Mounting scientific support for self-compassion as a powerful catalyst in recovery.
By Will Sutherland
This is the first in a two-part series on the complementary benefits of compassion in recovery and psychotherapy.
I love a good metaphor and I relish a broadly applicable simile. I take to figures of speech like a duck to cold water (a duck that enjoys Wim Hof cold-water exposure). This is one of the many reasons I love Improv Comedy, the art of improvising comedic scenes on stage. Which, due to its transient and ritualistic essence, is infused with beautiful and broadly applicable metaphors.
I once took an improv class where the teacher asked us to consider ourselves ‘Bears riding Unicycles’. Meaning, creating novel and hopefully comedic scenes from nothing, is already complicated and impressive enough. Instead of trying to impress the audience with overly complicated choices, we were encouraged to keep it simple. We were also encouraged to take stock of the challenging endeavor we were undertaking. Just like with every other metaphor I come across, I started to try and fit this one to every aspect of my life. At times it was like fitting a square usb-b cord into a round usb-c port. Eventually, I realized that an improviser imagining themselves as a unicycle-riding-bear, greatly parallels the effect of self-compassion in psychotherapy and recovery.
Simply engaging in mental health treatment is impressive and challenging enough. Any additional pressure to improve faster or greater, is unhelpful and counter-productive6. Berating and criticizing yourself to increase improvements, may appeal to you and even provide short term assurance. However, previous research strongly supports the positive and complimentary effect of a self-compassionate approach to mental health recovery5. Psychotherapy can be an incredibly challenging endeavor. So, anything that increases or decreases that challenge, is noteworthy. Especially something that is consistently beneficial for many different life challenges and psychological disorders8, 9, 10, 11.
Compassion has long been a core tenet of many religions and cultures, most notably Buddhism1. Over the last few decades scientific research has supported Buddhism’s belief in the importance of compassion. Self-compassion refers to how a person treats themselves in response to failure or significant challenges4. It has been consistently shown to reduce depressive symptoms11, to increase the ability to self-regulate5 and to increase relationship quality4. Self-compassion is typically learned through modelling from our primary caregivers. Nurturing received in early childhood can be a template for how we can, as adults, emotionally self-regulate and deal with adversity3, 4. However, not everyone receives the nurturing and compassion necessary to replicate it in adulthood4. Alarmingly, low self-compassion can have a significant impact on later life. Recent studies have found strong associations between low self-compassion substance abuse2, PTSD4, eating disorders5, personality disorders and physical health issues4.
This strong relationship between self-compassion and severe negative health outcomes, has compelled researchers to explore the reasons why it is so significant. One key theory suggests the association is due to the specific evolutionary development of human brains3. As far as we’re aware there was no brainstorming (pun intended) during the big bang about how human brain’s should be structured. Instead The human brain developed because of Darwinian Selection to Function3: Over millions of years higher-order parts of our brain developed over lower-order parts, in response to societal and environmental demands. Our modern-day challenge is to navigate the different, ad-hoc layering of our brain parts and their sometimes-conflicting motives. This can be quite the challenge, not unlike a bear riding a unicycle. One of the greatest factors influencing the evolution of our brains was social connections3. Strong motivations to make and maintain social connections would have increased our chances at survival3. So we are likely the descendants of those who were the most sensitive to social stimuli like connection and relational validation. In fact our brain chemistry is now significantly driven by social factors such as kindness, connection and mindfulness4. If these fundamental factors are modeled to us in childhood, they will then transfer to our tool belt of adaptive skills as an adult. However, without these skills both ordinary life stressors and psychological disorders are immensely harder to endure and recover from.
The good part is that self-compassion is a skill that can also be learned in adulthood4. There is a growing body of research working to identify the functional components of self-compassion13. In the next article I will outline these components and corresponding techniques that can improve self-compassion.
By Will Sutherland
Below are some phone numbers that are great for especially difficult times.
13 11 14 – Lifeline Crisis Support Line
1300 22 4636 – Beyond Blue
1. Hofmann SG, Grossman P, Hinton DE. Loving-kindness and compassion meditation: potential for psychological interventions. Clin Psychol Rev. 2011 Nov;31(7):1126-32. doi: 10.1016/j.cpr.2011.07.003. Epub 2011 Jul 26. PMID: 21840289; PMCID: PMC3176989.
2. Chen, Gila. (2019). The Role of Self-Compassion in Recovery from Substance Use Disorders. OBM Integrative and Complementary Medicine. 4. 10.21926/obm.icm.1902026.
3. Gilbert, P. (2014), The origins and nature of compassion focused therapy. Br J Clin Psychol, 53: 6-41. https://doi.org/10.1111/bjc.12043
4. Ferrari, M., Hunt, C., Harrysunker, A. et al. Self-Compassion Interventions and Psychosocial Outcomes: a Meta-Analysis of RCTs. Mindfulness 10, 1455–1473 (2019). https://doi.org/10.1007/s12671-019-01134-6
5. Inwood E, Ferrari M. Mechanisms of Change in the Relationship between Self-Compassion, Emotion Regulation, and Mental Health: A Systematic Review. Appl Psychol Health Well Being. 2018 Jul;10(2):215-235. doi: 10.1111/aphw.12127. Epub 2018 Apr 19. PMID: 29673093.
6. Lindsay M. Sutherland, Kent C. Kowalski, Leah J. Ferguson, Catherine M. Sabiston, Whitney A. Sedgwick & Peter R.E. Crocker (2014) Narratives of young women athletes’ experiences of emotional pain and self-compassion, Qualitative Research in Sport, Exercise and Health, 6:4, 499-516, DOI: 10.1080/2159676X.2014.888587
7. Nathan A. Reis, Kent C. Kowalski, Amber D. Mosewich & Leah J. Ferguson (2022) ‘That’s how I am dealing with it – that is dealing with it’: exploring men athletes’ self-compassion through the lens of masculinity, Qualitative Research in Sport, Exercise and Health, 14:2, 245-267, DOI: 10.1080/2159676X.2021.1920455
8. Braehler C, Gumley A, Harper J, Wallace S, Norrie J, Gilbert P. Exploring change processes in compassion focused therapy in psychosis: results of a feasibility randomized controlled trial. Br J Clin Psychol. 2013 Jun;52(2):199-214. doi: 10.1111/bjc.12009. Epub 2012 Oct 24. PMID: 24215148.
9. Kelly AC, Wisniewski L, Martin-Wagar C, Hoffman E. Group-Based Compassion-Focused Therapy as an Adjunct to Outpatient Treatment for Eating Disorders: A Pilot Randomized Controlled Trial. Clin Psychol Psychother. 2017 Mar;24(2):475-487. doi: 10.1002/cpp.2018. Epub 2016 May 30. PMID: 27237928.
10. Lucre KM, Corten N. An exploration of group compassion-focused therapy for personality disorder. Psychol Psychother. 2013 Dec;86(4):387-400. doi: 10.1111/j.2044-8341.2012.02068.x. Epub 2012 May 17. PMID: 24217864.
11. Cuppage J, Baird K, Gibson J, Booth R, Hevey D. Compassion focused therapy: Exploring the effectiveness with a transdiagnostic group and potential processes of change. Br J Clin Psychol. 2018 Jun;57(2):240-254. doi: 10.1111/bjc.12162. Epub 2017 Oct 17. PMID: 29044607.
12. Kelly AC, Carter JC, Zuroff DC, Borairi S. Self-compassion and fear of self-compassion interact to predict response to eating disorders treatment: a preliminary investigation. Psychother Res. 2013;23(3):252-64. doi: 10.1080/10503307.2012.717310. Epub 2012 Aug 24. PMID: 22917037.
13. Kristin D. Neff (2003) The Development and Validation of a Scale to Measure Self-Compassion, Self and Identity, 2:3, 223-250, DOI: 10.1080/15298860309027