A patient said the other day, “I just get so anxious, what is wrong with me? Why am I like this?” and burst into tears. A common complaint of our clients with anxiety and depression is that they beat themselves up over and over again. Their minds are filled with self-critical thoughts. These negative thoughts may be a product of how they have internalized a critical parent, their own perfectionism gone awry and or the dark thoughts that come with depression. By definition, feelings and thoughts of worthlessness are part of the landscape of depression. Anxious clients tend to get anxious about their worried thoughts and feelings. It is very easy to get sucked in to these thoughts. Sometimes they seem so real and so loud that they can be hard to ignore.

A newer line of research in Cognitive Behavior Therapy has delved into an area rarely given much time in our field. This is the field of Compassion-Focused Therapy. While you would think that a therapist would have lot of resources on compassion, there have been shockingly few in my line of work. In fact, while I was taught to be an empathic listener and to be kind and compassionate to my patients, there were no concrete ways I was taught to do so. Furthermore, there were no skills to teach my clients about how to be compassionate to themselves. Compassion was something that one thought of when speaking of spirituality or Buddhist practice.

A researcher in England named Paul Gilbert began looking at compassion and published a book on its use in psychotherapy in 2005. Since then, there has been burgeoning interest in how to use compassion in psychotherapy as a skill that one can learn. Dr. Dennis Tirch has written about how compassion can be broken into compassionate attention, compassion-focused imagery, compassionate thinking and compassionate behavior. Compassion can help one respond to negative thoughts and emotions in a way that is kind and accepting rather than punishing and amplifying. This can help to quiet those self-critical thoughts common to those struggling with anxiety or depression. Dr. Kristin Neff has looked at how a small gesture of self-compassion such as a hand over one’s heart is a way to gently soothe oneself and direct compassion inward. Compassion can be learned even for those with few past experiences of kindness in their own lives. Sometimes I ask the “fairy godmother question” as a way to activate one’s imagination of a compassionate other to help generate compassion towards the self and towards others.

I hope that reading this today will remind you to be kinder to yourself and to others as you move through your day. Even small gestures help -- a smile, saying hello, a gentle touch on the back or arm of a loved one, or simply reminding yourself that others are suffering too and we are all in this together.

For more information on Compassion-Focused Therapy at CBTDenver please call us at 303-355-5133 or email us at