1. Dennis Tirch, Ph.D. The Center for Mindfulness and Compassion-Focused Therapy Russell L. Kolts, Ph.D. Eastern Washington University

2. * Kind of soft, fluffy, and pink * “airy-fairy” * Being nice all of the time * Always giving people exactly what they want.

3. * Two psychologies at work: sensitivity to suffering, and motivation to help. * Compassion begins by approaching suffering…which is why the CFT-anger group is called True Strength.

4. * Emphasis on mindful awareness (awareness and sensitivity to suffering) combined with workable action (helping and motivation to help).

5. “Hope Comforting Love in Bondage” courtesy of the Birmingham Museums and Art Gallery Collections, Birmingham, UK Artist: Sidney Harold Meteyard, 1901

6. * Our brains are brilliant but problematic ‘patchwork quilts’ of evolved structures and functions. * Tricky dynamics between “old” emotional brains and “new” brains

7. * “We all just find ourselves here…” * Emotions as evolved capacities with specific purposes (3 Circles) * Emotions not as isolating, but as common elements that unite us. * Mindful observations of threat emotions as prompts for compassion.

8. * Old, emotional brain is very powerful, not very clever. * Threat emotions narrow our attention, lower our cognitive flexibility, and strongly influence the contents and process of our reasoning. * Emotional inertia via the interplay of emotional “old-brain”,“new brain”, and body

10. Understanding our Motives and Emotions Motives evolved because they help animals to survive and leave genes behind. Emotions guide us to our goals and respond if we are succeeding or threatened. CFT focuses on three types of emotion regulation system: 1. Those that focus on threat and self-protection 2. Those that focus on doing and achieving 3. Those that focus on contentment and feeling safe

11. Types of Affect Regulator Systems Incentive/resource- focused Wanting, pursuing, achieving, consuming Activating Non-wanting/ Affiliative focused Safeness-kindness Soothing Threat-focused Protection and Safety-seekingActivating/inhibiting Anger, Anxiety, Fear, Disgust Drive, Excitement, Vitality Content, Safe, Connected

12. The Threat System Threat-focused Protection and Safety-seekingActivating/inhibiting Anger, Anxiety, Disgust

13. Our Old/Emotional Brains are Biased toward Processing Threat In species without attachment, typically only 1-2% make it to adulthood to reproduce. Threats come from ecologies, food shortage, predation, injury, disease. At birth individuals must be able to ‘go it alone’, be mobile and disperse. Survival depends on efficiently detecting and responding to threat.

15. Attention ThinkingReasoning Behaviour MotivationEmotions Imagery Fantasy Anger

16. Threat-focused Protection and Safety-seeking Activating/inhibiting Anger Body/feelings Tense Heart increase Pressure to act Anger Attention/Thinkin g Narrow-focused Transgression/blo ck Scan – search Behaviour Increase outputs Aggressive displays Approach Dissociate

17. Threat-focused Protection and Safety-seeking Activating/inhibiting Anxiety Body/feelings Tense Heart increase Dry mouth “Butterflies” Afraid Attention/Thinkin g Narrow-focused Danger threat Scan – search Behavior Passive avoidance Active avoidance Submissive display Dissociate

19. The Drive and Resource Acquisition System Incentive/resource- focused Wanting, pursuing, achieving, consuming Activating Threat-focused Protection and Safety-seekingActivating/inhibiting Anger, Anxiety, Fear, Disgust Drive, Excitement, Vitality

20. Excited Body/feelings Activation Heart increase Pressure to act Disrupt sleep Attention/Thinkin g Narrow-focused Acquiring Explorative Behaviour Approach Engage Socialise Restless Celebrating Incentive/resource-focused Wanting, pursuing, achieving, consuming Activating

21. The Safeness System Incentive/resource- focused Wanting, pursuing, achieving, consuming Activating Non-wanting/ Affiliative focused Safeness-kindness Soothing Threat-focused Protection and Safety-seekingActivating/inhibiting Anger, Anxiety, Fear, Disgust Drive, Excitement, Vitality Content, Safe, Connected

22. Well-being Body/feelings Calm Slow Well-being Content Attention/Thinking Open-focused Reflective Prosocial Behaviour Peaceful Gentle Prosocial Non-wanting/ Affiliative-focused Safeness-kindness Soothing

24. Attention ThinkingReasoning Behaviour MotivationEmotions Imagery Fantasy Compassion

26. Why a Compassion Focus? People with chronic problems often come from neglectful or abusive backgrounds, have high levels of shame, and are often self-critical, self-disliking, or self-hating. Live in a world of constant internal and external threat. Have few experiences of feeling safe or soothed and are not able to do this for themselves. Often do poorly in trials. Soothing system poorly developed and will often say, “I understand the theory but do not feel relieved or safe.” This makes sense if that system is not working or developed.

27. * Blaming and shaming ourselves and others keeps us locked in threat-based emotions, fueling our problems. * Shame-based pain/distress fosters avoidance. * Warming things up can help us feel safe, balance emotions, and skillfully approach difficulties rather than avoid them.

28. “ There’s something wrong with me.” * We have unlimited access to our own internal experiences, and very limited access to those of others. (“I feel like a wreck, but they seem to be doing alright!”) * Evolution shaped us to be very concerned about how we exist in the minds of others, and how we compare to them.

30. * Compassion - “Being moved by suffering and motivated to alleviate it” * Compassion involves approaching and working with suffering.

31. Introducing Compassion-Work via Perspective Taking * The two-teachers metaphor: * Critical teacher vs Compassionate teacher * Which teacher would you want your child to have? * Which would help your child learn & progress? * When you observe yourself struggling or feeling threat emotions, which teacher does the voice in your head sound like?

32. Compassionate Self Work * The goal is to help our clients cultivate qualities that will help them to effectively work with difficult emotions and situations: * Compassion * Mindful awareness * Courage and Confidence * Kindness * Wisdom

33. Method Acting + Imagery * Imagining how we would think, feel, behave, appear, experience, and understand if we had these compassionate qualities. * Imagining the compassionate self in action: * From this perspective, how would you understand this situation? Feel? Think? Work with it?

34. Halfway between Self-as-context and Self-as-content * Emphasis on awareness, mindfulness – cultivating qualities that facilitate open awareness and reflectiveness. * However, knowing that we often will relate to ourselves in terms of a narrative, compassionate self work enables clients to cultivate an adaptive, value-driven version of the self.

35. * “Awareness not as content-free, but as not content-bound” * Steve Hayes, 6/19/14 * We can “harness what language can offer us” * Jennifer Plumb, 6/19/14

36. Exploring Emotions: The 4 Square/Multiple Selves Exercise Bring up a challenging situation. Focus on bodily feelings, thoughts, motivations, and fantasized behaviors. What does this self feel like, think, say, want to do? - Angry Self - Anxious Self - Sad Self - Compassionate Self – the “Captain of the Ship”

37. Attention ThinkingReasoning Behaviour MotivationEmotions Imagery Fantasy Anger

38. The Four-Square Exercise * A lot going on here: * Increasing awareness of various threat emotions that may be avoided. * Gives a window into the dynamics of self-criticism. * Exploring different emotional perspectives and how they organize the mind. * Learning to shift in and out of different emotions – and building confidence that they can do this without getting stuck. * The Compassionate-self in action – ability to have compassion for these emotional selves.

40. Significant Group X Time Interaction: STAXI Anger Expression Index – F (1,10) = 7.06, p =.024 (Blue line = CFT group).

41. Significant Group X Time Interaction: MAI Anger- Out scale – F (1,14) = 5.85, p =.03.

42. Significant Group X Time Interaction: MAI Anger-In scale – F (1,14) = 7.08, p =.019.

43. Except for decreases in fears of expressing compassion to others, the Group X Time interactions for changes in measures of compassion were generally not significant. * Fear of Compassion Scale * Expressing to Others F (1,12) = 8.43, p =.013* * Receiving from Others F (1,13) = 4.30, p =.058 * Compassion to SelfF (1,11) =.858, p =.374 * IRI Empathic Distress - F (1,13) =.311, p =.59 * Self-Compassion Scale Total – F (1,13) = 1.83, p =.20 (the CFT-group within-group changes and main effects of time were quite significant)

44. Example non-significant finding for Group X Time Interaction: IRI Perspective Taking – F (1,13) = 3.80, p =.073.

45. FOC Scale – Fear of Expressing Compassion to Others

46. FOC Scale – Fear of Receiving Compassion from Others

47. FOC Scale – Fear of Self-Compassion

48. Self Compassion Scale Total Score

49. Correlations between change scores for anger and compassion measures within CFT Group Anger Measure FOC– Compassion for Others FOC – Compassion from Others FOC – Compassion to Self Self- Compassion Scale total score MAI – Anger In.63 n = 9.73* n = 9.72* n = 8.87** n = 9 MAI – Anger Out.64 n = 9.69 n = 9.62 n = 8.37 n = 9 STAXI – Anger Expression Index.77 n = 7.72 n = 7.49 n = 6.24 n = 7 *p <.05 **p<.01