Deborah Lee

Compassion focused therapy for shame based PTSD

Dr Deborah Lee, Consultant Clinical Psychologist,  


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Compassionate Leadership


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Lead For Compassionate Leadership Berkshire Healthcare NHS Trust

Honorary Associate Professor, University College London

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Compassionate Leadership

'On Demand' £80.00


Recently there has been a rise of interest in bringing Compassion focused practices to the workplace in order to improve team functioning and wellbeing.  The concept of compassionate leadership brings leadership into every grade and domain in the workplace so that regardless of grade or seniority compassionate leadership is everyone’s business. Over the last three years, Berkshire Healthcare NHS Foundation Trust has developed and rolled out a compassionate leadership programme and has trained over 1500 of its staff, integrated it into its excellent managers programme and made it part of new starters induction.

The workshop uses the underlying theoretical principles of Compassionate Mind Training as a framework to explore self- compassion and team compassion. It allows participants to explore inhibitors and facilitators to compassionate practice in the workplace, thereby identifying those functioning in a threat focused team. During the workshop participants are encouraged to consider and commit to more compassion team cohesion.

Objectives of Training

To explore compassion as a motivation

To develop skills to enhance compassionate practices through self-awareness and compassionate habits

To develop compassionate motivations in our leadership and management styles and learn how to promote compassionate   team culture

To identify team functioning from a threat motivation and to develop tools to improve the emotional environment through compassionate team pledges.


Christiansen, A., O'Brien, M. R., Kirton, J. A., Zubairu, K., & Bray, L. (2015). Delivering compassionate care: the enablers and barriers. British Journal of Nursing, 24(16), 833-837.

Crawford, P., Brown, B., Kvangarsnes, M., & Gilbert, P. (2014). The design of compassionate care. Journal of clinical nursing, 23(23-24), 3589-3599.

Gilbert, P., (2009). Introducing Compassion Focused Therapy. Advances in Psychiatric Treatment, 15 199-208. Doi:10.1192/apt.bp.107.005264

Li, A., Early, S. F., Mahrer, N. E., Klaristenfeld, J. L., & Gold, J. I. (2014). Group cohesion and organizational commitment: protective factors for nurse residents' job satisfaction, compassion fatigue, compassion satisfaction, and burnout. Journal of Professional Nursing, 30(1), 89-99.

Pawson, R., & Tilley, N. (1997). Realistic evaluation. Sage.

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Compassion Focused Therapy for shame-based PTSD

On Demand workshop £80.00


Those who have experienced interpersonal trauma often experience self- blame, self- loathing, lack of trust, interpersonal difficulties, struggles to regulate threat-based emotions, flashbacks, avoidance and disconnection are prevalent issues to be addressed in therapy.  These difficulties are often described as Complex PTSD and at the heart of the distress are fragmented shame fuelled flashbacks/ trauma memories which are maintained by self-attacking thoughts/ self-blame and further perpetuate distress. Evidence based practice such a trauma focused CBT can sometime feel less effective with shame based trauma presentations, where clients report a ‘heart-head’ lag; they don’t feel on an emotional level what they know on an intellectual level(Lee, 2005). Furthermore emerging research demonstrates that experiences of shame and self-criticism respond less well to more traditional CBT approaches (Gilbert, 2009) but benefit more from compassion focused approaches (Kirby,Tellegen & Steindl, 2017, Beaumont, E).  These findings, as well as clinical developments in treating shame based trauma and Complex PSTD have emphasised the need to develop compassionate minds as an antidote to shame based states and moreover to bring into shame based memories, a felt sense of compassion (Lee, 2013).

The focus of this workshop will be to explore how to bring compassion to shame- based flashbacks memories as well as learn how to develop compassionate antidotes to shame based trauma narratives, in order to promote recovery and resolution from distressing symptoms of PTSD and Complex PTSD. The approach builds on evidence based practice such as trauma focused CBT (Ehlers & Clarke 2000) and Imagery Recripting (Arntz, 2012)

Compassion focused therapy was developed by Professor Paul Gilbert. The explicit goal is to develop, access and stimulate positive affect associated with self-soothing in the mind and body of the patient in order to promote an inner sense of psychological safeness (Gilbert, 2005, 2009).

Learning Objectives

·To briefly explore evolutionary theory of shame and self-criticism

·To explore CFT theory and practice as applied to shame- based trauma

·To understand how to use CFT to develop compassionate reframes to shame based trauma experiences.

·To learn ways to work directly with shame- based trauma memories using the compassionate soothing system.

Key references

  • Arntz, A (2012). Imagery Rescripting as a Therapeutic Technique: Review of Clinical Trials, Basic Studies, and Research Agenda.Journal of Experimental Psychopathology, Volume: 3 issue: 2, page(s): 189-208

  • Ashfield E., Chan, C & Lee, D.A., (2019) Building “A Compassionate Armour”: The Journey to Develop Strength and Self-Compassion in a Group Treatment for Complex PTSD.

  • Gilbert, P., (2009). Introducing Compassion Focused Therapy. Advances in Psychiatric Treatment, 15 199-208. Doi:10.1192/apt.bp.107.005264

  • Kirby, J. N., Tellegen, C.L., Steindl, S.R., (2017).  A Meta-Analysis of Compassion-Based Interventions: Current State of Knowledge and Future Directions. Behaviour Therapy, 48, 778-792.

  • Lee, D.A. (2015) Case conceptualisation in complex PTSD: integrating theory with practice.  In Tarrier, N.,( Eds).  Case Formulation in Cognitive Behaviour Therapy: The treatment of challenging cases. Routledge. London

  •  Lee, D.A., (2013). Compassionate-Mind Guide to Recovering from Trauma and PTSD: Using Compassion-Focused Therapy to Overcome Flashbacks, Shame, Guilt, and Fear New Harbinger, New York.

  • Lee, D.A (2012). The compassionate mind approach to recovering from trauma, using compassion focussed therapy. Constable & Robinson. London

  • Waite, F. Knight, M. & Lee, D.A. (2015): Self-Compassion and Self-Criticism in Recovery in Psychosis: An Interpretative Phenomenological Analysis Study. Journal of Clinical Psychology, Vol 71, 12.     


Compassionate Leadership for NHS Staff

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About Dr Deborah Lee

Brief Biography

Dr Deborah Lee is a Consultant Clinical Psychologist, Head of Berkshire Traumatic Stress Service and South Central Complex Treatment Service for Veterans. She is also an honorary Associate Professor at University College London. 

Deborah is a founding board member of the Compassionate Mind Foundation and has helped develop compassion focused approaches in clinical settings as well at work- place settings.

She is author of the Compassionate-Mind Guide to Recovering from Trauma and PTSD: Using Compassion-Focused Therapy to Overcome Flashbacks, Shame, Guilt, and Fear (2013). New Harbinger, New York.

Dr Lee has worked in the field of trauma for 28 years and specialises in the treatment of Complex PTSD.  Her particular area of clinical and research interest is in shame- based PTSD and self-criticism. She has pioneered the use of developing compassionate resilience as part of a phased based treatment approach to complex PTSD. She has widely contributed to the dissemination of her clinical knowledge through writing and delivering over 150 clinical workshops and talks in North America and Europe.


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