Compassion focused therapy

What is compassion focused therapy?

Compassion focused therapy is a talking therapy that helps people notice harsh self-criticism and respond to themselves with more warmth and steadiness. It was developed by the psychologist Paul Gilbert. It draws on research into how threat, soothing and drive systems shape emotion, and is often used alongside other approaches such as CBT.

The approach starts from a simple observation: many people are far harder on themselves than they would ever be on a friend. A demanding inner voice can follow a setback at work, a difficult relationship, or years of feeling not quite good enough. Compassion focused therapy treats that voice as something to understand rather than something to fight. It looks at where it came from, what it is trying to protect against, and how a calmer, more supportive way of relating to yourself might be built instead.

When compassion focused therapy helps

Compassion focused therapy tends to help people whose difficulties are tangled up with shame or a persistent sense of falling short. That can show up as anxiety that gets worse whenever mistakes feel likely, low mood linked to years of self-blame, or a pattern of working hard yet never feeling satisfied with the result. It is also used with people who have tried other therapies, made sense of their thinking patterns, and still find that a harsh inner critic gets in the way of change.

Some people come to compassion focused therapy after growing up around high expectations, frequent criticism, or environments where warmth felt conditional. Others simply notice that self-compassion feels foreign or even uncomfortable, and want help understanding why. The approach does not assume a single cause. It works with whatever pattern of self-relating has developed over time, and asks what a steadier alternative could look like for that particular person.

What sessions involve

Sessions are held online by video call, which suits people fitting therapy around work, caring responsibilities or a commute into central London from Greenwich and the surrounding area. Pace and content are shaped by what you bring each week rather than following a fixed script.

The three emotion systems

Compassion focused therapy uses a model of three interacting systems: a threat system that scans for danger and drives self-protection, a drive system that pushes towards achievement and reward, and a soothing system linked to calm and connection. For many people the threat and drive systems dominate, particularly when self-criticism has become an automatic habit. A large part of the work involves strengthening the soothing system, which can feel underused or unfamiliar at first.

Building a compassionate approach

Sessions might include compassionate imagery, working directly with the tone and content of self-critical thoughts, and exploring any fears about being kind to yourself, since this can feel unsettling for people who associate self-criticism with staying safe or motivated. The psychologist will explain the reasoning behind each exercise rather than asking you to take it on trust. Compassion focused therapy is frequently combined with cognitive behavioural approaches, so it can sit alongside other techniques you may already be using.

The evidence for compassion focused therapy

Compassion focused therapy is not currently named as a first-line treatment in NICE guidance in the way that cognitive behavioural therapy is for many common mental health difficulties. It sits alongside, rather than in place of, treatments with a longer NICE track record.

That does not mean the evidence base is thin. Research interest in compassion focused therapy has grown steadily since Paul Gilbert first developed the model, with a number of studies pointing to reductions in shame, self-criticism and self-attacking thoughts, and improvements in mood for people who respond well to this way of working. It is often introduced as part of a broader treatment plan, particularly where self-criticism has limited the impact of other therapies such as CBT. A psychologist can talk through where the evidence is strongest for your particular situation and how compassion focused therapy might fit alongside other NICE-recommended options.

Compassion focused therapy for Greenwich and south east London

This practice offers clinical psychologists for Greenwich and south east London, working online with adults, so sessions are accessible wherever you are based locally. That includes people living around Cutty Sark and Greenwich Park, and those coming from Blackheath, Charlton, Deptford, Lewisham, New Cross and Maze Hill. Greenwich and Maze Hill stations, along with the Cutty Sark and Greenwich DLR stops, put the area within easy reach of central London, but sessions themselves take place over video call rather than in a room in the town.

Working online means appointments can fit around a working week that includes travel into the city, without the need to build in extra time either side to travel to a clinic. It also means the practice is not limited by what is available on one particular high street. We will update this site as the practice develops.

If you are considering compassion focused therapy, an initial conversation is the usual way to work out whether it fits what you are looking for, and whether it makes sense on its own or alongside another approach.