ACT With Compassion

Every month, we scour the scientific literature for interesting studies that have practical implications for therapists working with shame, self-criticism, or compassion.

Below are a few of our favorites for this month:

Compassion Can Regulate Emotion without Decreasing Interpersonal Connection

This study examined several seasoned meditators and looked at changes in different brain regions when they were asked to use reappraisal versus compassion in response to others’ suffering. The authors found that reappraisal, or cognitively reinterpreting the meaning of the suffering (a frequently employed technique in traditional cognitive behavioral therapy) downregulated negative emotion and affected brain regions associated with cognitive control. Compassion, on the other hand, upregulated positive emotion and affected brain regions associated with connection and love.

Take away: Whereas reappraisal may be helpful for reducing individual distress, it may also come at a cost of making us less sensitive to the suffering of others by decreasing sensitivity to negative emotion. Compassion is a promising method of maintaining or enhancing connection while also regulating affect.

Read more: 
Engen, Haakon G., and Tania Singer. Compassion-based emotion regulation up-regulates experienced positive affect and associated neural networks. Social cognitive and affective neuroscience (2015).

Moving Beyond Fear of Compassion in Therapy

This study explored the process of compassion-focused therapy (CFT) with people meeting criteria for posttraumatic stress disorder. The authors intended to develop a better understanding of compassion and fear of compassion as they unfold in therapy. Because there is relatively little existing data on the topic, the authors took a qualitative approach, and they found five overarching themes: 1. The battle to give up the inner critic: who am I if I am not self-critical?, 2. An aversive and alien experience: how it feels to develop self-compassion, 3. The emotional experience of therapy, 4. Self-compassion as a positive emotional experience, and 5. A more positive outlook in the present and for the future.

Take away: Although the authors found that all of their participants expressed a fear of compassion, they also found that they developed a more positive relationship with compassion over time, and that the therapeutic relationship was very important to this process. Although this study is limited by a small sample size, it suggests that fear of compassion needs to be considered when we are conducting compassion-building work.

Read more: 
Lawrence, V. A., & Lee, D. (2014). An Exploration of People's Experiences of Compassion‐focused Therapy for Trauma, Using Interpretative Phenomenological Analysis. Clinical psychology & psychotherapy, 21(6), 495-507.

Nonverbal Shame Displays Predict Relapse and Declining Health in Recovering Alcoholics

In this study, the authors examined shame displays (i.e., slumped shoulders and narrowed chest) in the first 10 seconds of videotape of recovering alcoholics who were asked to, “Describe the last time you drank and felt badly about it.” The authors found that body posture in the 10 seconds of recording predicted likelihood of relapse and decline in health over the next 4 months, as well as number of drinks consumed among those who relapsed. In contrast, verbal reports of shame were not a very reliable predictor of subsequent relapse.

Take away: This study demonstrates the power of shame to affect substance use and health. In addition, it suggests that practitioners need to be able to detect displays of shame, and may need to educate their clients about shame, as clients may not be very reliable reporters.

Read more: 
Randles, D., & Tracy, J. L. (2013). Nonverbal displays of shame predict relapse and declining health in recovering alcoholics. Clinical Psychological Science,1(2), 149-155.