Tracy was walking past her bathroom door when she noticed her three-year-old daughter bent over the lavatory, with her little fingers about to plunge down her throat. Her daughter looked up and said: “Is this what we do, Mummy?”

Recounting the scene, Tracy, 33, is still clearly distraught. She says that she had been “caught out” by her daughter when she was making herself sick, and her little girl, by re-enacting the bulimic episode, seemed to indicate that she thought it was in the realm of normal grown-up behaviour. “It was a wake-up call,” says Tracy, who decided to see her GP the next day to ask for help.

Tracy, who became bulimic in her teens, had been given some general counselling at 18 but felt that it didn’t help her to address the issues underlying her eating disorder. “It helped a bit, but it was triggered off again when I split up with my daughter’s dad and then my mum died. She was my best friend, my rock. I blamed myself for the break-up of my marriage, and one way of not thinking about my mum or the break-up was to think about food 24/7. At first I thought it was a way of coping but it takes over your life.”

Tracy was referred to a pioneering eating disorder group recovery programme developed by Ken Goss, a consultant clinical psychologist and head of the Coventry Eating Disorders Service. The programme, run once a week for 20 weeks, is based on a pioneering therapeutic technique called Compassionate Mind Training (CMT), which teaches participants to develop strategies to treat themselves in a compassionate way.

CMT was developed by Paul Gilbert, a psychologist at the Mental Health Research Unit at Kingsway Hospital in Derby in the mid 1990s, not as a replacement for other psychological interventions but as a way of enhancing those treatments. “If people have a poorly developed capacity for self-reassurance, that needs to be the focus for development,” explains Gilbert.

Goss, who was working with Gilbert at the time, thought that this would be a good focus for the work he was doing with patients with eating disorders: “They experience high levels of shame and self-criticism, and CMT helps people to develop the ability to soothe themselves at times of emotional distress. For example, bingeing is often used as a way of promoting a positive or neutral emotional state to avoid anxiety, anger or shame. If people can activate the self-soothing system they won’t need to engage in bingeing to manage difficult feelings.”

Gilbert explains that it is a case of replacing one set of emotions with another. “So instead of self-anger or contempt, there is self-kindness and warmth. This is the same as in therapy for anxiety in which people are taught relaxation exercises because they can’t feel anxious and relaxed at the same time.”

The hypothesis on compassion is that it is a trainable mental skill that can cause greater activity in the left prefrontal part of the brain, which contains the neural network linked to empathy and maternal love. Richard Davidson, a Wisconsin-based neuroscientist, hooked up Buddhist monks, who generate “pure compassion” during meditation, to MRI machines and found the hypothesis to be true — that the left prefrontal cortex is swamped with activity and makes stronger connections between thoughts and feelings, and dampens activity in the right prefrontal area, which is connected to negative moods.

Cynics will say that the tenet of being kinder to yourself props up the self-help industry, with books on boosting self-esteem and “being your own best friend”. But advocates of self-compassion are keen to distance themselves from the more nebulous but omnipresent concept of self-esteem and the layman’s notion of compassion being akin to pity.

Professor Kristin Neff, of the University of Texas at Austin, who flies the flag for self-compassion therapy in the US (www. self-compassion.org), is keen to show how self-compassion differs from self-pity: “Self-pity tends to emphasise egocentric feelings of separation from others and exaggerates the extent of personal suffering. Self-compassion, on the other hand, lets one see the related experiences of self and other without these feelings of isolation and disconnection.”

Gilbert says that compassion for the self, like compassion for others, is driven by a desire to relieve suffering. “Compassion, which is an element of loving kindness, involves being open to the suffering of self and others. It has great potential to heal our minds and bodies.”

Such is Gilbert’s beliefin the therapeutic value of compassion that he set up the Compassionate Mind Foundation in Derby last year to help to promote and raise funds for more research into the scientific study of compassion.

Goss notes that self-compassion techniques are particularly useful for eating disorder patients partly because they are not good at asking for help from others. “They are often very self-critical and are unable or unwilling to allow others to help them. This is usually because they are fearful of the consequences of receiving support and compassion from another.” Those consequences are gaining weight or eating without purging, which can feel frightening to the person with the eating disorder.

A key part of Tracy’s therapy was learning how to develop an image of a compassionate person who would “talk” and comfort her when she felt that she was facing difficulties with food. “My compassionate image was my mum, and I had to write a letter to myself as if she were writing to me, the sort of things that she might say. It did give me a sense of calm to write it and read it, and ‘she’ wrote that I should be kind to myself the way I am to other people, and that the bad things that have happened are not my fault and that I shouldn’t take things out on myself by making myself sick or taking laxatives.”

The course involves education about eating disorders and their effects on mind and body, learning what triggers them and finding alternative, compassionate solutions to those problems. Four sessions are devoted to helping people to develop an image of a safe, happy place and a compassionate adviser, which could take the form of an animal, a person, a character from a book or TV, or even the therapist. The patient has to practise the imagery for 15 minutes a day. Goss likens it to toning up a muscle. This is where the reciprocal inhibition comes into play. The person with the eating disorder learns to soothe through compassionate thoughts instead of bingeing or starving.

Goss says: “As patients begin to generate and focus on this imagery, they frequently note a lowering of anxious arousal, a decrease in eating-disordered beliefs and behaviours, and a greater ability to act in a more compassionate and less socially anxious way than others.”

Tracy says that her CMT helped in unexpected ways. “It helped a lot with the food issues but also the way I feel about myself in general. I now believe that I am a good person and deserve to be treated well, and because I am eating more normally I am less snappy and kinder to others, too.”

Preliminary (as yet unpublished) studies suggest that introducing CMT to a therapeutic group for bulimia raises the recovery rate from 50 to 70 per cent, but Goss will remain cautiously optimistic until a more rigorous study is completed.

For Tracy, being kind to herself makes her feel better than bingeing and purging. “Food was on my mind 24 hours a day and I couldn’t sleep because I was hungry and it was a way of punishing myself. Now, with a compassionate mind, I see that I would never treat anyone else like that, so why treat myself like that? I can sit down to a meal with my daughter and enjoy it. Learning CMT has changed my life for the better.”

For more information, visit www.compassionatemind.co.uk . Compassion, edited by Paul Gilbert, is available through Routledge books (www.routeledgementalhealth.co.uk )