Evidentiary Findings Supporting the Effectiveness of Compassion Training

 

Evidentiary Findings Supporting the Effectiveness of Compassion Training

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Evidentiary Findings Supporting the Effectiveness of Compassion Training

SOURCES

• Helen Y. Weng (2013)
• Altered Traits (2017)
• Dr. James Doty, founder CCARE (f 2013)
• Nanja Holland Hansen Study (2021)
• Compassion institute (f 2017)
• Hooria Jazaieri (Santa Clara University)
• Thupten Jinpa, founder Compassion Institute (f 2017)
• Elaine Houston article (2021)
• Rick Hanson MD

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Helen Y. Weng (2013)

Weng #1

This is the abstract of the well-known 2013 academic published by researcher Helen Y. Weng of the Center for Healthy Minds at the University of Wisconsin-Madison, led by Richard J Davidson.

Abstract: Compassion is a key motivator of altruistic behavior, but little is known about individuals’ capacity to cultivate compassion through training. We examined whether compassion may be systematically trained by testing whether (a) short-term compassion training increases altruistic behavior and (b) individual differences in altruism are associated with training-induced changes in neural responses to suffering. In healthy adults, we found that compassion training increased altruistic redistribution of funds to a victim encountered outside of the training context. Furthermore, increased altruistic behavior after compassion training was associated with altered activation in brain regions implicated in social cognition and emotion regulation, including the inferior parietal cortex and dorsolateral prefrontal cortex (DLPFC), and in DLPFC connectivity with the nucleus accumbens. These results suggest that compassion can be cultivated with training and that greater altruistic behavior may emerge from increased engagement of neural systems implicated in understanding the suffering of other people, executive and emotional control, and reward processing. [Helen Y. Weng, Andrew S. Fox, Alexander J. Shackman, Diane E. Stodola, Jessica Z. K. Caldwell, Matthew C. Olson, Gregory M. Rogers, and Richard J. Davidson, “Compassion Training Alters Altruism and Neural Responses to Suffering,” Journal of Psychological Science, 2013 Jul 1; 24(7): 1171–1180. Published May 21, 2013]

Weng #2

In a study my colleagues and I [Helen Weng] conducted at the University of Wisconsin-Madison’s Center for Investigating Healthy Minds (directed by Dr. Richard J. Davidson), participants were taught to generate compassion for different categories of people, including both those they love and “difficult” people in their lives. Doing these kinds of exercises is a little like weight training–the compassion “muscle” is strengthened by practicing with people of increasing difficulty, like increasing weights over time.

After only two weeks of online training, participants in our study who practiced compassion meditation every day behaved more altruistically towards strangers compared to another group taught to simply regulate or control their negative emotions. Not only that, the people who were the most altruistic after receiving compassion training also were the individuals who showed the largest changes in how their brains responded to images of suffering. These findings suggest that compassion is a trainable skill, and that practice can actually alter the way our brains perceive suffering and increase our actions to relieve that suffering.

https://www.fastcompany.com/3037045/want-to-train-your-brain-to-feel-more-compassion-heres-how

[Helen Weng, “Want To Train Your Brain To Feel More Compassion? Here’s How,” Fast Company, Oct. 15, 2014]

Weng #3

Excerpt: The real test of whether compassion could be trained was to see if people would be willing to be more altruistic — even helping people they had never met. The research tested this by asking the participants to play a game in which they were given the opportunity to spend their own money to respond to someone in need (called the “Redistribution Game”). They played the game over the Internet with two anonymous players, the “Dictator” and the “Victim.” They watched as the Dictator shared an unfair amount of money (only $1 out of $10) with the Victim. They then decided how much of their own money to spend (out of $5) in order to equalize the unfair split and redistribute funds from the Dictator to the Victim.

“We found that people trained in compassion were more likely to spend their own money altruistically to help someone who was treated unfairly than those who were trained in cognitive reappraisal,” Weng says.

“We wanted to see what changed inside the brains of people who gave more to someone in need. How are they responding to suffering differently now?” asks Weng. The study measured changes in brain responses using functional magnetic resonance imaging (fMRI) before and after training. In the MRI scanner, participants viewed images depicting human suffering, such as a crying child or a burn victim, and generated feelings of compassion towards the people using their practiced skills. The control group was exposed to the same images, and asked to recast them in a more positive light as in reappraisal.

The researchers measured how much brain activity had changed from the beginning to the end of the training, and found that the people who were the most altruistic after compassion training were the ones who showed the most brain changes when viewing human suffering. They found that activity was increased in the inferior parietal cortex, a region involved in empathy and understanding others. Compassion training also increased activity in the dorsolateral prefrontal cortex and the extent to which it communicated with the nucleus accumbens, brain regions involved in emotion regulation and positive emotions.

“People seem to become more sensitive to other people’s suffering, but this is challenging emotionally. They learn to regulate their emotions so that they approach people’s suffering with caring and wanting to help rather than turning away,” explains Weng.

“It’s kind of like weight training … we found that people can actually build up their compassion ‘muscle’ and respond to others’ suffering with care and a desire to help.” [Jill Ladwig, “Brain can be trained in compassion, study shows,” W News (University of Wisconsin-Madison), May 22, 2013]

Altered Traits (2017)

Compassion meditation shows stronger benefits from the get-go; as few as seven total hours over the course of two weeks leads to increased connectivity in circuits important for empathy and positive feelings, strong enough to show up outside the meditation per se. This is the first sign of a state morphing into a trait, though these effects likely will not last without daily practice. [p. 250 - Daniel Goleman & Richard J. Davidson, Altered Traits: Science Reveals How Meditation Changes Your Mind, Brain, and Body, Sep. 5, 2017, ‎Avery]

To be sure, there are still many, many questions, about how altered traits occur, and much more research is needed. But the scientific data supporting altered traits have come together to the point that any reasonable scientist would agree that this inner shift seems possible. Yet too few of us at present realize this, let alone entertain the possibility for ourselves. [p.291- Daniel Goleman & Richard J. Davidson, Altered Traits: Science Reveals How Meditation Changes Your Mind, Brain, and Body, Sep. 5, 2017, ‎Avery]

Dr. James Doty, founder CCARE (f 2008)

In a recent interview on On Being with Krista Tippett, Nov 8, 2018, the founder of Stanford University’s Center for Compassion and Altruism Research and Education, Dr. James Doty, described research demonstrating that, in the brains of people who regularly practice compassion, their amygdala actually shrinks. /  … just like muscles, our mental muscle […] responds to exercise. It’s just which exercise you’re going to do. And one exercise relates to mindfulness, compassion, lovingkindness, having an open heart. And when you strengthen that muscle, the world becomes a vibrant place where you recognize the incredible aspect of humanity that surrounds you in every person, how every person has this incredible potential to change the world. / Or you can do a form of exercise that makes you afraid, that makes you pull away, that makes you think that people are your enemies, or that people are out for something. And, unfortunately, sometimes it’s an active choice, but for many people, they don’t even understand that this is happening. / What muscle are we exercising when we give the pity look? Doty’s website defines pity as, “sorrowfully noting another person’s suffering, but regarding them as outgroup, weak and/or inferior and hence, undeserving of any wish to alleviate, or efforts towards alleviating suffering.” When we are afraid of the pain of the other person, we protect ourselves by making unreal the other’s suffering, saying to ourselves, “this could never happen to me.” By contrast, when we exercise compassion, Doty says, we see that “every person has this incredible potential to change the world”, that we each are capable of authoring our own stories. [Adam Lavitt , “Compassion Is a Skill,” The Wisdom Daily, Apr. 20, 2016]

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Nanja Holland Hansen Study (2021)

Excerpt: This randomized clinical trial found that the CCT intervention decreased symptoms of depression, anxiety, and stress in caregivers of people with mental illness. The effects remained at the 6-month follow-up. Positive effects of CCT compared with the control group were observed on overall well-being, resilience, self-compassion, and cognitive reappraisal, an emotion regulation strategy. Perceived stress was reduced as well as emotion suppression, another emotion regulation strategy. Of the 5 facets of mindfulness, 4 facets either increased, such as observing and describing, or decreased, such as nonjudging and nonreacting. No significant results were observed on the facet of awareness and on the 4 dimensions or total score of the Multidimensional Compassion Scale. This may be associated with the fact that these dimensions of compassion require more time to cultivate. Furthermore, there is a lack of consensus on how to define and measure the compassion for others construct.13

Our findings that CCT decreased psychological distress and increased overall well-being are in line with previous RCTs on CCT.15-19 Comparing the results of our study with previous caregiver intervention studies, the literature does not present a clear picture of what kind of intervention is most helpful for caregivers of people with mental illness. An 8-week manualized group intervention with psychoeducation,31,32 a caregiver education and social support program,33 a cognitive behavioral therapy group,34,35 a mindfulness-based stress reduction program,36,37 and a yoga and compassion meditation program38 have shown improved mental health at the end of treatment, but have either not tested the effect at the 6-month follow-up or not found significant results. An individual therapy session intervention39 with 6 months of follow-up has produced similar results as our CCT study. [Nanja Holland Hansen, Lise Juul, Karen-Johanne Pallesen, et al Lone Overby Fjorback, Effect of a Compassion Cultivation Training Program for Caregivers of People With Mental Illness in Denmark: A Randomized Clinical Trial, March 8, 2021 JAMA Netw Open. 2021;4(3)]

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Compassion Institute

Born out of the Center for Compassion and Altruism Research and Education (CCARE) at Stanford University, research of the highest caliber is ingrained in the cultural DNA of the Compassion Institute. While research on CCT© is relatively young, a number of projects are in the pipeline, and we are hopeful this body of research will blossom as we collaborate with increasing numbers of researchers from around the world.

To date, research on CCT™ suggests consistent practice of CCT™ meditations can lead to:

Increased:

• Happiness
• Calmness
• Acceptance of emotions
• Self-acceptance
• Job satisfaction
• Self-caring behavior
• Compassion for self and others
• Openness to receiving compassion from others

Decreased:

• Worry and anxiety
• Anger
• Mind wandering
• Emotional suppression
• Reports of chronic pain severity

Hooria Jazaieri (Santa Clara University)

Abstract: Psychosocial interventions often aim to alleviate negative emotional states. However, there is growing interest in cultivating positive emotional states and qualities. One particular target is compassion, but it is not yet clear whether compassion can be trained. A community sample of 100 adults were randomly assigned to a 9-week compassion cultivation training (CCT) program (n = 60) or a waitlist control condition (n = 40). Before and after this 9-week period, participants completed self-report inventories that measured compassion for others, receiving compassion from others, and self-compassion. Compared to the waitlist control condition, CCT resulted in significant improvements in all three domains of compassion—compassion for others, receiving compassion from others, and self-compassion. The amount of formal meditation practiced during CCT was associated with increased compassion for others. Specific domains of compassion can be intentionally cultivated in a training program. These findings may have important implications for mental health and well-being.

[Hooria Jazaieri (Santa Clara University), Geshe Thupten Jinpa, Kelly Mcgonigal, (Palo Alto Research Center, Erika L Rosenberg (University of California, Davis), et al, “Enhancing Compassion: A Randomized Controlled Trial of a Compassion Cultivation Training Program,” Journal of Happiness Studies 14(4) August 2012]

Thupten Jingpa, founder Compassion Institute (f 2017)

Excerpt:

Edo Shonin: Based on a comprehensive systematic review that I recently conducted and that was published in the journal Mindfulness, although research findings relating to compassion and loving-kindness interventions are promising, there really is insufficient evidence still to open this up to the general public. Mindfulness has been researched for a while, and there is quite a degree of evidence now. But loving-kindness and compassion meditation are relatively new to the research field. Do you think we are jumping the gun a little bit?

Thupten Jingpa: Yes. This is where the problem is. The thing is because of the tremendous success of mindfulness in the general popular consciousness, people are looking for even a tiny finding in some research paper and picking it out … At this point, most of the studies are very crude…We have no understanding of the mechanisms by which these practices work. It is at a very, very, early stage.

Edo Shonin & William Van Gordon, “Thupten Jingpa on Compassion and Mindfulness,” Mindfulness In Practice, Published online: 14 October 2015.

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Rick Hanson MD - Author of Hardwiring Happiness: the New Brain Science of Contentment, Calm and Confidence (2013)

What evidence or experience do you have to support your claims about positive neuroplasticity?

There is tremendous evidence in published studies on psychological practices or interventions of various kinds – including the kinds I mention, notably relaxation and positive emotion practices – that they do lead to significant improvements in mental health indicators of various kinds: improvements that do change lives for the better in meaningful ways.

There is also tons of evidence in research studies about the effects of frequency of spaced practice and the effects of personal effort. One implication is that for people who do not experience a benefit that changes their life in a meaningful-to-them way, are exceptions to that rule because they did not actually practice whatever it was (e.g., mindfulness, gratitude) a few times a day, day after day after day.

Distinct from published research, I’ve received many anecdotal reports that my statement was true for them. This is evidence of a kind.

I have personally experienced that my statement is true. An N of 1, for sure, but still definitely the evidence of my own experience.

As a personal detail, I worked for a year for a mathematician who did probabilistic risk analyses, and it was a fascinating consideration of levels of evidence for propositions about reality. As is increasingly noted in the scientific community, including the life sciences and social sciences, the dichotomous true/false distinction of “statistical significance/non-significance” is mathematically silly. The crux is how much uncertainty we have about propositions. Then the question becomes, to what extent do certain kinds of evidence reduce uncertainty. By the definition of information, relevant information of any kind reduces uncertainty. Information comes from many sources, most of which are not randomized control group double-blind studies. For example, roughly half of the methods used routinely in medical settings do not have a study behind them, but they are within the standard of care because there are other kinds of evidence for their legitimate use. [Rick Hanson MD, Positive Neuroplasticity website, undated]

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Elaine Houston article (2021)

Excerpt:

~ Can Compassion Be Taught and Trained?

Compassion is a powerful aspect of the human experience and is one that can be trained. Weng et al. (2013) suggested that compassion can be cultivated with training and that greater altruistic behavior may emerge from an increased understanding of the suffering of other people.

With research on compassion interventions indicating significant improvements in psychological well-being and social connection (Neff & Germer, 2017), the importance of compassion is clear to see.

Compassion training focuses not only on suffering but also on supporting and encouraging compassion for the good of the self and others.

Through a range of breathing, postural, imaging techniques and developing recall skills that enable the recall of experiencing compassion, individuals are given the opportunity to experience what compassion is, or could be.

In essence, compassion training helps to create ideas in the mind about what can be achieved (Gilbert, 2014).

Compassion has been shown to have a number of benefits for both psychological and physiological health. With positive effects on mental health, emotion regulation, and interpersonal and social relationships (Kirby, 2017), it is clear that developing compassion can have significant and far-reaching benefits.

Fredrickson, Cohn, Coffey, Pek, and Finkel (2008) examined the effects of compassion meditation on emotional well-being. Their findings suggested that participants who went through compassion meditation practice experienced improved daily positive emotions, reduced depressive symptoms, and increased life satisfaction.

Allen and Knight (2005) theorized the importance of compassion to the remediation of depression and other negative emotional states.

According to their findings, compassion is ‘other-centered’ and a shift in attention to others can alleviate negative self-focus in depression to a more positive other-focus in compassion. Additionally, compassion appeared to ameliorate negative symptoms of social isolation.

In light of these significant benefits, psychotherapies and compassion-based interventions have now been developed with the specific aim of cultivating compassion.

~ How Can We Best Cultivate Compassion?

A growing body of evidence suggests that, at our core, most humans have a natural capacity for compassion. In fact, Warneken and Tomasello (2009) suggested that compassion is a natural and automatic response that has ensured our survival.

Their research indicated that infants too young to have learned the rules of politeness spontaneously engaged in helpful behavior without a promise of reward, and would even overcome obstacles to do so.

Despite this, everyday stress, social pressures and life experiences, in general, can make it difficult to experience and fully express compassion to ourselves and to others. Fortunately, we also have the capacity to nurture and cultivate a more compassionate outlook.

Compassion is a key component of individual, interpersonal, and societal well-being, thus the cultivation of compassion can be regarded as an important practice. Cultivating compassion is more than experiencing empathy or concern for others.

It develops the strength to cope with suffering, to take compassionate action, and the resilience to prevent compassion fatigue – an extreme state of tension and preoccupation with the suffering of others (Allen & Leary, 2010). These qualities support a wide range of goals, from improving personal relationships to making a positive difference in the world.

There is an ever-expanding scientific and clinical interest in understanding how compassion can be cultivated and regulated by compassion training programs. According to Kirby (2017), there are at least six current empirically-supported interventions that focus on the cultivation of compassion:

~ Compassion-Focused Therapy

Developed by Gilbert (2009), compassion-focused therapy focuses on two psychologies of compassion. The first is a motivation to engage with suffering, and the second is focused on action, specifically acting to help alleviate and prevent suffering.

Devised for individuals with severe and enduring mental health problems, compassion-focused therapy is an integrated and multi-modal approach concerned with alleviating the sense of shame and high levels of self-criticism we often experience. Through compassion-focused therapy, those who find it difficult to stimulate certain positive emotions can learn to do so through compassion and self-compassion practices.

~ Mindful Self-Compassion

Mindful self-compassion (MSC) was developed by Neff and Germer (2013) as a program to help cultivate self-compassion, that is treating yourself with the same kindness, concern, and support you would show to a good friend. MSC combines the skills of mindfulness and self-compassion to enhance our capacity for emotional well-being.

Designed for members of the general public, the program draws upon Tibetan Buddhist practices – incorporating traditional meditation and other informal self-compassion practices with evidence-based literature examining the benefits of self-compassion.

MSC offers self-compassion and mindfulness exercises to develop your compassionate voice, with an emphasis on distinguishing between the inner critic and compassionate-self.

~ Compassion Cultivation Training

Compassion cultivation training (CCT) combines traditional contemplative practices with contemporary psychology and scientific research to help you lead a more compassionate life. Developed by Jinpa (2010), CCT draws its theoretical underpinnings from contemplative practices of Tibetan Buddhism and Western psychology.

CCT delivers training in compassion practices across six steps (Kirby, 2017):

• Settling the mind and developing mindfulness skills.
• Experiencing loving-kindness and compassion for a loved one.
• Practicing LKM and compassion for oneself.
• Compassion towards others through embracing our shared common humanity.
• Compassion towards all beings.

·         Active compassion practice where one imagines taking away others’ pain and sorrow and offering to them one’s own joy and happiness.

~ Cognitively-Based Compassion Training

Cognitively-Based Compassion Training (CBCT) draws from what is known as ‘lojong’ in Indo-Tibetan Buddhism and trains practitioners to cultivate compassion through simple contemplative practices.

CBCT incorporates mindfulness and cognitive-restructuring strategies to encourage a shift of perspective through reflection about ourselves and our relationship to others (Reddy et al., 2012).

~ Cultivating Emotional Balance

The cultivating emotional balance (CEB) program is based on Western scientific research on emotions, and traditional Eastern contemplative practices and is aimed at building emotional balance (Ekman & Ekman, 2013).

This form of training is notably different from the other compassion-based interventions as there is an emphasis in the program on understanding emotions and being able to recognize the emotions of others (Kirby, 2017).

CEB is an educational training method that creates pathways to compassion by training and teaching individuals to recognize the suffering of others and of oneself, and to tolerate the distress more effectively through learning new ways of managing emotions.

~ Compassion and Loving-Kindness Meditations

Compassion Meditations (CM) or Loving-Kindness Meditations (LKM) are often combined and practiced together in compassion-based interventions to help settle the mind, increase compassion to self and others, and to improve mental health. CM and LKM are meditations during which the aim is to express goodwill, kindness, and warmth towards others by silently repeating a series of mantras.

Both practices involve a structured approach where individuals can learn to direct caring feelings towards oneself, then towards loved ones, then towards acquaintances, then towards strangers, then towards someone with whom one experiences interpersonal difficulties, and finally towards all living beings without distinction (Galante, Galante, Bekkers, & Gallacher, 2014).

[Excerpt from: Elaine Houston, B.Sc., “12 Best Compassion Training Exercises & Activities,” Positive Psychology, Sep. 13, 2021]

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[Updated 5/4/22]

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