In Compassion Focused Therapy (CFT), a powerful way of learning about yourself is through the idea of the ‘tricky brain’. Here, we discuss with people about how although our minds are amazing and have evolved fantastic abilities that have helped us thrive and survive as a species (for example, creativity, planning, imagination), these same abilities can also drive a lot of our suffering.
Here’s a brief outline about our old brain and new brain (always remembering that of course, this is a simplification of complex processes…):
Our old brain is really old (over 200 million years) and contains structures that are shared with other animals and which are important for survival. For example, basic motives (to avoid harm, to make us interested in food, sex and competition for things), emotions (like anger, anxiety, disgust) and behaviours (like fight and flight).
But about a million years ago our ancestors started to develop new abilities, which we call the ‘new brain’ and are particularly linked to the pre-frontal cortex. These new abilities include being about to imagine, plan, mentalize, reflect and self-monitor.
Whilst they can get on pretty well, sometimes old and new get in a bit of an unhelpful struggle. This is in part because their are bundles of neurons that carry information from old to new, and also down from new to old.
This then leads to some problems. For example, although it’s great that we can think back in time and also imagine the future, when these new brain abilities are guided by old brain emotions like anxiety, this can drive us in to rumination or worry. For some of us, when this happens we can get stuck with these loops in a painful way that ends up driving a lot of distress and suffering.
It’s important to remember that it’s not our fault though – we didn’t choose to have a brain that comes preloaded with these abilities.
But it can be helpful to become aware of these loops and find wise ways of working with them, which is what we try and support people to do in therapy.
Let’s look at how we can use this model to develop formulations.
Old Brain/New Brain - Formulation
Once you’ve shared with people about some of the basics on old and new brain, it’s then helpful to ask your clients something like: “can you tell me what types of loops in the mind you experience in life?”
So here we’re asking people to apply the psychoeducation of the old and new brain to themselves – to bring it from the theoretical into real life. The intention here is that by doing so, we can help people learn more about themselves and one of the reasons for their distress.
Let’s look at example that we used in the Compassionate Mind Workbook of John
Example 1: John
John was in bed, feeling relaxed after a long day at work. Just as he was about to fall asleep, a thought popped into his mind: ‘Did I remember to lock the office properly?’ Suddenly, his sleepiness disappeared, and he began to feel a little tension and anxiety in his stomach. Two hours later he was still awake, struggling with insomnia, tense and frustrated. His mind was going round in circles, not just about the unlocked office door, but images of all the computers and company secrets missing in the morning! As this feeling of anxiety continued, a new set of thoughts emerged: “Why am I so forgetful – maybe there’s something wrong with me” which continued to leave him feeling anxiety and tense.
We drew these loops out together in a formulation, which looked like this:
Let’s look at another example, again that we used in the Compassionate Mind Workbook but this time of Stephanie
Example 2: Stephanie
Stephanie had a big presentation coming up at work, where she would have to talk to a large audience, many of whom were managers and executives in her company. The presentation was on a topic that was new to her (she had just moved jobs to a new department), but a lot rested on her doing a good job. Just the thought of presenting was making her feel anxious, and she began to get persistent worries running through her mind: “What if I freeze and forget what to say”, “What if they ask me questions that I can’t answer”. These thoughts often led her to get caught up with feeling more anxious, and this sometimes she started to fantasise and plan for how she could get out of giving the talk: “If I start coughing and saying I’ve got a headache in the week leading up, maybe I can call in sick”. Unfortunately, this just added to her feelings of anxiety, and made it harder to concentrate on preparing for the talk. This also triggered a series of more self-critical thoughts which triggered familiar feelings of self-direct anger, disgust and a sense of inferiority.
Let’s take a look at what this looked like when it was drawn out
If you’d like to read more about formulations in CFT, you can find examples in the following places:
If you’re a therapist who would like supervision to learn more about how to use formulation in CFT, or how to develop your skills in CFT more generally, take a look here.
