When Caring for Others Leaves Scars on the Self

Healthcare workers are trained to stay calm under pressure, make quick decisions, and carry others through crisis. Yet the same habits that help them excel—high standards, vigilance, and a sense of duty—can quietly harden into relentless self-criticism. Over time, this can feed burnout, emotional numbness, and a private sense of failure, even when the job gets done. The research paper A qualitative evaluation of a compassion-focused therapy group intervention for UK healthcare staff at an acute hospital trust asks a simple but vital question: what happens when staff learn to turn compassion inward, in a structured group setting designed for their realities?

This study followed eight NHS staff who took part in a 12-week compassion-focused therapy (CFT) group aimed at those struggling with mental health difficulties and high self-criticism. Through in-depth interviews and qualitative analysis, the authors explored what participants found helpful, what felt challenging, and how the group experience affected their well-being. Why does this matter? Because “be kinder to yourself” is easy advice to give and hard to live—especially in a busy hospital culture where time is tight, standards are high, and mistakes feel personal. By listening closely to staff voices, this research sheds light on what makes compassion training acceptable, useful, and safe for people who routinely hold others through pain.

In short, the study reveals that CFT groups can foster a deep sense of group safeness and connection, reduce isolation, and offer practical skills to interrupt harsh inner talk. It also highlights the emotional weight of the work, pointing toward ways to tailor support—like smaller groups, clearer expectations, and follow-up sessions—to protect staff and sustain gains.

What Changed in the Room: Voices From the Group

Participants described the group as a place where shared NHS and caregiver identities made it safer to open up. Knowing that others understood shift work, clinical pressures, and the fear of “getting it wrong” lowered the guard. This sense of safeness made it easier to speak honestly about guilt, anxiety, and the inner critic that keeps whispering “you should have done more.”

The content of CFT resonated because it directly addressed self-criticism. Participants said the language and ideas helped them “put names” to experiences that had felt diffuse or shameful. This labeling increased self-awareness: instead of drowning in a bad day, they could notice, “My threat system is fired up,” and choose a different response. For example, after a tough handover, someone might catch the automatic “I’m useless” spiral and use a brief grounding practice to reset before the next patient interaction.

The group format itself became a teacher. Hearing others’ stories widened perspectives and softened rigid, self-blaming narratives. When a colleague described feeling broken after a complaint, it normalized distress and offered new ways to cope—such as taking a compassionate pause, seeking peer debrief, or reframing the event as part of human fallibility rather than personal failure. Participants reported learning skills they could use at work and at home, and several noticed overall emotional improvement.

However, the content sometimes felt emotionally triggering. Opening up heavy experiences in a group could stir anxiety or sadness. Participants recommended smaller groups, flexible pacing, and additional support options—like brief one-to-one check-ins or booster sessions—to help people feel held. Protected time away from clinical duties and clear information about what to expect also emerged as crucial for reducing hesitation and strengthening psychological safety.

Why Safeness Beats Harshness: The Psychology Behind the Shift

The findings fit well with established psychological models of compassion and shame. CFT proposes that our minds run on three interacting systems: threat (detect danger), drive (pursue goals), and soothing (feel safe and cared for). Healthcare often keeps the threat and drive systems on high—constant risk, constant targets—while the soothing system gets sidelined. By explicitly cultivating warmth, gentle tone, and supportive imagery, CFT helps rebalance those systems. Participants’ emphasis on “group safeness” suggests that the group setting itself activates the soothing system, making it easier to learn and apply new skills.

Group processes likely amplified the benefits. Classic group therapy factors—like universality (“I’m not the only one”), interpersonal learning (trying out new ways of relating), and cohesion—reduce shame and isolation. The shared professional identity of NHS staff added an extra layer of trust: people didn’t have to justify why a near-miss keeps them awake or why a complaint letter stings. That common ground made vulnerability feel more possible—and more productive.

Labeling experiences also matters. Research on affect labeling shows that naming emotions can decrease emotional intensity. Participants’ reports of being able to “put names” to their inner critic and bodily stress responses align with this: once named, feelings become information rather than verdicts. This, in turn, opens space for compassionate choices—like taking a three-minute breathing break before calling a family with difficult news or swapping a punitive inner script (“You failed”) for a supportive one (“That was hard; what do you need now to steady?”).

At the same time, the group wasn’t easy. Encountering painful memories or entrenched self-judgment can be activating, especially without enough time or individualized pacing. The suggestions for smaller groups, flexible content, and added support reflect a well-known tension: the very practices that heal shame can stir it first. Tailoring the dose and providing scaffolding are not “extras”; they’re core safety features for compassion work in high-stress systems.

Turning Insight Into Practice: Steps for Workplaces and Clinicians

For hospital leaders: prioritize protected time for staff to attend groups without guilt or work spillover. Signal that psychological recovery is as legitimate as clinical training. Offer clear pre-group information—who it’s for, what it involves, and what support is available—to reduce uncertainty. Keep groups small enough for trust to form, and build in options for brief one-to-one check-ins and periodic booster sessions to maintain gains during winter pressures or service changes.

For mental health teams: align CFT content with common healthcare stressors. For example, practice compassionate self-talk around complaints, near-misses, or moral distress from resource limits. Normalize warm tone of voice and grounding skills as “equipment” for the next shift, not luxury add-ons. Where possible, adapt pacing so emotionally triggering material can be approached safely, with time to process and regulate.

For teams and supervisors: integrate micro-compassion into routines. Start huddles with a 60-second settling breath. After critical incidents, schedule brief debriefs that include a compassionate check-in: “What feels hardest right now, and what’s one supportive step we can take?” Model non-punitive language in feedback. Small shifts in tone and timing reduce threat reactivity, making learning and collaboration easier.

For individuals: use short, doable practices. Before walking into a challenging conversation, place a hand on your chest, slow the exhale, and say a kind phrase you’d offer a colleague: “You’re doing your best; steady and proceed.” After a tough shift, write a few lines from a compassionate inner voice that acknowledges effort and pain without judgment. Over time, these micro-moments build the “soothing system”—the nervous system pathway that helps you reset rather than ruminate.

Across settings, remember the core takeaway of this research: the group’s shared identity and safeness did much of the heavy lifting. Any implementation should protect these ingredients by design.

A Small Group, A Big Signal

This qualitative study is modest in size but strong in message: when healthcare staff learn compassion skills in a safe, well-held group with peers who “get it,” they feel less alone, more aware, and better equipped to meet their inner critic with care. The authors of A qualitative evaluation of a compassion-focused therapy group intervention for UK healthcare staff at an acute hospital trust show that such groups are acceptable, beneficial, and worth scaling—if we tailor them thoughtfully and support them with time and clarity. Larger, mixed-method evaluations are the logical next step to test impact on wellbeing, absenteeism, and patient care.

Perhaps the most practical question is this: what would change if hospitals treated the inner worlds of staff with the same urgency as vital signs? If the answer is “safer teams and steadier care,” then compassion training isn’t a luxury—it’s core infrastructure.

Data in this article is provided by PLOS.

Related Articles

• Calming the Night: What a Korean Pre-Sleep Arousal Measure Tells Us About Sleeplessness
• When Focus Feels Heavy: How Task Pace and Personal Traits Shape Mental Effort
• Resilience Under Pressure The Bioscience Student Journey from Lockdown to Recovery
• Brains, Noise, and the Hidden Cost of Conversation for Neurodivergent People
• Parents on the Frontline of Autism and Mental Health in the UK