Compassion Focused Therapy for Hoarding Disorder€¦ · Initial findings on CFT for hoarding •Participants: Individuals who completed a 16-session Cognitive Behavioral Therapy

Compassion Focused

Therapy for Hoarding Disorder

Chia-Ying Chou, Ph.D.

Presentation for ICHC 2018 in Berkeley, CA

Compassion Focused Therapy

• Compassion-Focused Therapy (CFT) was founded by Dr. Paul Gilbert, University of Derby, U.K.

• CFT is a psychotherapy derived from research in developmental psychology, emotional neuroscience, evolutionary psychology, and Buddhism.

• CFT is a rapidly growing evidence based treatment method for a range of psychological problems, including shame-based difficulties and self-criticism, anxiety, mood regulation problems, posttraumatic reactions…

• http://www.compassionfocusedtherapy.com/

Agenda

• What is compassion?

• Why do we need compassion?

• How can compassion help with hoarding?

• Initial findings on CFT for hoarding

• Q & A

Let’s arrive here and now…

What is compassion?

“The sensitivity to suffering in oneself and others, with a willingness to try to alleviate or prevent it”

Wisdom – awareness and empathy for suffering, and the “right” way to alleviate it Commitment – the desire and sense of responsibility to help, not giving up or run away

Strength – emotional strength to endure difficulties

Warmth – when the above is done without warmth or friendliness, it may cause further suffering

Why do we need compassion?

• Experiential exercise 1:

a compassionate look at my morning

Why do we need compassion?

• Our human brain is a product of evolution

New Brain

• Sense of self • Planning • Ruminating • Reasoning • Imagining

We do something that our pet animals might not do!

Old Brain

• Physical safety • Survival needs • Social and emotional desires

We are motivated to achieve similar things as our pet

animals!

What happens when the Old Brain hijacks the New Brain?

It’s not your fault.

It’s your responsibility to

make things right for you.

How can compassion help with hoarding?

• The three motivational systems

• Compassion training empowers one through strengthening the soothing system and regaining balance.

Drive system

Incentive and

resource focused

Soothing system Contentment and safeness

Threat system

Protection and safety seeking

How can compassion help with hoarding?

• Experiential exercise 2:

De-clutter in the three different motivational systems

Initial findings on CFT for hoarding

• Participants:

Individuals who completed a 16-session Cognitive Behavioral Therapy group for hoarding in a large clinical trial at least 1 year ago, and still presented clinically significant hoarding symptoms (SI-R score > or = 42) at the time of screening for this follow-up study.

• Study design:

Reviewing CBT (15 weeks) or CFT as a follow-up treatment (16 weeks) – group assignment depending on availability at the time.

Initial findings on CFT for hoarding

0

10

20

30

40

50

60

70

Overall Difficultydiscarding

Acquisition Clutter

Pre-treatment Post-treatment

CFT group (N = 13)

0

10

20

30

40

50

60

70

Overall Difficultydiscarding

Acquisition Clutter

Pre-treatment Post-treatment

CBT group (N = 7)

Overall

SI-R scores

• Retention rates: 19 enrolled in CFT 13 (68%) completed 19 enrolled in CBT-R 7 (37%) completed or ongoing

SI-R scores

Initial findings on CFT for hoarding: participant feedback

How is CFT better than CBT?

• “The focus of CFT is on negative self-talk and on neutralizing it, rather than succeeding or failing on any tasks. This leads to a healthier (long term) attitude toward the clutter problem.”

• “CFT recognizes that saving or discarding is not a logical decision. Asking ourselves a list of logical questions, like we did in CBT, was not enough.”

• “The breathing and relaxation techniques that we practiced enabled me to remind myself of what my most compassionate, wise, strong, warm and committed self would do in any given situation of discomfort or distress.”

• “I feel a deeper emotional connection and kinship with the members in the CFT group.”

How is CFT worse than CBT?

• “For some people, CFT can be uncomfortable, especially with its emphasis on self-examination.”

• “For me, CFT was worse because it was less specific, and less about goal setting.”

• “CFT is not worse than CBT – however, CBT was better to come first, because it’s more about the “physical-ness” of hoarding issues (i.e. clutter).”

• “Effects of CFT is less measurable and more internal. A lot of work can’t be seen even though it’s in the works.”

• “CFT lacks some of the useful tools of CBT (e.g., using timer, daily de-cluttering sessions, “rules” of acquiring)”

Thank you, and for your information

• CFT-USA website address http://www.mindfulcompassion.com

• CFT for hoarding group coming up this summer

Email: [email protected]

Thank you,

and the most compassionate wishes for

you!