Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-745bb68f8f-v2bm5 Total loading time: 0 Render date: 2025-01-09T14:17:06.480Z Has data issue: false hasContentIssue false

Chapter 14.2 - Compassion-Focused Therapy

Published online by Cambridge University Press:  07 October 2022

By
Paul Gilbert
Edited by
Christopher C. H. Cook  and
Andrew Powell
Christopher C. H. Cook
Affiliation:
Institute for Medical Humanities, Durham University
Andrew Powell
Affiliation:
Formerly Warneford Hospital and University of Oxford
Get access

Summary

Humans are a highly social species with multiple physiological systems that have evolved specifically for social relating. There is now considerable evidence that the quality of our social relationships has an impact on both physical and mental health. Especially important is the dimension of feeling supported, valued and cared for, as opposed to feeling unsupported, devalued, excluded and uncared for. This chapter explores how compassion-focused therapy is rooted in working with these evolved, care-focused, motivational and physiological regulating systems. It is a therapy that highlights and helps patients to recognise the value of developing a compassionate orientation to themselves and others. The chapter also explores the degree to which some, but not all, spiritualities pursue the same goals, and how spiritual orientations to compassion can – for those with such views – support their progress through therapy.

Keywords

caringcompassionempathyevolutionmotivationtherapy
Type
Chapter
Information
Spirituality and Psychiatry , pp. 262 - 272
Publisher: Cambridge University Press
Print publication year: 2022

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Armstrong, K. (1999) A History of God. From Abraham to the Present: The 4000-Year Quest for God. London: Vintage Books.Google Scholar
Beck, A. T., Rush, A. J., Shaw, B. F. and Emery, G. (1979) Cognitive Therapy of Depression. New York: The Guilford Press.Google Scholar
Bering, J. M. (2002) The existential theory of mind. Review of General Psychology, 6, 3–24.Google Scholar
Bowlby, J. (1969) Attachment and Loss, Vol. 1. Attachment. London: Hogarth Press and The Institute of Psycho-Analysis.Google Scholar
Bowlby, J. (1973) Attachment and Loss, Vol. 2. Separation, Anxiety and Anger. London: Hogarth Press and The Institute of Psycho-Analysis.Google Scholar
Bowlby, J. (1980) Attachment and Loss, Vol. 3. Loss: Sadness and Depression. London: Hogarth Press and The Institute of Psycho-Analysis.Google Scholar
Bowlby, J. (1989) The role of attachment in personality development and psychopathology. In Greenspan, S. I. and Pollock, G. H., eds., The Course of Life, Vol. 1. Infancy. New York: International Universities Press, Inc., pp. 229–270.Google Scholar
Brown, S. L. and Brown, R. M. (2015) Connecting prosocial behavior to improved physical health: contributions from the neurobiology of parenting. Neuroscience and Biobehavioral Reviews, 55, 1-17.CrossRefGoogle ScholarPubMed
Brown, S. L. and Brown, R. M. (2017) Compassionate neurobiology and health. In: Seppälä, E. M., Simon-Thomas, E., Brown, S. L., Worline, M. C., Cameron, L. and Doty, J. R., eds., The Oxford Handbook of Compassion Science. New York: Oxford University Press, pp. 159–172.Google Scholar
Byrne, R. W. (2016) Evolving Insight. Oxford: Oxford University Press.Google Scholar
Carter, S., Bartal, I. B and Porges, E. (2017) The roots of compassion: an evolutionary and neurobiological perspective. In Seppälä, E. M., Simon-Thomas, E., Brown, S. L., Worline, M. C., Cameron, L. and Doty, J. R., eds., The Oxford Handbook of Compassion Science. New York: Oxford University Press, pp. 173–188.Google Scholar
Cozolino, L. (2014) The Neuroscience of Human Relationships: Attachment and the Developing Social Brain, 2nd ed. New York: W. W. Norton & Company.Google Scholar
Curran, T. and Hill, A. P. (2019) Perfectionism is increasing over time: a meta-analysis of birth cohort differences from 1989 to 2016. Psychological Bulletin, 145, 410–429.Google Scholar
Dearing, R. L. and Tangney, J. P. E. (2011) Shame in the Therapy Hour. Washington, DC: American Psychological Association.Google Scholar
Dedoncker, J., Vanderhasselt, M. A., Ottaviani, C. and Slavich, G. M. (2021) Mental health during the COVID-19 pandemic and beyond: the importance of the vagus nerve for biopsychosocial resilience. Neuroscience & Biobehavioral Reviews, 125, 1–10.Google Scholar
Di Bello, M. D., Carnevali, L., Petrocchi, N. et al. (2020) The compassionate vagus: a meta-analysis on the connection between compassion and heart rate variability. Neuroscience & Biobehavioral Reviews, 116, 21–30.Google Scholar
Di Bello, M., Ottaviani, C. and Petrocchi, N. (2021) Compassion is not a benzo: distinctive associations of heart rate variability with its empathic and action components. Frontiers in Neuroscience, 15, 617443.Google Scholar
Ditzen, B. and Heinrichs, M. (2014) Psychobiology of social support: the social dimension of stress buffering. Restorative Neurology and Neuroscience, 32, 149–162.Google Scholar
Ellenberger, H. F. (1970 ) The Discovery of the Unconscious: The History and Evolution of Dynamic Psychiatry. New York: Basic Books.Google Scholar
Forstmann, M., Yudkin, D. A., Prosser, A. M., Heller, S. M. and Crockett, M. J. (2020) Transformative experience and social connectedness mediate the mood-enhancing effects of psychedelic use in naturalistic settings. Proceedings of the National Academy of Sciences of the United States of America, 117, 2338–2346.CrossRefGoogle ScholarPubMed
Garcia-Romeu, A., Brennan Kersgaard, B. and Addy, P. H. (2016) Clinical applications of hallucinogens: a review. Experimental and Clinical Psychopharmacology, 24, 229–268.CrossRefGoogle ScholarPubMed
Gilbert, P. (1984) Depression: From Psychology to Brain State. Mahwah, NJ: Lawrence Erlbaum Associates.Google Scholar
Gilbert, P. (1989) Human Nature and Suffering. Mahwah, NJ: Lawrence Erlbaum Associates.Google Scholar
Gilbert, P. (1995) Biopsychosocial approaches and evolutionary theory as aids to integration in clinical psychology and psychotherapy. Clinical Psychology and Psychotherapy, 2, 135–156.Google Scholar
Gilbert, P. (1998) Evolutionary psychopathology: why isn’t the mind designed better than it is? British Journal of Medical Psychology, 71, 353–373.CrossRefGoogle ScholarPubMed
Gilbert, P. (2000) Social mentalities: internal ‘social’ conflict and the role of inner warmth and compassion in cognitive therapy. In Gilbert, P. and Bailey, K. G., eds., Genes on the Couch: Explorations in Evolutionary Psychotherapy. Hove: Brunner-Routledge, pp. 118–150.Google Scholar
Gilbert, P. (2007) The evolution of shame as a marker for relationship security: a biopsychosocial approach. In Tracy, J. L., Robins, R. W. and Tangney, J. P, eds., The Self-Conscious Emotions: Theory and Research. New York: The Guilford Press, pp. 283–309.Google Scholar
Gilbert, P. (2009) The Compassionate Mind: A New Approach to Life’s Challenges. London: Constable & Robinson.Google Scholar
Gilbert, P. (2010) Compassion Focused Therapy. London: Routledge.Google Scholar
Gilbert, P. (2011) Shame in psychotherapy and the role of compassion focused therapy. In Dearing, R. L. and Tangney, J. P., eds., Shame in the Therapy Hour. Washington, DC: American Psychological Association, pp. 325–354.Google Scholar
Gilbert, P. (2014) The origins and nature of compassion focused therapy. British Journal of Clinical Psychology, 53, 6–41.Google Scholar
Gilbert, P. (2017) Compassion as a social mentality: an evolutionary approach. In Gilbert, P., ed., Compassion: Concepts, Research and Applications. London: Routledge, pp. 31–68.Google Scholar
Gilbert, P. (2018) Living Like Crazy. York: Annwyn House.Google Scholar
Gilbert, P. (2020) Compassion: from its evolution to a psychotherapy. Frontiers in Psychology, 11, 586161.CrossRefGoogle ScholarPubMed
Gilbert, P. (2021) Creating a compassionate world: addressing the conflicts between sharing and caring versus controlling and holding evolved strategies. Frontiers in Psychology, 11, 582090.CrossRefGoogle ScholarPubMed
Gilbert, P. and Basran, J. (2018) Imagining one’s compassionate self and coping with life difficulties. EC Psychology and Psychiatry, 7, 971–978.Google Scholar
Gilbert, P. and Simos, G. (2022) Compassion Focused Therapy: Clinical Practice and Applications. London: Routledge.Google Scholar
Hartogsohn, I. (2018) The meaning-enhancing properties of psychedelics and their mediator role in psychedelic therapy, spirituality, and creativity. Frontiers in Neuroscience, 12, 129.Google Scholar
Hofer, M. A. (1994) Early relationships as regulators of infant physiology and behavior. Acta Paediatrica, 397, 9–18.Google Scholar
Keltner, D., Kogan, A., Piff, P. K. and Saturn, S. R. (2014) The sociocultural appraisals, values, and emotions (SAVE) framework of prosociality: core processes from gene to meme. Annual Review of Psychology, 65, 425–460.Google Scholar
Kim, J. J, Cunnington, R. and Kirby, J. N. (2020) The neurophysiological basis of compassion: an fMRI meta-analysis of compassion and its related neural processes. Neuroscience & Biobehavioral Reviews, 108, 112–123.Google Scholar
Kirby, J. N., Day, J. and Sagar, V. (2019) The ‘Flow’ of compassion: a meta-analysis of the fears of compassion scales and psychological functioning. Clinical Psychology Review, 70, 26–39.CrossRefGoogle ScholarPubMed
Kirkpatrick, L. A. (2005) Attachment, Evolution, and the Psychology of Religion. New York: The Guilford Press.Google Scholar
Lampert, K. (2005) Traditions of Compassion: From Religious Duty to Social Activism. New York: Palgrave Macmillan.CrossRefGoogle Scholar
Lippard, E. T. and Nemeroff, C. B. (2020) The devastating clinical consequences of child abuse and neglect: increased disease vulnerability and poor treatment response in mood disorders. American Journal of Psychiatry, 177, 20–36.Google Scholar
MacDonald, K. and MacDonald, T. M. (2010) The peptide that binds: a systematic review of oxytocin and its prosocial effects in humans. Harvard Review of Psychiatry, 18, 1–21.Google Scholar
Mayseless, O. (2016) The Caring Motivation: An Integrated Theory. Oxford: Oxford University Press.Google Scholar
Narvaez, D. (2017) Evolution, child raising, and compassionate morality. In Gilbert, P., ed., Compassion: Concepts, Research and Applications. London: Routledge, pp. 173–186.CrossRefGoogle Scholar
Petrocchi, N. and Cheli, S. (2019) The social brain and heart rate variability: implications for psychotherapy. Psychology and Psychotherapy, 92, 208–223.Google Scholar
Plante, T. G., ed. (2015) The Psychology of Compassion and Cruelty: Understanding the Emotional, Spiritual, and Religious Influences. Santa Barbara, CA: Praeger.Google Scholar
Porges, S. W. (2017) Vagal pathways: portals to compassion. In Seppälä, E. M., Simon-Thomas, E., Brown, S. L., Worline, M. C., Cameron, L. and Doty, J. R., eds., The Oxford Handbook of Compassion Science. New York: Oxford University Press, pp. 189–202.Google Scholar
Porges, S. W. and Furman, S. A. (2011) The early development of the autonomic nervous system provides a neural platform for social behaviour: a polyvagal perspective. Infant and Child Development, 20, 106–118.Google Scholar
Ricard, M. (2015) Altruism: The Power of Compassion to Change Yourself and the World. London: Atlantic Books.Google Scholar
Ryan, C. (2019) Civilized to Death: The Price of Progress. New York: Avid Reader Press.Google Scholar
Schore, A. N. (2019) Right Brain Psychotherapy. New York: W. W. Norton & Company.Google Scholar
Seppälä, E. M., Simon-Thomas, E., Brown, S. L., Worline, M. C., Cameron, C. D. and Doty, J. R., eds. (2017) The Oxford Handbook of Compassion Science. New York: Oxford University Press.Google Scholar
Siegel, D. J. (2012) The Developing Mind: How Relationships and the Brain Interact to Shape Who We Are. New York: The Guilford Press.Google Scholar
Singer, T. and Engert, V. (2019) It matters what you practice: differential training effects on subjective experience, behavior, brain and body in the ReSource Project. Current Opinion in Psychology, 28, 151–158.Google Scholar
Stellar, J. E. and Keltner, D. (2017) Compassion in the autonomic nervous system: the role of the vagus nerve. In: Gilbert, P., ed., Compassion: Concepts, Research and Applications. London: Routledge, pp. 120–134.CrossRefGoogle Scholar
Stevens, J. and Woodruff, C. C. (2018) The Neuroscience of Empathy, Compassion, and Self-Compassion. London: Academic Press.Google Scholar
Stott, R. (2007) When head and heart do not agree: a theoretical and clinical analysis of Rational-Emotional Dissociation (RED) in cognitive therapy. Journal of Cognitive Psychotherapy, 21, 37–50.Google Scholar
Tagliazucchi, E., Llobenes, L. and Gumiy, N. (2022) Psychedelics, connectedness, and compassion. In Gilbert, P. and Simos, G., eds., Compassion Focused Therapy: Clinical Practice and Applications. London: Routledge, pp. 360–370.Google Scholar
Tsering, G. T. (2005) The Four Noble Truths: The Foundation of Buddhist Thought. Vol. 1. Somerville, MA: Wisdom Publications.Google Scholar
Wallace, A. B. (2007) Contemplative Science: Where Buddhism and Neuroscience Converge. New York: Columbia University Press.Google Scholar
Yalom, I. R. (1980) Existential Psychotherapy. New York: Basic Books.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×