The role of our thoughts, feelings, fears and compassion in psychotherapy and recovery

It is increasingly recognised in the literature that the mechanism of change in psychotherapy is not well understood. Several decades of research into this area has failed to demonstrate the relative superiority of one model of psychotherapy over another. This psychotherapy-equivalence research has led to speculation as to the importance of specific aspects of therapy (for example challenging thoughts in cognitive behavioural therapy), and the role of non-specific factors in producing therapeutic change, including emotional experiencing in therapy. The first paper provides an integrative review of the evidence for the importance of focusing on cognition in therapy and suggests that more emphasis must be placed on what the literature has identified as vital ingredients of therapy. These do not appear to relate to cognition, but emotion. The second paper is a qualitative exploration of the experience of receiving an affect- focused model of therapy (compassion focused therapy) and the process of becoming self- compassionate. Seven people with a diagnosis of posttraumatic stress disorder who had completed a course of such therapy were interviewed. Results of the interpretative phenomenological analysis suggested that self-compassion initially triggered a highly aversive emotional response and was frightening. This was an important obstacle in therapy and participants identified the therapeutic relationship and gaining a sense of feeling understood as important factors enabling them to overcome this. Participants described subsequent positive emotional responses to self-compassion, and a new sense of hopefulness for the future. A process model of the journey from self-criticism to self-compassion is proposed, which requires further investigation, but provides guideposts as to the stages that clients are likely to progress for therapists working with this model.EThOS - Electronic Theses Online ServiceGBUnited Kingdo