For decades, evidence-based therapy, such as cognitive behavioral therapy, has been defined in terms of treatment protocols focused on syndromes as defined by the DSM and ICD. These psychiatric classification systems assume that psychological problems are expressions of latent disease entities. However, there is little evidence to support this restrictive assumption.

A process-focused approach (Process-Based Therapy, PBT) is now emerging. This approach does not rely on the assumption that psychological problems are expressions of latent disease entities, but it does not rule it out either. Instead, mental health problems are assumed to exist as systems of interconnected elements. As is true for many complex networks, such a change can occur abruptly once the network reaches a tipping point. PBT directly links treatment techniques to processes in the individual client, thereby linking classification to treatment based on functional analysis and complex networks. This offers a less restrictive and more externally valid alternative to the latent disease model, while offering exciting new directions for future research in psychiatry and is in line with personalized medicine.

In a sense, every form of psychotherapy aims to realize compassionate intentions. However, Compassion Focused Therapy (CFT; Gilbert, 2010) in distinct in the way that this approach targets compassion as an active psychotherapy process variable in assessment, case conceptualization and interventions. CFT is based on an evolutionary model of motives and emotions, that recognizes the central importance of human affiliation and attachment dynamics in emotion regulation and optimal adaptive functioning.

From the moment we are born and throughout our lives, the presence of care, compassion and love will affect us positively, on every level of our being, from our levels of anxiety and depression, to our heart rate variability and immune system functioning. Drawing on applied research in compassion science, contextual behavioral science this discussion will examine how cultivating compassion for self and other relates to psychological flexibility, our ability to mindfully contact the present moment and to pursue the realization of our values with wisdom, strength and courage. Making these connections is one small step in our community process of moving beyond therapy labels, to develop process based methods of alleviating and preventing human psychological suffering.

Covid-19 vaccines are delivered on a variety of ‘platforms’, traditional and innovative — all aiming at a common underlying mechanism of protection, i.e. stimulating the development of anti-spike-protein antibodies and T-cell activation.  Similarly, scholars have tried to delineate the common factors which underpin the 570 (and counting) varieties of psychotherapy, many of which,  as the ‘dodo-bird verdict’ suggests, can be highly effective, but none consistently demonstrably more so than another.

I shall argue that attachment theory and Friston’s Free Energy Principle provide an evidence base, rationale and theoretical framework for understanding the transmutative power of psychotherapies. In the ‘duet for one’ and built-in ambiguities of the psychotherapeutic relationship,  these include enhanced ‘granularity’ of entero- and extero-perceptions, an expanded range of ’top-down’ generative models,  and facilitated agency by which outdated models and repressed feelings can be revised and transcended.  The result is greater flexibility, range of choices, and resilience.