The Science of Compassion: A Research Brief
The Science of Compassion
A Research Brief
Executive Summary
This brief provides an overview of compassion science, including the latest findings on how compassion can be cultivated for purposes of physical and mental health and healing. The surge of interest in compassion science tracks a renewed understanding in the prosocial nature of human beings and a general contemporary trend to broaden the study of human health and wellbeing beyond disease and pathology to the positive emotions and behaviors that lead to human flourishing, individually and collectively. It’s also related to increased Western interest in the physical and mental benefits of Asian philosophies and contemplative traditions and practices, of which compassion is an essential goal and concern.
Long considered a philosophical and religious virtue, compassion has become the subject of rigorous scientific inquiry over the last 20 years. Empirical studies show that compassion was a key, adaptive trait for our species’ early survival and significantly contributes to our health and wellbeing. Additional research involving collaborations between Western scientists and contemplative scholars indicates that compassion is a skill that can be learned and improved through training, particularly with practices based on contemplative traditions, such as Buddhist meditation.
Despite these important findings, Western society often treats caring about the welfare of others as a luxury or a sign of good character rather than a critical component of human life. Instead, Charles Darwin’s survival-of-the-fittest theory is often evoked to suggest that defensive and competitive dispositions and behaviors, rather than other-focused concern, dominate human nature and are the primary sources of our success as a species and as individuals. This, however, is a misinterpretation of Darwin, who in fact said, “Sympathy will have been increased through natural selection; for those communities, which included the greatest number of the most sympathetic members, would flourish best, and rear the greatest number of offspring.”1
Modern science supports these remarks and shows that compassion is a consequence of our evolution and stems from deeply ingrained neurobiological patterns and systems, some of which are shared with other animals. This prosocial state of being is rooted in mother-child relationships, care of offspring and kin, and the crucial role of social connections in human progress.
Unfortunately, although compassion and helping behaviors are hardwired in the human brain and bodies just as fundamentally as is the fight-or-flight instinct for self-preservation, the pressures of modern life and survival-of-the-fittest social cultures increasingly have many people chronically primed for the latter. The stress of this is having profound physical and mental health consequences, as evidenced by the prevalence of heart disease, diabetes, depression, anxiety, and other stress-related disorders in our society.
By illuminating the physical and mental antecedents and impediments to compassion and the specific effects that cultivating it has on our bodies, brains, minds, and behavior, increasingly rigorous research is beginning to show that compassion may play a critical role in reversing these negative trends. For example, preliminary studies show that cultivating compassion can boost a person’s physical longevity and immunity; foster emotional wellbeing and social connections in daily life; increase positive emotions and and the tendency to act for the benefit of someone other than oneself, i.e., prosocial behavior;2 and lead to functional and structural changes in the brain known as plasticity. Additional findings indicate that compassion training programs can strengthen resilience and buffer the symptoms of burnout common among healthcare workers and other caregiving professionals, enabling them to continue their important work.
Future research will uncover even more promising clues on how compassion can enable individuals and the greater human community to “flourish best.”
Introduction
To be sensitive to the suffering of others and have a desire to alleviate that suffering is compassion. Compassion can be thought of as a psychological state, a trait, an emotion, a motivation, a behavior, or a combination of the foregoing, and one critique of compassion science is the lack of a consistent, precise concept among different studies. Many of the studies highlighted here, however, generally define compassion as sensitivity to another’s suffering coupled with a desire to alleviate that suffering.3
To understand what compassion is, it’s important to compare it to other human experiences and behaviors that are similarly triggered by witnessing or contemplating the pain or distress of others, but which have different mental and physical markers and consequences.
Compassion is most often confused or conflated with empathy, which scientists describe as vicariously experiencing, sharing, or mirroring another’s pain or emotion as if it was your own4 or, in the case of something called cognitive empathy, experiencing another’s thoughts or perspective.5 Empathy is typically a visceral and automatic response to another’s suffering, and because of this, empathy may be thought of as a key component of compassion. Unlike compassion, however, which is generally associated with warm, positive emotions and prosocial approach motivations and behaviors, empathy can lead to something called empathic distress,6 which involves strongly negative feelings and antisocial avoidance motivations and behaviors.7 Studies have also shown that because witnessing others’ suffering can lead to high levels of the stress hormone cortisol, people high in trait empathy are particularly prone to stress,8 while compassion has been linked to lower levels of cortisol.9Although most psychologists generally view empathy as a crucial aspect of emotional intelligence and social interaction, others, such as Paul Bloom, argue that the negative consequences of empathy along with the fact that empathy is often biased toward people who are similar and can be used to manipulate others, make compassion a preferable trait or behavior.10
Research also shows that biological, physiological, and psychological antecedents and markers of compassion are distinct from empathy, as are its physical, mental, and social consequences. For example, empathy can cause people to avoid or neglect others’ suffering because it’s too personally painful or traumatic, such as when healthcare workers burn themselves out and leave the profession due to the stress and fatigue of empathizing with patients.
Leading empathy and compassion science researchers Olga Klimecki and Tania Singer describe it this way: the psychology of empathy is self-related, i.e., the individual feeling empathic distress is suffering with the patient, while the psychology of compassion is other-related, i.e., an individual experiencing compassion has feelings for the patient.11 In fact, training caregivers, teachers, and other helping professionals to turn empathic distress and other negative feelings associated with stress and burnout into more positive and motivating feelings through compassion is one of the promising new areas of compassion science research and application.
Another concept that is related but distinct from compassion is altruism, which is the behavior or act of promoting someone else’s welfare even at great personal cost or
risk.12 Although altruism can and often does stem from compassion, altruistic behaviors also can be motivated by self-interest, guilt, or other reasons, such as when people donate money for tax purposes, volunteer under social pressure, or offer help to another with reciprocity in mind.
Compassion has always played an important role in civil society, but contemporary Western culture has typically treated it as a moral virtue rather than an innate human trait that is critical to health and happiness. This may stem from an historically pervasive assumption among many Western economists, philosophers, and even psychologists that humans are motivated first and foremost by self-interest and a blatant drive to seek pleasure and avoid pain and that rationality devoid of emotion or “soft” feelings is not only humanly possible, but the epitome of human success.
Numerous studies in psychology, neuroscience, and evolutionary biology now provide clear evidence that refutes those assumptions and proves that prosocial traits and behaviors such as compassion are instinctual and crucial to the survival and wellbeing of humans as a species and as individuals.
Key Findings
Evolutionary Origins of Compassion
The importance of social interactions and support to the long-term survival of various species is evident from the social reproductive habits of even the most primordial bacteria. There are several reasons compassionate behavior has been particularly important to human evolution, including for the development of vulnerable offspring, to strengthen bonds between reproductive partners, and to enable the kind of cooperation among strangers that has advanced our species from small tribes of hunter-gatherers to nation-states and global conglomerates.
More direct evidence supporting a human instinct to care about and help others comes from a variety of studies showing that human infants, as well as more primitive species such as chimpanzees, elephants, and even ants, respond to others’ distress despite obstacles and no personal benefit, illustrating that compassion-related behaviors are innate and not wholly dependent upon social learning.13
Additional support for compassion as a product of evolution comes from studies that show the neural networks and related spontaneous and autonomic neurophysiological processes associated with feelings of compassion overlap with the distinct brain structures and neurotransmitters that are associated with the impulse to care for vulnerable offspring—an other-focused, often costly undertaking that is clearly evolutionarily important—as well as regions related to reward, love, and affiliation (insula, ventral striatum, and medial orbitofrontal cortex).14
For example, studies show that the presence of oxytocin—a hormone and neuropeptide that is known to facilitate mammalian sexual activity, birth, lactation, maternal caregiving, and other social bonding behaviors—also signals prosocial behaviors such as compassion. Oxytocin is associated with a sense of safety and down-regulation of the body’s self-focused, autonomic, stress-response (e.g., flight or fight). One theory is that the presence of oxytocin may buffer the personal distress of witnessing another’s suffering such that the individual is motivated to approach and help.15
In sum, research suggests that compassion is natural, pleasurable, and physically beneficial in ways that have ensured human species’ survival. Although human beings are biologically inclined to experience compassion and behave accordingly, however, recent studies of genetic and epigenetic variations among oxytocin receptors suggest that some people may be more hardwired for compassion than others and that early life experiences, such as the quality of maternal nurturing, may affect this inclination as well.16 For example, studies of humans and rats have shown that the quality of early maternal care affects the expression of oxytocin receptor genes and stress hormones in offspring, which in turn have been found to correlate with such offsprings’ nurturing tendencies as parents.17
One recent study found that genetic variability in the oxytocin systems of participants determined the impact of training in loving-kindness meditation—a contemplative practice derived from Theravada and Tibetan Buddhism designed to increase compassion and positivity.18
The scientific consensus is that compassion derives from both nature and nurture and that the quality and quantity of it in human life result from a number of physical, psychological, social, and cultural factors. Determining the precise impact that cultivating compassion has on health and wellbeing and the best practices and programs for doing so have become leading research inquiries in neuroscience and psychology. The remaining sections of this brief provide a summary of findings from these studies.
Compassion in the Brain and Body
To fully understand why compassion contributes to health and wellbeing and how it can be further cultivated, researchers have begun to shed additional light on the neurological, biological, and physiological mechanisms that precede or accompany the experience of compassion and how they compare to those underlying other emotional responses, motivations, and behaviors, such as empathy.
For example, compassion is associated with activation of brain networks typically associated with reward, love, and social affiliation, while empathy seems to activate regions implicated in negative states, distress, and empathy for pain (anterior insula, medial/anterior cingulate cortex).
Empathy and compassion also have distinct effects on the parasympathetic and sympathetic nervous systems. According to neuroscientist Stephen W. Porges, “compassion relies on a ‘neural platform’ that enables an individual to maintain and express a physiological state of safety when confronted with the pain and suffering of others.”19 In particular, this platform involves the vagus—a cranial nerve that starts in the brain stem and connects to the heart, lungs, and other visceral organs. This nerve is part of the parasympathetic branch of the autonomic nervous system and serves to communicate sensory and motor information from the body to the brain and vice versa. According to Porges's polyvagal theory,20 the vagal circuit enables a compassionate response to the suffering of others because it slows the heart rate and facilitates a calm physiological state by putting the brakes on the body’s sympathetic nervous system, which otherwise would trigger an automatic flight-or-fight-or-freeze reaction to pain and distress.
Studies show that similar to the presence of oxytocin, this operation of the vagus promotes a physiological state associated with decreased stress; feelings of safety, warmth, and connection to others; and the potential to respect both the suffering and joy of others. In fact, research findings suggest that people with a high vagal tone, which indicates a more robust functioning of the vagus nerve, have better ability to regulate their emotions (i.e., stress) and more positive emotions.21
According to Porges, further theoretical evidence that compassion is physiologically primed comes from the historical use of compassion-focused practices in contemplative traditions, which act on the vagus in ways that induce these compassion priming effects. For example, the chanting, intentional breathing practices, and postures associated with some forms of meditation impact functioning of the vagus in a way that instigates the calm physiological state receptive to compassion. In other words, these purposeful behaviors can trigger an autonomic physiological state that reinforces an ability to cultivate compassion—the mind-body connection at work.
In contrast, empathy for others’ pain and suffering is associated with activation of the sympathetic nervous system, which triggers a defensive stress response.22 Studies show that prolonged activation of this kind of stress response can lead to decreased immune function,23 which in turn is associated with chronic inflammation;24 diseases such as cancer, heart disease, diabetes, and Alzheimer’s; and an elevated mortality risk.25
These underlying neural and physiological distinctions start to explain why empathy, though crucial for social interaction, can be maladaptive and physically and mentally debilitating, while compassion is associated with physical, mental, and social benefits.
Health Benefits of Compassion
Although not directly focused on compassion per se, numerous studies have found that helping behaviors significantly improve health and happiness. For example, a growing area of research has found that people who provide help to others (e.g., offer social support, care for ill relatives, volunteer) have better mental and physical health benefits than those who don’t help.26 At least one study found a decrease in mortality risk correlated with volunteering for compassionate motives, but not with volunteering for self-interested reasons.27
The finding that health benefits only accrued to those with compassionate rather than self-interested motives for helping was consistent with previous studies connecting health to social support and connections. For example, one study found that people in social relationships live longer than socially isolated individuals;28 one showed that people with more social connections have better immune function and are less likely to get sick; 29 and one showed that a lack of social connection is as serious a health danger as smoking, high blood pressure, obesity, and lack of exercise.30
The precise physiological mechanisms underlying the health benefits of helping remain unknown; however, researchers speculate that helping may trigger a reduction in stress caused by the associated positive emotions and activation of the caregiving neural circuits and physiology that primed the compassionate behavior. Future research is needed to provide strong evidence of this connection. More direct research on the impacts of compassion involve voluntary cultivation of it through meditation or other compassion training practices. Preliminary findings indicate that such compassion practices activate and strengthen particular brain regions and networks associated with increased wellbeing and influence compassionate responses in the real world. The exact neural pathways and mechanisms by which compassion is cultivated and impacts behavior, however, remain to be correlated.
Some of the studies on compassion cultivation are cross-section experiments to compare the brains, reported emotions, and observable behaviors of compassion meditation experts (Tibetan Buddhist monks, for example, with decades of experience) to those of novices and non-meditators. Other compassion research involves longitudinal studies on the effectiveness of modern compassion-focused meditation or cognitively-based compassion training programs. Most of these compassion training programs derive from traditional Buddhist practices and involve some aspect of quiet contemplation. These studies differ significantly, however, in the particular cognitive, emotional, or behavioral pathways targeted; in their length and intensity; and in whether they include additional training components such as discussions or group therapy.31
The bulk of early studies indicating benefits of cultivating compassion involve the practice of loving-kindness meditation (LKM). The Buddhist concept of loving-kindness focuses not necessarily on alleviating the suffering of others, but on cultivating benevolence, love, and care toward self and others. Western LKM practices, however, often incorporate a wish to relieve suffering, starting with the self, loved ones, and close friends and moving on to neutral and difficult others, then strangers, and finally all living beings.32
The following are key findings:
- Well-known positive psychology researcher Barbara Fredrickson and colleagues found that after eight to nine weeks of LKM, randomized participants compared to a control group reported an increase in trait positive emotions and feelings of social connection and a decrease in depression even though frequency of negative feelings had not declined.33 A subsequent study by Fredrickson and Bethany Kok confirming similar results correlated this increase in positive emotions with a higher vagal tone—a proxy for better health.34
- After only one week of short-term compassion training based on LKM, participants showed an increase in positive feelings not just in daily life, but in response to the suffering of others and those feelings correlated with functional and structural changes in the brain known as plasticity—in this case increased activation in compassion-related brain circuits (i.e., those implicated in caregiving, social affiliation, and feelings of love).35
- In an important study showing the distinct neural signatures of empathy and compassion, participants first received empathy training with results showing an increase not only in empathy but also negative feelings, self-experienced pain, and a susceptibility to negative affect in response to other daily situations. Subsequent training in LKM was shown to reverse those effects—bringing negative emotions back to baseline levels and increasing positive emotions.36
- One study found that a mere seven minutes of LKM boosted good feelings and sense of social connection, if only temporarily.37
- In a pilot study on chronic low back pain, subjects who participated in a LKM training program reported lower pain and less anger and distress than those who had received only standard treatment.38
- Recent studies have found LKM to be an effective intervention for increasing positive emotions and decreasing depression and other negative symptoms of disorders such as schizophrenia39 and PTSD.40 In the case of PTSD, however, findings in the initial pilot study suggested that an increase in self-compassion as a result of LKM was a mediating factor, which makes the direct impact on PTSD of cultivating compassion for others less clear. The leading researcher of self-compassion who originally measured the concept defines it as self-kindness coupled with a recognition of one’s common humanity and a non-biased awareness of one’s experiences.41 While self-compassion has some of the same antecedents and personal benefits as compassion, it is distinct in nature and effect, and at least one study suggests that self-compassion and compassion don’t always correlate.42
The correlation between compassion meditation and boosts in positive emotions and psychological wellbeing is an extremely important finding and research topic. Numerous studies link positive emotions and psychological wellbeing with less stress and depression and greater physical and emotional resilience, coping capabilities, creativity, cognitive flexibility, happiness, and prosocial behavior.43 Psychological wellbeing has also been found to influence future health and longevity at the molecular level, by affecting gene expression and immunity in significant ways.44
While other mental health strategies such as classic cognitive reappraisal, distraction, and negative thought suppression aim to decrease negative emotions and behaviors through a top-down approach, studies of compassion meditation indicate the effectiveness of a mental training technique that boosts positive emotions and coping capabilities by triggering deeply entrenched and instinctual neural pathways related to nurturing and affiliation.
Studies of expert meditators—Buddhist monks for example, who have engaged in LKM for decades including during intensive retreats—show that these neural pathways can be dramatically enhanced with practice. For example, in a groundbreaking 2008 study,45 neuroscientists Antoine Lutz, Julie Brefczynski-Lewis, Tom Johnstone, and Richard Davidson used functional magnetic resonance imaging (FMRI) to compare the brains of expert meditators (with 10,000 or more hours of experience) to novices during compassion meditation. While the participants meditated they were presented with different sounds—some neutral and some involving negative human vocalizations. Compared to the novice meditators, expert meditators showed more activation in brain structures and functions associated with empathy and emotional resonance—sharing a person’s feelings, sensing another person’s mental state or perspective, and paying more attention.
Perhaps most interestingly, the experts but not the novices also showed activation in the brain’s motor centers in response to distressing sounds, which suggests that their brains were preparing their bodies to act. One reason that experts versus novices may be more primed to act is that they also show a pattern of brain activity associated with down-regulation of self-focused thoughts and mind-wandering.46 In other words, the experts became neurologically and physiologically more inclined to compassionately respond to the suffering of others with action rather than to turn away from the discomfort or hesitate over self-concerns.
In addition to compassion meditation, a number of other compassion training and intervention programs described in this brief have shown promising results in randomized controlled trials, although effect sizes have been moderate. A recent meta-analysis of 21 such trials involving adult participants showed significant post-intervention changes in levels of compassion, self-compassion, and mindfulness, and reductions in suffering-based outcomes of depression, stress, and psychological distress.47
Social Impacts and Benefits of Compassion
Initial support for the theory that compassion leads to prosocial behavior comes from studies that show compassion training triggers neurophysiology associated with the down-regulation of avoidance and other emotionally-charged antisocial behaviors (which are often triggered by empathic distress to suffering) and with the up-regulation of prosocial responses to suffering during meditative and non-meditative states.48 In other words, the brain and body seem primed for compassion.
Another line of research is probing whether compassion training may lead to better interactions between members of different racial, social, or economic groups. For example one study found a significant decrease in bias against stigmatized groups (in this case blacks and the homeless) in a group randomly assigned to training in LKM, as compared to controls.49
Other studies (though sparse) do provide direct evidence that cultivating compassion translates into actual helping behaviors. These studies compare helping or altruistic decisions made in experimental games or simulations by participants who received compassion training versus those who received none or other types of mental training, such as training in empathy.50 Significantly, these studies affirm that compassion and empathy have not only distinct neurophysiological and psychological markers, but also disparate behavioral consequences, with compassion being associated with helping and forgiveness behaviors and empathic distress being associated with less helping and more aggressive behavior.
Researchers found similar prosocial behavior results in a study of children who received compassion training through a mindfulness-based kindness curriculum—they shared more stickers with wide range of classmates than a control group in an experiment post-training.51 Further empirical evidence for the notion that internal cultivation of compassion leads to an increase in prosocial behavior comes from the studies of long-term meditators. One experimental study found that Tibetan Buddhists who’d engaged in lengthy meditation retreats (three or more years) showed more charitable and forgiving behaviors against opponents in a game than novice meditators.52
Another line of research connecting compassion with prosocial benefits and behavior is on the experience of moral elevation, which researchers describe as an emotional response similar to awe that results from being deeply moved by witnessing a stranger acting compassionately on behalf of another.53 Participants in studies induced to experience moral elevation report an increase in compassion themselves as well as other positive emotions such as optimism, hope, tenderness, love, and inspiration.54 Other studies show that witnessing compassionate and altruistic acts elicits actual compassionate behavior in a pay-it-forward manner or chain reaction.55
Compassion Development and Training
While compassion has biological roots and was crucial to human evolution, studies on compassion meditation and training indicate that it’s not a fixed trait, but a skill that develops over time and can be strengthened with practice.56 This is a crucial discovery now that we know (1) how much compassion impacts health, healing, wellbeing, and prosocial behavior and (2) that genetics, temperament, childhood development and experiences, as well as other psychological factors can influence individual propensities for the development of compassion.
For example, those who lack a sense of security and trust in their interpersonal relationships may have trouble recognizing the perspectives or suffering of others,57 and people with poor emotion regulation skills may be more prone to empathic distress and self-focused concerns in the presence of others’ suffering.58
In addition, socio-economic and cultural factors may play a significant role in how different people understand, cultivate, and express compassion.59 For example, many cultures and philosophies in the West, particularly in the United States, tend to emphasize individualism as key to success and prosperity, while Asian cultures and philosophies, particularly Buddhist, tend to stress that happiness comes from less self-focus and more compassion.
A variety of evidenced-based compassion training programs and practices are currently in use to address impediments to compassion, as well as particular health disorders and healing modalities. Most are secular in design, but tend to draw from Buddhist philosophies and contemplative practices in varying degrees. They also vary in terms of their underlying theories of compassion, training protocols, and targeted intervention purposes and populations. As such, while randomized, controlled studies of compassion training programs and practices on the whole have been encouraging, positive results from particular programs and practices are limited to the contexts in which they’ve been studied and applied.
The following list provides a brief overview and comparison of the most prominent, empirically-supported meditation practices, compassion training programs, and interventions.
Compassion Meditation (CM) and Loving-Kindness Meditation (LKM).
Not a training program per se, the contemplative practice of meditation generally involves cultivation of mindfulness—present moment awareness and nonjudgmental acceptance of experience60—and contemplative scholars have long suggested that practicing mindfulness leads to increased awareness of and sensitivity to the suffering of others as well as prosocial behavior.61 Empirical support for this theory comes from studies involving a widely-known program involving mindfulness meditation called mindfulness-based stress reduction (MSBR)62 as well as from studies of compassion and loving-kindness meditation mentioned in this brief. In contrast to attention-focused mindfulness meditation practices, however, which often focus on a target (e.g., the body, breath, a mantra) and nonjudgmental monitoring of thoughts and feelings, compassion-related meditation practices are designed to alter the content of thoughts and emotions in a way that shifts priorities more toward the wellbeing of others and less toward the self.63
Both CM and LKM practices involve systematic reflection on phrases designed to cultivate kind and loving feelings toward self and a series of others—starting with loved ones and moving on to difficult people, strangers, and finally all living beings—these styles are distinct in their style and framework. LKM practices primarily focus on generating a wish that self and others be happy, while CM focuses on generating a wish that self and others be free from suffering as well as on cultivating the motivation to help relieve that suffering. As previously discussed, CM and LKM are the practices most often used in empirical studies to determine the underlying mechanisms and consequences of compassion.
Cognitively Based Compassion Training (CBCT) and Compassion Cultivation Training (CCT).
Both of these secular programs include contemplative influences from Tibetan Buddhism and incorporate analytical meditation and other cognitive processes for cultivating or constructing compassion through a systematic multi-step process taught over a number of weeks.
CBCT
CBCT was developed by Lobsang Tenzin Negi initially to address rising rates of depression among undergraduates at Emory University in Atlanta, Georgia. CBCT has since been adapted for use with other populations, including medical professionals, trauma survivors, veterans, and elementary school children. CBCT draws from Tibetan Buddhist lojong (mind-training) practices, and the program’s underlying theory is that compassion buffers stress and suffering by shifting maladaptive self-concerns into healing connections with others.64 Studies of CBCT have shown post-intervention reductions in biological markers of stress and inflammation in undergraduates students and reductions in inflammation in foster kids.65
CCT
CCT was developed by Thupten Jinpa and a team at Stanford University and has been used with undergraduates, cancer survivors, veterans, and healthcare professionals. The program’s underlying theory comes from Jinpa’s definition of compassion, which comprises four key components: (1) cognitive awareness of suffering; (2) emotional concern for that suffering; (3) a wish to see that suffering relieved; and (4) motivation to help relieve that suffering. Studies of CCT interventions with adults have shown self-reported, post-intervention increases in compassion, self-compassion, mindfulness, and happiness and decreases in worry and emotion suppression.66
Compassion Focused Therapy (CFT)
CFT was developed by Paul Gilbert, a professor at Derby University in the UK, to be a compassion-based system of psychotherapy to help patients become more supportive, kind, and encouraging to themselves as part of their treatment for mental health disorders such as depression. The program draws from traditional cognitive-behavioral therapy (CBT) techniques, Buddhist concepts of compassion, and the evolutionary and biological connection between wellbeing and affiliative relationships. The theory is that by training their minds to cultivate compassion, patients can overcome dysfunction (due to nature or nurture) in their innate human capacity for soothing in response to threat and thus improve psychological wellbeing. According to Gilbert’s theory, compassion is a skill with three components: (1) what we feel for others, (2) what we feel from others toward ourselves, and (3) what we feel toward ourselves. Studies have shown that CFT may be particularly effective with patients suffering from self-criticism and related mood disorders.67
Cultivating Emotional Balance (CEB)
CEB was developed by Paul Ekman and Alan Wallace, a world-renowned emotions researcher and Buddhist scholar, respectively, in consultation with the Mind and Life Institute. CEB is a secular training program designed to help people, particularly those in stressful positions, better manage their emotional lives for greater wellbeing. Training components include both mindfulness and compassion-based contemplative practices along with other emotion regulation tools for understanding and managing emotions and cultivating happiness for oneself and in relationship to others. Compared to controls, a group of school teachers participating in an eight-week intensive CEB program reported post-intervention decreases in negative emotional behavior and showed increases in prosocial responses to suffering.68
Limitations and Future Directions
Although the science of compassion has grown tremendously over the last two decades, research findings are preliminary and limited by a number of factors. Although studies on the associated neurophysiological and biological markers of compassion have been illuminating, we don’t yet have a precise picture, and there is no monolithic compassionate brain or body state applicable to every individual in every context. Further evidence is needed to understand the neural activations and other underpinnings of compassion in different populations, in different settings, and in connection with different types of suffering witnessed. There’s also a need for a more consistent definition of compassion and more consistent methodological approaches to assessing its antecedents and effects. Additional long-term studies are needed to determine critical developmental periods for compassion education and training in children and adolescents, and the extent to which compassion training effects are long-term or sustainable. Additional research is also needed to understand the specific mind and body mechanisms by which cultivation of compassion leads to compassionate behavior in the real world.
Conclusion
Science has begun to converge with contemplative practice traditions in finding that kindness and compassion for others is both primal and a primary source of health, longevity, healing, and wellbeing for human beings, both individually and collectively. Future research in this emerging field of study will provide key insights into the precise pathways, mechanisms, and effective applications for further developing and cultivating compassion throughout the human lifespan.
Key Terms in Compassion Science
Altruism:
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Acting for another’s welfare despite the risk or cost to oneself.
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Compassion:
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Sensitivity to the suffering of another accompanied by the motivation to alleviate that suffering; also referred to as empathic concern (Goetz, Keltner, & Simon-Thomas, 2010).
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Empathy:
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Vicariously experiencing, sharing, or mirroring another’s pain or emotion as if it was your own (Preston & de Waal, 2002).
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Empathic distress:
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Strong negative feeling in response to sharing another’s pain as if it’s happening to the self, accompanied by the motivation to withdraw from the situation and avoid the aversive response (Sagi & Hoffman, 1976).
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Empathy for pain network:
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Brain network that shows activation when witnessing the pain of others. Regions in this network—anterior insula and the medial/anterior cingulate cortex regions—also activate during first-hand pain experiences (Lamm, Decety & Singer, 2011).
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Oxytocin:
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A hormone and neurotransmitter (chemical messenger in the brain) involved in key aspects of childbirth, lactation, maternal behavior, social bonding and trust-based interactions, sexual pleasure, and other prosocial and compassion-related behaviors.
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Parasympathetic nervous system: (PNS):
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The branch of the autonomic nervous system sometimes called the “rest and digest” or “feed and breed” system. The PNS controls heart rate, sexual arousal, respiration, and digestion and conserves energy by bringing the body back to homeostasis after a flight-or-fight stress response activated by the sympathetic nervous system.
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Prosocial behavior:
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A broad range of actions intended to benefit other people or another person (e.g., helping, comforting, sharing and cooperation) (Batson, 2012).
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Self-compassion:
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An emotionally positive and compassionate self attitude to protect against the negative consequences of self-judgment, isolation, and rumination (such as depression) (Neff, 2003).
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Sympathetic nervous systems (SNS):
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The branch of the autonomic nervous systems that stimulates the body’s flight-or-fight response to stress by increasing heart rate and blood pressure, dilating the pupils, and increasing sweating.
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Vagus nerve
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A cranial nerve that starts in the brain stem and connects to and communicates with the heart, lungs, and other visceral organs. As a core component of the PNS, it helps to regulate heart rate and inhibit the stress response of the SNS. Scientists believe the vagus plays an important role in cultivating the neurophysiological state conducive to caregiving and feelings of love and compassion. (Porges, 2017).
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About the Author
Katherine Ludwig is a writer and editor for the Contemplative Sciences Center.
Footnotes
- ^ Darwin, C. (1871/2004). The Descent of Man. (p. 130). Penguin Classics.
- ^ Batson, C. D. (2012). A history of prosocial behavior research. In A. W. Kruglanski, & Wolfgang Stroebe (Eds.), Handbook of the History of Social Psychology (pp. 243-264). New York, NY: Psychology Press.
- ^ Goetz, J. L., Keltner, D., & Simon-Thomas, E. (2010). Compassion: an evolutionary analysis and empirical review. Psychological Bulletin, 136(3), 351.
- ^ Preston, S. D., & De Waal, F. B. (2002). Empathy: Its ultimate and proximate bases. Behavioral and Brain Sciences, 25(1), 1-20.
- ^ Lamm, C., Batson, C. D., & Decety, J. (2007). The neural substrate of human empathy: effects of perspective-taking and cognitive appraisal. Journal of Cognitive Neuroscience, 19(1), 42-58.
- ^ Sagi, A., & Hoffman, M. L. (1976). Empathic distress in the newborn. Developmental Psychology, 12(2), 175-176.
- ^ Batson, C. D. (2017). The empathy-altruism hypothesis: What and so what? In E. M. Seppälä, E. Simon-Thomas, S. L. Brown, M. C. Worline, C. D. Cameron, & J. R. Doty (Eds.), The Oxford Handbook of Compassion Science (pp. 27-40). New York, NY: Oxford University Press. Klimecki, O., & Singer, T. (2012). Empathic distress fatigue rather than compassion fatigue? Integrating findings from empathy research in psychology and social neuroscience. Pathological Altruism, 368-383.
- ^ Buchanan T. W., Bagley, S. L., Stansfield, R. B., & Preston, S.D. (2012). The empathic, physiological resonance of stress. Social Neuroscience. 7(2), 191-201.
- ^ Pace, T. W., Negi, L. T., Adame, D. D., Cole, S. P., Sivilli, T. I., Brown, T. D., ... & Raison, C. L. (2009). Effect of compassion meditation on neuroendocrine, innate immune and behavioral responses to psychosocial stress. Psychoneuroendocrinology, 34(1), 87-98.
- ^ See Bloom, P. (2016). Against Empathy: The Case for Rational Compassion. New York, NY: HarperCollins.
- ^ Singer, T., & Klimecki, O. M. (2014). Empathy and compassion. Current Biology, 24(18), R875-R878.
- ^ For an overview of psychological and philosophical theories regarding altruism, see Ricard, M. (2015). Altruism: The Power of Compassion to Change Yourself and the World. New York, NY: Little, Brown and Co.
- ^ For example see Clay, Z., & de Waal, F. B. (2013). Development of socio-emotional competence in bonobos. Proceedings of the National Academy of Sciences, 110(45), 18121-18126; Warneken, F., & Tomasello, M. (2006). Altruistic helping in human infants and young chimpanzees. Science, 311(5765), 1301-1303; Lee, P. C., Fishlock, V., Webber, C. E., & Moss, C. J. (2016). The reproductive advantages of a long life: Longevity and senescence in wild female African elephants. Behavioral ecology and sociobiology, 70(3), 337-345; Nowbahari, E., Scohier, A., Durand, J. L., & Hollis, K. L. (2009). Ants, Cataglyphis cursor, use precisely directed rescue behavior to free entrapped relatives. PLoS One, 4(8), e6573.
- ^ See Goetz, J. L., Keltner, D., & Simon-Thomas, E. (2010). Compassion: An evolutionary analysis and empirical review. Psychological Bulletin, 136(3), 351-374 and Klimecki, O. M. & Singer, T. (2017). The compassionate brain. In E. M Seppälä, E. Simon-Thomas, S. L., Brown, M. C Worline, C. D. Cameron, & J. R Doty (Eds.), The Oxford Handbook of Compassion Science (pp. 109-120). New York, NY: Oxford University Press.
- ^ See Carter, S. C., Bartal, I. B., & Porges, E. C. (2017). The roots of compassion: An evolutionary and neurobiological perspective. In E. M Seppälä, E. Simon-Thomas, S. L., Brown, M. C. Worline, C. D. Cameron, & J. R. Doty, (Eds.), The Oxford Handbook of Compassion Science (pp. 173-188). New York, NY: Oxford University Press.
- ^ Kumsta, R., Hummel, E., Chen, F. S., & Heinrichs, M. (2013). Epigenetic regulation of the oxytocin receptor gene: implications for behavioral neuroscience. Frontiers in Neuroscience, 7, 83; Saturn, S. R. (2017). Two factors that fuel compassion: The oxytocin system and the social experience of moral elevation. In E. M Seppälä, E. Simon-Thomas, S. L., Brown, M. C Worline, C. D. Cameron, & J. R. Doty (Eds.), The Oxford Handbook of Compassion Science (pp. 121-132). New York, NY: Oxford University Press.
- ^ For early studies on the effects of maternal care on stress hormones of offspring, see Champagne, F. A., Francis, D. D., Mar, A., & Meaney, M. J. (2003). Variations in maternal care in the rat as a mediating influence for the effects of environment on development. Physiology & Behavior, 79(3), 359-371 and Francis, D., Diorio, J., Liu, D., & Meaney, M. J. (1999). Nongenomic transmission across generations of maternal behavior and stress responses in the rat. Science, 286(5442), 1155-1158. For studies on link between maternal care and oxytocin receptor gene methylation patterns in offspring, see Beery, A. K., McEwen, L. M., MacIsaac, J. L., Francis, D. D., & Kobor, M. S. (2016). Natural variation in maternal care and cross-tissue patterns of oxytocin receptor gene methylation in rats. Hormones and Behavior, 77, 42-52 and Unternaehrer, E., Meyer, A. H., Burkhardt, S. C., Dempster, E., Staehli, S., Theill, N., ... & Meinlschmidt, G. (2015). Childhood maternal care is associated with DNA methylation of the genes for brain-derived neurotrophic factor (BDNF) and oxytocin receptor (OXTR) in peripheral blood cells in adult men and women. Stress, 18(4), 451-461.
- ^ Isgett, S. F., Algoe, S. B., Boulton, A. J., Way, B. M., & Fredrickson, B. L. (2016). Common variant in OXTR predicts growth in positive emotions from loving-kindness training. Psychoneuroendocrinology, 73, 244-251.
- ^ Porges, S. W. (2017). Vagal pathways: Portals to compassion. In In E. M Seppälä, E. Simon-Thomas, S. L., Brown, M. C Worline, C. D. Cameron, & J. R Doty (Eds.), The Oxford Handbook of Compassion Science (pp. 189-202). New York, NY: Oxford University Press.
- ^ Porges, S. W. (2007). The polyvagal perspective. Biological Psychology, 74, 116–143.
- ^ See Stellar, J. E., Cohen, A., Oveis, C., & Keltner, D. (2015). Affective and physiological responses to the suffering of others: Compassion and vagal activity. Journal of Personality and Social Psychology, 108(4), 572; Fabes, R. A., & Eisenberg, N. (1997). Regulatory control and adults' stress-related responses to daily life events. Journal of Personality and Social Psychology, 73(5), 1107; Thayer, J. F., Hansen, A. L., Saus-Rose, E., & Johnsen, B. H. (2009). Heart rate variability, prefrontal neural function, and cognitive performance: The neurovisceral integration perspective on self-regulation, adaptation, and health. Annals of Behavioral Medicine, 37(2), 141-153..
- ^ Lamm, C., Decety, J., & Singer, T. (2011). Meta-analytic evidence for common and distinct neural networks associated with directly experienced pain and empathy for pain. Neuroimage, 54(3), 2492-2502; Lamm, C., & Singer, T. (2010). The role of anterior insular cortex in social emotions. Brain Structure and Function, 214(5-6), 579-591; Singer, T., Critchley, H. D., & Preuschoff, K. (2009). A common role of insula in feelings, empathy and uncertainty. Trends in Cognitive Sciences, 13(8), 334-340.
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- ^ Konrath, S., Fuhrel-Forbis, A., Lou, A., & Brown, S. (2012). Motives for volunteering are associated with mortality risk in older adults. Health Psychology, 31(1), 87–96.
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- ^ Cohen, S. (1988). Psychosocial models of the role of social support in the etiology of physical disease. Health Psychology, 7(3), 269-297.
- ^ House, J. S., .Landis, K. R., & Umberson, D. (1988). Social relationships and health. Science, 241(4865), 540-545.
- ^ For specific details on and comparisons between and among these various compassion training practices and programs, see the section of this brief titled Compassion Development and Training.
- ^ Salzberg, S. (2002). Lovingkindness: The Revolutionary Art of Happiness. Boston: MA, Shambala.
- ^ Fredrickson, B. L., Cohn, M. A., Coffey, K. A., Pek, J., & Finkel, S. M. (2008). Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Journal of Personality and Social Psychology, 95(5), 1045-1062.
- ^ Kok, B. E., & Fredrickson, B. L. (2010). Upward spirals of the heart: Autonomic flexibility, as indexed by vagal tone, reciprocally and prospectively predicts positive emotions and social connectedness. Biological Psychology, 85(3), 432–436.
- ^ Klimecki, O. M., Leiberg, S., Lamm, C., & Singer, T. (2012). Functional neural plasticity and associated changes in positive affect after compassion training. Cerebral Cortex, 23(7), 1552-1561.
- ^ Klimecki, O. M., Leiberg, S; Ricard, M., & Singer, T. (2013). Differential pattern of functional brain plasticity after compassion and empathy training. Social Cognitive and Affective Neuroscience, 9(6), 873–879.
- ^ Hutcherson, C. A., Seppala, E. M., & Gross, J. J., (2008). Loving-kindness meditation increases social connectedness,” Emotion, 8(5), 720–724.
- ^ Carson, J. W., Keefe, F. J., Lynch, T. R., Carson, K. M., Goli, V., Fras, A. M., & Thorp, S. R. (2005). Loving-kindness meditation for chronic low back pain: Results from a pilot trial. Journal of Holistic Nursing, 23(3), 287-304.
- ^ Johnson, D. P., Penn, D. L., Fredrickson, B. L., Kring, A. M., Meyer, P. S., Catalino, L. I., & Brantley, M. (2011). A pilot study of loving-kindness meditation for the negative symptoms of schizophrenia. Schizophrenia Research, 129(2-3), 137-140.
- ^ Kearney, D. J., Malte, C. A., McManus, C., Martinez, M. E., Felleman, B., & Simpson, T. L. (2013). Loving‐kindness meditation for posttraumatic stress disorder: A pilot study. Journal of Traumatic Stress, 26(4), 426-434.
- ^ Neff, K. (2003). Self-compassion: An alternative conceptualization of a healthy attitude toward oneself. Self and Identity, 2(2), 85-101.
- ^ See López, A., Sanderman, R., Ranchor, A. V., & Schroevers, M. J. (2018). Compassion for others and self-compassion: levels, correlates, and relationship with psychological well-being. Mindfulness, 9(1), 325-331.
- ^ For a review of the health and wellness effects of positive emotions, see Fredrickson, B. L., & Cohn, M. A. (2008). Positive emotions. In M. Lewis, J. M. Haviland-Jones, & L. F. Barrett (Eds.), Handbook of Emotions. Vol. 3 (pp. 777–796). New York, NY: Guilford Press.
- ^ Fredrickson, B. L., Grewen, K. M., Coffey, K. A., Algoe, S. B., Firestine, A. M., Arevalo, J. M., ... & Cole, S. W. (2013). A functional genomic perspective on human well-being. Proceedings of the National Academy of Sciences, 110(33), 13684-13689.
- ^ Lutz, A., Brefczynski-Lewis, J., Johnstone, T., & Davidson, R. J. (2008). Regulation of the neural circuitry of emotion by compassion meditation: effects of meditative expertise. PloS One, 3(3), e1897.
- ^ Brewer, J. A., Worhunsky, P. D., Gray, J. R., Tang, Y. Y., Weber, J., & Kober, H. (2011). Meditation experience is associated with differences in default mode network activity and connectivity. Proceedings of the National Academy of Sciences, 108(50), 20254-20259.
- ^ Kirby, J. N., Tellegen, C. L., & Steindl, S. R. (2017). A meta-analysis of compassion-based interventions: Current state of knowledge and future directions. Behavior Therapy, 48(6), 778-792.
- ^ For a review see Weng, H. Y., Schuyler, B., & Davidson, R. J. (2017). The impact of compassion meditation training on the brain and prosocial behavior. In In E. M Seppälä, E. Simon-Thomas, S. L., Brown, M. C Worline, C. D. Cameron, & J. R Doty (Eds.), The Oxford Handbook of Compassion Science (pp. 133-146). New York, NY: Oxford University Press.
- ^ Kang, Y., Gray, J. R., & Dovidio, J. F. (2014). The nondiscriminating heart: Lovingkindness meditation training decreases implicit intergroup bias. Journal of Experimental Psychology: General, 143(3), 1306-1313.
- ^ Ashar, Y. K., Andrews-Hanna, J. R., Yarkoni, T., Sills, J., Halifax, J., Dimidjian, S., & Wager, T. D. (2016). Effects of compassion meditation on a psychological model of charitable donation. Emotion, 16(5), 691-705; Weng, H. Y., Fox, A. S., Shackman, A. J., Stodola, D. E., Caldwell, J. Z., Olson, M. C., ... & Davidson, R. J. (2013). Compassion training alters altruism and neural responses to suffering. Psychological science, 24(7), 1171-1180; Weng, H. Y., Fox, A. S., Hessenthaler, H. C., Stodola, D. E., & Davidson, R. J. (2015). The role of compassion in altruistic helping and punishment behavior. PLoS One, 10(12), e0143794; Leiberg, S., Klimecki, O., & Singer, T. (2011). Short-term compassion training increases prosocial behavior in a newly developed prosocial game. PloS One, 6(3), e17798.
- ^ Flook, L., Goldberg, S. B., Pinger, L., & Davidson, R. J. (2015). Promoting prosocial behavior and self-regulatory skills in preschool children through a mindfulness-based kindness curriculum. Developmental Psychology, 51(1), 44-51.
- ^ McCall, C., Steinbeis, N., Ricard, M., & Singer, T. (2014). Compassion meditators show less anger, less punishment, and more compensation of victims in response to fairness violations. Frontiers in Behavioral Neuroscience, 8, 424.
- ^ Haidt, J. (2003). Elevation and the positive psychology of morality. Flourishing: Positive Psychology and the Life Well-lived, 275, 289; Keltner, D., & Haidt, J. (2003). Approaching awe, a moral, spiritual, and aesthetic emotion. Cognition and Emotion, 17(2), 297-314.
- ^ Algoe, S. B., & Haidt, J. (2009). Witnessing excellence in action: The ‘other-praising’ emotions of elevation, gratitude, and admiration. The Journal of Positive Psychology, 4(2), 105-127.
- ^ Schnall, S., & Roper, J. (2012). Elevation puts moral values into action. Social Psychological and Personality Science, 3(3), 373-378; Schnall, S., Roper, J., & Fessler, D. M. (2010). Elevation leads to altruistic behavior. Psychological Science, 21(3), 315-320; Fowler, J. H., & Christakis, N. A. (2010). Cooperative behavior cascades in human social networks. Proceedings of the National Academy of Sciences, 107(12), 5334-5338.
- ^ Roeser, R. W., Colaianne, B. A., & Greenberg, M. A. (2018). Compassion and human development: Current approaches and future directions. Research in Human Development, 15(3-4), 238-251.
- ^ Mikulincer, M., & Shaver, P. R. (2005). Attachment security, compassion, and altruism. Current Directions in Psychological Science, 14(1), 34-38.
- ^ Batson, C. D. (2011). Altruism in Humans. New York, NY: Oxford University Press; Eisenberg, N., Fabes, R. A., & Spinrad, T. L. (2006). Prosocial development. In W. Damon, R. M. Lerner, & N. Eisenberg (Eds.), Handbook of Child Psychology: Social, Emotional, and Personality Development (Vol. 3) (6th ed., pp. 646-718). Hoboken, NJ: Wiley.
- ^ For an overview, see Koopmann-Holm, B., & Tsai, J. L. (2017). The cultural shaping of compassion. In E. M Seppälä, E. Simon-Thomas, S. L., Brown, M. C Worline, C. D. Cameron, & J. R Doty (Eds.), The Oxford Handbook of Compassion Science (pp. 273-286). New York, NY: Oxford University Press.
- ^ Bishop, S. R., Lau, M., Shapiro, S., Carlson, L., Anderson, N. D., Carmody, J., ... & Devins, G. (2004). Mindfulness: A proposed operational definition. Clinical Psychology: Science and Practice, 11(3), 230-241.
- ^ Dalai Lama, T. G., & Ekman, P. (2008). Emotional awareness: Overcoming the Obstacles to Psychological Balance and Compassion. New York, NY: Holt.
- ^ Shapiro, S. L., Oman, D., Thoresen, C. E., Plante, T. G., & Flinders, T. (2008). Cultivating mindfulness: Effects on well‐being. Journal of Clinical Psychology, 64(7), 840-862; Condon, P., Desbordes, G., Miller, W. B., & DeSteno, D. (2013); Meditation increases compassionate responses to suffering. Psychological Science, 24(10), 2125-2127.
- ^ Dahl, C. J.; Lutz, A., & Davidson, R. J., (2015). Reconstructing and deconstructing the self: Cognitive mechanisms in meditation practice. Trends in Cognitive Science, 19(9), 515–523.
- ^ Ozawa-de Silva, B., & Negi, L. T. (2013). Cognitively-based compassion training: Protocol and key concepts. In T. Singer and M. Bolz (Eds.), Compassion: Bridging Theory and Practice (pp. 416-437).
- ^ Pace, T. W., Negi, L. T., Sivilli, T. I., Issa, M. J., Cole, S. P., Adame, D. D., & Raison, C. L. (2010). Innate immune, neuroendocrine and behavioral responses to psychosocial stress do not predict subsequent compassion meditation practice time. Psychoneuroendocrinology, 35(2), 310-315; Pace, T. W., Negi, L. T., Dodson-Lavelle, B., Ozawa-de Silva, B., Reddy, S. D., Cole, S. P., ... & Raison, C. L. (2013). Engagement with cognitively-based compassion training is associated with reduced salivary C-reactive protein from before to after training in foster care program adolescents. Psychoneuroendocrinology, 38(2), 294-299.
- ^ Jinpa, T. (2015). A Fearless Heart: How the Courage to Be Compassionate Can Transform Our Lives. New York, NY: Hudson Street; Goldin, P. R., & Jazaieri, H. (2017). The Compassion Cultivation Training Program (CCT). In E. M Seppälä, E. Simon-Thomas, S. L., Brown, M. C Worline, C. D. Cameron, & J. R Doty (Eds.), The Oxford Handbook of Compassion Science (pp. 237-245). New York, NY: Oxford University Press.
- ^ Gilbert, P. (2014). The origins and nature of compassion focused therapy. British Journal of Clinical Psychology, 53(1), 6-41; Leaviss, J., & Uttley, L. (2015). Psychotherapeutic benefits of compassion-focused therapy: An early systematic review. Psychological Medicine, 45(5), 927-945.
- ^ Kemeny, M. E., Foltz, C., Cavanagh, J. F., Cullen, M., Giese-Davis, J., Jennings, P., ... & Ekman, P. (2012). Contemplative/emotion training reduces negative emotional behavior and promotes prosocial responses. Emotion, 12(2), 338-350.