A True North Psychology publication Written by Dr Sara Tookey In my early 20s, I found myself at a crossroads in my career. I was craving a deeper, more meaningful approach to therapy. That's when I discovered existential psychotherapy - a captivating blend of philosophy and psychology. Existentialism opened my eyes to a new way of making sense of life’s deepest questions and set me on a professional and personal journey of discovery. Existential psychotherapy explores the unique experiences of humans, emphasising personal responsibility and the freedom to make choices in pursuit of living a more authentic and meaningful life. In this post, I’ll share my personal connection to existential therapy and provide an accessible overview of how it works. - My Journey with Existential Psychotherapy - Existential psychotherapy origins and key principles - Benefits and effectiveness - How it can help - What it’s like to be a client in this approach - References & related resources Finding Meaning in the Mystery: My Journey with Existential Therapy Life's mysteries have intrigued me since childhood. Growing up in a household with contrasting belief systems, my father was an adamant atheist; my mother, a devout Catholic. I learned to sit with life's biggest questions, particularly the ones that don’t have answers. My parents taught me to critically examine my beliefs and to explore what felt right to me, while appreciating differing perspectives. When I was 16, my mother died of cancer. Her guidance during her courageous journey toward death enabled me to explore the depths of my grief and gain insight into the precious impermanence of life. I realised then that connection gives life meaning. Working as a counsellor in my early career, I was learning to apply Cognitive Behavioural Therapy and Dialectical Behavioural Therapy i n group in-patient settings. I felt we were merely scratching the surface of clients' struggles and felt somewhat disheartened by psychological approaches that aimed to alleviate symptoms without addressing the core causes of people’s suffering. This led me to look for the answers in spiritual and philosophical texts. Here I found my connection with existential philosophy. Existentialism offered me hope, a sense of calm amid the uncertainties of life, and permission to embrace life in all its messiness. Existential psychotherapy resonated deeply, blending philosophy and psychology to explore life's core questions. I trained as an existential psychotherapist in Seattle University's Existential Phenomenological Psychotherapy program , beginning a professional and personal journey of discovery. During my training I underwent my own therapy as a client of this approach, and the educational program provided more than theoretical knowledge and practical skills. The teachings were deeply personal and meaningful, which enabled me to incorporate existential concepts into my daily life and way of being personally and professionally. I later went on to train as a Clinical Psychologist, specialising in various therapeutic approaches and in areas of psycho-oncology, palliative care, identity and relationship issues and psychedelic therapies. Existential psychotherapy remains integral to my practice, helping others navigate the complexities of existence, confront their fears, embrace life's uncertainties and find meaning. What is Existential Psychotherapy? Existential psychotherapy is a unique form of therapy that looks to explore difficulties clients encounter from a philosophical perspective. The therapist takes a unique role in therapy by abandoning the role of the expert, relating to the client in a genuine way, as a fellow human with shared struggles. Existential psychotherapy empowers people to examine the impact of their personal choices on their life, to take responsibility for them, and to come to terms with their own fears and limitations. It is applicable to all facets of the human condition, from broad struggles like lack of meaning, relationship conflicts, identity crises, depression and anxiety, to specific challenges including social anxiety, obsessive patterns, and addictions. Existentialism emphasises the importance of understanding individual subjective experiences, and argues that human existence is in its very nature, subjective. Existential therapy focuses on addressing fundamental existential concerns that are intrinsic to being human, including death, meaninglessness, isolation, and freedom ( Yalom, 1980 ). Psychological difficulties are therefore seen as arising from core existential issues. Rather than techniques, existential psychotherapy offers guiding principles for practice. The therapeutic relationship, and way of being with the client, takes precedence over techniques aiming to change behaviour. The focus is not learning skills or habits but confronting one’s fears, taking responsibility for our choices and actions, to find meaning and lead an authentic and fulfilling life. The aim of the therapist is to guide clients to accept realities like uncertainty and take responsibility for choices. They help the client to question their assumptions, allowing clients to uncover new possibilities ( Dattilio et al., 1998 ). If you’re interested in learning more about the history and theory of Existential therapy, I recommend book, which offers a comprehensive overview of the various existential psychotherapy schools and approaches. Existential therapy draws on existential philosophy to explore life’s core questions: Who am I? How do I face mortality? What is my purpose? How do I live authentically? Who can it help? Existential therapy is applicable for various challenges of living. It has been successfully applied to address difficulties such as anxiety, depression, existential crises, identity confusion, relationship challenges and trauma (Rayner & Vitali, 2015; Vos, 2016 ). While the evidence base for existential therapy continues to evolve, research and clinical practice have demonstrated its effectiveness across various contexts. Studies reveal positive outcomes including lowered anxiety, improved self-esteem and relationships, enhanced wellbeing, meaning, hope and optimism (Rayner & Vitali, 2015; Vos, 2016). Existential therapy shows promise for specific populations too, like individuals receiving end-of-life care where it has been linked to reduced existential distress and improved quality of life ( Moadel et al., 1999 ; Fawzy et al., 1995 ) . This therapeutic approach can be beneficial for people facing existential crises, feelings of emptiness, lack of direction, or searching for a deeper sense of purpose and fulfilment in in their lives. Limitations: Like any therapy, existential psychotherapy has limitations. Key critiques include lack of empirical evidence compared to other therapies, reliance on client motivation or readiness for change, and applicability across diverse cultural frameworks. Some argue it fits Western individualistic cultures more than collectivist ones that define self through social ties. It may not fully address social factors causing problems that clients feel powerless to change. Additionally, as a perspective rather than structured approach, it lacks a systematic framework, posing challenges for standardised research. Clinically, those seeking a problem-focused approach may be disappointed by philosophical discussion. Applications are also limited for clients who have severe mental lines, those in extreme crisis and people unable to express themselves in dialogue. How does it help? Core existential questions are addressed in dialogue to help clients: Confront their existential anxieties: The anxiety that arises from the awareness of one's mortality and the uncertainty of life's outcomes is explored in an open and honest dialogue with the therapist. By facing these fundamental concerns, individuals can develop resilience, find acceptance, and discover new perspectives that enable them to live more fully in the present. Connect with their authenticity: Learning to live authentically is seen as a goal in life and in therapy. Clients are encouraged to connect with their true values, beliefs, and desires for living, rather than conforming to societal expectations or norms. Enhance self-awareness: A client learns to gain insight into their thoughts, emotions and behaviours. Through introspection and reflection, one can make conscious choices aligned with their authentic selves, leading to personal growth and self-empowerment. Take personal responsibility: Clients are empowered to recognise their freedom of choice and to take ownership of their choices, actions, and responses to life circumstances, empowering them to create meaningful change and embrace their personal agency. Engage in a meaning-making process: Clients are guided to explore and create their own personal meaning and purpose in life, even in, and especially in the face of adversity or existential challenges. Acknowledge existential isolation: Clients are encouraged to acknowledge the inherent sense of aloneness in the human condition. They are guided to find ways to connect with themselves, others and the world around them. Focus on the ‘Here-and-Now’: Clients are encouraged to focus on the ‘here-and-now’ and the person’s immediate experience rather than dwelling on the past or worrying about the future. In therapy sessions the therapist also works in a relational way, focusing on the therapeutic relationship between the therapist and client ( Yalom, 2002) . The Experience as a Client in Therapy: In my own experience as a client in existential psychotherapy, the therapeutic bond with my existential therapist was the single most impactful factor in my therapy. This is because existentially oriented therapists strive for mutually authentic and honest relationships with their clients. Therapist and client interact as equals, with the therapist demystifying the process by answering questions transparently rather than remaining opaque ( May & Yalom, 1989 ). This genuine relating with my therapist allowed me to be open and vulnerable in a way that I never had been before, which enabled me to feel safe to confront my fears and practice acceptance. As a psychologist and psychotherapist who works in an existentially oriented way, many of my clients have expressed how grateful they have been for my transparency, my honesty and shared humanity. As a result of engaging in existentially oriented psychotherapy, my clients have described an increased self-awareness, being able to connect with their inner-direction or compass, feeling empowered and having a greater sense of ease and acceptance of the difficulties of life. Below is a testimonial from one of my clients, depicting their experience of existential therapy: "Before starting existential therapy, I was paralysed by my fear of death. My fear kept me from really engaging with life and connecting with the people I loved the most. Together we explored what was really important to me and she helped me to find ways to reconnect with my inner joy and my sense of self that had been hidden from me for so many years. Though still anxious at times, I now understand the role of my anxiety and feel empowered to live in a way that is true to who I am and I can do the things I used to love without fear holding me back. Existential therapy helped me to open up my perspective, reconnect with my resilience and be more accepting of the things I can’t control. I'm forever grateful for this opportunity to rediscover meaning and joy.” Conclusion & Summary Existential psychotherapy allows us to navigate the complexities of existence, grapple with our fears, and find meaning amidst life's uncertainties. It is a pathway that invites us to embrace the fullness of our humanity, to explore the depths of our emotions and to live lives that resonate with our true selves. While research continues to expand our understanding of its efficacy, existential therapy stands as a valuable perspective for individuals seeking to explore their existence and find meaning and authenticity. Drawing upon existential philosophy and psychology, existential therapy provides a unique perspective on the complexities of human experience. By addressing existential concerns, a person can discover purpose, enhance self-awareness, foster acceptance, and cultivate resilience. If you’re seeking meaning, purpose, direction or a deeper understanding of yourself, existential therapy may be the right fit for you. To get started, book a 30-minute consultation today. Initial Therapy Consultation We welcome your thoughts and reflections on this therapeutic perspective. Subscribe to our newsletter to keep up to date on the latest news, events, resources and features from True North Psychology Relevant References and Resources Books: Bakewell, S. (2016). At the Existentialist Café: Freedom, Being, and Apricot Cocktails. Other Press. Barnett, L., & Madison, G. (Eds.). (2012). Existential Therapy: Legacy, Vibrancy and Dialogue. Routledge. Camus, A. (1991). The Myth of Sisyphus and Other Essays. Vintage Books. (Original work published 1942) Cooper, M. (2003). Existential Therapies. SAGE Publications. Dattilio, F. M., Freeman, A. (Eds.), & Blue, J. L. (1998). Comprehensive clinical psychology: Vol. 6. Interpersonal, family, and group therapy. Elsevier Science/Pergamon. ( link to PDF text ) Frankl, V. E. (2006). Man's Search for Meaning. Beacon Press. (Original work published 1946) May, R. (1969). The Discovery of Being: Writings in Existential Psychology. W. W. Norton & Company. May, R., & Yalom, I. D. (1984). Existential therapy. In R. J. Corsini (Ed.), Current psychotherapies (3rd ed., pp. 354-391). Peacock Publishers. May, R., & Yalom, I. D. (1989). Existential psychotherapy. In R. J. Corsini & D. Wedding (Eds.), Current psychotherapies (4th ed., pp. 363–402). F.E. Peacock. ( link to PDF text) Seguin, C.A. (1965). The existential therapist. In R. May (Ed.), Existential psychology. Tillich, P. (2014). The Courage to Be. Yale University Press. (Original work published 1952) Yalom, I. D. (1980). Existential Psychotherapy. Basic Books. Yalom, I. D. (2002). The Gift of Therapy: An Open Letter to a New Generation of Therapists and Their Patients. HarperCollins. Articles Published in Scientific and Academic Journals: Fawzy, F. I., Fawzy, N. W., Arndt, L. A., & Pasnau, R. O. (1995). Critical review of psychosocial interventions in cancer care. Archives of General Psychiatry, 52(2), 100–113. https://doi.org/10.1001/archpsyc.1995.03950140018003 Moadel, A., Morgan, C., Fatone, A., Grennan, J., Carter, J., Laruffa, G., Skummy, A., & Dutcher, J. (1999). Seeking meaning and hope: Self-reported spiritual and existential needs among an ethnically-diverse cancer patient population. Psycho-Oncology, 8(5), 378-385. https://doi.org/10.1002/(SICI)1099-1611(199909/10)8:5 <378::AID-PON406>3.0.CO;2-A Rayner, M., & Vitali, D. (2021). Short-term existential psychotherapy in primary care: A quantitative report. Journal of Humanistic Psychology. Advance online publication. https://doi.org/10.1177/00221678211018281 Spinelli, E. (2015). Existential psychotherapy: An introductory overview. The Journal of Contemporary Psychotherapy, 45(1), 7-15. https://doi.org/10.1007/s10879-014-9285-0 van Deurzen, E., Craig, E., Laengle, A., & Taylor, S. (2017). The effectiveness of Existential Psychotherapy: A systematic review of empirical studies. Existential Analysis, 28(2), 349-368. Vos, J., Craig, M., & Cooper, M. (2014). Existential therapies: A meta-analysis of their effects on psychological outcomes. Journal of Consulting and Clinical Psychology, 83(1), 115-128. https://doi.org/10.1037/a0037167 Vos, J. (2016). Working with meaning in life in mental health care: A systematic literature review of the practices and effectiveness of meaning-centred therapies. In P. Russo-Netzer, S. Schulenberg, & A. Batthyany (Eds.), Clinical perspectives on meaning: Positive and existential psychotherapy (pp. 61–87). Springer International Publishing. https://doi.org/10.1007/978-3-319-41397-6_4 Wampold, B. E., & Imel, Z. E. (2015). The great psychotherapy debate: The evidence for what makes psychotherapy work (2nd ed.). Routledge. https://doi.org/10.4324/9780203582015 Websites and Organisations: Society for Existential Analysis (SEA) Existential-Humanistic Institute The New Existentialists British Association of Existential Psychotherapists (BAEP) American Existential Division (Division 32) of the American Psychological Association (APA)

Written by Dr Sara Tookey As a psychologist who integrates Compassion Focused Therapy (CFT) into my practice and compassion into my own life values-system, I've witnessed firsthand the transformative power that developing compassion can have on a person's overall well being, mental health and in enabling us to heal wounds from our pasts.  Compassion Focused Therapy Approach Theoretical Basis of CFT The Costs of Self-Criticism & Isolation The Benefits of Self-Compassion Who Can Benefit from CFT? Experiencing CFT in Session Conclusion & Summary Stay Connected / Get Help Now References for this article Compassion Focused Therapy Approach Compassion Focused Therapy (CFT) is a modern therapeutic approach, developed by psychologist Dr Paul Gilbert   in the 1990s.  The approach emphasises cultivating compassion to alleviate human suffering, and is grounded in evolutionary psychology, affective neuroscience, psychology, and Buddhist traditions. CFT is considered a "third-wave" cognitive-behavioural therapy, emphasising mindfulness, acceptance, and emotional awareness. CFT's core objective is to cultivate self-compassion, compassion for others, and the ability to receive compassion. It views compassion as a deep sensitivity to suffering coupled with a commitment to alleviate and prevent it. By intentionally nurturing compassion towards ourselves, others, and receiving it, we can skilfully respond to pain in transformative ways. Critically, CFT recognises that our difficult experiences have impacted us through no fault of our own. With a compassionate understanding that we've done our best, it supports finding new ways to reduce these impacts and respond to ourselves with greater care. Theoretical Basis of CFT The Evolutionary Roots of Compassion From an evolutionary perspective, our capacity for compassion and caring for suffering enabled early humans to band together, increasing chances of survival. Tribes high in compassion traits like empathy and reciprocity outlasted less cooperative groups ( Wilson et al., 2014 ).  Humans have an innate, biological predisposition toward forming connections and social bonds - we are literally wired to connect. In present times, substantial evidence demonstrates that lacking compassion for ourselves and others exerts major tolls on our mental and physical health. Emotion Regulation Systems CFT is based on the idea that our well-being is influenced by three emotional regulatory systems (Gilbert, 2014) : The Threat System  (focused on detecting threat to keep us safe), centred in the amygdala The Drive System  (focused on resources and incentives), located in midbrain regions The Soothing System (focused on connection and comfort), involving the prefrontal cortex, vagus nerve, and oxytocin release Many mental health struggles reflect having an overactive threat system which over-detects threats, telling us we’re not safe when we are. The key components of CFT include education on the concept of compassion, understanding the human mind's evolutionary perspective, exploring the roles of shame and self-criticism, and learning to balance these three emotional regulatory systems. How our Brains Regulate Emotions At birth, our brains are wired with a "threat-protection system" located in the amygdala and other l imbic system structures .  This emotional regulation system detects threats and responds with instincts like fight, flight, or freeze responses to ensure survival.  In childhood, our caretakers ideally help us develop a "self-soothing system" - where the sound of their caring voice and touch calms our distress. However, for many, we weren’t properly soothed as a child, and so did not learn how to do this for ourselves. Early attachment trauma, neglect, or abuse means our threat system becomes over-developed while our ability to self-soothe fails to develop.  We can then face an imbalance between the inner critic voice - constantly scanning for danger and flaws - and an inner nurturing voice. Strengthening our self-compassion muscle through CFT exercises is akin to learning to speak to ourselves as a caring parent would, quieting inner distress. The Costs of Self-Criticism and Isolation Research shows high self-criticism strongly predicts increased depression ( Kim et al., 2011 ; Kim et al., 2020 ), anxiety disorders ( Cox et al., 2004 ; Thakur and Baumann, 2022 ), suicide risk ( O'Neill et al., 2021 ), addiction relapse ( Snoek et al., 2021 ), and inflammatory disease ( Trindade et al., 2021 ). Brain imaging studies found that self-critical neural patterns light up areas linked to threat response rather than reasoning centres - showing that when we are self-critical, we are actually attacking ourselves (e.g. Longe, 2009 ). A global review found chronic social isolation increases mortality risk over 15 years as much as smoking 15 cigarettes a day  ( Hold-Lunstad et al., 2015 ). Our biological health suffers without compassionate connections. The Benefits of Self-Compassion One of the most important things we can do in therapy is help people learn to be compassionate towards themselves. As children, we're often taught to be kind, courteous, and generous to others. Rarely are we taught that extending kindness inwardly, to ourselves is equally as vital. Many of us are conditioned by family and society to view self-compassion as selfish, indulgent, or weak - failing to recognise its inherent value and strength for wellbeing. Self-compassion is also exceptionally difficult to do, partly due to these ingrained messages and partly because our wiring for social connection makes compassion for others easier. Yet cultivating self-compassion is essential for healing and growth. By intentionally building self-compassion skills through practices like supportive self-talk  ( Tod et al., 2011 ), writing compassionate letters to ourselves ( Swee et al., 2023 ), or loving-kindness meditation ( Hoffman et al., 2011;   Hutcherson et al., 2008 ) , we can strengthen neural circuits that evoke the caring presence of our "compassionate self." ( Stevens et al., 2018 ) Additional well-documented benefits of self-compassion include: Reduced depression ( MIllard et al., 2023 ) Lower addiction relapse rates ( Craig et al. 2020 ; Chen et al., 2019 ) Buffered emotional reactivity to stress ( Cosely et al., 2010 ; Kirby et al., 2017 ) Increased motivation toward self-improvement goals ( Breines and Chen, 2012 ) Deeper self-insight and life satisfaction ( Frank et al., 2021 ) Reduction in physiological pain perception (e.g.   Maratos et al., 2020 ). You can read more about the importance of the compassion focused approach in our recent article: Men’s Mental Health: Challenging stigma, learning vulnerability and giving compassion . Developing the Compassionate Self CFT founder Dr. Paul Gilbert uses the metaphor of developing our “compassionate self” to represent accessing wisdom, strength, warmth, and the drive to care for wellbeing in the face of suffering - our own and others’.  When we engage in practices like loving-kindness meditation , self-compassion journaling , or soothing touch , we activate and reinforce neural pathways of emotional resilience and connection. We re-pattern self-relating in ways that support coping, healing, taking responsibility, and living deeply. Who Can Benefit from CFT? CFT is beneficial for those struggling with high self-criticism, shame, low self-esteem, mood disorders, trauma, and more. At its core, CFT works by accessing and strengthening our innate capacity for compassion. The CFT approach recognises that often, lack of self-compassion reflects early childhood attachment patterns  and difficult life events that have trained our threat system to respond to safe situations with a threat response, detect threats where there is safety and to attack us ( Kim et al., 2020 ). With compassion focused exercises, we can retrain our brains to respond to ourselves with the same care and kindness we might show a good friend. Experiencing CFT in a session: In CFT the compassionate therapist models compassion skills and nurtures the development of compassion within the client. The therapist guides the client through mindfulness practices, vivid imagery exercises, and behavioural techniques. The goal is to help activate the client's self-soothing system, which can counterbalance excessive reactions driven by threat perception or unhelpful urges. This allows us to care for ourselves in harder moments with the warmth of compassion, quieting inner distress. In turn, drive system energy can flow toward meaningful pursuits (the things that really matter to us)  rather than an unending strive for perfectionism. CFT enables clients to cultivate an "inner ally" - a compassionate inner voice that can replace the harsh "inner critic" that often fuels shame, self-blame and negative self-talk. By relating to themselves and others with greater kindness and empathy, clients can improve self-esteem, reduce anxiety, and boost motivation for positive personal growth. The therapy provides a toolkit of compassionate mind/body exercises that clients can use to emotionally navigate life's challenges. The supportive inner ally acts as a psychological safety net during difficult times, countering negative thought patterns with a soothing, understanding perspective. This compassionate self-to-self relating helps create a sense of emotional security and resilience. Conclusion & Summary Compassion Focused Therapy offers a powerful approach to alleviating human suffering by helping individuals cultivate greater self-compassion, compassion for others, and the ability to receive compassion. By intentionally strengthening our "compassionate self" through practices like compassionate imagery, letter writing, and mindfulness, we can counteract harsh self-criticism, reduce anxiety and shame, enhance emotional resilience, and foster deeper connections with ourselves and others. CFT can be particularly beneficial for those struggling with low self-esteem, mood disorders, trauma, perfectionism, or excessive self-blame and inner conflict. At its core, CFT helps retrain our minds to respond to personal suffering with the same kindness and care we would offer a loved one, enabling us to navigate life's challenges with greater self-compassion, motivation, and overall well-being. Note: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified mental health professional for personalized guidance. WANT TO LEARN MORE? Below are recommended readings if you're interested in learning more about Compassion Focused Therapy and how you can implement skills of compassion to improve your mental health and support wellbeing. The Compassionate Mind Workbook: A step-by-step guide to developing your compassionate self - By Elaine Beaumont and Chris Irons The Compassionate Mind -By Paul Gilbert The Compassionate Mind Approach to Difficult Emotions: Using Compassion Focused Therapy Paperback - By Chris Irons Book an initial 30 minute consultation with one of our Compassion-Focused-Therapy Psychologists Today Initial Therapy Consultation We welcome your thoughts and reflections on this therapeutic perspective. Subscribe to our newsletter to keep up to date on the latest news, events, resources and features from True North Psychology References Breines, J. G., & Chen, S. (2012). Self-compassion increases self-improvement motivation. Personality & Social Psychology Bulletin, 38(9), 1133–1143. https://doi.org/10.1177/0146167212445599 Chen, Y., Bai, Y., Kalatharan, M., Chen, Z., Guo, T., Lu, J., Wang, W., & Hu, J. (2019). Effect of a mindfulness-based relational intervention on women with medical assisted reproduction: A randomized controlled trial. Journal of Psychosomatic Research, 123, 109739. https://doi.org/10.1016/j.jpsychores.2019.109739 Cosley, B. J., McCoy, S. K., Saslow, L. R., & Epel, E. S. (2010). Is compassion for others stress buffering? Consequences of compassion and social support for physiological reactivity to stress. Journal of Experimental Social Psychology, 46(5), 816–823. https://doi.org/10.1016/j.jesp.2010.04.008 Cox, B. J., Fleet, C., & Stein, M. B. (2004). Self-criticism and social phobia in the US national comorbidity survey. Journal of Affective Disorders, 82(2), 227–234. https://doi.org/10.1016/j.jad.2003.12.012 Craig, C., Hiskey, S., & Spector, A. (2020). Compassion focused therapy: a systematic review of its effectiveness and acceptability in clinical populations. Expert Review of Neurotherapeutics, 20(4), 385–400. https://doi.org/10.1080/14737175.2020.1746184 Frank, T., & Banner-Lukaris, D. (2021). The benefits of knowing and caring about oneself: The role of self-insight and self-compassion in identity and well-being. https://doi.org/10.24124/2021/59221 Gilbert P. (2014). The origins and nature of compassion focused therapy. The British journal of clinical psychology, 53(1), 6–41. https://doi.org/10.1111/bjc.12043 Hoffmann, S. G., Grossman, P., & Hinton, D. E. (2011). Loving-kindness and compassion meditation: potential for psychological interventions. Clinical Psychology Review, 31(7), 1126–1132. https://doi.org/10.1016/j.cpr.2011.07.003 Holt-Lunstad, J., Smith, T. B., Baker, M., Harris, T., & Stephenson, D. (2015). Loneliness and social isolation as risk factors for mortality: a meta-analytic review. Perspectives on Psychological Science, 10(2), 227–237. https://doi.org/10.1177/1745691614568352 Hutcherson, C. A., Seppala, E. M., & Gross, J. J. (2008). Loving-kindness meditation increases social connectedness. Emotion, 8(5), 720–724. https://doi.org/10.1037/a0013237 Kim, J. J., Gerrish, R., Gilbert, P., & Kirby, J. N. (2021). Stressed, depressed, and rank obsessed: Individual differences in compassion and neuroticism predispose towards rank-based depressive symptomatology. Psychology and Psychotherapy, 94(S2), 188–211. https://doi.org/10.1111/papt.12270 Kim, J. J., Kent, K. M., Cunnington, R., Gilbert, P., & Kirby, J. N. (2020). Attachment styles modulate neural markers of threat and imagery when engaging in self-criticism. Scientific Reports, 10(1), 13776. https://doi.org/10.1038/s41598-020-70772-x Kim, S., Thibodeau, R., & Jorgensen, R. S. (2011). Shame, guilt, and depressive symptoms: a meta-analytic review. Psychological Bulletin, 137(1), 68–96. https://doi.org/10.1037/a0021466 Kirby, J. N., Day, J., & Sagar, V. (2019). The 'flow' of compassion: A meta-analysis of the fears of compassion scales and psychological functioning. Clinical Psychology Review, 70, 26–39. https://doi.org/10.1016/j.cpr.2019.03.001 Longe, O., Maratos, F. A., Gilbert, P., Evans, G., Volker, F., Rockliff, H., & Rippon, G. (2010). Having a word with yourself: neural correlates of self-criticism and self-reassurance. NeuroImage, 49(2), 1849–1856. https://doi.org/10.1016/j.neuroimage.2009.09.019 Maratos, F. A., & Sheffield, D. (2020). Brief Compassion-Focused Imagery Dampens Physiological Pain Responses. Mindfulness, 11, 2730–2740. https://doi.org/10.1007/s12671-020-01485-5 Millard, L. A., Wan, M. W., Smith, D. M., & Wittkowski, A. (2023). The effectiveness of compassion focused therapy with clinical populations: A systematic review and meta-analysis. Journal of Affective Disorders, 326, 168–192. https://doi.org/10.1016/j.jad.2023.01.010 O'Neill, C., Pratt, D., Kilshaw, M., Ward, K., Kelly, J., & Haddock, G. (2021). The relationship between self-criticism and suicide probability. Clinical Psychology & Psychotherapy, 28(6), 1445–1456. https://doi.org/10.1002/cpp.2593 Snoek, A., McGeer, V., Brandenburg, D., & Kennett, J. (2021). Managing shame and guilt in addiction: A pathway to recovery. Addictive Behaviors, 120, 106954. https://doi.org/10.1016/j.addbeh.2021.106954 Stevens, F.L. et al. (2018). The brain that longs to care for itself: The current neuroscience of self-compassion. In E. Seppälä et al. (Eds.), The Oxford Handbook of Compassion Science. Oxford University Press. Swee, M. B., Klein, K., Murray, S., & Heimberg, R. G. (2023). A Brief Self-Compassionate Letter-Writing Intervention for Individuals with High Shame. Mindfulness, 14(4), 854–867. https://doi.org/10.1007/s12671-023-02097-5 Thakur, N., & Baumann, N. (2022). Breaking the anxious cycle of self-criticism: Action orientation buffers the detrimental effects of a self-critical personality style. Journal of Affective Disorders, 301, 30–35. https://doi.org/10.1016/j.jad.2022.01.014 Tod, D., Hardy, J., & Oliver, E. (2011). Effects of self-talk: a systematic review. Journal of Sport & Exercise Psychology, 33(5), 666–687. https://doi.org/10.1123/jsep.33.5.666 Trindade, I. A., & Sirois, F. M. (2021). The prospective effects of self-compassion on depressive symptoms, anxiety, and stress: A study in inflammatory bowel disease. Journal of Psychosomatic Research, 146, 110429. https://doi.org/10.1016/j.jpsychores.2021.110429 Wilson, D. S., Hayes, S. C., Biglan, A., & Embry, D. D. (2014). Evolving the future: toward a science of intentional change. The Behavioral and Brain Sciences, 37(4), 395–416. https://doi.org/10.1017/S0140525X13001593

Written by Dr Sara Tookey November is Men’s Mental Health Awareness Month, also known as 'Movember'. While Movember often focuses on mustache-growing campaigns, its purpose is to raise awareness of men’s health issues, including mental health. Men face disproportionately high rates of mental health challenges and suicide compared to women, yet stigma prevents many men from seeking help. Providing compassionate, male-centered mental health resources and support is crucial. The Problem: Stats on Men's Mental Health Patriarchy Harms Men Too Barriers to Receiving Help Compassion for Men's Mental Health Compassion Focused Therapy Conclusion Recommended Readings Stay Connected / Get Help Now References for this article The Problem: Statistics on Men's Mental Health According to the Office for National Statistics (ONS, 1 ) in the UK, men account for around 75% of registered suicides , with an average of 84 men dying by suicide per week. Men aged 45-49 have the highest suicide rates, at 25.5 deaths per 100,000 in 2019 ( 1 ) . A report from the World Health Organization estimated that men are 1.8 times more likely to take their own lives when compared to compared to women, a fact supported by a recent review of research into men's mental health. Men also have higher rates of substance abuse disorders. Per the Substance Abuse and Mental Health Services Administration (SAMHSA), men are over twice as likely as women to be heavy drinkers and three times more likely to have a cannabis use disorder (2) . Despite these statistics, men are less likely to access mental health services. Only 36% of referrals to NHS talking therapies are for men ( 3 ). Outdated stigma prevents many men from seeking help. Patriarchy Harms Men Too While patriarchal structures privilege men over women in many ways, rigid masculine norms also have detrimental effects on men's mental health and wellbeing. Research over the past 20 years has shown that traditional masculinity – marked by stoicism, competitiveness, dominance and aggression – is largely harmful for men ( 4 ). Cultural norms and gender stereotypes have been circulating for generations, and they can be toxic for men and their personal relationships ( 4 ). When it comes to processing emotions, there are different expectations for men and women. Women are often viewed as “sensitive,” and therefore society finds female expression of feelings, like sadness or fear more acceptable. But men, who are seen as strong and fearless ("masculine") are not encouraged to outwardly express their emotions. Men have been socialised to be strong, fearless, to restrict emotional expression and vulnerability, and just "get on with it". However, restricting emotions and feelings can be detrimental to a man's mental health. Researchers have also found men who conform more to masculine norms see risky behaviors like heavy drinking as more normal and are more likely to engage in them ( 5 ), further endangering their physical and mental health. This masculine avoidance of vulnerability extends to seeking psychological help. Men who embody traditional masculine ideals are more negative about mental health services than men with flexible gender attitudes ( 6 ) and as a result are less likely to seek help ( 7 ). Male socialisation that emphasises self-sufficiency leads many men to suffer privately rather than seeking crucial support. For example, norms discouraging emotional expression teach boys to suppress feelings rather than develop healthy coping strategies. This makes men less likely to seek help for mental health issues out of shame and increases their risk of commiting suicide ( 8 ) by denying them access to crucial support structures. Beliefs that seeking help shows weakness ( 9 ) discourages men from seeking professional and social support, leading them to feel more isolated and alone in their struggles. Patriarchy also defines masculine value largely by status, strength, and career success ( 9 ). When men fail to achieve these narrow goals, they may experience profound self-doubt and low self-worth, despite accomplishments in other areas like relationships or community. Rigid thinking defines some emotions, like empathy, as exclusively "feminine," preventing human connection and preventing them from accessing crucial social connection and support. Dr Fredric Rabinowitz, former president of the American Psychological Society and steward of the 2005 guidelines for the Society for Psychological Study of Men and Masculinities emphasises how men are raised to be "self-sufficient and able to take care of themselves" and that "any sense that things aren't OK needs to be kept secret". Rabinowitz says. “Men who keep things to themselves look outward and see that no one else is sharing any of the conflicts that they feel inside. That makes them feel isolated. They think they’re alone. They think they’re weak. They think they’re not OK. They don’t realize that other men are also harboring private thoughts and private emotions and private conflicts.” Stephanie Pappas, writer of the American Psychological Association Journal, highlights the the "tragic ramifications of these private conflicts" when she writes: "These private conflicts can have tragic ramifications. Though men report less depression than women, they complete suicide at far higher rates than women, and the numbers are moving in the wrong direction" ( Stephanie Pappas, 2019, APA, Vol 50, No. 1 ). Dismantling restrictive masculine norms liberates men to embrace their full humanity. Supporting boys to process and express their emotions in healthy ways ( 10 ), have diverse interests, and nurture intimate bonds without shame leads to improved mental health outcomes. Constructing masculinity as multifaceted and flexible rather than oppositional to femininity benefits men and society as a whole. Compassion in Men's Mental Health Compassion-focused therapy (CFT) is an integrative psychotherapy approach developed by psychologist Dr. Paul Gilbert that combines research and tools from psychology, neuroscience, and Buddhism. CFT focuses on cultivating compassion towards oneself and others as an emotional resource for managing difficulties like shame, self-criticism, trauma, and mental health issues. (I will delve more into CFT in future articles- so stay tuned) The Founder of Compassion Focused Therapy, Dr Paul Gilbert says: “If you want one recipe to make you unhappy, it would be to focus on the things you criticize or don’t like about yourself.” Paul A. Gilbert, The Compassionate Mind CFT can be particularly helpful for men struggling with mental health difficulties due to its emphasis on self-compassion ( 11 ). Rigid masculine norms that discourage emotional expression and help-seeking and encourage perfectionism and career status often lead men to be very self-critical about themselves and their own mental health struggles. CFT teaches men to treat themselves with the same understanding they would show a friend, thereby reducing shame ( 12 ). CFT uses evolutionary psychology and affect regulation systems theory to explain why self-criticism develops and how to strengthen inner compassion ( 13 ). Mindfulness, imagery, and behavior change exercises aim to activate the self-soothing system to balance excessive threat and drive system reactions. A compassionate therapist models and nurtures compassion skills development. Research employing CFT in the male population has shown that s elf-compassion partially mediates the relationship between mental health shame and mental health problems ( 12 ) and improves wellbeing ( 11 ) . By focusing on self-care rather than self-blame, CFT can make therapy more accessible for men. It provides tools to manage unhelpful thought patterns while reducing shame and stigma as barriers to treatment. Integrating self-compassion into men's mental health services may improve mental health treatment outcomes and save lives. What does CFT look like in the therapy session? For many of my male clients, the first step in seeking help for their mental health is admitting that they need help and this can often be the most difficult step. This is because, admitting they need help contradicts the gender norms they grew up with, which highlighted traditional masculine ideals of strength, control, and self-reliance (often masquerading as "resilience"). Some of the most valuable work we can do in therapy is to support people to learn how to bring compassion inward toward themselves. Some us are taught as children, the importance of offering courtesy, kindness and generosity to others, but few are ever taught the importance of showing this same kindness to ourselves. Many are taught by their caregivers and by their social groups that self-compassion is an "indulgence", "selfish" or "soft" and "weak". CFT uses mindfulness, relaxation, and imagery exercises to develop inner compassion. Men cultivate an "inner ally" to replace the "inner critic" that fuels shame and self-blame. By relating to themselves and others with more kindness and empathy, men can improve self-esteem, reduce anxiety, and boost motivation for positive change. Integrating self-compassion into therapy gives men an emotional toolkit to navigate life's challenges. The inner ally's supportive voice counters negative thoughts and creates an emotional safety net during difficult times. Compassion-focused approaches build on men's strengths while addressing destructive shame and self-criticism. Conclusion & Summary Challenging outdated masculine stereotypes and stigma against mental illness is key to improving men's mental health. Offering compassionate, male-centered care can encourage men to seek help early, preventing mental health crises and suicide. Supporting men's mental health requires understanding gender-specific barriers and providing tailored resources. With compassion and understanding, we can create a society where men feel comfortable prioritizing mental wellness. Note: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified mental health professional for personalised guidance. WANT TO LEARN MORE? Below are recommended readings exploring the impact of Masculinity and Men's Mental Health. I Don't Want to Talk About it: Overcoming the secret legacy of male depression, by Terrence Real The Boy With the Topknot by Sathnam Sanghera, and Toast by Nigel Slater Stay Connected With compassion and understanding, we can create a society where men feel comfortable seeking mental health support. What are your tips for supporting men's mental health? Please share your thoughts with us and please let us know what other topics you like to read about in our blog! READ MORE from our Blog HERE! And Subscribe to our newsletter to keep up to date on the latest news, events, content, resources and features from True North Psychology Do you need therapeutic support? See MAN HEALTH for UK-based male-focused mental health support groups, hotlines and online communities where men can find solidarity and resources. Book a consultation with one of our therapists below. Initial Therapy Consultation References 1. https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/suicidesintheunitedkingdom/2019registrations#main-points 2. https://www.samhsa.gov/data/report/2019-nsduh-detailed-tables 3. https://www.menshealthforum.org.uk/key-data-mental-health 4. Pappas, S. (2019). APA issues first-ever guidelines for practice with men and boys. CE CORNER, APA, Vol 50, No. 1. https://www.apa.org/monitor/2019/01/ce-corner 5. Mahalik JR, Burns SM, Syzdek M. Masculinity and perceived normative health behaviors as predictors of men's health behaviors. Soc Sci Med. 2007 Jun;64(11):2201-9. doi: 10.1016/j.socscimed.2007.02.035. Epub 2007 Mar 26. PMID: 17383784. 6. Yousaf, O., Popat, A., & Hunter, M. S. (2015). An investigation of masculinity attitudes, gender, and attitudes toward psychological help-seeking. Psychology of Men & Masculinity, 16 (2), 234–237. https://doi.org/10.1037/a0036241 7. Springer KW, Mouzon DM. "Macho men" and preventive health care: implications for older men in different social classes. J Health Soc Behav. 2011 Jun;52(2):212-27. doi: 10.1177/0022146510393972. Epub 2011 Apr 13. PMID: 21490311. 8. Sagar-Ouriaghli I, Godfrey E, Bridge L, Meade L, Brown JSL. Improving Mental Health Service Utilization Among Men: A Systematic Review and Synthesis of Behavior Change Techniques Within Interventions Targeting Help-Seeking. Am J Mens Health. 2019 May-Jun;13(3):1557988319857009. doi: 10.1177/1557988319857009. PMID: 31184251; PMCID: PMC6560805. 9. https://www.medicalnewstoday.com/articles/mens-mental-health#barriers-to-access 10. https://kidshelpline.com.au/parents/issues/helping-kids-identify-and-express-feelings 11.J Smith , S Lad , S ; Hiskey , J A Barry , R Kingerlee , M Seager , L Sullivan (2019). Of compassion and men: using compassion focused therapy in working with men The Palgrave Handbook of Male Psychology and Mental Health, p. 483 - 507 12. Kotera, Y., Green, P., & Sheffield, D. (2019). Mental health shame of UK construction workers: Relationship with masculinity, work motivation, and self-compassion. Journal of Work and Organizational Psychology, 35 (2), 135–143. 13. Chris Irons (2014). Royal College of Psychiatrists, publication. https://www.rcpsych.ac.uk/docs/default-source/members/sigs/spirituality-spsig/spirituality-special-interest-group-publications-chris-irons-compassion-evolutionary-understandings-and-cft.pdf

Written by Dr Sara Tookey Welcome to the True North Psychology Blog, a space dedicated to exploring topics relevant to mental health, wellbeing and living a life with authenticity. I am Dr. Sara Tookey, the founder and director of True North Psychology. This blog is open to the TNP community and members of the wider public. In writing this blog, I hope to create a space to explore important aspects of living, and to cultivate a community that facilitates supportive sharing of experiences and information. I will aim to provide thoughtful reflections, evidence-based insights drawn from research, and where appropriate, practical and accessible tips to support our mental health and wellbeing. It is my commitment to curate content that is not only informative, trustworthy, relatable and honest. By joining our readership you will gain first access to new posts, updates, trainings, workshops, community support gathering events. You will also have a say in the topic areas worth exploring in posts. Topics you can expect to read about Psychedelic Science and Non-ordinary States of Consciousness: I am particularly passionate about the field of psychedelic science and its potential in treating mental health difficulties . As a therapist working on psychedelic research trials, I have seen the transformative power of these molecules when used responsibly and under professional guidance. With this new emerging field more and more people are exploring psychedelic-assisted therapy in an attempt to treat what ails them or with the intention of developing a deeper understanding of themselves and the world around them. We will explore the latest research findings, discussing both the benefits and risks associated with psychedelic-assisted therapy and the emerging field. Additionally, we will delve into non-ordinary states of consciousness, which offer valuable insights into the depths of our being. Living and Dying with Illness: We will explore the crucial topics of palliative care and psycho-oncology, acknowledging the immense courage and understanding required when facing terminal illnesses. Drawing from my 12 years of experience in cancer and palliative care, as well as personal encounters with loss, we will shed light on the psychological, existential, and spiritual aspects of this challenging journey. Together, we will delve into the emotional challenges, existential dilemmas, and share inspiring stories of those who have walked this path. Sex, Gender, Relationships & Identity: In this blog, I am committed to providing a safe and inclusive space for individuals struggling with or exploring issues related to their gender, sexuality, relationships, and self-identity (including neurodivergence), addressed from an intersectional lens. We will engage in discussions that foster a sense of belonging and empower individuals to love and embrace their true selves. Psychology, Psychotherapy, and Mental Health Practice: Leveraging my experiences as a therapist and a client, I will offer insights into psychology, psychotherapy, and mental health practices. Together, we will navigate the challenges of finding the right therapist and develop a deeper understanding of various therapeutic approaches. We will explore existential psychotherapy, which is at the core of my practice, and contemplate its profound applications for daily life, including topics such as life and death, self-connection, and our relationships with others and the world around us. Challenges of Living: Life presents us with a myriad of challenges , and in this blog, we will address them openly and honestly . From everyday struggles to mental illness, I will provide practical tools, tips, and resources to support your well-being and resilience. My Pledge True North Psychology is guided by principles of compassion, integrity, sustainability, and community. Together, we can. create an environment of empathy and exploration, engaging openly to discuss and reflect on the human experience. I strive to present information with humility and integrity, maintaining the highest ethical standards in everything I share. Moreover, I strongly believe in considering sustainability, both in our personal lives and in the broader context, and will explore ways to support our mental well-being while being mindful of the planet we inhabit. This blog serves as a community platform where we can connect, share our thoughts, and support one another on this journey of self-discovery and growth. Welcome to the True North Psychology Community I invite you to dive into the articles, engage in meaningful discussions, and embark on a path of self-reflection and understanding. Together, we can navigate the complexities of being human and strive for a more fulfilling and authentic existence. Stay tuned for upcoming blog posts, where we will delve deeper into these fascinating topics. I also encourage you to reach out with any suggestions or specific topics you would like me to cover. Your input is valuable to me as I shape the content of this blog. Join the True North Psychology Community Hub by clicking the button below, and stay connected with our latest posts, news, and resources. Let's build a community where we can learn from one another, share our experiences, and provide support along this journey of self-discovery and growth. "You have to stand on your own feet, you have to have your own courage, and your own truth... but the joys of this solitary journey, are nothing compared to the joys of journeying together." -Friedrich Nietzsche