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OBM Integrative and Complementary Medicine

(ISSN 2573-4393)

OBM Integrative and Complementary Medicine is an international peer-reviewed Open Access journal published quarterly online by LIDSEN Publishing Inc. It covers all evidence-based scientific studies on integrative, alternative and complementary approaches to improving health and wellness.

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Open Access Opinion

The Way is in Training: Martial Arts-informed Compassionate Mind Training to enhance CFT Therapists’ Compassionate Competencies

Neil E Clapton 1,*, Syd Hiskey 2

  1. Avon and Wiltshire Mental Health Partnership NHS Trust, Swindon, United Kingdom

  2. Private Practice, The Oaks Hospital, Colchester, United Kingdom

* Correspondence: Neil E Clapton

Academic Editor: Chris Irons

Special Issue: Compassion Focused Therapy (CFT) - New Insights and Outcomes

Received: July 31, 2022 | Accepted: December 27, 2022 | Published: January 04, 2023

OBM Integrative and Complementary Medicine 2023, Volume 8, Issue 1, doi:10.21926/obm.icm.2301001

Recommended citation: Clapton NE, Hiskey S. The Way is in Training: Martial Arts-informed Compassionate Mind Training to enhance CFT Therapists’ Compassionate Competencies. OBM Integrative and Complementary Medicine 2023;8(1):19; doi:10.21926/obm.icm.2301001.

© 2023 by the authors. This is an open access article distributed under the conditions of the Creative Commons by Attribution License, which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is correctly cited.

Abstract

Traditional Martial Arts practice(s) can be construed as forms of fully embodied Compassionate Mind Training (CMT). Integration of these body-mind systems can be a powerful means to cultivate and entrain important therapist competencies in compassionate engagement and action. Through such training and personal practice, compassion-focused therapists can develop and enhance their abilities to stimulate and access compassionate motivation at a deeply embodied level. Martial arts-informed CMT thus has the potential to afford therapists greater sensitivity, attunement, distress tolerance, courage and compassionate responsiveness, particularly in difficult therapeutic encounters such as alliance ruptures.

Keywords

Martial arts; compassionate mind training; compassion focused therapy; embodied compassion; therapist compassion 

1. Introduction

There is an increasing and renewed focus on the explicit cultivation of compassion in psychotherapy [1,2], particularly the importance of the flow of compassion between therapist and client [2,3], and how to sustain therapists’ compassion in difficult therapeutic encounters such as alliance ruptures. One such proposed training approach is that of martial arts-informed Radically Embodied Compassion training for psychotherapists [4,5,6].

This paper extends recent work on the relevance of traditional martial arts to compassion cultivation by linking this to the development of the specific compassionate competencies of engagement and action proposed by the multi-modal Compassionate Mind Training (CMT) model [7]. The relevance and applicability of integrating traditional martial arts into compassion-focused therapists’ personal practice, including numerous affordances in their psychotherapeutic work, is highlighted.

1.1 The Importance of Personal Practice(s) for Therapists’ Personal and Professional Development

Personal practices (PPs) for those providing psychotherapeutic interventions are becoming increasingly acknowledged as an important component of developing effective therapists and delivering effective therapies [8,9]. Such personal practice has been defined as formal psychological interventions and techniques that therapists engage with self-experientially over an extended period of time, with a reflective focus on their personal and/or professional development [8].

Personal practice(s) have been proposed to impact on a number of key domains, including personal development/wellbeing, self-awareness, interpersonal beliefs/attitudes/skills, reflective skills, and conceptual/technical skills [9]. The Personal Practice Model outlined by Bennett-Levy and Finlay-Jones [9] suggests that the above impacts occur through creating and crossing a ‘reflective bridge’ between one’s personal self and therapist self, thus enhancing therapist effectiveness by integrating the personal/interpersonal with the technical/conceptual [8,9].

These reviews and proposed model highlight a broad range of personal practices that might facilitate therapist skill development that is not limited to personal therapy. Whilst it is beyond the scope of this paper to explore all forms of potential therapist personal practice(s), these include: (a) Self-Practice/Self-Reflection (SP/SR) programmes, where therapists practice therapeutic strategies on themselves, reflect on their experiences and learn ‘from the inside out’ [9,10,11]; (b) meditation-based programmes, where therapists engage in formal and sustained mindfulness and compassion practices [12,13]; and (c) more body-oriented programmes such as yoga and qigong [14,15]. All of these personal practices have the potential to improve not only therapist self-care but also therapeutic efficacy, possibly via processes of improved intrapersonal and interpersonal mindfulness and compassion [12,16,17].

Similarly, Twemlow [18,19] suggested the need to move beyond merely the technical aspects of psychotherapy training and look to other creative means to fine-tune the attentional and emotivational capacities of psychotherapists. These include the meditative and martial arts, which Twemlow highlighted entrain concepts and principles derived from Zen philosophy that are essential to therapist self-development and the unfolding of compassion in psychotherapy [18,19].

1.2 The Relevance of Personal Practice to Therapist Compassion in Compassion Focused Therapy (CFT)

There has been an upsurge in research exploring therapeutic uses of compassion, with studies consistently showing that its deliberate cultivation leads to improved well-being, quality of life, symptom severity and mental health [20,21,22,23,24,25,26]. For clinical populations, work to date in this regard has centred on Compassion Focused Therapy (CFT) [24,27] as an evidence-based treatment for various mental health problems. CFT places a particular importance on the dynamic flow of compassion in relationships in order to sustain emotional resilience, optimal functioning and well-being [2,3]. Importantly, many clinical populations experience multifarious and complex fears, blocks and resistances (FBRS) to compassion across and within the three flows [3]. A central task of CFT therapists is to work with and address these FBRs, and that the therapeutic relationship is central to this work [28]. The process of helping clients be more open to receiving and internalising compassion is thus likely dependent on therapists’ own compassionate qualities of warmth, distress tolerance, empathy, non-judgement, patience and persistence [29,30].

A recent small qualitative study [31] of psychotherapists engaging in personal practice of compassion meditation training for four weeks suggests that such mind training positively impacts on therapists' abilities and attributes in compassionate engagement [2,32] in their clinical practice. In addition to self-reported increases in therapists' self-compassion, this included perceived increases in the quality of their therapeutic presence, acceptance of their client’s whole being, and tolerance for suffering [31]. Mindfully compassionate acts such as centering oneself immediately prior to client encounters, as an act of allowing one to bring one’s helpful intention to help alleviate suffering, have been shown to be possible in a matter of minutes [33], with practices demonstrating a positive effect on in-session presence and perceived effectiveness.

A qualitative study on the use and value of personal practice in CFT suggested that this impacts on both therapist personal development and their therapeutic work [34]. This included subjective increases in compassion for self and for others (i.e. their clients), a greater (self) awareness of what they were bringing to the therapy space (including an increased felt sense of centeredness and confidence) and an increased ability to tolerate and work with their clients’ emotions [34].

1.3 Compassionate Mind Training (CMT) and the Multi-modal Model of Compassionate Competencies in CFT and CMT

One such system of compassion cultivation is that of Compassionate Mind Training (CMT) [7,35,36], a set of specific mind-body practices designed to stimulate physiological processes associated with compassion(ate) motivation [37,38] and the development of a compassionate self-identity (referred to in CFT and CMT as one’s Compassionate Self). CMT incorporates a range of breathing, postural and other embodiment (facial expression, voice tone), attentional, mindfulness and imagery practices to stimulate and cultivate compassion. Whilst CMT was originally developed for clinical populations [39,40], its utility and application has also broadened to non-clinical populations [41], including its relevance for the professional and personal development of those in psychotherapeutic roles [10,11,42].

The multi-modal CMT model is a helpful heuristic to aid both clinical work and therapist development. The social mentality of compassion [43,44] and its competencies are often diagrammatically depicted via two concentric circles, one for engagement skills and one for action attributes (see Figure 1, below). These twelve separate but interrelated components are all potentially trainable but also crucially need to be rooted in, coordinated and integrated by the caring motivational system associated with compassion, that results in wise courageous engagement and action when faced with suffering [5,43]. Multi-modal CMT training for therapists can thus help them to develop the wisdom, strength, courage and commitment to undertake psychotherapeutic work that is difficult, challenging and (at times) threatening.

Click to view original image

Figure 1 The multi-modal Compassionate Mind Training model, depicting the key competencies and skills of compassion. From Gilbert (2020) [2], Domains for therapeutic engagement. Adapted from Gilbert (2009) [45] The Compassionate Mind with permission from Little, Brown Book Group.

Relative ease of embodiment and enactment of one's Compassionate Self as accessed via CMT practices has been shown to be key to CMT's effectiveness [46]. Crucially, in this study, the ability to more easily embody one's Compassionate Self was most salient and prevalent for participants when attempting to regulate difficult emotions and in challenging interpersonal situations, thus dynamically positively influencing the flows of compassion to self and others [46]. Although this study was not conducted with psychotherapists, it has clear implications for the enactment of compassion in psychotherapy.

1.4 The Potential of Traditional Martial Arts for Therapist Self-development and Relevance to the Embodiment and Enactment of Compassion in Psychotherapy

There have been recent renewed calls for more embodied and psychophysiological approaches to psychotherapy training and therapist self-development [5,47], given that interpersonal processes such as attunement and synchrony are mediated by physiological processes [47]. Embodied self-regulation becomes even more salient when it comes to the enactment of compassion(ate) flow, as our abilities to maintain a compassionate stance tend to break down under pressure [48,49], typified by difficult therapeutic encounters such as alliance ruptures [50].

The martial arts offer a well-developed platform to engage in such embodied practice [4]. Traditional martial artists are arguably extremely adept in the art of embodied self-regulation [51], evidenced by research that points to superior attentional, motivational switching and integrative capacities [52,53,54], as well as greater impulse control and distress tolerance in threatening situations [55,56]. Their training requires them to develop deeply embodied distress tolerance abilities in the face of antagonistic relational threats [4,6,57] and respond in a prosocially-driven co-regulatory manner [51,58,59], that is focused on neutralising/halting actions that cause suffering and re-establishing relational harmony [5,60,61]. Similarly, psychotherapists need to embody and to have entrained all of these abilities and capacities in order to be a safe container [51,62] and secure base [63] for their clients, with such attachment-based functions also seen as essential for the emergence and flow of compassion in therapeutic relationships [2,64,65].

A seminal study by Faggianelli and Lukoff [61] of eight psychotherapists who were also highly skilled Aikidokas highlights how the personal practice of a traditional martial art influences therapist self-development and transfers to the therapy space. A central theme was that the body-mind training of Aikido afforded them a greater ability to relate compassionately and empathically with their clients. This was further linked to the practice and cultivation of a body-mind state of being centered, allowing them to be more present and skilfully (i.e. wisely compassionately) responsive in therapeutic encounters. Importantly, participants highlighted that whilst Aikido shared similarities with other disciplines such as meditation and yoga, they felt that Aikido was more actively engaged with everyday reality and afforded a greater capacity to remain calm during conflictual interpersonal encounters.

1.5 Traditional Martial Arts as Radically Embodied Compassion

Psychotherapy, in any form, is an act of courage on behalf of both clients and therapists [66,67,68,69]. On the latter front, various scholars have advocated for psychotherapeutic training and continued personal and professional development to focus on the cultivation and refinement of virtuous character strengths, particularly that of courage [66,70]. It can be argued that the path to the alleviation of suffering requires deeply ingrained compassionate courage and wisdom to persist in the face of immense emotional distress and relational challenges [2,66,70,71].

Traditional martial arts training and CMT share similar philosophies, in that their focus is on cultivating and entraining various body-mind attributes/competencies that support compassionate engagement and action when faced with suffering. Both CMT and martial arts-informed training for therapists [6,18,19,51] are body-mind self-cultivation systems [72] aimed at developing and strengthening what could be construed in Buddhist terms as the bodhisattva spirit [73]. Gilbert and Choden [35] highlight how courage is a key attribute of the bodhisattva (or spiritual warrior), allowing one to tolerate fear to engage with and alleviate suffering, even at the risk of one’s own safety. This strong, courageous and protective body-mind set has been referred to by some scholars as fierce compassion [74,75]. The ultimate purpose of training in the martial arts is to become a fearlessly courageously compassionate human being [6,76], a gentle or peaceful warrior [51,77] who fully embodies virtuous character strengths including benevolence, courage and wisdom [78] in order to best help and serve others [79]. Courage and wisdom are at the core of compassion and the cultivation of a compassionate self-identity [2,5,35,80], and are replete throughout history as integral components to warrior codes and mindsets [78,79].

Traditional martial arts can be construed as a form of radically embodied compassion, in that martial arts practice(s) can entrain ease of access to the psychophysiological-motivational state associated with compassion [5,6], via body-mind unification of kinaesthetic, proprioceptive and interoceptive processes [81,82]. Such practice(s) can give rise to an integrated courageous, powerful, calm and centered state that can prepare the practitioner for extreme challenge by remaining stable/grounded, flexible and aware [81]. Resiliently maintaining this balanced preparatory state of action-readiness in the present moment via embodiment and movement can provide numerous affordances, in terms of reflexiveness and skilfulness of response(s) [57,83].

2. Martial Arts-informed Compassionate Mind Training for CFT Therapists

Accordingly, we (Clapton and Hiskey) developed Radically Embodied Compassion [5] training for therapists, a body-mind system that draws on and integrates the principles and practices of CFT, CMT and traditional martial arts [6]. Such training and personal practice aims to develop compassionate motivation at a deeply embodied level [5,6], affording therapists greater sensitivity, attunement, distress tolerance, courage and compassionate responsiveness in therapeutic encounters [4,5,6].

We propose and outline an embodied enactive training framework (i.e. ‘Way’) for CFT therapists that highlights how integrating elements of traditional martial arts into their personal and clinical practice may enhance specific compassion(ate) competencies of engagement and action. We argue these competencies can be further enhanced, especially in times of therapeutic rupture [48], via traditional martial arts training (see Table 1, below) and that this might facilitate therapy process and efficacy [65].

Table 1 Example of engagement and action competencies in relation to traditional martial arts and psychotherapy.

2.1 Stance and Breathwork

Many preparatory stances, salutes and other ritualised behaviours (e.g. bowing) serve the purpose of setting and signalling (to self and others) one’s motivational intent [84], and are connected to a philosophy of virtuous conduct and humility [85]. A palm covering a fist can be used to stimulate and signal strength, courage, bravery and vigour [86] balanced with caring protection and peaceful benevolent wishes, whilst bowing signals one’s courtesy and respect for the other. These are ways of embodying care for well-being, in the sense that they involve adopting a physical and corresponding (e)motivational stance [81] in line with the highest ethical level of self-defence in combat, to be helpful and least harmful to the other [87].

‘Ready’ stances that are integral to many martial arts are important precursors to any subsequent action, in that they involve the physical, mental and emotional preparedness/readiness to engage and become totally present during ensuing encounters [77]. They are important first steps in placing the body in a poised state of action-readiness that confers both stability and flexibility of responsiveness [57,83]. These ‘ready’ stances and associated body postures (hand positions/signs) have been shown to have a demonstrable impact on distress tolerance abilities, in that they help to reduce anxiety and a shift to greater predominance of parasympathetic nervous system activity when they are performed before being subjected to a stressful task [88]. They can thus be used as powerful pre-session embodied centering practices [5,6] that stimulate the neurophysiology associated with a preparedness to compassionately engage with suffering [89,90,91].

Static and dynamic stance and guard work can be seen as forms of embodied CMT practices that afford affective and attentional balance/stability across emotional states [5,61,77], of which balance in these domains has been proposed as essential for the emergence, arising and enaction of compassion [92,93]. These stances and postural positions are ways of embodying approach motivation that in turn influences physiology, motivational behaviour, and emotional and cognitive processes [94,95]. Priming a courageous and heroic body-mind set in this way, by intentionally manipulating physical posture to be standing and expansive rather than sitting, has been shown to affect speed and frequency of prosocial behaviour [96]. This affords the CFT practitioner access to a psychophysiological-motivational state of fearless courageous compassion [5,6,76], or what has also been termed as peaceful courage [77] and centeredness [61,97,98], that remains ‘online’ and resilient in response to social threat signals [99].

When combined with breath control, often practiced as Soothing Rhythm Breathing practice in CMT [35,45], this can afford the practitioner access to a sense of what would be construed in attachment terms as an unlimited secure base [100,101]. This internal secure base is unlimited in the sense that it can be drawn on in times of significant (di)stress and hostility [100,101] when one needs to stay affiliatively socially engaged [4,5,6,50], acting as a continuous source of replenishment and empowerment [100,101]. It is thus aligned with a Compassionate Self that has developed and entrained deeply embodied distress tolerance to suffering [4] which can be accessed and sustained when it is most difficult and most needed [6], indicative of parasympathetically-mediated physiological resilience under stress [102]. This is supported by research demonstrating that combining paced breathing with movement and rhythmic skeletal muscle contraction produces a more resilient parasympathetic nervous system response than breathing practices alone when preparing for stressful events [102]. It is unsurprising then that many Traditional Martial Arts systems place a specific emphasis upon the unification of breath and movement practices [103].

2.2 Embodied Movement Practices to Afford and Enhance In-session Synchrony, Motivational Monitoring and Switching, and Rupture-repair

Maai exercises [6,104] can help CFT practitioners develop competencies for sensitivity, sympathy, empathy, attention and sensation. Maai refers to the ‘engagement distance’ between oneself and another [104,105], both in terms of the spatio-temporal distance and the degree of harmony-disharmony/synchronicity-asynchronicity during encounters [105]. Embodying a strong, stable, courageous and affiliative stance from a safe (enough) distance can help to increase the practitioner’s ability to sensitively attune to, sympathetically moved by and wisely compassionately responsive to another’s suffering [90,106,107].

Such partner work and drill exercises typically encompass processes involving kinaesthetic empathy and intersubjectivity [108,109], including embodied and somatic mirroring [110,111], moving in and out of synchrony [108,112], spontaneity [113,114] and flexible responsiveness [57,83]. The sense of shared flow and perceived emotional synchrony that arises out of these processes can thus help to foster and enhance the flow of compassion between each other [115] during therapeutic encounters. This is further supported by research showing that heightened movement synchrony can evoke more compassion, cooperative and altruistic behaviours [116], likely via greater shared intentionality [117] and shared dysphoric experiences [118], underpinned by physiological synchronisation of each’s autonomic nervous systems and oxytocinergic systems [58,119,120,121,122]. These exercises/drills can thus help the CFT practitioner fine-tune their Compassionate Self’s abilities to access their embodied knowledge, intuitive wisdom, compassionate communication and decision-making whilst in action [6,49,57,123,124].

Kata/forms/poomsae are a coordinated series of movements (combined stances/postures and hand/foot positions in the form of blocks and strikes), combined with breathing patterns and vocalisations, performed against an imaginary opponent. Katas are directly relevant to CFT practitioners and CMT personal practice as they mirror important psychotherapeutic processes, including the generation, absorption, redirection and projection of physical, emotional and spiritual energies [76]. Kata are essentially a way to integrate various aspects of CMT training in a more fully embodied and enactive way [5,6], encompassing many compassionate engagement and action competencies.

Kata can be harnessed as a kinaesthetic/motor imagery practice to visualise and enact a radically embodied compassionate response to anticipated suffering in therapeutic encounters [125], fully animating the practitioner's Compassionate Self and priming it for reflexive activation. This has previously been described as involving a process of somatic metaphorism [126], a mode of deploying the body to make sense of non-martial relational situations and challenges. This has been further refined by Clapton and Hiskey [5,6] as somatic metamorphism, in the belief that such training can lead to a deeper somatic alchemical transformation/transmutation as extolled by other martial artists and scholars [49,76,82,127]. In this way Kata practice can be thought to entrain a grounding in competencies such as non-judgement, distress tolerance, empathy, sensitivity and sympathy while also incorporating action competencies such as imagery, attention, behaviour and feeling.

Within traditional martial arts emphasis is placed on development of mushin [76], a Zen term translated as the mind without mind or a state of "no-mindness". Put another way, this means a mind not occupied by thoughts or emotions and therefore free from attachment to a particular response. It is felt to be reached or arrived at when a martial artist's mind is free from thoughts of anger, fear, or self during combat. This leads to a sense of freedom to act and react towards others spontaneously from a position of one's entrained natural reaction/felt intuition. Such practices, typically involving moving meditation, help develop attention, non-judgement and spontaneous/unencumbered compassionate flow. Neuropsychologically, mushin has been proposed to be a product of the autonomous dorsal visuomotor modules of the brain becoming more predominant through training in action [128], further supported by recent fMRI research into the neural mechanisms underpinning such superior attentional abilities in martial artists [52].

Kata and sparring drills can also be construed and utilised as moving tonglen (i.e. ‘sending and receiving’ Tibetan Buddhist meditation) practices [35,129], in that they involve a physical and emotional ‘receiving’ of another's suffering and a ‘giving’ back of compassion in various forms [5,6]. This affords practitioners powerful radically embodied ways to work with their clients and their own fears, blocks and resistances to compassion [130], in a manner that allows the practitioner to welcome, align/blend with, absorb and redirect such emotional energy [61,114]. These are crucial abilities in being able to compassionately repair and resolve inevitable ruptures in the therapeutic alliance [4,5,6,65].

Motivational conflict, both interpersonally and intrapersonally, are central issues in psychotherapy that underpin and maintain much human suffering [131,132,133,134,135]. Working with, resolving and transforming such conflicts rests on a therapist's ability to motivationally monitor and help switch one's own and clients' motivational systems [134], into social mentalities that are more conducive to affiliative and harmonious functioning [44,135]. Such rapid switching of motivational systems and corresponding emotional states is likely predicated on what has been described as locomotion motivation [136,137], a motivation for smooth movement and change from state-to-state. These motivational switching abilities can be entrained and greatly enhanced by embodied movement practices [124,137].

Martial artists are extremely adept at such motivational monitoring and switching [5,6], supported by recent fMRI research suggesting that such abilities become more entrained and efficient through traditional martial arts training [52] whilst also reducing inner conflict between one’s Behavioural Approach (BAS) and Behavioural Inhibition (BIS) motivational systems [72]. This is because much of their training requires rapidly and flexibly shifting between threat-focused self-protective to affiliative motivational systems during and after simulated antagonistic encounters [57,58]. This mirrors rupture-repair processes that are central to any psychotherapy, but particularly so for compassion focused therapists who will inevitably encounter frequent rupture events due to their clients and own fears, blocks and resistances to compassion [130].

Imaginal and embodied enacting of compassionately responding to confrontation and withdrawal ruptures [125], by blending with and redirecting energy (i.e. behaviour competencies), are more embodied ways of developing non-judgement, as it requires one to drop blame of the other [61]. These can further help strengthen competencies in sensitivity, sympathy, empathy, attention, reasoning, sensation and feeling, in that resistance is transformatively seen and felt as a vehicle for deepening compassionate understanding and growth [61,65,114,138]. Such work has the potential to enhance synchrony within psychotherapy [50,134,139,140] between client and therapist, as well as both strengthening therapeutic presence [89,141] and affording courage by both parties within the therapy space.

3. Conclusion

Entraining therapist skills to deliver complex process-driven work such as CFT is important [2,24]. In answering calls to develop novel ways to enhance the therapist self through embodied and psychophysiological approaches [4,5,6,47,142], we propose that traditional martial arts afford the development of many of the components of CFT’s multi-modal model.

To further test out this hypothesis, future research may firstly focus on evidencing proof of concept by measuring changes in therapist competencies of compassionate engagement and action after engaging in training workshops and following sustained personal practice. Once established, studies may then wish to contrast more standard CMT for therapists with the more radically embodied martial arts-informed CMT approach outlined, including investigating whether this has differentially measurable impacts on neurophysiological and psychotherapeutic processes and outcomes.

In sum, we propose that the outlined embodied and enactive approach that integrates traditional martial arts and CMT is a potentially powerful compassionate self-cultivation system for CFT therapists to enhance their personal-professional development and clinical practice. From the perspective of the CFT therapist then, as for the practising martial artist, the ‘way’ is in training.

Author Contributions

Both authors contributed equally to the writing of this work.

Funding

The authors received no financial support for the research, authorship and/or publication of this article.

Competing Interests

Dr Neil Clapton and Dr Syd Hiskey are co-founders of Fierce Compassion Martial Arts (FCMA), a (currently non-profit) training organization and system designed to cultivate Radically Embodied Compassion described in this opinion paper.

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