Andrew Fleming
How we talk about Psychosis will shape what we think, feel and do about it. 1. What can we learn by listening to the experiences of people: who report unusual experiences but never come into services who receive a diagnosis for their experiences, and then recover Both may provide key insights into, how experiences can be integrated in benign / helpful way the protective factors / mechanisms facilitating this process Herriot-Maitland, knight & Peters (2012)
Childhood Adversity and Psychosis People who had experienced three types of trauma were 18 times more likely to be psychotic than non-abused people. People who had experienced five types of trauma were 193 times more likely to be psychotic. Shevlin et al 2007
Why CFT? Psychotic experiences are often associated with shame and self criticism. CFT developed to reduce shame and self criticism Develops a new relationship with self based on warmth, care, kindness and self soothing Understandable responses and ways of coping Vs symptoms
CFT Core Components Psycho education on evolved tricky brain Three functions of affect regulation model Build compassion focussed motives, skills and identity
Compassion begins with a reality check... We are an emergent species in the flow of life our brains, with their motives, emotions and competencies are products of evolution, designed to function in certain ways. Much of the circumstances of our lives, over which we have no control, have major implications for the kinds of minds we have, the kind of person we become, the values we endorse, and the lives we live. Old Brain / New Brain
Our Tricky Brains: Interaction of old and new psychologies Mindful Brain New Brain: Imagination, Thinking, Planning, Rumination, ToM, Mentalisation, self-awareness, self-identity Old Brain: Motives (food, sex, relationship seeking, caring, status) Emotions (anger, anxiety, sadness, joy) Behaviours (fight, flight, shut down etc) COMPASSION
Three systems model Drive and resource seeking Directed by emotions: Excitement and Pleasure Soothing and affiliation Directed by emotions Contentment safeness, connection Threat and self protection Directed by emotions: Anger, anxiety, disgust
Gumley et al (2010) In psychosis, not only may the threat system be highly sensitized and vigilant to certain types of threat, the maturation of the soothing system.. seems compromised, greatly interfering with threat regulation.
Compassion Compassion is the sensitivity to the suffering of self and others and the causes of suffering with a deep commitment to try to alleviate and prevent it. Dalai Lama Compassion is the courage to descend into the reality of human experience Paul Gilbert
Compassionate mind
The practices Body work Breath work slowing and soothing rhythm Attention Imagery Motivations, thinking and actions Compassionate letter writing.
The Three C s Curiosity Compassion Acceptance
Compassionate Recovery Connectedness Hope Identity Meaning Empowerment. Leamy et al ( 2011)
Taking it further...
References Gilbert, P (2009) The Compassionate Mind. London: Constable & Robinson. Gumley et al (2010). A compassion focussed model of recovery after psychosis International Journal of Cognitive Therapy 3(2) 186-201, 2010 Herriot-Maitland C, knight M & Peters E (2012) A qualitative comparison of psychotic-like phenomena in clinical and non-clinical populations. British Journal of Clinical Psychology, 51, 37-53. doi:10.1111/j.2044-8260.2011.02011.x Leamy M, et al (2011) Conceptual framework for personal recovery in mental health: systematic review and narrative synthesis. The British Journal of Psychiatry Nov 2011, 199 (6) 445-452; DOI: 10.1192/bjp.bp.110.083733 Mayhew S (2015) Compassion Focussed Therapy for people experiencing psychosis in Innovations in Psychosocial Interventions for Psychosis ( Meaden and Fox eds) 2015 Shevlin et al, (2008) Cumulative Traumas and Psychosis: an Analysis of the National Comorbidity Survey and the British Psychiatric Morbidity Survey Schizophrenia Bulletin, Volume 34, Issue 1, 1 January 2008, Pages 193 199, https://doi.org/10.1093/schbul/sbm069