Pain is a natural defense mechanism. In fact, it signals to any living creature, from amoeba to plants, up to more advanced animals like us, that something is not going right. Pain it's not only present throughout our lives, but it’s something essential to life itself. In Buddhism, there is an actual equation of suffering, indicating how it’s resulting from pain multiplied by the resistance to it:

In fact, the more we resist pain, the more we suffer: we endure for a long time something that we don't want, that we wouldn't want to be there, but it does exist and is an inevitable reality. Pain, either physical or emotional, is an integral part of our lives: it is not a choice, it is a sensation that we just feel. Judging it, rejecting it, trying to suppress it leads only to its amplification, worsening the quality of our lives, until we could even wonder about their sense.

Compassion Focused Therapy (CFT) is a psychotherapeutic approach focused, as the name itself suggests, on compassion, i.e. that sensitivity to suffering of self and others, with a commitment to try to alleviate and prevent it.
Developed in 2005 by British psychologist Paul Gilbert, CFT is an integrated, multimodal approach that has its roots in evolutionary psychology, social and developmental psychology, Buddhist psychology and neurosciences. It integrates data from research on the neural networks underneath interpersonal relationships with attachment theory and cognitive behavioral therapy techniques. Gilbert identified some central and common elements in many psychological disorders, such as guilt, shame and self-criticism.

CFT was created to help clients who have high levels of these three elements and on whom traditional psychotherapeutic techniques have little effect; although they are capable of following and applying the cognitive and behavioral exercises, in fact, these clients are unable to benefit from the therapy as a whole. In other words, they "know" what to change in order to feel better, but they don't "feel" that this change is feasible: deep down they reject it, they don't experience it as authentic, they automatically find themselves having dysfunctional thoughts and behaviors, remaining in suffering.

CFT is based on the evolutionary hypothesis that in the human brain there are three brain systems underlying emotions’ regulation:

• The threat system (associated with adrenaline and cortisol production), which acts to detect threats in the environment and elicit rapid emotions of fear, anger or disgust, which motivate us to act promptly and protect ourselves. As outcome of this emotional regulation process, we face the threat (fight), escape it (flight) or submit (freeze).  
• The drive and resource seeking system (associated with dopamine production), which motivates us to search for the resources we need (food, sexual opportunities, new territories, alliances, etc.). It activates energizing emotions, makes us want to achieve new goals and allows us to feel desire, excitement, to rejoice once successes and rewards are obtained. 
• The soothing and contentment system (associated with endorphins and oxytocin production), which promotes affiliative social behaviors, sense of belonging, ability to establish intimate interpersonal relationships. This system elicits a sense of peace, contentment, well-being and tranquility.

The main goal of CFT is restoring balance between these three emotion regulation systems, so that people become able to use and increase the activity of their calming system. Through therapy clients learn to work with their systems to help themselves feeling safe and confident when facing life's challenges. They learn to train the soothing system, cultivating compassion towards ourselves, towards others and the ability to also welcome others’ compassion; this trains parasympathetic system’s activity, leading to a progressive increase in vagal tone and heart rate variability - factors strongly connected to psychophysical well-being.

Here is a video that illustrates an example of the three systems and the work done in CFT with our most disturbing internal "voices" (e.g. critical or threatening ones).

Techniques and tools

CFT goals are pursued through several techniques and tools such as:

• psychoeducation
• therapeutic relationship
• guided discovery process
• experiential practices (imagery techniques, chairwork)
• mindfulness
• specific exercises to cultivate compassion and compassionate thinking