Chair‐work is an experiential method used within compassion‐focused therapy (CFT) to apply compassion to various aspects of the self. This is the first study of CFT chair‐work and is focused on clients' lived experiences of a chair‐work intervention for self‐criticism. Twelve participants with depression were interviewed following the chair‐work intervention and the resulting data were examined using interpretative phenomenological analysis. Three superordinate themes were identified: “embodiment and enactment,” “externalising the self in physical form” and “emotional intensity.” The findings suggest the importance of accessing and expressing various emotions connected with self‐criticism, whilst highlighting the potential for client distress and avoidance during the intervention. The role of embodying, enacting and physically situating aspects of the self in different chairs is also suggested to be an important mechanism of change in CFT chair‐work. The findings are discussed in terms of clinical implications, emphasising how core CFT concepts and practices are facilitated by the chair‐work process.
Compassion-focused therapy, and related compassionate-mind imagery exercises, can be adapted specifically to develop compassion in trainee psychotherapists. Creating, and engaging with, an 'ideal compassionate supervisor' in an imaginal form can support psychotherapy trainees in their clinical practice and development, their supervision and their personal lives. The cultivation of therapist self-compassion can reduce unhelpful cognitive processes such as worry, rumination and self-criticism whilst increasing self-reflection, attentional flexibility and approach behaviour. Identifying, and working with, blocks to compassion is important when cultivating clinician self-compassion Therapist self-practice of compassion-focused exercises can provide important insights into the nature of compassion and its cultivation in clients.
There is a universal recognition of the value of imagery for experiential learning and emotional connection. Therapists apply a variety of rationales for using imagery. Avoidance of using imagery in CBT practice is widely reported and occurs for a variety of personal and clinical reasons. Clinicians' own experience of imagery has a significant influence on the way in which imagery is understood, utilized and experienced in therapy. Future training and research in imagery should more explicitly address the clinician factors that can inhibit or facilitate the use of evidence-based imagery interventions.
Objective
A core aspect of compassion focused therapy (CFT) is addressing fears, blocks, and resistances (FBRs) to compassion. How CFT therapists do this with clients remains unclear. This study aims to explore the perspectives of well‐trained, experienced CFT therapists regarding how they work with FBRs in the context of CFT.
Methods
A qualitative study was conducted. Participants were asked five open‐ended questions regarding (a) their experiences of working with FBRs to compassion, (b) how they understand and formulate FBRs, (c) specific ways they address FBRs, (d) how other therapists might learn about working with FBRs, and (e) their top recommendations. A total of 64 participants completed the online questionnaire, and the qualitative data were analysed using thematic analysis.
Results
The analysis produced four interrelated superordinate themes: (a) Getting “alongside” and “behind”: The central role of formulation, (b) “It's not your fault”: Psychoeducation, (c) “Get experiential”: An emphasis on experiential interventions, and (d) “Respect the wisdom”: The importance of therapeutic process.
Conclusions
Working with FBRs to compassion is critical in CFT. Understanding the wisdom in the client's FBRs, and validating and de‐shaming the client's FBRs are crucial. We provide clinical recommendations regarding working with FBRs as part of CFT.
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