松和宁静的状态。
• 个性化指导：
  • 治疗师可以根据来访的具体需求和偏好，提供个性化的指导和建议，使练习更加有效。

知识点阐述

• 安全空间意象的作用：

  • 创造安全感：通过想象一个安全、平静、宁静和有归属感的空间，帮助来访在心理上建立安全感。
  • 多感官体验：来访需要关注这个空间的各种感官细节，如视觉、听觉、嗅觉和触觉，以增强心理体验的真实感。
  • 亲社会维度：在CFT中，加入了亲社会的维度，让来访想象在这个空间中的其他生物或人欢迎他们，重视他们，从而增加情感支持和归属感。
  • 适应性：并非每个来访都能立即找到一个适合自己的“安全空间”，需要通过多次尝试和调整来找到最适合的意象。

• 身体工作的辅助作用：

  • 舒缓呼吸：通过舒缓的节奏呼吸，帮助来访放松身心，为进入意象练习做好准备。
  • 温和微笑：提示来访微笑，有助于进一步增强心理体验的积极感受。

• 实际应用：

  • 情绪调节：通过安全空间意象，来访可以在心理上获得安全感，从而更好地调节情绪，减少焦虑和压力。
  • 自我同情：这项练习有助于培养来访的自我同情能力，让他们在面对困难时更加温和地对待自己。
  • 长期影响：持续的练习可以激活大脑中与安全、满足和宁静相关的部分，从而在长期内改善来访的情绪状态和生活质量。

• 理想的同情心意象练习：

  • 目的：帮助自我批评的来访学会自我安抚和发展被接受和关心的感觉。
  • 方法：通过想象一个理想的人物，这个人物理解他们、有同情心，并给予关爱、支持和鼓励。
  • 特征识别：治疗师与来访合作，识别出理想养育者会具备的特征，如接受、善意的关心和爱。
  • 非评判性：强调这个养育者是支持的、养育的和鼓励的，永远不会对来访进行评判、批评或羞辱。
  • 形象发展：帮助来访发展出这个养育者的形象、声音，以及他们可能如何互动。
  • 适用性：即使来访生活中没有这样的人，也可以通过想象来创造这样的存在。
  • 实际效果：通过这种练习，来访可以学会在面对困难时更加温和地对待自己，减少自我批评，增强自我同情。

知识点阐述

• 安全空间意象的作用：

  • 创造安全感：通过想象一个安全、平静、宁静和有归属感的空间，帮助来访在心理上建立安全感。
  • 多感官体验：来访需要关注这个空间的各种感官细节，如视觉、听觉、嗅觉和触觉，以增强心理体验的真实感。
  • 亲社会维度：在CFT中，加入了亲社会的维度，让来访想象在这个空间中的其他生物或人欢迎他们，重视他们，从而增加情感支持和归属感。
  • 适应性：并非每个来访都能立即找到一个适合自己的“安全空间”，需要通过多次尝试和调整来找到最适合的意象。

• 身体工作的辅助作用：

  • 舒缓呼吸：通过舒缓的节奏呼吸，帮助来访放松身心，为进入意象练习做好准备。
  • 温和微笑：提示来访微笑，有助于进一步增强心理体验的积极感受。

• 实际应用：

  • 情绪调节：通过安全空间意象，来访可以在心理上获得安全感，从而更好地调节情绪，减少焦虑和压力。
  • 自我同情：这项练习有助于培养来访的自我同情能力，让他们在面对困难时更加温和地对待自己。
  • 长期影响：持续的练习可以激活大脑中与安全、满足和宁静相关的部分，从而在长期内改善来访的情绪状态和生活质量。

• 理想同情心意象练习：

  • 目的：帮助自我批评的来访学会自我安抚和发展被接受和关心的感觉。
  • 方法：通过想象一个理想的人物，这个人物理解他们、有同情心，并给予关爱、支持和鼓励。
  • 特征识别：治疗师与来访合作，识别出理想养育者会具备的特征，如接受、善意的关心和爱。
  • 非评判性：强调这个养育者是支持的、养育的和鼓励的，永远不会对来访进行评判、批评或羞辱。
  • 形象发展：帮助来访发展出这个养育者的形象、声音，以及他们可能如何互动。
  • 适用性：即使来访生活中没有这样的人，也可以通过想象来创造这样的存在。
  • 实际效果：通过这种练习，来访可以学会在面对困难时更加温和地对待自己，减少自我批评，增强自我同情。

知识点阐述

• 安全空间意象的作用：

  • 创造安全感：通过想象一个安全、平静、宁静和有归属感的空间，帮助来访在心理上建立安全感。
  • 多感官体验：来访需要关注这个空间的各种感官细节，如视觉、听觉、嗅觉和触觉，以增强心理体验的真实感。
  • 亲社会维度：在CFT中，加入了亲社会的维度，让来访想象在这个空间中的其他生物或人欢迎他们，重视他们，从而增加情感支持和归属感。
  • 适应性：并非每个来访都能立即找到一个适合自己的“安全空间”，需要通过多次尝试和调整来找到最适合的意象。

• 身体工作的辅助作用：

  • 舒缓呼吸：通过舒缓的节奏呼吸，帮助来访放松身心，为进入意象练习做好准备。
  • 温和微笑：提示来访微笑，有助于进一步增强心理体验的积极感受。

• 实际应用：

  • 情绪调节：通过安全空间意象，来访可以在心理上获得安全感，从而更好地调节情绪，减少焦虑和压力。
  • 自我同情：这项练习有助于培养来访的自我同情能力，让他们在面对困难时更加温和地对待自己。
  • 长期影响：持续的练习可以激活大脑中与安全、满足和宁静相关的部分，从而在长期内改善来访的情绪状态和生活质量。

• 理想的同情心意象练习：

  • 目的：帮助自我批评的来访学会自我安抚和发展被接受和关心的感觉。
  • 方法：通过想象一个理想的人物，这个人物理解他们、有同情心，并给予关爱、支持和鼓励。
  • 特征识别：治疗师与来访合作，识别出理想养育者会具备的特征，如接受、善意的关心和爱。
  • 非评判性：强调这个养育者是支持的、养育的和鼓励的，永远不会对来访进行评判、批评或羞辱。
  • 形象发展：帮助来访发展出这个养育者的形象、声音，以及他们可能如何互动。
  • 适用性：即使来访生活中没有这样的人，也可以通过想象来创造这样的存在。
  • 实际效果：通过这种练习，来访可以学会在面对困难时更加温和地对待自己，减少自我批评，增强自我同情。

知识点阐述

练习的强大力量

• 深度体验：
  • 这个练习展示了如何通过特定的元素加深来访的体验，例如关注障碍、引导合作探索和详细说明照顾者的品质。
  • 治疗师在练习前后的跟进和反馈也非常重要，有助于来访更好地理解和应用练习。

障碍的处理

• 问题解决：
  • 治疗师鼓励来访自己解决问题，例如珍妮通过戴耳机和下载海洋声音来克服噪音问题。
  • 治疗师的热情肯定和鼓励可以增强来访的自信心和积极性。

共情和理解

• 普遍化：
  • 治疗师通过将问题普遍化，帮助来访减轻个人化的压力，例如“我们都没有真正有这样的人”。
  • 详细说明照顾者的品质，帮助来访构建一个理想的支持者形象。

情感支持

• 情感共鸣：
  • 治疗师在听到来访分享时的情感反应，虽然不是CFT计划的一部分，但可以增强治疗的真实性和亲和力。
  • 这种情感共鸣可以为来访树立勇气和接受的榜样，特别是在处理情感问题时。

个体差异

• 灵活调整：
  • 不同的来访对练习的反应可能不同，治疗师需要根据来访的具体情况灵活调整。
  • 例如，对于某些来访，自我同情练习可能比想象一个外在的照顾者更为有效。

真实性的重要性

• 真实情感：
  • 治疗师应保持真实，展示真实的情感，这可以增强治疗的深度和意义。
  • 真实的情感交流可以建立更强的信任关系，帮助来访更好地开放和表达自己。

通过这些方法，治疗师可以有效地引导来访进行深层次的自我探索和情感释放，从而达到治疗的目标。

知识点阐述

意象练习的多样性

• 多种练习：
  • CFT中不仅包括安全空间和理想的同情形象练习，还有许多其他意象练习，如对痛苦、威胁感和痛苦的同情，以及对自我的同情。
  • 这些练习旨在帮助来访在不同的方面体验和实践同情，从而提升心理健康和情感福祉。

同情的流动

• 流动方向：
  • 同情的流动可以是多方向的，包括从外部到自我，从自我到自我（或自我的某个方面，如痛苦），以及从自我到他人。
  • 通过这种多方向的流动，来访可以更全面地体验和实践同情，增强内心的平衡和和谐。

创造体验

• 具体方法：
  • 在每个练习中，都强调通过具体的意象、感受和语言来创造接收或给予同情的体验。
  • 例如，通过想象温暖的光线、重复温暖的短语等方式，帮助来访更具体地感受到同情的力量。

动机和感受

• 动机方面：
  • 练习中包含动机方面的内容，如扩展或接收同情的愿望，帮助来访明确练习的目的和意义。
  • 通过这些动机，来访可以更积极地参与到练习中，获得更好的效果。

个性化和灵活性

• 个性化调整：
  • 练习可以根据来访的具体情况和需求进行个性化调整，例如选择不同的颜色、短语等。
  • 这种灵活性使得练习更加贴近来访的生活和情感体验，提高其实际应用的价值。

常用短语

• 温暖的短语：
  • 在慈悲和慈爱冥想中常用的短语，如“愿你免受痛苦”，“愿你幸福”等，可以帮助来访更具体地表达和感受同情。
  • 这些短语可以在练习中大声或想象中重复，增强练习的效果。

通过这些方法，CFT中的意象练习不仅可以帮助来访在情感上获得支持和安慰，还可以促进内心的平衡和和谐，提升整体的心理健康水平。

知识点阐述

对他人抱有同情的重要性

• 研究支持：
  • 越来越多的研究表明，专注于他人福祉的慈悲和慈爱冥想练习不仅在提升幸福感方面，还在正念、生活目标、社会支持和减少疾病等方面，对自我产生了可测量的好处。
  • 例如，Frederickson等人（2008）的研究显示，这些练习可以显著提升个体的幸福感和生活质量。

自我同情与对他人同情的关系

• 综合发展：
  • 尽管CFT强调自我同情的发展，但培养对所有人的同情，包括自我在内，是非常重要的。
  • 安全系统是进化设计用来响应连接的，因此通过增加对他人的同情而产生的社会收益对来访显然是可取的。

实践方法

• 慈爱冥想：

  • 想象将同情发送给另一个人，可以是一个亲人、一个正在受苦的人，甚至是一个来访正在斗争的人。
  • 从来访关心并希望帮助的人开始更容易。转变为同情自我的视角，来访想象自己向另一个人发送善良、温暖和慈悲的愿望。
  • 这可以包括来访想象自己的善良和同情以光的形式延伸到另一个人身上，使那个人充满和平、轻松和幸福。
  • 还可以包括说出“对自我的同情”部分中描述的短语，这次是针对另一个人。这些短语可以根据接收者的具体需求进行调整，重点放在温暖、同情和希望帮助对方的感受上。

• 日常练习：

  • 来访可以想象另一个人（或实际看着这个人），提醒自己这个人和其他所有人一样，只想幸福而不受苦。
  • 这个简短的练习可以在走路时、等红灯时或任何时候有其他人出现时进行。目的是反复养成以同情方式意识到他人的习惯。

• 生命循环的想象：

  • 作为前一练习的扩展，来访可以想象另一个人，意识到就像每个人一样，那个人的生活同样深邃，充满了希望、梦想、胜利、悲剧、失望和人类经验的全部范围。
  • 可以想象另一个人从出生到死亡的生命循环，作为一个无助的孩子出生，成长成熟（包括所有这一切），变老，死去，冥想者想象在整个过程中向个体延伸慈悲和慈爱。
  • 这个练习可以通过反思“如果我能为这个人的生活做出贡献，我希望他们过什么样的生活？”来强调，连接到自己深切的愿望，希望他人能找到幸福和摆脱痛苦。

资源和合作

• 资源：
  • 除了书籍（例如，Kolts & Chodron, 2013; Gilbert & Choden, 2013; Germer, 2009; Neff, 2011），快速的互联网搜索“慈悲和慈爱冥想”会带来许多书面和指导音频练习，可用于培养对自己和他人的同情。
  • 与个别来访合作，找到适合他们的具体练习。关键是找到方法帮助来访在面对自己和他人的痛苦时感到温暖的同情而不是严厉的批评，并发展温暖的感受和帮助他人的善愿。

通过这些方法，CFT中的练习不仅可以帮助来访在情感上获得支持和安慰，还可以促进内心的平衡和和谐，提升整体的心理健康水平。

C H A P T E R 11 Using Compassionate Imagery In order for compassion to become real for our patients, it needs to be felt at an experiential level. Increasingly, we’re discovering that imagery is an effective method for facilitating experiential work with clients (Hackmann, Bennett-­Levy, & Holmes, 2011). In the Compassionate Self exercise, we used imagery to help clients shift perspectives and practice compassionate ways of working with difficult situations. In this chapter, we’ll explore ways to use imagery to help clients manage distress and balance their emotions.

AN ORIENTATION TO IMAGERY Since CFT makes frequent use of imagery, let’s consider how to effectively introduce clients to imaginal work. Often, when clients hear “imagine” or “imagery,” they think it means, “creating vivid pictures in the mind.” This idea can be an obstacle; while some clients will be able to effort- lessly create such vivid mental pictures, many others will struggle to do so. The key to overcoming this block is to help clients realize that imaginal work isn’t about making vivid pictures—­it’s about creating mental experiences (Gilbert, 2010). Let’s explore a method for introducing this practice to clients, developed by Paul Gilbert: Therapist: Jenny, as I mentioned in our last session, today we’ll introduce some imagery exercises to help you bring up feelings of safeness to balance your emotions when your threat system is really going. I thought it would be useful to talk a bit about how to use imagery before we get started. How does that sound? Jenny: Sounds good. Therapist: Besides the Compassionate Self exercises we’ve been doing, have you ever used mental imagery? Perhaps closed your eyes and tried to imagine something? Jenny: Last year I took a yoga class, and sometimes the teacher would have us imagine things—­like being somewhere like a beach, or being a tree, with life flowing into us from the ground beneath us. That sort of thing. Therapist: Cool—­how did you like it? Jenny: I liked it, but sometimes it worked better than others. I should take another yoga class, because it was really relaxing. Therapist: Sounds like a good idea—­yoga is fantastic, and it fits really well with what we’re doing. It’s good that you’ve had some experience with imagery. Sometimes people struggle with imagery work because they think it involves creating really vivid pictures in their minds. Some people can do that, but other people really struggle with it. Jenny: I think I know what you mean. I’m not really good at that. Therapist: (Smiles.) Me neither—­I’m not good at “seeing things” in my mind. But here’s the thing: what we’re after isn’t about creating vivid mental pictures, but creating mental experiences. Could we do a brief exercise to demonstrate what I mean? Jenny: (nodding interestedly) Sure. Therapist: Great. Let’s start by shifting into that comfortable, upright position we’ve been using for our exercises…feet flat on the floor, back straight, eyes closed. Let’s do thirty seconds or so of soothing rhythm breathing, slowing down the breath, and focusing on the sense of slowing. Slowing down the body, slowing down the mind. Jenny: (Closes her eyes and breathes slowly.) Therapist: (Waits thirty seconds.) I’m going to briefly prompt you to bring a few different situations to mind. As I do, just allow yourself to imagine the situation I’m describing. Jenny: (Nods.) Therapist: First, bring to mind how you got here this morning—­imagining the route you took when you were driving, riding, or walking here. (Waits thirty seconds.) Now, bring to mind your favorite dessert. (Waits thirty seconds.) Now, bring to mind the last vacation you took, or if one doesn’t come to mind, a vacation you’d like to take. (Waits thirty seconds.) When you’re ready, gently allow your eyes to open. Jenny: (Waits a moment, then slowly opens her eyes, shifts, and smiles a bit.) Mmmm. Therapist: Were you able to get a mental sense of all the things I mentioned? Jenny: I was. It was nice. I didn’t want to stop. Therapist: Nice! It sounds like you were able to get a mental experience of those things—­ the route you took, the dessert, the vacation—­and like some emotions came up as well? Jenny: Yeah. It felt nice to imagine myself walking along the beach like I did last summer. Therapist: Excellent! That’s mental imagery. It’s about bringing an experience to mind, so we’ve got a good sense of it. Sounds like you’ve already noticed one of the benefits of imagery—­that our old, emotional brains respond to imagery by producing different emotions, like that pleasant feeling you got from imagining yourself back on the beach. Exercises like this can give clients a sense of what imaginal work is like, and can give them con- fidence that they can do it. We want to create a mental context in which the client is able to focus on the imagery exercises, minimizing distractions caused by self-­evaluative thoughts of whether or not they are doing it correctly.

CREATING A SAFE PLACE One goal of CFT is to help clients learn to work with the three circles to balance their emotions, particularly when they notice themselves shifting into threat mode when a more balanced approach would be helpful, or when they observe they’ve been fueling feelings of threat through rumination or threatening imagery. Imagery can be a powerful tool for getting the safeness system online, and one way to do this involves safe place imagery. (Sometimes it’s referred to as “soothing space” imagery for clients who don’t like the term “safe place.”) In this practice, clients imagine themselves in a setting that creates feelings of safeness, calm, peacefulness, and belonging. Many therapists will have used imagery in this way. As in other such practices, we have clients focus on the various sensory details of this soothing place. In CFT, we add a dimension to the typical safe place practice by introducing an affiliative component to the imagery. This is done via specific instructions such as, “If there are other beings in this place, imagine that they welcome you, value you, and are happy to see you. In fact, imagine that this place itself values your presence—­as if you complete it, and it is happy that you are here.” Let’s consider how this practice might be introduced and facilitated in a therapy session: Therapist: Jenny, now that we’ve explored what we mean by imagery, I’d like to introduce a specific practice designed to help get your safeness system working for you—­to help you connect with feelings of calm and peacefulness when you notice your threat system is really going. How does that sound? Jenny: Why not? Therapist: Great. In a way, you’ve got a head start on this one. A few moments ago, you said you enjoyed imagining yourself back on that beach from your vacation—­so much that you didn’t want to stop. What did you like about that? Jenny: I love the beach. I love everything about it—­the smell, the feeling of sand under my feet, watching and listening to the waves, the sun. I like to walk on the beach for hours. It’s so peaceful. Therapist: That does sound wonderful. Jenny: It is. It’s my favorite thing to do. Therapist: That’s a perfect segue into our next exercise. This is called the “Safe Place exercise.” We’re going to imagine being in a place that helps you feel safe, comfortable, peaceful, and soothed. The idea is to create a mental experience of this place and the feelings that go along with being there. Sometimes it takes time to figure out what sort of place to use—­but it sounds like you may already have a good place in mind. Do you think the beach would work for this exercise? Jenny: The beach would be perfect. Therapist: Great. So let’s go ahead and get started. We’ll begin with some soothing rhythm breathing, to slow down our bodies and minds. Then I’ll prompt you to imagine the beach. I’ll ask you to describe what it’s like on the beach—­like it’s really happening—­so we can create a deep mental experience. Then I’ll be quiet and leave you to the imagery for about five minutes. If your mind begins to wander or you get distracted by thoughts, that’s no problem—­just manage it like we do with mindful breathing, by noticing you’ve become distracted and gently bringing yourself back to the beach. Ready to go? Jenny: Let’s do it. Therapist: Sitting in an upright, comfortable position, the eyes gently closing. Jenny: (Shifts a bit, closes her eyes, and slows her breathing.) Therapist: Allowing the breath to take on a slow, comfortable rhythm. Focusing on the sense of slowing. (Waits five seconds.) Slowing down the body, slowing down the mind. (Waits thirty seconds to one minute.) Jenny: (Breathes slowly.) Therapist: Now, imagining yourself on that beautiful beach. Opening yourself to the soothing experiences there. When you’ve got the image, describe what you’re doing and experiencing. Imagine yourself, there on the beach, with all the sounds, smells, and images you love. Jenny: (Pauses for five to ten seconds.) I’m walking down the beach, and I can feel the sand squishing underneath my feet. I like the way it feels on my toes. Therapist: That’s perfect, Jenny. What else are you noticing? What does it feel like? Jenny: It’s warm and peaceful. The sun is shining on my face, and the wind is gently blowing through my hair. I can hear the waves and the sound of the seagulls. (Pauses for a few seconds.) I can smell the ocean. Therapist: Allow yourself to be filled with feelings of safeness, peacefulness, and joy at being in this wonderful place. Maybe allow a gentle smile to cross your face, as you enjoy being here. Jenny: (Smiles.) Mmmm. Therapist: Imagine that the seagulls you hear are happy that you are here with them. Likewise, if there are any people or other beings in this place, imagine that they welcome you. They value you; they’re happy you are here. (Waits twenty to thirty seconds.) Imagine that this place itself welcomes you. It values your presence, almost as if you complete it. It is happy you are here. Jenny: (Breathes peacefully.) Therapist: Let’s take some time to imagine being in this place, filled with feelings of safeness, peace, and contentment. Imagine all the sensations that come with being in this place. Jenny: (Continues to breathe peacefully.) Therapist: (Waits five minutes.) When you’re ready, gently shift your attention to the slow sensation of the breath, and allow your eyes to open. Jenny: (Waits twenty seconds or so, then gradually opens her eyes. Smiles.) Therapist: How was that? Jenny: That was really nice. Really peaceful. Therapist: Did you get a mental experience of this place, and the feelings that go with it? Jenny: I did. It felt completely comfortable and peaceful. Therapist: Were you able to imagine that the place and the creatures in it welcomed you? Jenny: Yeah. It was kind of like one of those children’s movies where the animals do funny things. I imagined seagulls flying along beside me, or looking up at me from where they were standing on the beach. It was fun to imagine that. Therapist: Were there any other people on the beach? Jenny: Not at first, but after you said that, I imagined a few lying on blankets, higher up on the beach, just lying in the sun and enjoying themselves. It was really peaceful. Therapist: That’s exactly how it’s supposed to work. Would you be up for practicing this two or three times over the next week? The idea is to really get used to visiting this place in your mind, activating those parts of your brain that help you feel safe, content, and peaceful. Jenny: I’d love to. Therapist: Fantastic. It helps to practice initially when you’re already feeling pretty calm, to get good at bringing up the imagery. Once that feels manageable, try using the imagery when your threat system is going and you want to balance things a bit by connecting with feelings of safeness. Does that make sense? Jenny: Sure does. Things went really smoothly in the vignette above, as Jenny had identified a likely “safe place” in the previous imagery exercise (an occasional advantage of using a “favorite vacation” prompt in introducing imagery), and she was very good at connecting with the image of the beach. She was also able to quickly move into the imagery and describe it in therapy. It won’t always go this smoothly. Some clients won’t have a place from memory, so we’ll work with them to consider what such a place might be like. Sometimes I start by briefly mentioning a few of my “places”—­a walk on a northwestern beach, sitting in a pine forest, even having a pint in a favorite English pub, sur- rounded by smiling faces and 300-­year-­old oak, my nose filled with the soothing aroma of a steak-­ and-­ale pie at my table. For clients who don’t transition as easily into imagery as Jenny did, we can provide sensory anchors, using our knowledge of what might be soothing to the client: “Imagine feeling the sun on your face, the smells and sounds of the ocean…” We want to say just enough to facilitate the imagery and feelings of peacefulness and soothing that accompany it, and then gently recede, leaving the client with the imagery. Some clients will need to experiment with a few different “places” before they find one to settle on. Finally, the body work is important—­setting the stage with soothing rhythm breathing and prompting a gentle smile can help clients more fully enter into the experience, adding yet another soothing implicit input into the emotional brain. I really can’t say enough about this practice. While no practice works for everyone, I’ve seen men in prison for violent crimes, who had spent decades struggling with anger, use this practice to soothe themselves when they noticed their anger arising. These men used the imagery to balance their emotions and reengage to deal effectively and assertively with situations that previously would have led to verbal or physical aggression.

THE IDEAL COMPASSIONATE IMAGE PRACTICE British psychologist Deborah Lee developed a practice called the “perfect nurturer” or “ideal com- passionate image” practice (Lee, 2005). This practice was designed to help self-­critical clients learn to self-­soothe and develop feelings of being accepted and cared for, by imagining an ideal figure who understands them, has compassion for them, and extends kindness, support, and encourage- ment. In this practice, the therapist works collaboratively with the client to identify characteristics that his ideal nurturer would have—­perhaps acceptance, kind concern, and affection—­and a deep understanding of what the client is going through. In contrast to experiences that clients may have had with people in their lives, it is emphasized that this nurturer is supportive, nurturing, and encouraging, and is never judgmental, critical, or shaming of the client. The therapist will also help the client develop an image of what this nurturer looks like and sounds like, and how they might interact. As with the safe place exercise above, the idea is to help the client create as vivid a mental experience as possible. If the client has someone in his life who embodies these qualities (or someone he imagines embodies the qualities, such as a spiritual figure), he can use this in his visualization. Some clients may initially struggle with the exercise, protesting that they’ve never had anyone like this in their lives. If this happens, we can emphasize that actually, none of us has someone like this—­someone who is perfectly understanding, supportive, and nonjudgmental. The idea is to imagine what a being like this would be like, and to imagine that person extending kindness, under- standing, and acceptance to us. Let’s consider what this practice might look like in a therapy session: Therapist: Jenny, I’m glad you like the safe place imagery we introduced last session. How did that go over the past week? Jenny: Really well. It’s my favorite piece of homework so far. I did it three times over the past week. Therapist: Excellent! Repeated practice really is the key. As you’ve done the practice, have you noticed anything that helps or gets in the way? Jenny: Well, it helps if I have a quiet place to practice. My dorm can be pretty noisy in the evening, which is when I have time. I ended up putting on headphones to try and make things a little more quiet, and then it occurred to me that I could probably download an mp3 of the sound of the ocean. So I went online and did that, and now when I do the exercise, I listen to the ocean sounds, which makes it seem even more real. Therapist: Wow! I should have you teaching this stuff! That’s a perfect example of compassionate thinking, Jenny—­noticing a problem or obstacle, and then instead of getting caught up in it and giving up, asking What might be helpful in working with this? When you did that, not only were you able to address the obstacle, but you found a way to make the practice work even better—­a way that hadn’t even occurred to your therapist. Jenny: That is pretty cool. Therapist: It sure is. I’m gonna steal that ocean-­mp3 idea, by the way. That’s pure gold! Jenny: (Laughs.) Feel free. Therapist: I thought we might try out another imagery exercise. Does that sound all right? Jenny: Sure. Therapist: As we’ve discussed, self-­criticism has been a struggle for you, and you’ve had experiences of being criticized and picked on by others—­really painful experiences. Jenny: (Gets a somewhat pained expression; looks down; speaks slowly.) Yeah. Therapist: I can tell those memories—­those experiences in your mind—­still bring a lot of hurt with them. We want to use imagery to help you have very different experiences—­experiences of being cared about, accepted, and understood. Jenny: (Looks up at the therapist.) Therapist: We’re going to imagine a perfect nurturer—­someone who absolutely cares about you, accepts you, deeply understands you, and wishes the very best for you. Someone who would never judge or ridicule you. How does that sound? Jenny: It’s hard to imagine. I’ve never had anyone like that. Therapist: None of us has, really. Real people can’t support us perfectly in that way—­and your compassionate image doesn’t even have to be a person. It could be an animal, or some other type of being. I know people who have used an ancient tree, for example. The idea is to imagine a being that could help you feel safe, accepted, understood, and supported. Let’s start by imagining the qualities your nurturer would have. What would this being be like? How would the being relate to you? Jenny: Well, they’d be nice to me, and would never make me feel stupid. They’d accept me just as I am. Therapist: That’s great. So they’d be kind, and accepting. Anything else? Jenny: They wouldn’t judge or criticize me. They’d just like me. Therapist: They wouldn’t judge you. Maybe along with that, they would completely understand you, understand where you’re coming from…really liking you and wanting to help and encourage you when you’re struggling. Jenny: Yeah, that sounds good. Therapist: Let’s start with those qualities: kindness, acceptance, understanding, and encouragement. Let’s imagine what this kind being might be like—­if it is human or nonhuman, if it has a gender, what it might look like, that sort of thing. What do you think your perfect compassionate image might be like? Jenny: I don’t know… (Pauses, thinking.) Therapist: (Waits in silence.) Jenny: I think it would be a woman. An older woman, who’s gone through it and knows what it’s like to grow up as a woman and go through all this. Therapist: Someone who really understands, because she’s been through it. Jenny: Exactly. She could maybe see some of herself in me, and knows how to help me through it, because she’s gone through it herself. Therapist: What might she look like? Sound like? How would she act? Jenny: She’d have gray hair, and a really kind smile. She’d have a gentle voice, and would laugh a lot. She’d have a good sense of humor. Therapist: It sounds like she’d be a lot like your compassionate self—­kind, wise, and confident. Able to help you handle whatever comes up. Jenny: Exactly. Therapist: I think we have a great start, here. Would you like to start the exercise now? Jenny: Sure. (Shifts into an upright posture, closes her eyes, and slows her breathing.) Therapist: Starting with a minute or so of soothing rhythm breathing… (Waits twenty to thirty seconds.) Slowing down the body, slowing down the mind… (Waits twenty to thirty seconds.) Jenny: (Breathes quietly.) Therapist: Bringing to mind the image of this kind, wise, confident woman who cares deeply about you, understands you, and is there to support you. Jenny: (Face relaxes a bit; breathes quietly.) Therapist: Imagining her with you, smiling kindly at you. Imagine that she likes you, and wants you to feel understood. Imagine her extending kindness and compassion to you, in whatever way would be most helpful and soothing. Imagine what she might do or say. Imagine being filled with her kindness, understanding, and acceptance. Jenny: (Continues to breathe quietly.) Therapist: (Waits five minutes.) If anxiety or other difficult emotions come up for you, imagine her there, understanding and supporting you. Imagine her supporting you as you struggle, believing in you. She understands how hard it can be, and how that isn’t your fault. Imagine her extending kindness and support as you face these challenges. Jenny: (Breathes quietly.) Therapist: (Waits five minutes.) When you’re ready, allow your eyes to gently open, bringing the feelings of being accepted, understood, and supported with you, back into the room. Jenny: (Pauses a few moments, then slowly opens her eyes.) Therapist: How was that? Jenny: I really liked it. It was really beautiful, actually. Therapist: Can you tell me about it? Jenny: I could see her, and she was there with me…and at some point I figured out that this was my future self. And she understood exactly what I’m going through, and… (Begins crying softly.) Therapist: (Waits quietly with a kind smile, eyes tearing up a bit.) Jenny: (still crying) …and she wanted me to be happy. And she knew that I am going to be okay. That I’m going to make it. (Smiles softly.) Therapist: (Leans in, speaking gently.) You are going to make it, Jenny. Jenny: 150 (Smiles.) I’m starting to believe that. In the example, we see how powerful this practice can be. There are certain elements demon- strated above that can deepen the experiential aspects of the practice. First, notice that before introducing the exercise, the therapist follows up on other imagery practices to see if there are obstacles to which they should attend. Jenny, like many clients, was able to problem-­solve and deepen her practice in working with an obstacle—­which the therapist warmly reinforces. Moving into the practice, the therapist speaks to a potential obstacle—­that Jenny doesn’t have anyone in her life like this—­by generalizing it (“None of us really has someone like that”), and elaborating on the nurturer’s qualities. Before moving into the imagery itself, the therapist facilitates a collaborative exploration of qualities Jenny would like her nurturer to have—­in terms of both the emotional qualities and ori- entation she will have toward Jenny, and the physical qualities that will facilitate the imagery. During the practice, the therapist prompts Jenny to first imagine the nurturer supporting her, and then how this might play out should anxiety or other difficulties arise for her. As always, the thera- pist checks in after the exercise, taking a cue from Jenny’s ideal compassionate image about how to support Jenny. Finally, you’ll notice that the therapist is visibly moved upon hearing about Jenny’s experience with the imagery. While this is not a planned part of CFT (that would be disingenuous), I included it because I became teary while writing the vignette and recalling such experiences in therapy. Of course, the therapist’s emotionality should never play out in a way that intrudes upon or detracts from the therapy, shifting the focus from the client to the therapist. However, I’ve found it can be a powerful experience for clients to occasionally see that the therapist is genuinely moved by their work in therapy. It’s important for the therapist to be a real human being with real feelings, and allowing that to show sometimes can create meaningful moments that deepen the therapy experi- ence. It can also model courageousness and acceptance for clients who may struggle in allowing themselves to experience or express their own emotions. As you might suspect, the exercise doesn’t always go as smoothly as it did with Jenny. As with all of the practices, we don’t want to force things if it becomes clear the practice isn’t working for the client (although we don’t want to give up at the first sign of resistance, either). For example, I had a client for whom this exercise consistently brought up deep pain associated with her experience of never having had anyone who seemed to offer her genuine caring—­the act of trying to imagine someone being so kind to her activated her attachment system in very threatening ways. For this client, it was much more helpful to use the Compassionate Self exercise to extend compassion to herself—­which didn’t trigger the same powerful emotional memories—­as well as working to develop real-­life relationships that provided her with real-­world experiences of acceptance and support.

OTHER IMAGERY EXERCISES While I’ve focused on the safe place and ideal compassionate image practices, there are a number of other imagery exercises that are common to CFT. A recurrent theme in these practices is the flow of compassion—­into the self from outside, from the self to the self (or aspects of the self, like pain), and from the self to others. In each of these practices, there is an emphasis on trying to create experiences of receiving or giving compassion, complete with motivational aspects (to extend or receive compassion), the felt experience of being filled with compassion or the warmth of extend- ing it to others, imagery components (of being filled with compassion or it flowing out of the self to others), and sometimes repeated phrases (for example, May you have happiness, peace, and ease). There are a number of resources that detail examples of compassion-­focused imagery practices (e.g. Germer, 2009; Kolts & Chodron, 2013). I’ll briefly describe a few of these practices.

Compassion for Distress, Threat Feelings, and Pain In this practice, the client shifts into the kind, wise, confident perspective of the compassionate self, and imagines sending compassion out to parts of the self that are experiencing distress, pain, or threat feelings like anxiety, anger, or sadness (Gilbert, 2009a; Kolts 2012; Gilbert & Choden, 2013). The client imagines feelings of compassion and warmth arising within, and imagines extend- ing that compassion out to the pain or discomfort. It can involve a visualization in which the com- passion is pictured as a warm-­colored light (the client picks the color) that surrounds, soothes, and kindly envelopes the aspect of the self that is in pain.

Compassion for the Self In this practice, which is similar to many Buddhist practices, the client imagines being filled with compassion from an external or internal source. One variation involves imagining compassion flowing in from the universe or an external source (such as one’s compassionate image) in the form of colored light coming in through the heart or the crown of the head, filling the body, and creating feelings of safeness and ease as it flows in and fills the person. Another variation of this practice (which we touched on earlier) involves the client shifting into the perspective of the compassionate self and imagining that she is extending compassion to a struggling version of the self. In this practice, after a brief compassionate self induction, the vulner- able version of the self is imagined (anxious self, self-­critical self, angry self, and so on), perhaps in a difficult situation. From the perspective of the compassionate self, the client imagines extending warm, compassionate feelings toward the struggling self—­moved by how much this vulnerable self is struggling. Perhaps she connects with the feelings and good intentions behind the struggle. (In the case of Jenny, for example, the anxiety may be a reflection of how much she really wants to connect with others). She then imagines extending compassion to this vulnerable version of the self in whatever way would be most helpful, soothing, and reassuring. This practice can also involve repeating phrases out loud or imaginally, in a warm tone of voice, tailored to what would be most helpful. Common phrases used in compassion and loving-­kindness meditation (in which compas- sion is the wish that the being be free from suffering, and loving-­kindness is the wish that she has happiness) include things like: May you be free from suffering, (name). May you be happy, (name). May you flourish, (name). May you find peace, (name). (Gilbert & Choden, 2013, 247) Variations of these phrases can be designed to focus on extending compassion to versions of the self that are experiencing specific sorts of difficulties, including anxiety (May you be free of agitation and anxiety. May you feel safe.), anger (May you be free of turmoil which stirs your anger and frustration), or self-­ criticism (May you be free of pain that causes this self-­criticism) (Gilbert & Choden, 2013). Statements involv- ing “being free” of difficult affective states should ideally be embedded within an overall practice that involves building up feelings of safeness, peace, and balance.

Compassion for Others Increasingly, research shows that practices such as loving-­kindness and compassion meditation focused on the well-­being of others produces measurable benefits for the self in terms of both hap- piness and behavioral outcomes such as mindfulness, purpose in life, social support, and reductions in illness (e.g. Frederickson, Cohn, Coffey, Pek, & Finkel, 2008). While CFT places a strong focus on the development of self-­compassion, I think it’s important that the focus really be on developing compassion for everyone, with an acknowledgment that the self is included in this. Given that the safeness system is designed by evolution to respond to connection, the social gains that can be produced through development of increased compassion for others are clearly desirable for clients. Additionally, deepening compassion for others can play a primary role in the treatment of clients struggling with behaviors that can actually harm others, such as in problematic anger (Kolts, 2012). A number of practices can be used in cultivating compassion and loving-­kindness for others, many of which are adapted from Buddhist sources (e.g. Salzberg, 1995): • Loving-­kindness meditation: Imagine sending compassion out to another person—­a loved one, someone who is suffering, or even someone with whom the client is strug- gling. (It’s usually easier to begin with someone the client cares about and wants to help.) Shifting into the perspective of the compassionate self, the client visualizes sending kindness, warmth, and compassionate wishes to the other person. This can involve the client imagining his kindness and compassion extending to the other person in the form of light, filling that person with peace, ease, and happiness. It can also involve saying the phrases described in the “Compassion for the Self” section above, this time directed at the other person. The phrases can be tailored to the specific needs of the recipient, with the emphasis on feelings of warmth, compassion, and the desire to be helpful to the person. • The client can visualize another person (or actually look at the person), reminding herself that this person, just like everyone else, only wants to be happy and to not suffer. This brief practice can be done while walking, or waiting at a stoplight, or at any other time another person is present. The idea is to repeatedly get into the habit of becoming aware of others in a compassionate way. • As an extension of the previous practice, the client can visualize another person, with the awareness that just like everyone else, that person has a life that runs just as deep as the client’s—­just as filled with hopes, dreams, triumphs, tragedies, disappointments, and the full range of human experiences. The other person can be visualized going through the cycle of life from birth to death, being born as a helpless child, growing up and maturing (with all that entails), growing older, and dying, with the meditator imag- ining extending compassion and loving-­kindness to the individual throughout the process. This practice can be punctuated by the reflection, If I could contribute to this person’s life, what sort of life would I want them to have?, connecting with one’s deep wish that others could find happiness and freedom from suffering (Kolts, 2012; Kolts & Chodron, 2013). There are many other compassion and loving-­kindness practices that motivated clients can use to deepen their experience of compassion for themselves and others. In addition to books (e.g. Kolts & Chodron, 2013; Gilbert & Choden, 2013; Germer, 2009; Neff, 2011), a quick Internet search for “compassion and loving-­kindness meditation” brings up numerous written and guided audio practices that can be used to cultivate compassion for oneself and others. I’d recommend working collaboratively with individual clients to find specific practices that work for them. The key is to find ways to help clients learn to feel moved (warm sympathy rather than harsh criticism) when faced with their suffering and the suffering of others, and to develop feelings of warmth and the kind motivation to help.

SUMMARY Imagery can be a powerful tool as clients grow in their capacity to work with emotions and extend compassion to themselves and others. In using imagery in therapy, the key is to begin with an idea of the underlying psychological processes we wish to facilitate. Is it helping the client create feel- ings of safeness in herself? Learn to accept compassion from an external source? Learn to develop and extend compassion toward her own pain and difficult emotions? Learn to develop and extend compassion to other people? With these processes in mind, we can select imagery exercises and structure a practice plan that will help clients gradually deepen their capacity to self-­soothe and to feel genuine compassion for themselves and others.