Compassion-focused chairwork for voice-hearing relationships, body triggers and motivational states.

Purpose: This paper aims to build on a recent theoretical and empirical review of CFT for psychosis by outlining a more detailed account of how voice-hearing perceptions may be generated and triggered, and the implications for clinical practice. It also aims to provide a detailed and practical illustration of how CFT for voice-hearing is applied in therapy.

Method: This paper summarises the evolution-informed rationale for CFT for voice-hearing and integrates into this framework some major developments in cognitive neuroscience-namely predictive processing models of perception-to develop a richer account of the mechanisms and targets of CFT for voice-hearing. The clinical application of this model is demonstrated using a description of compassion-focused chairwork for voice-hearing.

Results: The enriched perceptual modelling of CFT for voice-hearing is complementary to the (evolution-informed) accounts in the existing CFT literature, while adding precision and utility when it comes to describing compassion-focused chairwork for voice-hearing and discussing some of the key clinical considerations for therapists wishing to use this method.

Conclusions: CFT for voice-hearing is an integrated biopsychosocial approach that indicates therapy targets linked to both sides of the voice-to-voice hearer relationship, to corresponding embodied and motivational states, and to the past traumas and conflicts that may drive these patterns. CFT chairwork is particularly well suited to addressing some of the perceptual, embodied and motivational drivers of voice-hearing experiences. We recommend the development of detailed intervention protocols for therapist guidance on specific techniques such as CFT chairwork, which can be used in future evaluation research.