“Cultivating the Conditions for Safeness”: An Exploration of Patient’s Experiences of a Compassion Focused Group Psychotherapy Program for People with a Diagnosis of Personality Disorder

Individuals who have early attachment trauma can be fearful and resistant to caring behaviour from others and for themselves. This is partly because stimulation of the caring motivational system ignites trauma attachment memory. As a consequence, these individuals are unable to access care-attachment systems, supported by neurobiological processes involving the vagus nerve, oxytocin, and the frontal cortex, for modulating threats and regulating interpersonal distress. This paper outlines a Compassion Focused Group Psychotherapy (CFGP) devised to address this issue through a slow paced, rolling psychotherapeutic program. 40 people with a history of attachment and relational trauma, who had been referred for psychotherapy to an NHS outpatient psychotherapy service, took part in a 12-month Compassion Focused Group Psychotherapy program (CFGP), with a 12 month follow up. 31 patients completed the program. From this group a cohort of 9 patients were invited to take part in individual interviews about their experience of CFGP and potential mechanisms of change. Qualitative data suggested that developing a sense of ‘safeness in the room’ with each other was one of the most important aspects and mechanism of change. This was coupled with the implicit and explicit cultivation of the ‘flows of compassion’, through the ‘structured components of the model’. These processes enabled patients to use the group as a safe haven and a secure base to undertake the ‘moments of change’, to begin to experience new compassion-based versions of themselves, their relationships and to manage ‘transitions and endings’. This study demonstrates that the slow, open and rolling nature of this group psychotherapy programme, and the explicit and implicit cultivation of compassionate competencies, gave the group members a positive experience of caring and compassion. The focus on developing affiliative connections offered new learning and was key to the cultivation of ‘safeness’ within and between groups members. The development of compassionate and caring motivational systems supported the group to become more able to use themselves and each other as sources and means of regulation.