Compassion-Focused eating disorder recovery

Compassion-Focused Imagery for Eating Disorder Recovery


Techniques such as imagery and mindfulness help clients develop coping skills rooted in self-compassion.

Key points:

  • Compassion-Focused Therapy (CFT) is an integrative therapeutic approach developed to support healing for individuals struggling with high levels of shame and self-criticism.
  • Most eating disorder (ED) clients enter treatment with a self-compassion deficit that increases feelings of shame and isolation. 
  • CFT promotes mental, emotional, and relational healing by providing tools and techniques that encourage clients to cultivate kindness towards themselves and others – and enable them to receive kindness as well.

What is Compassion-Focused Therapy?

Developed by Dr. Paul Gilbert, an English psychologist, CFT is an evidence-based therapeutic approach built on the belief that compassion (toward self and others) effectively alleviates the shame and self-criticism that feed psychological dysfunction. It promotes mental and emotional healing by helping clients replace internalized shame and self-criticism with acceptance and self-compassion.

 It also aids in the cultivation of mood management and relational skills and is proven effective not only in the treatment of eating disorders but in treating common comorbidities.

Who can benefit from Compassion-Focused Therapy?

CFT has proven beneficial for individuals with high levels of isolating traits such as shame and self-criticism, including those struggling with:

  • Anxiety
  • Depression
  • Eating Disorders
  • Trauma
  • Mood disorders


CFT exercises are skill-based and deliberately target shame and self-criticism. Examples include:

  • Rhythmic breathing 
  • Imagery exercises
  • Body scans and embodiment exercises
  • Mindfulness

Self-Compassion – an Antidote for Self-Criticism

CFT is a powerful method for cultivating self-compassion, without which lasting recovery from eating disorders is impossible. But how do we define “compassion” and what are the distinctive features of “self-compassion?”

Paul Gilbert, the English psychologist who saw the need for and subsequently developed CFT defines compassion as “a sensitivity to suffering in self and others with a commitment to try to alleviate or prevent it.”

 Dr. Kristine Neff,  a pioneer in the field of self-compassion research, defines self-compassion as being warm and understanding toward oneself, especially in the face of struggle. It consists of three main elements: 

  • kindness
  • common humanity 
  • Mindfulness

With self-compassion, we give ourselves the same kindness and care we’d give to a good friend. – Dr. Kristine Neff

Shame Reduction

Shame is a focus on self, guilt is a focus on behavior. Shame is “I am bad.” Guilt is “I did something bad.” How many of you, if you did something that was hurtful to me, would be willing to say, “I’m sorry. I made a mistake?” How many of you would be willing to say that? Guilt: I’m sorry. I made a mistake. Shame: I’m sorry. I am a mistake. – Dr. Brené Brown

Everyone experiences feelings of shame. For individuals struggling with certain mental health conditions, such as eating disorders, depression, and anxiety, feelings of shame and self-criticism can become overwhelming, painful, and debilitating. A primary goal of CFT in treating eating disorders is to help clients develop ways of engaging with distress in their recovery from the perspective of the compassionate self. 

A focus on compassion helps clients reduce shame and self-criticism.

A focus on compassion helps clients reduce shame and self-criticism.

Guided Exercise: Imagining the Ideal Image of Compassion

The following exercise is adapted from Kolts, R. L. (2016). CFT made simple: a clinician’s guide to practicing compassion-focused therapy. New Harbinger Publications. Providers may facilitate this exercise for clients. Alternatively, clients may record themselves reading the script below for self-guided compassion training.

This exercise is designed to help clients engage with their personal image of the ideal compassionate self.

Sit comfortably and become aware of your breath. You may close your eyes or soften your eyelids to narrow your focus to a single spot. 

In this exercise, you’ll use your imagination to develop an image – an image of pure compassion.

This image can be anything – anything that allows you to activate feelings of kindness towards yourself and others. 

Relax and elongate the breath. Compassion. Inhale… compassion. Exhale … compassion. 

Continue smooth, steady breathing. Notice – what images come to mind when you think of compassion?

Inhale… compassion. Inhale… compassion.

What feelings are arising? What physical sensations can you observe?

Inhale… compassion. Inhale… compassion.

Allow feelings, thoughts, images, and physical sensations to rise and fall with the breath without judgment.

Inhale… compassion. Inhale… compassion.

Now, allow a single image of compassion to emerge. Take your time. Don’t seek to force or control this image. It may be vivid. It may be faint. It may just be a feeling – a sense that compassion is present.

Feed this image with your breath. Inhale… compassion. Exhale… compassion.

Allow this image of compassion to radiate warmth and kindness. Notice how it feels to receive this warmth and kindness. 

Imagine feeling seen and understood by this pure image of compassion.

 Inhale… compassion. Exhale… compassion.

This image of compassion is wise and profound. It cares for your well-being and accepts you as you are. 

 Inhale… compassion. Exhale… compassion.

How does it feel to be in the presence of pure compassion?

 Inhale… compassion. Exhale… compassion.

What happens to your physical posture when you open yourself to receiving this warmth and kindness?

 Inhale… compassion. Exhale… compassion.

Observe your facial expression, and notice sensations in the body. Does anything feel different now than when you began this exercise?

 Inhale… compassion. Exhale… compassion.

How does your image of compassion communicate? What sounds does it make? What words does it use? What is its tone?

Inhale… compassion. Exhale… compassion.

How is your image of compassion comforting you?

Inhale… compassion. Exhale… compassion.

Hold this image in your heart, and resolve to summon this image whenever compassion is needed in daily life. 

Long inhale…pause…. Long open-mouth exhale, sighing happily and softly blinking the eyes open.

This image of compassion will be most effective in helping you cope with struggle if you can remember to nourish it regularly when you are not struggling. With practice, even something as simple as mindful breathing can help you activate feelings of compassion to replace the tendencies to shame and self-criticize. 

Alsana’s Focus on Compassion

Alsana is strengthening its current therapeutic approach (which includes Cognitive Behavioral Therapy (CBT), Motivational Interviewing, and Dialectical Behavioral Therapy (DBT)) with the addition of Compassion Focused Therapy (CFT) – a method proven effective in shame reduction and trauma treatment. 

“Our clients come to us with a self-compassion deficit. Without self-compassion, there can be no recovery,” said Heather Russo, LMFT, CEDS-S, Chief Clinical Officer for Alsana. “Our mission to expand access to holistic, transdiagnostic, and evidence-based eating disorder treatment is supported by our commitment to data-driven care and a culture that cultivates compassion… as a community of care providers, I believe we must strive to embody the compassion and self-compassion we want for our clients.” Read more about CFT at Alsana.

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