The origins and nature of compassion focused therapy


  • Paul Gilbert

    Corresponding author
    1. Mental Health Research Unit, Asbourne Centre, Kingsway Hospital, Derby, UK
    • Correspondence should be addressed to Paul Gilbert, Mental Health Research Unit, Kingsway Hospital, Derby DE22 3LZ, UK (email:

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Compassion focused therapy (CFT) is rooted in an evolutionary, functional analysis of basic social motivational systems (e.g., to live in groups, form hierarchies and ranks, seek out sexual, partners help and share with alliances, and care for kin) and different functional emotional systems (e.g., to respond to threats, seek out resources, and for states of contentment/safeness). In addition, about 2 million years ago, (pre-)humans began to evolve a range of cognitive competencies for reasoning, reflection, anticipating, imagining, mentalizing, and creating a socially contextualized sense of self. These new competencies can cause major difficulties in the organization of (older) motivation and emotional systems. CFT suggests that our evolved brain is therefore potentially problematic because of its basic ‘design,’ being easily triggered into destructive behaviours and mental health problems (called ‘tricky brain’). However, mammals and especially humans have also evolved motives and emotions for affiliative, caring and altruistic behaviour that can organize our brain in such a way as to significantly offset our destructive potentials. CFT therefore highlights the importance of developing people's capacity to (mindfully) access, tolerate, and direct affiliative motives and emotions, for themselves and others, and cultivate inner compassion as a way for organizing our human ‘tricky brain’ in prosocial and mentally healthy ways.

Practitioner points

  • The human brain is highly evolved for social processing and these mechanisms are being increasingly well understood and integrated into psychotherapy.
  • Among the most central processes that regulate emotion and sense of self are those linked to social roles such as status, sense of belonging and affiliation, and caring.
  • Many psychological difficulties are rooted in social relational problems especially in feeling cared for by others, having a caring interest in others, and having a caring, affiliative orientation to oneself.
  • Helping clients in these domains can address problems of moods, problematic behaviour and a range of shame and self-critical linked difficulties.