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.

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.