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Clinical Meeting: On compassion, eating and self-care

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Image by Joss James
Image by Joss James

This month we were pleased to have psychologist Dr. Courtney Raspin and therapist Jacqui Finnigan who came to talk to us about an eating disorders group they recently co-facilitated at the London Art Therapy Centre.
The group ran for 8 weeks and was entitled “The Compassionate Way through Overeating”.

The clinical meeting was well attended and it was lovely to see so many new and familiar faces. Perhaps characteristically of the therapy and caring professions, nearly all the practitioners at the meeting were women. Without prior arrangement, several team members brought food for the session. Sharing this nourishment resonated with the group; as therapists, we often hold our clients’ distress but do not make the time to find our own nourishment and containment.

For the art-making part of the session Courtney asked us to think about the word “compassion”. Interestingly, most images depicted protective layers with a core, often in warm colours – there was a sense of something coming from the heart, as well as a womb-like, protective, warm and sheltering place. This led to a discussion about the meaning of compassion and, above all, the ability to be compassionate towards one’s self.

Courtney and Jacqui went on to outline the theory behind Compassion Focused Therapy (CFT). CFT employs Mindfulness and compassion-based exercises to help clients develop kindness, warmth and empathy towards themselves, in place of the critical inner voice so many of us carry throughout our lives. This approach was crystallised by Professor Paul Gilbert* and uses several theories, including evolutionary psychology, attachment and neuroscience, to look at emotions regulation in clients who have a great deal of self-criticism and shame.

Courtney and Jacqui explained that when we experience negative feelings, our bodies and neurological systems go into a “threat-focused”, fight or flight state. We then have two options: the first is self-soothing and allowing ourselves to experience the uncomfortable feelings in the knowledge that they will pass. The second option is trying to “get rid” of (or splitting off) the uncomfortable feelings by distracting ourselves from the pain we feel. We might do this by being overly-driven, by consuming or engaging in impulsive behaviour, including self-destructive behaviour. In people who struggle with eating, the relationship with food – and the action of over or under eating – can be used as a defence against difficult feelings, yet the result feeds into a cycle of shame and negative self-image. Courtney and Jacqui demonstrated, through several powerful mindfulness exercises, the ways they encourage clients to increase their ability to self-sooth, accept difficult feelings, learn to care for themselves and their bodies, and engage in safe (rather than self-defeating) behaviours when they are under stress.

At certain points in the meeting the jargon of clinical psychology had to be “translated” into the psychotherapy-oriented terminology many of us are more familiar with. Yet it was clear that, ultimately, we are all referring to the same human experience and the same needs for safety, containment and understanding. And as with most forms of psychotherapy, the aim of CFT is to enable clients to feel safe and contained within themselves, without frantically searching for external ways to be soothed – be it through other people, self-destructive behaviour or their relationship with food.

* Paul Gilbert is the founder of CFT. An interesting and accessible account of this approach can be found in his book The Compassionate Mind.

Information about Courtney and Jacqui’s next group

Further information about CFT can be found on the Compassionate Mind Foundation’s website

Posted by Nili Sigal, art therapist &
clinical meetings coordinator

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