Multiple emotions, multiple selves: compassion focused therapy chairwork

Abstract

Compassion focused therapy (CFT) is rooted in an evolutionary view of the human mind as formed of a multitude of contrasting, and often conflicting, motivations, emotions and competencies. A core aim of the therapy is to help clients understand the nature of their mind in a way that is de-pathologizing and de-shaming. The approach is also focused on the cultivation of compassion to work with these difficult aspects of mind. CFT includes the ‘multiple-selves’ intervention which involves the differentiation of threat-based emotion and an exploration of their conflict. Compassion is then applied to the client’s affective world to aid regulation and integration. This paper focuses on clients’ experiences of a chairwork version of multiple-selves, wherein clients personify their emotions in separate chairs. Nine participants with depression were interviewed directly following the intervention and the resulting data were analysed using interpretative phenomenological analysis. Three interconnecting themes were identified: appreciating emotional complexity; the role of chairwork process; and compassionate integration. The results highlight the importance of emotional differentiation in understanding internal multiplicity and conflict in depression, and the role of compassion in creating a sense of personal coherence. The embodied and enactive nature of chairwork was found to be of benefit in identifying and separating emotion, and in developing new forms of self-relating. The paper discusses the clinical implications of such findings for the treatment of depression. Key learning aims As a result of reading this paper, readers should: (1) Learn about the ‘multiple-selves’ framework for working with threat emotions. (2) Appreciate the complexity of emotions in depression. (3) Understand how chairwork processes can be used to access, differentiate and address emotional material. (4) Develop insight into how compassion can be used to regulate emotions and integrate aversive experiences.

‘It was like the unicorn of the therapeutic world’: CBT trainee experiences of acquiring skills in guided discovery

“…The first master theme ‘competing selves’ resonated with existing literature on topics including the concept of a ‘multi-mind’ (Bell et al ., 2021), role transition (Robinson et al ., 2012; Wilcockson, 2020), cognitive dissonance (Festinger, 1957), and the role of formal and informal self-practice/self-reflection (SP/SR) in therapist skill development (Bennett-Levy, 2006; Haarhoff, 2006; Leahy, 2001).…”

“…Young et al, 2006). Indeed Bell et al (2021) describe the human mind 'as a multiplex of motivations, emotions and cognitive competencies that give rise to conflict and distress' (p. 2). The sub-themes 'Discomfort of change' and 'Resisting old ways' capture the essence of this intrapersonal conflict.…”

“…Existing research also suggests that trainee CBT practitioners perceive supervision to have the greatest impact on the development of their clinical competence (Kennedy-Merrick et al, 2008;Rakovshik and McManus, 2013) and that they are receptive to exploring their own therapy interfering beliefs within supervision (Roscoe, 2021a). The intrapersonal conflict experienced by trainees could be addressed in supervision through experiential methods which engage with the concept of 'multiple selves' (Bell et al, 2021). For example, chair work (see Roscoe, 2021b for an example of how a therapist can work through their own blocks).…”

“Suddenly you are King Solomon”: Multiplicity, transformation and integration in compassion focused therapy chairwork.

“…As highlighted by the work of Pinto-Gouveia and Matos (2011), shame episodes can have the quality of traumatic memories and become “central” to individuals’ sense of self. The identification of specific memories via imagery during chairwork could provide potential targets for imagery rescripting (which has been found to be effective as a stand-alone treatment for depression, Brewin et al, 2009), or for alternative CFT interventions whereby the “critic” is identified as an internalization of an abusive other and is externalized from the self (e.g., via chairwork, Bell, 2019).…”

Evaluation of a Virtual Compassionate Living Group for Patients with Chronic Pain

“…This may include sessions on chair-work where techniques are used to separate parts of the self into different chairs. Compassion is then applied to these different parts to bring about regulation and integration [43]. It is also important to note that the clinically significant change analyses on the SCS-SF and the FSCSRS were measured against normative data from a non-clinical sample who are not in pain.…”