Profile: Dr Chris Irons And Compassion Focused Therapy
Dr Chris Irons is a clinical psychologist, author, researcher and leading international CFT trainer. He is co-director of Balanced Minds – a specialist Compassion Focused Therapy provider and co-developer of the world’s first compassion app. We sat down with Chris and discussed what made psychology become real for him, learning not to do it all, and his desire for compassion to become infused into our structures, organizations and environments.
A Grounding in Compassion and Therapy
How did you become interested in Compassion Focused Therapy?
The answer to that has two layers. The initial layer is that I come from a family of people who have tended to help others. One of my grandfathers was a head teacher, whilst the other settled in the UK from Jamaica following the second world war, dedicated his life to fighting racism and prejudice, and was subsequently awarded an OBE for his work in race relations. My parents were both teachers, and many of my uncles and aunts also worked in the helping professions, so much of my family rhetoric was steeped in helping and supporting people. At the heart of it, compassion evolves from this desire to be helpful to others.
The next layer was, in part, serendipity. I took a four-year undergraduate psychology degree, and the entire third year was a work placement. I‘d struggled to find something that would be right for me, and over the summer I complained to a good friend that I hadn’t got a placement arranged, and was beginning to panic about this. His father, who was a general practitioner, overheard me saying this, and offered to look into it. The next week, I got a phone call from him suggesting that I contacted a professor called Paul Gilbert, whom he had heard good things about, although they hadn’t met. So, I wrote to Paul, asking if I could do a work placement. Luckily, he said yes!
That placement changed my understanding of psychology. Though I’d always been interested in psychology, I went from struggling to connect the interesting theoretical ideas I was learning about during my degree, to a sense of how they could be applied to the real world. Working with Paul Gilbert showed me first-hand how ideas and theories that he was developing were tested out directly with people, and how these could then lead to therapeutic applications for people struggling with psychological difficulties.
It was during this placement year in 1999 – before it was developed into a psychotherapeutic approach or model – that I was exposed to the early development of what would later be called Compassion Focused Therapy. It was a privilege to witness up close some of this process, and it was very inspiring.
After completing my placement, I returned to university to complete my final year, and felt that things made sense in a way they didn’t previously. After graduating, I took a position with Paul and his research team as a Research Psychologist, while also doing a part time PhD with him. During a wonderful three years, we conducted lots of interesting research on different aspects of what we were integrating in to the CFT model – for example, attachment theory, shame, self-criticism, compassion, and self-reassurance.
Alongside conducting research, I was also doing some clinical work under Paul’s supervision. This continued when I got on to clinical training, as I spent a further year and a half of training placements working with Paul and the CFT model. I think one of the reasons this model appealed to me so much was because I’d been involved in researching some of its constituent parts, but it was mostly because it seemed to meld areas of psychology, science (e.g. evolutionary theory, attachment theory, neuroscience, neurophysiology, social psychology), and therapy (e.g. psychodynamic ideas, CBT, Rogerian, existential and so on) in a highly integrated yet ‘human’ way.
Are there any stand-out moments when you realized how powerful this approach was?
I remember one moment very clearly. It was the first study in CFT which used some of the practices that would later become a central exercise in the approach known as the ‘compassionate other’. In this study we asked a group of people that had long standing difficulties with depression and self-criticism to generate an image of a compassionate other, and then to try using this image to access compassion and reassurance when they were struggling or feeling depressed. I remember very clearly how powerful and helpful that exercise was to them, but also how many people found it difficult. Whilst some could talk clearly about how supportive, caring and kind they would be to somebody else who was going through something similar, when they tried to engage in this approach for themselves, they found it incredibly hard. They experienced all sorts of blocks to compassion, which we would later describe as fears, blocks and resistances (FBRs) to compassion. Seeing how helpful some people found this practice, but how difficult it was for others, was a real standout moment.
Why do you think that having self-compassion is so important and why should everybody practice it?
In answering this question, it’s important to start by saying that CFT is interested in the three flows of compassion. The first flow is the compassion that we have for other people who are in distress and struggling. The second flow is how able are we to seek out and receive other people’s kindness and care when we’re struggling. The third flow is self-compassion. Depending on the person and their difficulties, they may need to work on all three of these, or maybe just one or two flows. In the research literature, each of these flows has been found to be related to a variety of helpful and healthy psychological variables, whereas low levels in each flow tend to be associated with psychological distress.
In relation to self-compassion in particular, there are a number of reasons why it’s so important. To start with, your relationship with yourself is the most important one you’ll ever have, and whilst we’re raised to often be kind and caring to others, it’s rare to be explicitly taught by our parents how to be compassionate to ourselves. Moreover, whilst we’re taught useful subjects at school that we’ll need for life, like maths, science, and English, most of us aren’t given classes on how to understand, work with and support our own minds and emotions.
It’s more than just an imbalance that’s significant here. If you add up every hour that you’re in a relationship with someone else through your life (whether this be family, friends, colleagues or a romantic partner), this comes nowhere near the amount of time that you spend in relationship with yourself. Sadly, many of us don’t just treat ourselves without compassion, but we can be quite hostile, critical and angry with ourselves, and in ways that we would never be with people that we care about in life.
The research literature backs this up. Many studies have found that when you develop self-compassion, or are lucky enough to be self-compassionate in the first place, this is associated with lower levels of shame, self-criticism, rumination, worry, or other difficulties. That’s why learning how to be with yourself is such an important skill to have.
When you’re training people in compassion, what are the biggest misconceptions or challenges that they come across, and how do you address them?
When we train clinicians, there’s often a sense that all therapies are compassionate, so why is ours ‘the’Compassion Focused Therapy? The point I would make here is that lots of therapies involve elements of compassion, but in CFT, what we’re talking about is how compassion textures and guides all aspects of the therapeutic process: not only in the therapeutic relationship or how you understand others, but also in what we do in therapy.
For many clients, the major blocks are the myths around compassion, and these can be challenging for clinicians too. This can include the myth that compassion is soft, weak and fluffy, that it involves letting yourself or others off the hook, or allowing yourself to make mistakes without trying hard to fix them. It’s that compassion is nice sometimes, but won’t get you anywhere in life or fix mental health problems. In CFT, these are referred to as the fears, blocks and resistances (FBRs) of compassion, and identifying, understanding and working with these are often a key focus in CFT. As I often say when I’m teaching, you know something is common in life when a psychologist develops a questionnaire to measure that ‘thing’, and this is the case for CFT with a measure called the Fear of Compassion Scale.
There are many ways to try and address some of these myths and FBRs about compassion. For example, if a person’s concern is that compassion is weak or wishy-washy, one useful approach is to clarify what compassion is, which from a CFT perspective is ‘a sensitivity to the suffering of self and others, with a commitment to relive and prevent it’. A crucial aspect of this definition is that to engage in and work with suffering, we often need strength and courage. For example, firefighters going into a burning building to save a child is an act of compassion, but we would never describe them as weak, but rather as brave, strong and courageous. Nelson Mandela is another great example. He was often described as someone very warm, kind and caring, but we never would have described him as weak. The reality is that compassion often requires strength and courage to turn towards pain and to find ways to try to alleviate it.
How do you help clinicians guide their clients through the transition of practicing exercises, to applying these new ways of thinking to their own lives?
It’s a bit like fitness. If you’d not been doing any exercise for a year, and then started going to the gym four times a week for three months, you would definitely notice a variety of physiological benefits. Your blood pressure would probably reduce, and your bones and muscles would get stronger. Our research in CFT has found that when people engage in compassionate mind training (CMT) practices regularly, like going to the gym, this has a variety of benefits: from reductions in shame, self-criticism and a number of psychological measures of distress, to increasing the flows of compassion, pleasurable emotions and wellbeing.
But we can stretch this comparison further. Going to the gym regularly doesn’t just benefit your physiology in a generic way, it also helps you in specific circumstances. For example, imagine that you were late to catch a train, and the only way you could make it on time would be to run quickly for a minute without stopping. If you’d been doing regular fitness training, you could use these physical benefits to sustain your run and make it to the train in time. However, if you’d not been going to the gym regularly, you’d likely be out of breath and have to stop running after a short time. Similarly, CMT practice doesn’t just help in a generic way. Research by colleagues of mine have found that the most benefits were found when people were able to apply their compassionate mind in circumstances of difficulty and distress. So, we do compassionate mind training practices in part to help clients cultivate a capacity for compassion, but also to help them put this fitness to work on a day-to-day basis, so that when their threat system turns on, they can meet it with their compassionate mind.
What is CFT not great for?
Well, my honest answer is that I don’t know. We haven’t found a presenting issue yet that CFT doesn’t seem to be useful for, but ultimately, it can only ever be shown through proper research trials. I think it’s important for all therapies to remain humble in how they view and evaluate themselves, and strive to keep on developing ideas and therapeutic approaches that will help people more.
However, one of the reasons why I’m so hopeful about how far reaching CFT can be is partly because it’s a highly integrated approach, but crucially, it’s built upon the sciences, so we’re constantly looking to understand more about human distress and suffering, and to find ways to relieve and prevent this.
Is there a place for CFT to integrate with other types of approaches?
It’s important to separate out the different aspects of therapy: the theory and understanding about the nature of distress and suffering that informs a therapy, and the interventions and practical elements that are used in session to help clients. A concern for us is that sometimes people try to take techniques (for example, compassionate mind training exercises in CFT) and apply them as a technique or intervention without understanding the broad theoretical aspects of CFT which inform and guide their use.
CFT is already a highly integrated, biopsychosocial approach, which draws influence from other approaches and branches of science that influence both the theory and technique aspects of our approach. For example, on the theory side, CFT draws from theories including: evolution, attachment, psychodynamic, social and developmental psychology, cognitive, behavioural, neuroscience and neurophysiology. In terms of techniques, CFT is multimodal, in that we aim to alleviate distress in multiple domains (e.g. attention, thinking, emotion, behaviour, sensory/body, imagery). Sometimes you might work primarily with cognition and reasoning like cognitive therapy would, at other times you might work specifically with emotions, a bit like emotion focused therapy would, and for other people you might work very behaviorally, as you would in the behavioral traditions. The idea here is that we have six major domains to focus on and think about. Whether you use one or many of them, which would work best to help this person? This also means that CFT uses many techniques and interventions which are also used in other therapies. This can include (amongst others) chair work, imagery rescripting, thought records, behavioral experiments, socratic questions, activity scheduling, exposure and so on.
So, can you integrate CFT ideas and techniques into other therapies? Yes, of course, but we’d always caution that is done from a sound theoretical understanding of CFT. As an approach, we are already highly integrated, drawing upon an eclectic range of interventions and techniques.
Can you tell us about your mission regarding compassion and CFT? What motivates you?
My mission is to try to spread the ideas, the practices, and the benefits of self-compassion and CFT to as many people as possible. That’s what motivates me, and it’s why we set up Balanced Minds in 2012.
One way I’ve sought to do this is by training therapists in the ideas, principles and the practices of CMT, and to increase the accessibility of CFT workshops and resources. My recent passion has been in finding different ways to spread the ideas and practices of CFT that have traditionally been restricted to the therapy room, to a wider audience, including those who will never seek out therapy for themselves. I love being a therapist, but I’ve always had a sense that if I spent all my time in the therapy room, I’d be restricted in how many people can benefit from CFT. For example, recently I’ve spent time developing a short online self-compassion course and The Self-Compassion App, both based on the CFT model, but which anybody, wherever they are in the world, can engage with.
Where do you think compassion is going? What’s going to be happening differently in 20 years-time?
I would hope that compassion becomes as familiar as mindfulness is now. When hearing about mindfulness became more common during the last two decades, many were sceptical about what it was, and whether it could help. Today, many people are not only familiar with what mindfulness is, but have also benefited directly from practicing it, and it’s become integrated in many different areas of our culture and communities. My hope is that a similar thing happens with compassion. I hope people will know what it means, why it’s beneficial, how they can practice it, and how they can use it, for others and for themselves.
If I was dreaming ‘big’, I would love to compassion to be embedded throughout core structures within our countries and culture. For example, although it’s already slowly started to happen, it would be amazing if compassion – and some of the ideas of CFT – could be integrated throughout all the layers of an organization. Whether it’s a business, corporation, charity, hospital or school, I would hope that the entire organization, from the top to the most junior member of staff, would be steeped in compassion.
What advice would you give your younger self?
There would be different advice for different aspects of my life. For my career, I would definitely tell myself to have the confidence to follow the things that make my heart sing the most. In my early career I spent too much time trying to do everything: I worked full time in the NHS, and then in my own time I conducted research, published papers, wrote books, taught, and set up a company. It’s obvious now that juggling all of those things was neither healthy nor sustainable, and nowhere near a good work-life balance!
The thing that ultimately helped was a conversation with Paul Gilbert, where he simply asked me “What’s the most important thing to spend your time on?” Whilst I did enjoy all the different parts of my working life, this was an easy question to answer – I wanted to work with CFT.
As soon as that was clear to me, everything fell into place. I asked myself what job I could do that allowed me to spend time following my passion, which led to following a path that prioritises CFT. If I could give advice to my younger self, it would be to prioritize the thing you’re most passionate about, and that you love the most.
- Irons, C., & Beaumont, E. (2017). The compassionate mind workbook: A step-by-step guide to developing your compassionate self. Robinson. Link
- Dale-Hewitt, V., & Irons, C. (2015). 10 Compassion Focused Therapy. Formulation in Action, 161. Link
- Matos, M., Petrocchi, N., Irons, C., & Steindl, S. R. (2022). Never underestimate fears, blocks, and resistances: The interplay between experiential practices, self‐conscious emotions, and the therapeutic relationship in compassion focused therapy. Journal of Clinical Psychology. Abstract
- Irons, C. (2022). Compassion focused therapy (CFT) for emotion regulation difficulties. In Compassion Focused Therapy(pp. 459-478). Routledge. Link
New compassion resources coming very soon!