Compassion

Conceptualisations, Research and Use in Psychotherapy

Paul Gilbert, Paul Gilbert

• Publisher: Routledge
• Year: 2005
• ISBN:
  9781135443740
• Edition: 1
• Topic: Psychology
• Subtopic: Clinical Psychology
• Index: Psychology

What is compassion, how does it affect the quality of our lives and how can we develop compassion for ourselves and others?

Humans are capable of extreme cruelty but also considerable compassion. Often neglected in Western psychology, this book looks at how compassion may have evolved, and is linked to various capacities such as sympathy, empathy, forgiveness and warmth. Exploring the effects of early life experiences with families and peers, this book outlines how developing compassion for self and others can be key to helping people change, recover and develop ways of living that increase well-being.

Focusing on the multi-dimensional nature of compassion, international contributors:

• explore integrative evolutionary, social constructivist, cognitive and Buddhist approaches to compassion
• consider how and why cruelty can flourish when our capacities for compassion are turned off, especially in particular environments
• focus on how therapists bring compassion into their therapeutic relationship, and examine its healing effects
• describe how to help patients develop inner warmth and compassion to help alleviate psychological problems.

Compassion provides detailed outlines of interventions that are of particular value to psychotherapists and counsellors interested in developing compassion as a therapeutic focus in their work. It is also of value to social scientists interested in pro-social behaviour, and those seeking links between Buddhist and Western psychology.

Chapter 1

Introduction and outline

Paul Gilbert

Introduction

The book explores the psychology of compassion. Although it has been long neglected in Western psychology, Eastern traditions have viewed compassion as central to liberating our minds from the power of destructive emotions such as fear, anger, envy and vengeance (Goleman, 2003). Compassion not only is a process that underpins the building of prosocial relationships with others, but also has great potential to heal our minds and bodies. In Buddhist traditions, compassion is linked to metta or loving-kindness. This form of loving is not linked to ‘desire’ for the other or seeking attachments. Salzberg (1995) says that metta comes from two words meaning ‘gentle’ and ‘friend’ (p. 24). Compassion (which is an element of loving-kindness) involves being open to the suffering of self and others, in a non-defensive and non-judgemental way. Compassion also involves a desire to relieve suffering, cognitions related to understanding the causes of suffering, and behaviours – acting with compassion. Hence, it is from a combination of motives, emotions, thoughts and behaviours that compassion emerges.

The great insights of the Buddha were basic observations on life and are illuminated in the four noble truths (Walpola Sri Rahula, 1959/1997). These are that life is full of threats and suffering (or dukkha – sometimes translated as dis-ease). All sentient beings seek to be free of suffering (dukkha). However, many of our ways of trying to reduce threats and relieve ourselves of suffering and distress, such as seeking the love/approval of other humans, fame, glory, sex or wealth, may offer only temporary comforts (all things are impermanent). Moreover, they can leave us worse off because we can come to crave these things, fear their loss, and in pursuing them we can distort our sense of self and create envy and suffering for others. The Buddha argued that to ‘become enlightened’ and create an inner state of ‘being at peaceful happiness’ was to come to see through these ‘illusions or afflictions’ by training the mind. Cultivating loving-kindness and compassion for self and others was a path to the release from suffering for all.

It has probably only been over the past century or so that Western psychology has shown much interest in Eastern psychologies. This is in part due to different ‘world views’ and the non-availability of good translations (Harvey, 1990). As Western science turns its attention to the power of compassion as a healing process it will do so with a culturally constructed mind-set. For example, Nisbett et al. (2001) have explored the impact of different culture styles (individual vs collective) on the way people give meaning to and think about the world around them, their relationships and the nature of their lives. They compared ancient Greek and Chinese societies, and more modern Western and non-Western societies. In societies that focus on relationships, the way of seeing the world is in terms of patterns and the interconnected nature of things. This ripples through all facets of life: the type of medical sciences that develop (for example, non-Western medicine tends to focus on yin and yang, bodily energies and the flow of patterns of energies), the nature of the universe (for example, created by sets of balancing and interacting forces/energies; dialectics), the way people are seen as responsible for their actions (for example, personal responsibility is tempered by social circumstances and contexts for actions), and the values on which their self-identities are formed. Harmony is valued over competition and conflict. In contrast, individual-focused cultures create styles of thinking that split things into individual categories and units. Medicine is about discrete disease entities. The cultural focus is on developing logic, rationality, the classification and dissecting of objects, studying smaller and smaller individual units. Individual achievement is valued; individuals are held responsible for themselves and are not (seen as) socially constructed; competition (rather than harmony) is valued whereby the strongest or best (whether an individual or a scientific idea) prove themselves in competition with others.

These contrasting styles pose an essential dialectic to our thinking, which can benefit from their integration and from seeing that both give insights to different types of truth. As the Dalai Lama (2003) says:

Buddhism and science are not conflicting perspectives on the world, but rather differing approaches to the same end: seeking the truth. In Buddhist training, it is essential to investigate reality, and science offers its own ways to go about this investigation. While the purposes of science may differ from those of Buddhism, both ways of searching for truth expand our knowledge and understanding.

(p. xiii)

The past 30 years or so have seen major efforts to blend Western and Eastern psychological concepts. For example, John Crook, who was both a professor of ethology and a practicing Zen meditator, explored how evolution theory and Buddhism were highly compatible in his wide-ranging book The Evolution of Human Consciousness (Crook, 1980). Since the 1950s there have been increasing studies of the physiological and psychological effects of breathing control, mindfulness, yoga and meditation on states of mind, physical illness and mental illness (a recent example being Davidson et al., 2003). Efforts to integrate Eastern psychologies and mind training practices with Western forms of psychotherapy have also advanced greatly in the past few decades (e.g. Young-Eisendrath & Muramoto, 2002; Watson et al., 1999), with specific integrated therapies for borderline personality difficulties (Linehan, 1993) and depression relapse prevention (Segal et al., 2002). Integration can be difficult, however, due to different language and problems in translating ‘meaning and concepts’, different focus of interest (Clark, 1994; Young-Eisendrath & Muramoto, 2002), and Eastern approaches requiring that a ‘therapist’ be an active participant in practices (e.g. mindful meditation) and not just trained to deliver ‘technologies’. Western psychotherapies and Eastern psychologies are designed to do different things and work in different ways. Welwood (1999) offers a thoughtful discussion on how some people can seek ‘spiritual solutions’ for complex psychological problems (for example, spending long periods of time at retreats, seeking gurus or communities) but make little progress. Sadly, these can be strategies of avoidance of one’s inner pain, not of healing it. Thus Western psychotherapy has evolved from a particular way of thinking about ‘self in the world’, within a particular culture to address specific psychological problems. The way Eastern approaches are designed to address or alleviate these difficulties is different in focus and design. Indeed, as Welwood (1999) indicates, some people need to develop/strengthen their sense of self and identity before they engage in a journey to try to transcend it, and in this context the therapist relationship and ability to engage with things the person may try to avoid may be crucial.

Despite this growing interest, and the centrality of loving-kindness and compassion in Buddhist psychology, Western psychology has not (until recently) focused on compassion as a central psychological concept (Davidson & Harrington, 2002). Instead Western psychology has focused on related concepts such as affiliative behaviour, prosocial behaviour, forms of attachment, and different types of love (e.g. sexual/passionate, romantic or friendly, intimate or committed), underpinned by different competencies (such as empathy and sympathy). It is also notable that personal relief from depression, anxiety and anger is more commonly (in the West) rooted in building self-esteem, self-efficacy or self-regulation (on ‘doing or achieving’), and is less often focused on the cultivation of loving-kindness to self and others (Neff, 2003). Yet if compassion is a healing process, as Buddhism suggests it is, then we should make this central to our investigations of exactly what it is, and how it works. We need to know how Western science can aid us in understanding the processes involved in compassion and how to cultivate it in our relationships with ourselves, with others and in our political deliberations.

The aim of this book is not to compare and contrast Eastern and Western conceptions of compassion, as others have sought to do (Davidson & Harrington, 2002; Goleman, 2003). Nor is it to reach any agreed definition of compassion; authors were free to use their own definitions. Rather, the issue of compassion is addressed from multiple perspectives, especially in regard to thinking about compassion as a process for healing in a psychotherapy context. All authors took to the challenge enthusiastically.

Outline

The book is organised into two parts. The first part covers themes of conceptualisation and research. Chapter 2 offers a biopsychosocial overview of compassion. It is suggested that compassion is an emergent property of our minds that is dependent on the interaction of complex processes that include genes, psychological systems, early life experiences and social ecologies. Chapter 3, by Sheila Wang, develops an important model of compassion that is able to link Buddhist conceptualisations of mind with neuroscience. She points out that we are all highly interdependent beings who are in a constant process of co-regulation at multiple levels. Compassion is a process that can have multilevel organising properties. Gillath, Shaver and Mikulincer, in Chapter 4, review much of the data on how our early attachment relationships can create the contexts for developing compassion for others. Their landmark research has done much to illuminate the link between early attachment experiences and subsequent prosocial behaviour. This has clear implications for childcare. Chapter 5, by Bierhoff, looks as the links between helping behaviour, prosocial behaviour and altruism and explores the importance of social learning, group process and self-identity to compassion. Chapter 6 addresses the key issue of how relationships can stay supportive and warm even in the context of conflicts. Worthington, O’Connor, Berry, Sharp, Murray and Yi explore the key role of forgiveness and guilt in compassion. They point out how these can be involved in psychological problems and that excessive forgiveness can have a dark side.

Part II is primarily focused on how compassion can be a healing process in psychotherapy. Eastern approaches often seek to help a person obtain deep insights (for example, reach a more subtle level of conscious awareness) that undermine mental anguish. Western psychological therapies, however, focus on: developing a clear formulation derived from some theory of mental processes (e.g. psychodynamic, systemic or cognitive); articulating clear and specific therapeutic aims (e.g. to overcome a phobia or work with traumatic memories); providing specific experiences (e.g. within a therapeutic relationship or via exposure to feared situations or feelings); work with ‘acknowledged–conscious’ and ‘less acknowledged or less conscious’ material; and (for some) give instruction/psychoeducation in how to regulate one’s feelings and thinking (e.g. as in the cognitive-behavioural tradition). Questions of higher (or more subtle) levels of consciousness and the ‘ability to awaken’ are not a focus here (Watson et al., 1999). Part II therefore explores compassion primarily within this context of Western, and in particular cognitive-behavioural, therapy.

Leahy in Chapter 7 presents an important exploration of how humans need to learn the meaning of their emotions and how to regulate emotions. Compassion for self and others can be difficult without supportive early relationships offering emotional validation and providing frameworks and guidance for affect understanding, integration and regulation. These learning opportunities can be re-established in therapy by a process of validation of the patient’s feelings, especially for those who have lacked parental support and guidance. The use of guided imagery as a therapeutic aid to Western psychotherapies (used especially by Jung in his work on active imagination and amplification) has attracted increased interest over the past 100 years, and especially the past 30 years. In Buddhist psychology compassionate imagery, as a healing process, has been developed over thousands of years. In Chapter 8, Ringu Tulku and Mullen offer important insights into the use of compassionate imagery, and the process of focusing on compassionate deities. These deities and images emerge from the cultural history of Buddhism. The authors also reflect on the social construction of ‘embodied beings’ who have certain qualities, and the process of an imaginary merging with them, becoming them, and internalising their qualities.

Allen and Knight, in Chapter 9, remind us that in the West depression (primarily a disorder of positive affect) is a major health problem and is increasing. They explore how two compassion-based therapies, mindfulness and compassionate mind training, can be used to help depressed people and prevent relapse. Gilbert and Irons, in Chapter 10, address some of the reasons why many psychological difficulties are rooted in people’s inner experience of themselves and in particular self-criticism and self-hatred. They give an overview of self-attacking, exploring it from a safety behaviours and functional analysis point of view. They describe various therapeutic techniques that include imagery and types of compassionate focus (called compassionate mind training), which can be used for helping people become compassionate and accepting of themselves. In Chapter 11, Lee uses case studies from her work with people with post-traumatic stress disorder to illustrate her own modifications to this therapeutic approach. In particular she discusses the role of imagery of ‘the perfect nurturer’ for compassionate mind training. Ann Hackmann, in Chapter 12, also uses illuminating case studies to outline her imagery work with anxiety disorders. She raises the important therapeutic need for empowerment as well as compassion in imagery work. Last, but by no means least, Bates in Chapter 13 provides a fascinating insight into the healing potential of group therapeutic processes. Coming from a cognitive background, he explores how compassion between participants becomes expressed, the role of the therapist in facilitating this intragroup communication, and the healing properties of doing so.

All these chapters seek to use insights and concepts about compassion to inform their own clinical practice. Each therapist intuits that compassionate relationships have powerful effects and health-regulating properties. Although empathy, positive regard and many other prosocial relational interactions have been recommended as central to psychotherapy for many years, compassion offers a slightly different way of thinking about these processes and opens up new avenues for research and development, one especially exciting possibility being the power of compassionate imagery to stimulate new brain pathways.

References

Clark, J.J. (1994). Jung and Eastern Thought: A Dialogue with the Orient. London: Routledge.

Crook, J.H. (1980). The Evolution of Human Consciousness. Oxford: Oxford University Press.

Dalai Lama (2003). Foreword. In D. Goleman (ed.), Destructive Emotions and How We Can Overcome Them: A Dialogue with the Dalai Lama, pp. xiii–xv. London: Bloomsbury.

Davidson, R. & Harrington, A. (eds) (2002). Visions of Compassion: Western Scientists and Tibetan Buddhists Examine Human Nature. New York: Oxford University Press.

Davidson, R.J., Kabat-Zinn, J., Schumacher, J., Rosenkranz, M., Muller, D., Santorelli S.F., Urbanowski, F., Harrington, A., Bonus, K. and Sheridan, J.F. (2003). Alterations in brain and immune function produced by mindfulness meditation. Psychosomatic Medicine, 65, 564–570.

Goleman, D. (2003). Destructive Emotions and How We Can Overcome Them: A Dialogue with the Dalai Lama. London: Bloomsbury.

Harvey, P. (1990). An Introduction to Buddhism: Teachings, History and Practices. Cambridge: Cambridge University Press.

Linehan, M. (1993). Cognitive Behavioral Treatment of Borderline Personality Disorder. New York: Guilford.

Neff, K.D. (2003). Self-compassion: An alternative conceptualization of a healthy attitude toward oneself. Self and Identity, 2, 85–102.

Nisbett, R.E., Peng, K., Choi, I. & Norenzayan, A. (2001). Culture and systems of thought: Holistic versus analytic cognition. Psychological Review, 108, 291–310.

Salzberg, S. (1995). Loving-Kindness: The Revolutionary Art of Happiness. Boston: Shambhala.

Segal, Z., Williams J.M.G. & Teasdale, J. (2002). Mindfulness-Based Cognitive Therapy for Depression. A New Approach to Preventing Relapse. London: Guilford.

Walpola Sri Rahula (1959/1997). What the Buddha Taught. Oxford: Oneworld.

Watson, G., Batchelor, S. & Claxton, G. (eds) (1999). The Psychology of Awakening: Buddhism, Science and Our Day-to-Day Lives. London: Rider.

Welwood, J. (1999). Realisation and embodiment: Psychological work in the service of spiritual development. In G. Watson, S. Batchelor & G. Claxton (eds), The Psychology of Awakening: Buddhism, Science and Our Day-to-Day Lives, pp. 137–166. London: Rider.

Young-Eisendrath, P. & Muramoto, S. (2002). Awakening and Insight: Zen Buddhism and Psychotherapy. Hove: Brunner-Routledge.

Part 1
Conceptualisations and research

Chapter 2

Compassion and cruelty

A biopsychosocial approach

Paul Gilbert

If compassion is rooted in desires to alleviate suffering, prosocial behaviour and loving-kindness (Dalai Lama, 1995, 2001; see Chapter 1), then its antithesis is cruelty. My Concise Oxford Dictionary (Allen, 1990) defines ‘cruel’ as: ‘1. Indifferent to or gratified by another’s suffering. 2. Causing pain or suffering, esp. deliberately.’ (p. 279). Of these two human potentials, Goodall (1990) argues that:

although the basic aggressive patterns of the chimpanzee are remarkably similar to some of our own, their comprehe...

Table of contents

• Cover Page
• Half Title page
• Title Page
• Copyright Page
• Contents
• List of Contributors
• Acknowledgements
• 1 Introduction and outline
• Part I Conceptualisations and research
• Part II Compassion and use in psychotherapy
• Index