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Compassionate mind training with people who hear malevolent voices: A case series report
... Although, there is limited empirical understanding of how CFT and CMT impacts upon the three emotion regulation systems proposed by the CFT model, particularly the drive system (Panting, 2018). There is growing evidence highlighting the effectiveness of CMT on increasing levels of compassion and subsequently reducing levels of emotional distress in both non-clinical (Matos et al., 2017) and clinical populations (Beaumont et al., 2012;Gilbert & Procter, 2006;Mayhew & Gilbert, 2008). CMT practices involve working with physiological processes (i.e., body posture, breathing, facial expressions and voice tones) as well as developing compassionate qualities such as wisdom, strength and commitment to stimulate the three flows of compassion (Matos, Duarte, Duarte, Gilbert, & Pinto-Gouveia, 2018). ...
... Currently, there is no consensus on the most useful CMT practices, with several variations in the literature (Beaumont et al., 2012;Gilbert & Procter, 2006;Matos et al., 2017;Mayhew & Gilbert, 2008). For example, Matos et al.'s (2017) CMT intervention consisted of participants attending a two hour face-to-face psychoeducational session, followed by a set of daily audio recorded CMT practices for two weeks, which resulted in significant increases across all three flows of compassion, as well as reductions in levels of selfcriticism, depression and stress. ...
... Indeed, self-criticism has been associated with difficulties in accessing feelings of self-compassion (Gilbert & Procter, 2006;Warren, Smeets, & Neff, 2016), as well as being a barrier to effective treatment outcomes (Warren et al., 2016). While there is currently no consensus on the most useful CMT practices, with variations in the literature (Beaumont et al., 2012;Gilbert & Procter, 2006;Matos et al., 2017;Mayhew & Gilbert, 2008), the current CMT practices primarily focused on enhancing the three flows of compassion. The findings of this study suggest it may also have been helpful to include a CMT practice specifically targeting self-criticism, to then enhance self-compassion. ...
The first chapter is a systematic review and meta-analysis which aimed to explore the relationship between self-compassion and compassion towards others among healthcare professionals. The review was conducted in line with PRISMA guidelines and a multi-base search identified 11 studies that met the inclusion criteria for the review. Overall, a small positive association was found between self-compassion and compassion towards others. This review offers preliminary support that it may be possible for interventions to target self-compassion to enhance compassionate care among healthcare professionals. Although, due to the cross-sectional nature of the included studies, conclusions regarding a causal relationship is limited. Future research directions are discussed.
The second chapter is an empirical paper which aimed to reduce burnout and self-criticism among mental healthcare professionals using Compassionate Mind Training (CMT; Gilbert, 2000) to increase the three flows of compassion (to self, towards others and from others). In total, 205 mental healthcare professionals participated in Part A of the study, exploring baseline associations between the three flows of compassion, burnout and self-criticism. Cross-sectional analyses revealed significant negative associations between self-compassion and compassion from others and burnout, while compassion towards others negatively associated with client-related burnout only. Burnout positively associated with self-criticism, depression, anxiety and stress. Part B of the study consisted of a randomised controlled trial with 68 mental healthcare professionals. Analyses revealed openness to receiving compassion from others significantly increased and personal and work-related burnout significantly decreased post-intervention. These findings have important clinical implications for understanding and reducing burnout and self-criticism among mental healthcare professionals.
Keywords: Mental Healthcare Professionals, Burnout, Self-Criticism, Compassionate Mind Training, Flows of Compassion, Self-Compassion, Compassion towards Others, Compassion from Others.
... Other studies evaluating CFT with people with severe and enduring mental health problems have tended to report data from case and observational studies. Mayhew and Gilbert (2008) reported on a case series of compassionate mind training (a key feature of CFT) for three individuals hearing malevolent voices. The study found that after 12 weekly sessions, all participants reported fewer malevolent and fewer persecuting voices, and two of the three heard more reassuring voices. ...
... However, it is important to note that that out of 27 individuals offered the group, only 13 (48%) completed the group, and the remaining individuals were lost to follow-up. This is similar to the dropout rate reported in other studies (e.g., Mayhew & Gilbert, 2008). Some people did not attend any sessions, whereas others did attend for at least one group session and then dropped out. ...
... It has been noted in previous research that some people report finding CFT work difficult, and indeed working on fears and blocks is a core part of the therapy (Gilbert, 2014). Previous research has noted participants finding it difficult to hold on to more than a fleeting compassionate image , difficulties generating an image that is not also self-critical (Mayhew & Gilbert, 2008), and a range of fears or blocks, including thoughts that self-compassion is self-indulgent or destructive (Lucre & Corten, 2013). ...
Objectives
Psychological therapy groups for people in adult mental health services can relieve waiting list pressures and potentially reduce stigma and social isolation. Compassion-focused therapy (CFT) focuses on shame and self-criticism. The aim of this study was to evaluate a transdiagnostic CFT group.
Design
Quantitative and qualitative data were obtained from 13 people who completed the group.
Methods
Participants completed a range of pre- and post-group self-report outcome measures that assess self-criticism and self-compassion.
Results
Statistically significant improvements were found on all measures used, suggesting that attending the CFT group did result in meaningful changes. People who completed the group also provided positive feedback about the experience.
Conclusions
The results suggest that running CFT groups is feasible and acceptable to clients with a range of psychiatric diagnoses as part of their care from community mental health teams. People who completed the group demonstrated significant improvements. A proportion of people did not complete the group, and more research is required about the reasons for this. Limitations of this study are considered together with future directions for research into CFT.
... Furthermore, neuroimaging studies have pointed out that both LKM and CM enhance activation of brain areas involved in emotional processing and empathy, such as the insula and the anterior cingulate cortex (Lutz, Brefczynski-Lewis, et al., 2008;Lutz et al., 2009;Lutz, Slagter, et al., 2008), and brain areas related to positive emotions, care, love, and affiliation (Klimecki, Leiberg, Lamm, & Singer, 2012). Compassion-and self-compassion-based treatments have also begun to be researched in clinical settings, showing positive preliminary results with people with high self-criticism and shame-related problems (Gilbert & Procter, 2006), schizophrenia (Mayhew & Gilbert, 2008), and social anxiety disorder (Werner et al., 2011). Secular compassion cultivation training programs have emerged over the last 5 years in a joint effort between Buddhist contemplatives and Western psychologists, including the Compassion Cultivation Training at Stanford's Center for Compassion and Altruism in Research and Education (CCARE; Jazaieri et al., 2012); the Cognitive-Based Compassion Training from the Emory-Tibet Partnership (Pace et al., 2009(Pace et al., , 2010; the Mindful Self-Compassion training designed by Kristin Neff and Christopher Germer (Neff & Germer, 2013); and the Compassionate Mind Training designed by Paul Gilbert in the United Kingdom (Gilbert, 2010;Gilbert & Procter, 2006). ...
... In another study, Gilbert and colleagues examined the effects of this same training protocol with people who met the diagnostic criteria for paranoid schizophrenia (Mayhew & Gilbert, 2008). Potential participants were recruited among people between ages 15 and 65 who had a diagnosis of schizophrenia, experienced hostile auditory hallucinations, and were identified from Community Mental Health Teams in the Derbyshire Mental Health NHS Trust. ...
... More recently, research on generative practices (loving-kindness, compassion, and selfcompassion) is also beginning to show that programs promoting these practices enhance psychological well-being and diminish psychological symptoms. For example, Gilbert's Compassionate Mind Training had significant effects on self-reported anxiety, depression, selfattacking, feelings of inferiority, submissive behavior, and shame in people with high shame and self-criticism (Gilbert & Procter, 2006), and significant decreases in depression, anxiety, and paranoia in patients with schizophrenia (Mayhew & Gilbert, 2008). In the first randomized controlled trial of the Mindful Self-Compassion training (Neff & Germer, 2013), this program proved effective in decreasing stress, anxiety, and depression, and in enhancing life satisfaction, compared to a wait-list group. ...
Although research on contemplative practices has increased in the last few decades, empirical research assessing compassion-based interventions is still in its infancy, and none of this research has been carried out in South America. Using a mixed-method approach, this study investigated the effects of the first implementation in Spanish of the Compassion Cultivation Training (CCT) with a community sample in Santiago de Chile. CCT is a 9-week contemplative group education protocol based on traditional Tibetan Buddhist teachings and contemporary psychology, developed by the Center for Compassion and Altruism in Research and Education at Stanford University. Compassion cultivation training (26 participants) was compared to a randomized waitlist control group (24 participants) and an active matched control group trained in an 8-week Mindfulness-Based Stress Reduction program (MBSR; 32 participants). The groups were assessed using measures of Psychological Wellbeing (depression, anxiety, stress, life satisfaction, and happiness), Contemplative Skills (mindfulness and self-compassion), and Altruistic Orientation (empathic concern, empathic distress, cognitive empathy, compassion for others, and identification with all humanity) at baseline, postintervention, and 2-month follow-up. Semi-structured interviews were carried out with 12 CCT participants. To offset self-report bias, friendly observer reports (questionnaires for friends and family members of participants) of CCT and MBSR participants were contrasted with participant data. Whereas the waitlist group did not show statistically significant pre-post changes in any outcome measure, CCT participants showed significant improvements in all three areas: Psychological Wellbeing (decreased depression and stress [ps < .001], increases in life satisfaction and happiness [ps < .05], and a trend toward significance for decreased anxiety [p < .07]); Contemplative Skills (increased mindfulness and self-compassion; ps < .001), and Altruistic Orientation (increased cognitive empathy, empathic concern, compassion for others, and identification with all humanity; and decreased empathic distress; all ps < .005). The MBSR comparison group also presented significant enhancements in psychological well-being and contemplative skills after the training; however, this group did not significantly change in empathic concern, compassion for others, and identification with all humanity. Friendly observer reports confirmed that cultivating compassion not only enhances personal well-being but also positively impacts relationships with others.
... Self-compassion is conceptualized as the ability to relate to distressing feelings with kindness, common humanity, and mindful awareness (Depue & Morrone-Strupinsky, 2005;Neff, 2003). Selfcompassion has been shown to be negatively correlated with distress from voices (Mayhew & Gilbert, 2008), and the presence of voices and unusual beliefs (Eicher, Davis, & Lysaker, 2013). These findings are supported in a case study in which development of self-compassion was described as useful in management of distress from critical voices (Kennedy & Ellerby, 2016) Birchwood et al. (2004) suggest that the way individuals relate interpersonally also influences the way they relate to their voices. ...
... This study demonstrated that mindfulness of voices, self-compassion, and secure attachment were positively associated with each other and negatively associated with distress/severity of voices. Self-compassion emerged as significantly correlated with lower distress and severity of voices, supporting the limited range of past findings related to hearing voices (Eicher et al., 2013;Mayhew & Gilbert, 2008), and the suggestion that selfcompassion may play a part in self-soothing and regulation of feelings of threat (Gilbert, 2009). However, the findings may also imply that those who are highly distressed by their voices are not as able to access feelings of self-compassion. ...
... Although the study design was cross-sectional, the findings provide support for the emerging evidence base of mindfulness-based and compassion-focused therapies for people who are distressed by their voices (Chadwick, Hughes, Russell, Russell, & Dagnan, 2009;Chadwick et al., 2016;Eicher et al., 2013;Mayhew & Gilbert, 2008) as well as some insight into the mechanisms involved. The findings support theory underpinning compassionate mind training (CMT; Gilbert & Procter, 2006). ...
Objectives:
Developing compassion towards oneself has been linked to improvement in many areas of psychological well-being, including psychosis. Furthermore, developing a non-judgemental, accepting way of relating to voices is associated with lower levels of distress for people who hear voices. These factors have also been associated with secure attachment. This study explores associations between the constructs of mindfulness of voices, self-compassion, and distress from hearing voices and how secure attachment style related to each of these variables.
Design:
Cross-sectional online.
Method:
One hundred and twenty-eight people (73% female; Mage = 37.5; 87.5% Caucasian) who currently hear voices completed the Self-Compassion Scale, Southampton Mindfulness of Voices Questionnaire, Relationships Questionnaire, and Hamilton Programme for Schizophrenia Voices Questionnaire.
Results:
Results showed that mindfulness of voices mediated the relationship between self-compassion and severity of voices, and self-compassion mediated the relationship between mindfulness of voices and severity of voices. Self-compassion and mindfulness of voices were significantly positively correlated with each other and negatively correlated with distress and severity of voices.
Conclusion:
Mindful relation to voices and self-compassion are associated with reduced distress and severity of voices, which supports the proposed potential benefits of mindful relating to voices and self-compassion as therapeutic skills for people experiencing distress by voice hearing.
Practitioner points:
Greater self-compassion and mindfulness of voices were significantly associated with less distress from voices. These findings support theory underlining compassionate mind training. Mindfulness of voices mediated the relationship between self-compassion and distress from voices, indicating a synergistic relationship between the constructs. Although the current findings do not give a direction of causation, consideration is given to the potential impact of mindful and compassionate approaches to voices.
... Gilbert and Procter (2006) developed the compassion-focused therapy (CFT) program, which invites high self-criticizing participants to engage in compassionate, nurturing, and reassuring imagery and self-talk. The effectiveness of CFT has been reported for those who have chronic difficulties, such as anxiety and depression (Gilbert & Procter, 2006), and can reduce hostile voices, paranoia, and self-criticism (Mayhew & Gilbert, 2008). Self-soothing interventions derived from CFT can lower shame and skin complaints among acne sufferers (Kelly, Zuroff, & Shapira, 2009), and group CFT for psychosis was associated with clinical improvements and increases in compassion (Braehler et al., 2013). ...
... The subscale focuses on limited aspects of mindfulness, including keeping emotions in balance and approaching feelings with curiosity and openness, although mindfulness is a broader concept than this. The present study recruited low self-compassionate participants, which no other studies have done (Braehler et al., 2013;Gilbert & Procter, 2006;Jazaieri et al., 2012;Kearney et al., 2013;Mayhew & Gilbert, 2008;Neff & Germer, 2013). Thus, the present study offered the first support for the use of a treatment focused on self-compassion for low self-compassionate people and enhanced the clinical implications for those who are vulnerable to psychopathology. ...
... It is also noteworthy that the ESP was effective in increasing self-compassion in a population that tends to have lower self-compassion than Americans (Arimitsu, 2014), but it should be considered carefully because the present study has applied only for low self-compassionate individuals in a high self-criticizing culture (Kitayama et al., 1997). The ESP has a potential to be applied worldwide because it has the similar components of programs focused on compassion in high self-critical individuals (Gilbert & Procter, 2006), a normal population (Fredrickson et al., 2008;Jazaieri et al., 2012;Neff & Germer, 2013), patients with PTSD (Kearney et al., 2013), and patients with psychosis (Braehler et al., 2013;Mayhew & Gilbert, 2008). Since it is not clear yet that the ESP program would be effective for a normal population, or patients in different cultures, further research is needed to examine it. ...
To date, there is no evidence suggesting that a program aimed at increasing self-compassion is effective in interdependent cultures such as Japan. The aim of this study was to examine the effects of an Enhancing Self-Compassion Program (ESP) among Japanese individuals in a randomized controlled study. Individuals reporting low self-compassion (N = 40) were randomly assigned to an ESP or wait-list control group. Participants completed self-report questionnaires at pretreatment, post-treatment, and a three-month follow-up. In the post-treatment and follow-up, ANOVAs revealed that the ESP group (N = 16) had significant improvements in each of the subscales of self-compassion (Cohen’s ds: .91–1.51) except for mindfulness, whereas the control group (N = 12) did not. Greater reductions in negative thoughts and emotions in the ESP group were also found. These gains remained at follow-up. These findings suggest that an ESP may be an effective and acceptable adjunct intervention for Japanese individuals with low self-compassion.
... For instance, Connor and Birchwood (2013) found that shame was the third most reported thematic content of voices. Finally, there is some preliminary evidence that compassion-focused therapy, whose primary goal is to reduce shame by increasing self-compassion, has a significant effect on voice whose content is hostile (Mayhew & Gilbert, 2008). ...
... Furthermore, our results represent a first step to the understanding of the role of shame in the experience of hallucination (like-experiences), which suggest that interventions targeting shame could also be beneficial in reducing hallucinations (McCarthy-Jones, 2017). There is some preliminary evidence that Compassion-focused therapy (CFT) has a significant effect on changing hostile voices into more reassuring and less malevolent voices (Mayhew & Gilbert, 2008). CFT was developed based on evidence showing that high levels of shame and self-criticism in individuals with histories of abuse, which results in considerable difficulties in self-compassionate (Gilbert, 2003(Gilbert, , 2009. ...
Introduction: Feelings of shame may be an important factor implicated in the onset and maintenance of hallucination (or hearing voices). Shame has been shown to increase trauma-related intrusions and avoidance and may reinforce negative beliefs about the self, which in turn may contribute to hallucinations in clinical and non-clinical populations. To our knowledge, no study has so far explored the role of shame in hallucination-proneness. Therefore, the main goal of the present study is to explore the mediation role of shame, trauma-related intrusions and avoidance in the association between childhood trauma and hallucination-proneness.
Methods: Self-report questionnaires were used to assess past traumatic experiences, trauma-related symptoms, shame, and hallucination proneness in 175 participants from the general population.
Results: Mediation analyses (joint-significance test and Monte Carlo test) showed that both shame and intrusions mediated the association between childhood trauma and hallucination-proneness.
Conclusions: Our results reinforce the importance of considering previous experiences of trauma and trauma-related symptoms, including feelings of shame in individuals experiencing hallucinations. Moreover, this study reinforces previous studies showing some preliminary evidence that compassion-focused therapy, whose primary goal is to reduce shame by increasing self-compassion, could have a significant effect on voices whose content is hostile.
... In particular, it has been argued that experiences of social threat after trauma, signalled through the emotion of shame, may both encourage the development of AVH and colour their content (McCarthy-Jones, 2012, 2017a. The Compassion Focused Therapy (CFT) framework suggests that an inability to mitigate shame, either through an inability to self-soothe, or through a lack of available external soothing (due to, for example, social isolation), could perpetuate this threat (Mayhew & Gilbert, 2008;Gilbert, 2009). By helping people to develop self-compassion and self-soothing, perceived threats can reduced. ...
... By helping people to develop self-compassion and self-soothing, perceived threats can reduced. For example, when Mayhew and Gilbert (2008) applied CFT to three patients who heard voices they found that CFT "had a major effect on voice-hearers' hostile voices, changing them into more reassuring, less persecutory and less malevolent voices". This suggests that experiences of shame and guilt may underpin some negative voice-content and, crucially, that working with these emotions in therapy can result in changes to the affective valence of voice-hearing. ...
Negative voice-content is the best sole predictor of whether the hearer of an auditory-verbal hallucination will experience distress/impairment necessitating contact with mental health services. Yet, what causes negative voice-content and how interventions may reduce it remains poorly understood. This paper offers a definitions of negative voice content and considers what may cause negative voice-content. We propose a framework in which adverse life-events may underpin much negative voice-content, a relation which may be mediated by mechanisms including hypervigilance, reduced social rank, shame and self-blame, dissociation, and altered emotional processing. At a neurological level, we note how the involvement of the amygdala and right Broca's area could drive negative voice-content. We observe that negative interactions between hearers and their voices may further drive negative voice-content. Finally, we consider the role of culture in shaping negative voice-content. This framework is intended to deepen and extend cognitive models of voice-hearing and spur further development of psychological interventions for those distressed by such voices. We note that much of the relevant research in this area remains to be performed or replicated. We conclude that more attention needs to be paid to methods for reducing negative voice-content, and urge further research in this important area.
... Recent research suggests compassion focused practice can be beneficial for a range of client groups. Particularly, assisting individuals with enduring mental health problems (Braehler et al., 2012;Gilbert & Proctor, 2006;Mayhew & Gilbert, 2008), eating disorders (Gale et al., 2012), social anxiety (Boersma et al., 2014), alcohol dependency (Brooks et al., 2012) and trauma symptom reduction (Beaumont et al., 2012;Beaumont & Hollins Martin, 2013;Bowyer et al., 2014).Bowyer et al. (2014)used CMT as an intervention to enhance TF-CBT with a 17year-old girl, who had suffered sexual assault at the age of 13. Results indicated a significant increase in self-reassurance and reduction in trauma, depression, shame and self-attacking symptoms post-therapy. Likewise,Beaumont et al. (2012)found that individuals (n = 32) developed more self-compassion post-therapy when compassionate mind training was used as a therapeutic intervention. ...
... The present findings are consistent with the results of Thompson andWaltz (2008), who suggest that incorporating techniques into therapy that help create affiliative feelings may benefit individuals suffering with symptoms of trauma develop selfcompassion. The results are in keeping with the findings of previous studies suggesting that when CFT is incorporated into psychotherapy it can be effective in helping individuals who experience mental health problems (Beaumont et al., 2012Beaumont et al., : 2013Boersma et al., 2014;Bowyer et al., 2014;Braehler et al., 2012;Brooks, et al., 2012;Gale et al., 2012;Gilbert and Proctor, 2006;Mayhew & Gilbert, 2008). A strength of the study was that participants in both groups completed therapy which is consistent with the findings fromEhlers et al., (2005). ...
Individuals working for the emergency services often bear witness to distressing events. This outcome study examines therapeutic interventions for Fire Service personnel (FSP) experiencing symptoms of trauma, depression, anxiety and low levels of self-compassion. This study aims to investigate the effectiveness of using Compassion-Focused Therapy (CFT) as an adjunct to Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) in reducing symptoms of trauma, anxiety and depression and increasing self-compassion. A convenience sample ( n = 17) of participants, referred for therapy following a traumatic incident, were allocated to receive 12 sessions of either TF-CBT or TF-CBT coupled with CFT. The study employed a repeated-measures design. Data were gathered pre- and post-therapy, using three questionnaires: (1) Hospital Anxiety and Depression Scale; (2) Impact of Events Scale-R; (3) Self-Compassion Scale – Short Form. TF-CBT combined with CFT was more effective than TF-CBT alone on measures of self-compassion. Significant reductions in symptoms of depression, anxiety, hyperarousal, intrusion and avoidance and a significant increase in self-compassion occurred in both groups post-therapy. The study provides some preliminary evidence to suggest that FSP may benefit from therapeutic interventions aimed at cultivating self-compassion. Further research is warranted using a larger sample size and adequately powered randomized controlled trial, to detect statistically significant differences and to negate the risk of confound due to low numbers resulting in significant differences between groups at baseline. Using CFT as an adjunct to TF-CBT may help FSP, who bear witness to the distress of others, cultivate compassion for their own suffering.
... In clinical settings, there is some evidence for efficacy of compassion-focused therapy (CFT) and compassionate mind training (a group program based on CFT), offered to mixed groups of patients with moderate to severe mental health problems who showed significant reductions in depression, anxiety, shame and self-criticism (Gilbert and Procter 2006; Judge et al. 2012; Lucre and Corton 2013). There is also preliminary evidence for patients with eating disorders (Gale et al. 2014 ), and patients with persistent psychotic phenomena (Mayhew and Gilbert 2008). Even patients in a high security ward benefited from group CFT with large effects on levels of depression and self-esteem (Laithwaite et al. 2009). ...
... In clinical settings, there is some evidence for efficacy of compassion-focused therapy (CFT) and compassionate mind training (a group program based on CFT), offered to mixed groups of patients with moderate to severe mental health problems who showed significant reductions in depression, anxiety, shame and self-criticism (Gilbert and Procter 2006;Judge et al. 2012;Lucre and Corton 2013). There is also preliminary evidence for patients with eating disorders (Gale et al. 2014), and patients with persistent psychotic phenomena (Mayhew and Gilbert 2008). Even patients in a high security ward benefited from group CFT with large effects on levels of depression and self-esteem (Laithwaite et al. 2009). ...
We developed a novel compassion-focused training (mindfulness-based compassionate living; MBCL) and examined its effects in a heterogeneous psychiatric outpatient population with regard to feasibility and changes in levels of depression, anxiety, mindfulness and compassion. The training consisted of nine weekly 2.5-h sessions. Thirty-three patients, who had followed a mindfulness-based stress reduction (MBSR) program or a mindfulness-based cognitive therapy (MBCT) program beforehand, participated in the study (mean age 48.1 years; 82 % female). Participants completed self-report questionnaires before and directly after the MBCL training. Levels of depression, but not of anxiety, reduced, and levels of mindfulness and self-compassion increased. Serious limitations of this study are the small sample size, the lack of a control group and the fact that about half of the participants did not complete the posttraining questionnaires. However, we determined that it is feasible to conduct further research on this novel MBCL training program as a basis for more robust empirical investigation in the future, more specifically examining the effects of MBCL and preferably also the underlying working mechanisms.
... Qualitative accounts from patients with psychosis highlight the potential role of self-compassion in facilitating recovery in psychosis (Waite et al., 2015). Current research studies have found positive outcomes for compassion focussed therapy for psychosis (Mayhew and Gilbert, 2008;Brahler et al., 2013). However, these studies have not focussed on reducing symptoms of psychosis, and they do not focus specifically on persecutory delusions. ...
... Although we believe that the pressing issue now is how best to treat negative self-cognitions in patients with psychosis . A number of small studies have investigated treatment of negative self-cognitions, including self-compassion (Mayhew and Gilbert, 2008;Braehler et al., 2013) and selfesteem (Hall and Tarrier, 2003). However, these studies have not tested improvements in persecutory delusions specifically. ...
There has been growing awareness of the high prevalence of negative cognitions about the self in patients with persecutory delusions, and it has been proposed that paranoid fears build upon these perceived vulnerabilities. This study aimed to investigate for the first time a wide range of different conceptualisations of the negative self, and to examine associations with suicidal ideation, in patients with persecutory delusions. Twenty-one patients with persecutory delusions and twenty-one non-clinical individuals completed measures relating to negative self cognitions. The delusions group also completed a measure of suicidal ideation. It was found that the patients with persecutory delusions had low self-compassion, low self-esteem, increased fears of being mad, beliefs of inferiority to others, negative self-schemas, and low positive self-schemas when compared to the non-clinical control group. The effect sizes (Cohen’s d) were large, and the different conceptualisations of negative self cognitions were highly associated with one another. Self-stigma did not differ between the two groups. Furthermore, suicidal ideation was highly associated with low self-compassion, low self-esteem, fears of madness, and negative self-schema but not self-stigma. This study shows marked negative self cognitions in patients with persecutory delusions. These are likely to prove targets of clinical interventions, with patient preference most likely determining the best conceptualisation of negative self cognitions for clinicians to use.
... Παράλληλα, φάνηκε και το αυξημένο ποσοστό συμπόνιας προς τον εαυτό και ενσυναίσθησης έπειτα από τη χρήση μεθόδων Συμπονετικού Νου. Παρά το ότι υπάρχει περιορισμένος αριθμός ερευνών για την αξία αυτής της προσέγγισης, απαιτείται περισσότερη και εκτενέστερη έρευνα σχετικά με την αποτελεσματικότητά της [26]. Η ΓΣΘ αποτελεί μία αποδεδειγμένη μορφή θεραπείας για τη διαταραχή, καθώς συμβάλλει στη μείωση των συμπτωμάτων της. ...
... Clients undergoing CMT are trained how to mindfully tolerate thoughts and feelings (Barnard & Curry, 2011). In fact, studies examining the effectiveness of this technique is very promising, however only few of these have been published (Mayhew & Gilbert, 2008). Seemingly, Neff, Kirkpatrick and Rude (2007) used the two-chair technique to facilitate students who were selfcritical. ...
This study reports the initial try out of an intervention program aimed to enhance subjective wellbeing through increase in individual's levels of compassion and forgiveness. The program was conducted among Filipino counselors. A single group pretest-posttest quasiexperimental design was adopted to test the effect of the Compassion and Forgiveness-Based Intervention Program on subjective well-being. Sixteen counselors enrolled in their post graduate degree were recruited to participate in the modular courses held in four sessions, four hours per session run in a two-month period. Pre-test and posttest assessments were conducted before and after the intervention program. Results obtained from paired t-tests demonstrated significant increase in the counselors' levels of compassion for others, self-compassion, forgiveness of others and subjective well-being after the intervention program. The results provide initial evidence on the role of compassion and forgiveness as pathways to subjective well-being. It is recommended that more interventionist research agenda be conducted to further examine the role of compassion, forgiveness to counselors' well-being
... Bunun yanı sıra bu programın öğrencilerin yaşam doyumlarını artırmada da etkili olacağı düşünülmüş ve Nas (2021) tarafından yapılan araştırmada da programın yaşam doyumu üzerinde etkili olduğu görülmüştür. Bu bağlamda alanyazın incelendiğinde, merhamete dayanan program ve eğitimlerin bireylerin psiko-sosyal gelişimleri, ruh sağlığı, iyi oluşları ve yaşam doyumları üzerinde olumlu biçimde etkide bulunduğu anlaşılmaktadır (Mayhew ve Gilbert, 2008;Issa ve Raison, 2009 (Hökelekli, 2013). • Merhamet, zor durumda olan bireylere karşı duyulan acıma, üzüntü duyma hissi ve bu his sonucunda iyilik yapma ve yardım etme olarak açıklanabilmektedir (Polat, 2016). ...
... Even if the LKM exercise took only 15-20 minutes itself, the effects of the treatment were also modest. According to clinical studies, the LKM treatment contained 8 weekly 1-hour parts to decrease chronic low back pain (Carson et al., 2005), and 12 1-hour weekly parts for treating patients with paranoid symptoms in schizophrenia (Mayhew & Gilbert, 2008). ...
Research in positive psychology aims to find and develop diverse ways to improve human well-being and the psychophysical functioning (Fredrickson, 2008; Seligman, 2002; Sheldon & Lyubomirsky, 2006). As an example, the studies regard such concepts as positive emotions, character strengths or meaning in life. One of the most frequently studied constructs is also gratitude, that is regarded as the appreciation of all what is meaningful, as well as valuable, to oneself (Sansone & Sansone, 2010). Also, the social aspect of being grateful, and the effects of gratitude on one’s health and physical functioning, are frequently emphasized (McCullough, Kimeldorf & Cohen, 2008; Fox, Kaplan, Damasio and Damasio 2015; Algoe, Haidt & Gable, 2008). Among great amount of work about general gratitude already, there is still little research about gratitude contemplation, one of the exercises that enable a person experiencing gratitude in form of meditation. In this article, first I explain the meaning of the gratitude construct and its impact on peoples psychophysical state in general. Then, I analyze one of the newest gratitude activity, that is gratitude contemplation, its definition, the way of use and the results of recent empirical studies worldwide. Finally, I critically discuss the findings and conclude with future steps for further research on gratitude contemplation. I believe that the results and analysis presented in the article create a base for further research in the area of positive psychology.
... As such, despite the struggle with compassion exercises compassion training may still be worthwhile. In a small case series applying compassionate mind training among 3 patients with schizophrenia spectrum disorders, Mayhew and Gilbert (2008) reported that one out of the three participating patients had difficulty applying compassion because he felt he did not deserve compassion (possibly due to undisclosed shame-linked fantasies), however, all 3 patients received symptom reduction. Also, in support of compassion training to schizophreniaspectrum disorder, a randomized feasibility trial comparing group CFT plus treatment as usual (TAU) with TAU found more improvement in the CFT intervention (Braehler et al., 2013). ...
Anger dysregulation is part of a broad range of clinical disorders, and as a dynamic risk factor for aggression anger is highly relevant in clinical populations. Problems of anger and reactive aggression are trans-diagnostic and treatments should target the mechanisms involved in problematic anger across disorders. There is empirical evidence that anger rumination is associated with anger as well as aggression. Because rumination-focused CBT (RfCBT) has shown that reduction in rumination seems to be associated with transdiagnostic reductions in symptoms, the present study aimed at extending the applicability of the RfCBT model to target problematic anger in a case of schizotypal personality disorder (SPD). The current study was a clinical case study with a patient suffering from problematic anger and anger rumination, and diagnosed with schizotypal personality disorder (SPD) receiving 25 sessions of rumination-focused CBT (RfCBT) for problematic anger. The primary focus was on anger and anger rumination, which was reduced during therapy, and maintained in the 3 months follow up. Results on the measures of repetitive negative thinking also showed a decrease, however symptoms of depression and anxiety had increased from pre- to post treatment. RfCBT can be applied to a case of SPD with problematic anger, thereby showing proof of concept for a transdiagnostic use of RfCBT and opening up for future research in this area. The applicability of RfCBT to anger problems among patients diagnosed with SPD needs to be replicated in a larger sample of patients diagnosed with SPD/problematic anger and anger rumination.
... Thus, it could be inferred that compassion arises when a person begins to realize his or her current situation, and this is also related to the moment in which a person begins to make plans for the future and set personal goals. In Mayhew and Gilbert's (2008) case studies, administering "compassionate mind training" to three psychotic voice hearers helped these patients to develop empathy and feel safer and less threatened, allowing to at least two of them to continue their life projects. However, the fact that compassion showed a relationship with perceived social support could also imply the establishment of reciprocal relationships, which are expected in solid and healthy interpersonal relationships (Jung, 1990). ...
The impact of religiosity and spirituality (R/S) on mental health and the importance of incorporating R/S in mental health treatment have been previously explored. However, clarification is needed regarding the effects of R/S in the process of recovery from persistent mental disorders (PMDs). This study identifies how different R/S factors correlate with the stages of recovery, while considering individual psychological well-being and perceived social support. Seventy-five individuals who use Madrid's public services for people with PMD completed questionnaires assessing those factors. We found that during the recovery process, R/S correlated with psychological well-being and perceived social support, and that these variables were associated with the five stages of recovery differently. We further identified the importance of gratitude, compassion, inner peace, and connection with life in the recovery process. Overall, our findings highlight the importance of these R/S variables in particular recovery stages for individuals with PMD.
... Las intervenciones psicológicas centradas en la compasión se han analizado de manera sistemática en el ámbito aplicado, y diversos estudios han utilizado estas intervenciones en poblaciones con trastornos como esquizofrenia (Braehler et al., 2013;Laithwaite et al., 2009;Mayhew y Gilbert, 2008), sintomatología ansiosa y depresiva (Gilbert y Irons, 2004;Gilbert y Procter, 2006), trastorno bipolar (Laithwaite et al. 2009), desórdenes crónicos de personalidad (Lucre y Corten, 2013), acné crónico (Kelly, Zuroff y Shapira, 2009), trastornos alimentarios (Gale, Gilbert, Read y Goss, 2014), efectos posteriores a traumas (Beaumont et al. 2012), lesiones cerebrales por accidentes de tráfico (Ashworth, Gracey y Gilbert, 2011), tabaquismo (Kelly, Zuroff, Foa y Gilbert, 2010), depresión, ansiedad, trastorno obsesivo-compulsivo, ansiedad social y autolesiones deliberadas (Judge, Cleghorn, McEwan y Gilbert, 2012). ...
El constructo compasión utilizado en el presente estudio se definió como el profundo deseo de aliviar el sufrimiento propio y el de los demás. En esta investigación se describe el proceso de construcción y evaluación de las propiedades psicométricas de una escala de compasión para población mexicana. La muestra estuvo compuesta por 385 personas de al menos 16 años de edad de la población general. El análisis de consistencia interna de la escala mostró una alta confiabilidad, y el análisis factorial exploratorio una estructura de tres factores de primer orden y un factor general de segundo orden que explicaron 44.7% de la varianza. El análisis factorial confirmatorio comprobó esta estructura y arrojó buenos índices de ajuste relativo y general para la escala. En conclusión, el instrumento que aquí se presenta es confiable para evaluar la compasión en la población mexicana.
... They posit that self-compassion activates the self-soothing system, thereby reducing feelings of fear and isolation (Gilbert, 2005;Gilbert, 2009;Gilbert & Irons, 2005). Although the effectiveness of this approach is emerging, preliminary findings suggest that CFT significantly reduces self-hatred and associated anxiety and depression (Gilbert & Proctor, 2006;Mayhew & Gilbert, 2008). Consistent with the construct of self-compassion, mindfulness-and acceptance-based interventions aim to reduce maladaptive evaluations of one's self and experiences to promote more adaptive ER (Gratz & Tull, 2010;Kuyken et al., 2010), and these approaches have demonstrated effectiveness in treating OCD (Fairfax, 2008;Twohig, Hayes, & Masuda, 2006;Twohig et al., 2010;Wilkinson-Tough, Bocci, Thorne, & Herlihy, 2010). ...
Self-compassion involves extending kindness and understanding to one's self. Research has demonstrated inverse relationships between self-compassion and maladaptive constructs associated with obsessive–compulsive disorder (OCD), including emotion regulation (ER) difficulties. The current study sought to explore associations between self-compassion, ER difficulties, and OCD severity. Data were collected at the International Obsessive–Compulsive Disorder Foundation convention from 62 attendees who reported having a diagnosis of OCD (51% male, mean age 35.9 years). Findings demonstrated that self-compassion and ER difficulties were associated with overall OCD severity. Results also indicated that ER difficulties mediated relationships between self-compassion and overall OCD severity, as well as the severity of two OCD symptom dimensions, responsibility for harm and unacceptable thoughts. These findings suggest that self-compassion and ER difficulties may be involved in the maintenance and severity of OCD.
... For example, Lysaker and colleagues 120 have developed interventions designed to foster awareness of different cognitive operations and integrate them into a more coherent experience of self. Finally, this review suggests the need for further investigation of therapies that target the interactive, dynamic, and phenomenologically rich nature of hallucinations, such as Avatar Therapy, 121 Compassion Focused Therapy, 122 and Voice-Dialogue. 123 ...
Recent psychiatric research and treatment initiatives have tended to move away from traditional diagnostic categories and have focused instead on transdiagnostic phenomena, such as hallucinations. However, this emphasis on isolated experiences may artificially limit the definition of such phenomena and ignore the rich, complex, and dynamic changes occurring simultaneously in other domains of experience. This article reviews the literature on a range of experien-tial features associated with psychosis, with a focus on their relevance for hallucinations. Phenomenological research on changes in cognition, perception, selfhood and reality, temporality, interpersonal experience, and embodiment are discussed, along with their implications for traditional conceptualizations of hallucinations. We then discuss several phenomenological and neurocognitive theories, as well as the potential impact of trauma on these phenomena. Hallucinations are suggested to be an equifinal outcome of multiple genetic, neurocognitive, subjective, and social processes; by grouping them together under a single, opera-tionalizable definition, meaningful differences in etiology and phenomenology may be ignored. It is suggested that future research efforts strive to incorporate a broader range of experiential alterations, potentially expanding on traditional definitions of hallucinations. Relevance for clinical practice, including emphasizing phenomenologically responsive techniques and developing targeted new therapies , is discussed.
... In this line, Singer and Bolz (2013), propose the ReSource Model of Compassion (Bornemann & Singer, 2013). This model suggests that the cultivation of compassion revealing how compassion diminishes reactivity to stress and is central to the process of recovery from psychopathology ( Gilbert, 2010a;Gilbert & Procter, 2006;MacBeth & Gumley, 2012;Mayhew & Gilbert, 2008;Pace et al., 2013). ...
There is growing evidence of how compassion training enhances psychological and physical well-being (Zessin, Dickhäuser, & Garbade, 2015), however, there are very few studies analyzing the efficacy of Compassion-Based Interventions (CBI) on breast cancer survivors (BCS) (Dodds et al., 2015). According to the World Health Organization (WHO), breast cancer (hereafter referred to as BC) is the most common neoplasm among women and is a major public health problem worldwide (22.7% of all female cancers) (McGuire, 2016; Perou, Sorlie, Eisen, & Van De Rijn, 2000; R. L. Siegel, Miller, & Jemal, 2015; R. L. Siegel, Miller, & Jemal, 2016; Torre et al., 2015). For this and many other reasons, it is important to begin and continue doing research that addresses the after-treatment-breast-cancer-emotional-turmoil with new psychological approaches (Dodds et al., 2015; Thewes et al., 2014).
According to the American Society of Clinical Oncology (ASCO), being a BCS means different things, depending on who experiences it. For some, it means having no signs of cancer after finishing treatment. Survivors may experience a mixture of strong feelings, including joy, concern, relief, guilt, and fear (Mols, Vingerhoets, Coebergh, & Franse, 2005). Others become very anxious about their health and uncertain about coping with everyday life. Some people may even prefer to put the experience behind them and feel that their lives have not changed in a major way (Mayer, 2017).
A vast body of research evaluating the effects of psychosocial interventions on psychological adaptation during cancer treatment has been done (Antoni, 2013; Guo et al., 2013; Stanton, 2006; Stanton, Luecken, MacKinnon, & Thompson, 2013). In a systematic review (Fors et al., 2011), data show that psychoeducational programs, cognitive behavioral therapy and social and emotional support are the most significant therapies for improving mood, quality of life (QoL), and observed fatigue. The impact of psychological interventions on cancer survival is relevant and a growing number of evidence confirms it. In a review of studies, Stanton et al. (2005) found that persistent psychological and physical decrements occur for a subset of cancer survivors.
During the last decade, a growing number of empirical data for new intervention approaches has arisen. There is a call for empirical attention to a broader range and relevant ways to intervene with complementary approaches (Goldstein et al., 2005; Richardson, Sanders, Palmer, Greisinger, & Singletary, 2000). Research is beginning to accumulate valuable data on such interventions for cancer survivors as yoga (Cohen, Warneke, Fouladi, Rodriguez, & Chaoul‐Reich, 2004), massage (Hernandez-Reif et al., 2004) and mindfulness meditation (Carlson, Speca, Patel, & Goodey, 2003).
In oncological settings, Mindfulness-Based Interventions (MBI) have proved their efficacy in promoting well-being and QoL domains (Sinatra & Black, 2018; Zainal, Booth, & Huppert, 2013). These kind of interventions have shown to be effective in training coping strategies when dealing with psychosocial stress related to the disease, relieving anxiety, stress, fatigue, general mood, sleep disturbance, and improving psychological aspects of QoL (Carlson et al., 2003; Carlson & Garland, 2005). Moreover, data show that MBI can significantly improve psychological domains such as anxiety, depression, and stress in cancer survivors not only after intervention but at long-term (Cramer, Lauche, Paul, & Dobos, 2012; Piet, Wurtzen, & Zachariae, 2012).
The concept of compassion has appeared in psychology in relation to the mindfulness and MBI. In the last two decades, compassion has extended to other domains such as the medical field (Kemper, Larrimore, Dozier, & Woods, 2006; Mascaro et al., 2016; Rousseau, 2004; Strasser et al., 2005; Von Dietze & Orb, 2000), psychotherapy (Gilbert, 2010a; Gilbert & Procter, 2006; Gilbert, 2013), and others (Davidson & Harrington, 2002; Desbordes et al., 2012; Dodds et al., 2015; Mascaro, Rilling, Tenzin Negi, & Raison, 2012; Ozawa-de Silva et al., 2012; Pace et al., 2009; Pace et al., 2012; Reddy et al., 2013; Singer & Bolz, 2013).
Well designed contemplative-based programs have highlighted the benefits of compassion training on physical health, evocation of positive emotions, mental health, social belonging parameters (Grant, 2013; Mascaro, Pace, & Raison, 2013; Neff & Germer, 2013) and on bringing first and third person methods together into the scientific paradigm (Klimecki, Ricard, & Singer, 2013; Kok, 2013). In the last decade CBI have shown to improve psychological functioning and well-being in clinical and educational settings (Kirby, Tellegen, & Steindl, 2015; Kirby, 2017).
As for the empirical framework, we should point out that the main aim of this study is to analyze the efficacy of Cognitively-Based Compassion Training (CBCT) Program in a Randomized Clinical Trial (RCT) on a sample of BCS. The specific objectives are aimed to analyze the efficacy of CBCT in variables related to QoL, psychological symptomatology, psychological dimensions linked to fear of cancer recurrence (FCR), self-compassion, compassion and mindfulness trait facets and the influence of CBCT over participants’ compassion and self-compassion semantic construct, when compared to a treatment as usual (TAU) control group. Hypothesis of this study predicts that CBCT group will show improvement in all of the variables showed above. Moreover, participants’ semantic construction, of what is a compassionate and self-compassionate individual, will be modified in the direction of what CBI and compassion-based contemplative traditions propose after going through the CBCT program.
A RCT was designed. Participants (n = 56) were randomly assigned to CBCT (n = 28) or a treatment-as-usual control group (n = 28). Pre-post intervention and 6-month follow-up measures took place to evaluate health-related quality of life; psychological symptomatology; psychological stress, coping strategies, and triggering cognitions for FRC; self-compassion and compassion; mindfulness facet traits; and semantic construction of compassion and self-compassion concepts in both intervention and wait-list groups
CBCT was effective in diminishing stress caused by fear of FCR (F [2, 96.863] = 3.521, p < .05), fostering self-kindness (F [2, 97.453] = 5.769, p < .01) and common humanity (F [2, 98.323] = 6.161, p < .01), and increasing overall self-compassion scores (F [2, 96.277] = 5.423, p < .01), mindful observation (F [2, 96.052] = 4.709, p < .05), and acting with awareness skillsets (F [2, 98.598] = 3.444, p < .05). CBCT also proved to influence participants’ mental construction of what is a self-compassionate and compassionate being.
This research project is another call for deepening scientific knowledge and paying more attention to the mechanisms and implications of training in compassion and exploring the potential of these type of programs for cancer survivorship contexts. In this line of reasoning, a promising potential of compassion programs is the explicit intent to cultivate skills to cope with internal (feelings, thoughts, sensations, memories, self-criticism, etc) and external (lost, sickness, death, criticism) difficulties and turn them into opportunities for growth from the basis of a selflessness perspective (Dambrun & Ricard, 2011; Dambrun et al., 2012). Moreover, more efforts should be focused in dapating compassion training programs to Latin-Mediterranean-Catholic settings.
... In contemplative traditions, its primary goal is to become familiar with the nature of one's mind (Dalai Lama & Cutler, 1998). Recent studies have shown that secularized meditation practices can reduce stress, increase well-being and positive affect, health, cognitive and socio-affective functioning as well as brain plasticity (Baer, 2003;Davidson et al., 2003;Gilbert & Procter, 2006;Goyal et al., 2014;Jacobs et al., 2011;Klimecki, Leiberg, Lamm, & Singer, 2012;Klimecki, Leiberg, Ricard, & Singer, 2013;MacLean et al., 2010;Mayhew & Gilbert, 2008;Moyer et al., 2011). Likewise, the cultivation of loving-kindness and self-compassion (Hofmann, Grossman, & Hinton, 2011;Hutcherson, Seppala, & Gross, 2008;Leiberg, Klimecki, & Singer, 2011;Lutz, Greischar, Perlman, & Davidson, 2009;Pace et al., 2009;Rockliff, Gilbert, McEwan, Lightman, & Glover, 2008;Weng et al., 2013) through meditation have been investigated by third-person methods, that is measuring objective outcome measures such as brain plasticity, sympathetic and neuroendocrine changes, or prosocial behavior. ...
Despite increasing interest in effects of meditation, systematic in-depth research on how it qualitatively feels to engage in different kinds of contemplative practices is still missing. To fill this gap, we explore the validity of Micro-phenomenological Interviews (MpI) to assess experiences during breathing meditation (BM), observing-thought meditation (OTM), and loving-kindness meditation (LKM). We performed psycholinguistic analyses, quantitative ratings and qualitative explorations of 104 MpI (N = 57). All results reveal differential affective, bodily and sensorial fingerprints: BM-transcripts contain the most body-related vocabulary, specifically sensations in nose and abdomen. OTM-transcripts contain the most cognition-related vocabulary. OTM is experienced in head and face. LKM-transcripts contain the most vocabulary related to socio-affective processes. LKM is associated to love, sensations around the heart, and warmth. The LKM-outcomes were replicated with another independent set of MpI. These findings verify the merit of MpI as a scientific tool to gain reliable first-person data beyond questionnaires or rating scales.
... Responding with compassion to self and voices are central tenets of compassion-focused therapy (CFT). As with ACT, CFT seems to be appealing to clinicians, but to date it has evidence from only one case study when used specifically for the treatment of voices (Mayhew 2008). ...
In a previous article in this journal, Turkington et al suggested a number of psychological approaches that an individual can use to reduce the distress caused by hearing voices. Despite having popular appeal, only some of these approaches have evidence for their effectiveness. Within a clinical context where few patients with psychosis have access even to evidence-based approaches, the reader is invited to familiarise themselves with the evidence before selecting which approaches to introduce to their patients.
DECLARATION OF INTEREST
M.H. is one of the authors of the self-help book Overcoming distressing Voices that is promoted within the article.
... For example, loving kindness and compassion for others have been empirically related to decreased depression and stress and enhanced wellbeing (Cosley et al. 2010;Fredrickson et al. 2008;Steffen and Masters 2005). In addition, Gilbert's Compassionate Mind Training had significant effects on self-reported anxiety and depression in people with high shame and self-criticism (Gilbert and Procter 2006), and significant decreases in depression, anxiety, and paranoia in patients with schizophrenia (Mayhew and Gilbert 2008). ...
Mindfulness-based interventions generally include compassion implicitly, but it remains to be seen whether implicit compassion training can be effective, or if it needs to be trained explicitly through specific meditations and relational practices. This research study had two specific goals. The first was to expand the literature on the effects of compassion-based interventions (CBIs) by assessing the impact of the Compassion Cultivation Training program (CCT) on anxiety, depression, stress, life satisfaction, happiness, mindfulness, empathy, self-compassion, compassion for others, and identification with all humanity, through a wait-list randomized controlled trial in a community sample (study 1). Secondly, this research addressed the following question: Does a CBI—an explicit compassion training—have a differential impact in terms of empathy, compassion, and identification with all humanity, compared to a mindfulness-based intervention (mindfulness-based stress reduction (MBSR)) in which compassion is taught implicitly? (study 2). Groups were assessed at baseline, post-intervention, and 2-month follow-up, and analyses involved repeated-measures of analysis of variance (ANOVA) for group contrasts. Compared to the wait-list group, CCT participants showed significant improvements in psychological well-being (decreased depression and stress, increases in life satisfaction, happiness, mindfulness, and self-compassion) and compassion skills. Both MBSR and CCT were effective in generally enhancing psychological well-being and increasing mindfulness and compassion, but CCT had a greater impact on developing compassionate skills, especially empathic concern and identification with all humanity. This research highlights the potential for a complementary (rather than competitive) relationship between mindfulness- and compassion-based interventions.
... Early studies of CMT have demonstrated effectiveness even with complex psychological difficulties (Beaumont and Martin 2013;Braehler et al. 2013;Gilbert and Procter 2006;Mayhew and Gilbert 2008). More recent studies using nonclinical populations also found evidence for the effectiveness of CMT. ...
This paper explores indicators of practice quality of a brief compassion mind training (CMT) intervention and their impact on the development of an inner sense of one’s compassionate self (CS) and a range of self-report measures. Participants were randomly assigned to one of two conditions: compassionate mind training (CMT; n = 77) and wait-list control. Participants in the CMT condition practiced a range of CMT practices during 2 weeks. Each week, participants completed a feedback questionnaire, measuring practice frequency, helpfulness and embodiment of the practices in everyday life. Self-report measures of compassion, positive affect, shame, self-criticism, fears of compassion and psychopathological symptoms were also completed at pre and post. Practice frequency was associated with the frequency and easiness of embodiment of the CS. Perceived helpfulness of the practices was related to greater embodiment of the CS and to increases in compassion, reassured self, relaxed and safe affect and decreases in self-criticism. The embodiment variables of the CS were associated with higher compassion for the self, for others and from others and with improvements in reassured self, safe affect and compassionate goals. Embodiment of the CS and perceived helpfulness of the practices predicted compassion for the self and experience of compassion from others at post-intervention. Perceiving compassion cultivation practices as helpful and being able to embody the CS in everyday life is key to foster self-compassion and the experience of receiving compassion from others, as well as to promote feelings of safeness, contentment and calmness.
... Tradycyjne strategie terapii poznawczo-behawioralnej zostały wzbogacone o dodatkowe metody polegające na wzmacnianiu wspomnień pozytywnych (competitive memory training -COMET) [10] oraz o trening pracy z poczuciem wstydu i wewnętrznej krytyki (compassionate mind training -CMT). [11] Ich zastosowanie ma pomóc w radzeniu sobie i przeformułowaniu negatywnego schematu siebie. ...
... Learning new ways to manage threat may have a beneficial impact on memory representations, intrusions and appraisals. For example, third wave approaches including dialectic behavior therapy, mindfulness, acceptance and commitment therapy and compassion-focused therapy could be of value (Linehan, 1993;Mayhew and Gilbert, 2008;Morris et al., 2013). Further research is required to identify the effectiveness of these approaches, and what works best for whom. ...
In recent years, empirical data and theoretical accounts relating to the relationship between childhood victimization and psychotic experiences have accumulated. Much of this work has focused on co-occurring Posttraumatic Stress Disorder or putative causal mechanisms in isolation from each other. The complexity of posttraumatic stress reactions experienced in psychosis remains poorly understood. This paper therefore attempts to synthesize the current evidence base into a theoretically informed, multifactorial model of posttraumatic stress in psychosis. Three trauma-related vulnerability factors are proposed to give rise to intrusions and to affect how people appraise and cope with them. First, understandable attempts to survive trauma become habitual ways of regulating emotion, manifesting in cognitive-affective, behavioral and interpersonal responses. Second, event memories, consisting of perceptual and episodic representations, are impacted by emotion experienced during trauma. Third, personal semantic memory, specifically appraisals of the self and others, are shaped by event memories. It is proposed these vulnerability factors have the potential to lead to two types of intrusions. The first type is anomalous experiences arising from emotion regulation and/or the generation of novel images derived from trauma memory. The second type is trauma memory intrusions reflecting, to varying degrees, the retrieval of perceptual, episodic and personal semantic representations. It is speculated trauma memory intrusions may be experienced on a continuum from contextualized to fragmented, depending on memory encoding and retrieval. Personal semantic memory will then impact on how intrusions are appraised, with habitual emotion regulation strategies influencing people’s coping responses to these. Three vignettes are outlined to illustrate how the model accounts for different pathways between victimization and psychosis, and implications for therapy are considered. The model is the first to propose how emotion regulation and autobiographical memory may lead to a range of intrusive experiences in psychosis, and therefore attempts to explain the different phenomenological associations observed between trauma and intrusions. However, it includes a number of novel hypotheses that require empirical testing, which may lead to further refinement. It is anticipated the model will assist research and practice, in the hope of supporting people to manage the impact of victimization on their lives.
... Following the initial assertiveness phase, the avatar's character gradually changes to become conciliatory or even helpful. This initiates a second phase which focuses on issues of self-esteem and identity, work that is consistent with other recent approaches emphasizing the importance of self-esteem and selfcompassion in working with distressing voices (Mayhew and Gilbert 2008 ;van der Gaag et al. 2012). Specifi c work on self-esteem typically includes asking the person to get friends and family to provide a list of their strengths and best qualities which can then be used in dialogue with the avatar. ...
... 189-191). Evidence suggests that CFT can reduce distress for patients in acute in-patient settings (Heriot-Maitland 2014) and can reduce distress from critical auditory hallucinations (Mayhew 2008). While CFT would appear to be a viable complement to the cognitive model, there are no randomised trials of CFT in the treatment of psychosis to date. ...
The evidence base for cognitive-behavioural therapy (CBT), family therapy, psychoeducation and cognitive remediation as adjuncts to antipsychotic medication in the treatment of schizophrenia is well established. It is, however, clear that the moderate effect size of the best researched of these treatments (CBT) compared with treatment as usual reduces to small when compared with an active psychological treatment. It would seem that many different psychosocial interventions de liver benefit in schizophrenia. We are now at a stage in their development when new treatments are being energetically piloted and combination treatments tested. This article outlines the most promising of these new interventions and attempts to answer the crucial question as to their differential effects on different psychotic presentations.
LEARNING OBJECTIVES
• Be aware of the most promising new psychosocial treatments for schizophrenia
• Learn the key elements of each intervention
• Understand which of these approaches might be best suited to particular presentations of schizophrenia spectrum disorder
... Pour conclure, notons que même si les TCC et leurs dérivées n'ont pas toujours un impact significatif sur la réduction des HAV (fréquence, contenu…), elles peuvent aider le patient à mieux vivre avec elles et à mieux les accepter. Le patient peut ainsi parvenir à moins obéir aux voix (exemple de la méthode CTCH, Cognitive Therapy for Command Hallunications -thérapie cognitive pour les hallucinations de commande ; Trower et al., 2004 ;Birchwood et al., 2014) ou à moins se laisser influencer par leur contenu dans le cas de voix humiliantes (thérapie COMET, van der Gaag et al., 2012) ou critiques (méthode CMT, Mayhew & Gilbert, 2008). Les patients rapportent aussi souvent une amélioration de leur qualité de vie (e.g., Wiersma et al., 2004). ...
... personal relationship with others, physical health, self-acceptance, satisfaction). [141] Preliminary evidence from proof-of-concept clinical trials in individuals with schizophrenia, [142] posttraumatic stress disorder, [143] and more recently in dysthymia [144] show increases in positive emotions, anhedonia, and an improved sense of self and others. In our treatment, clients are given an audio-guide to generate an image of the recipient (self, another person, a pet), gently sending loving kindness ("may you be healthy," "may you have peace," "may you be free from suffering") while mindfully observing how "wishing well" influences their emotions in the moment. ...
Anhedonia, or loss of interest or pleasure in usual activities, is characteristic of depression, some types of anxiety, as well as substance abuse and schizophrenia. Anhedonia is a predictor of poor long-term outcomes, including suicide, and poor treatment response. Because extant psychological and pharmacological treatments are relatively ineffective for anhedonia, there is an unmet therapeutic need for this high-risk symptom. Current psychological and drug treatments for anxiety and depression focus largely on reducing excesses in negative affect rather than improving deficits in positive affect. Recent advances in affective neuroscience posit that anhedonia is associated with deficits in the appetitive reward system, specifically the anticipation, consumption, and learning of reward. In this paper, we review the evidence for positive affect as a symptom cluster, and its neural underpinnings, and introduce a novel psychological treatment for anxiety and depression that targets appetitive responding. First, we review anhedonia in relation to positive and negative valence systems and current treatment approaches. Second, we discuss the evidence linking anhedonia to biological, experiential, and behavioral deficits in the reward subsystems. Third, we describe the therapeutic approach for Positive Affect Treatment (PAT), an intervention designed to specifically target deficits in reward sensitivity.
... Bu sistem " sosyal güven ve memnuniyet olarak adlandırılmakta, (Gilbert, McEwan, Irons ve Cheung, 2007), psiko-sosyal işlevsellikle önemli bir rol oynamaktadır (Kelly, Zuroff, Leybman ve Gilpert, 2012). Bireyin bu sistemini güçlendirecek terapötik yaklaşımlar faydalı olmakta ve bazı psikolojik rahatsızlıklara olan kırılganlığı azaltmaktadır (Gilbert ve Procter, 2006, Mayhew ve Gilbert, 2008). Buna ek olarak insanlar sosyal etkinliklere katılarak (birlikte olmaktan zevk alınan arkadaşlarla vakit geçirme gibi) ya da sosyal olmayan etkinlikler yaparak da olumlu duygular kazanabilirler (Gilbert ve diğerleri, 2009). ...
Adaptation of the Social Safeness and Pleasure Scale to Turkish. Social safeness has been defined as the degree that people experience their social worlds as safe, warm, and soothing and it includes feelings of belonging, acceptance, and feelings of warmth from others. Social safeness is also related to how people experience pleasure, positive feelings and emotions in social situations. This study investigated the adaptability of the Social Safeness and Pleasure Scale (SSPS; Gilbert et al., 2009) to Turkish. The sample of study consists of 350 high school students. Results of confirmatory factor analysis demonstrated that the eleven items loaded on one factor and the goodness of fit coefficients of unidimensional model were high (x²=71.82, df=40, p=0.00149, RMSEA=.048, NFI=.96, CFI=.98, IFI=.98, RFI=.95, GFI=.96, SRMR=.042). The internal consistency coefficient of the scale (Cronbach alpha) was .82. The corrected item-total correlations of SSPS ranged from .34 to .61. These results demonstrate that the measures obtained the Turkish version of seem considerably valid and reliable.
... Compassionate Mind Training (CMT [24]), Compassion-Focused Therapy (CFT [21]), and the Mindful Self-Compassion program [26] are examples of such targeted interventions. These therapeutic models, again usually delivered in group settings, aim to foster a kinder and more accepting attitude towards oneself through the use of formal meditations (such as living kindness meditation; LKM), home practice and informal practices for daily life (such as self-compassionate letter writing), and have been demonstrated to be effective with, for example, community participants [26], people who hear malevolent voices [56], and those with chronic mood difficulties [24]. ...
Objective: To present current research and theory on the potential of self-compassion as a clinical concept for improving health-related outcomes in chronic illness, and make recommendations for the application of self-compassion interventions in clinical care to improve well-being and facilitate self-management of health for this group.
Methods: Narrative review of the literature.
Results: Current theory indicates that the self-kindness, common humanity, and mindfulness components of self-compassion can foster adaptive responses to the perceived setbacks and shortcomings that people experience in the context of living with a chronic illness. Research on self-compassion in relation to health has been examined primarily within non-medical populations. Cross-sectional and experimental studies have demonstrated clear links between self-compassion and lower levels of both perceived stress and physiological indictors of stress. A growing evidence base also indicates that self-compassion is associated with more frequent practice of health-promoting behaviours in healthy populations. Research on self-compassion with chronic illness populations is limited, but has demonstrated cross-sectional links to adaptive coping, lower stress and distress, and the practice of important health behaviours. There are several interventions for increasing self-compassion in clinical settings, with limited data suggesting beneficial effects for clinical populations.
Conclusion: Self-compassion holds promise as an important quality to cultivate to enhance health-related outcomes in those with chronic health conditions. Further systematic and rigorous research evaluating the effectiveness of self-compassion interventions in chronic illness populations is warranted to fully understand the role of this quality for chronic illness care.
... 11,19,65,66 Focusing on the experience and development of compassion has been found to reduce depression, anxiety, and self-criticism in people presenting to a community mental health team, 67 in people with long-term mental health problems, 68 and people in a high-security psychiatric setting. 69 Compassion-focused therapy (CFT) has been shown to be helpful for people with psychosis 70,71 ; and for people with emotional difficulties and personality disorders. 72 Ashworth et al 73 found CFT to be a valuable addition in helping people with acquired brain injury. ...
This paper argues that studies of mental health and wellbeing can be contextualized within an evolutionary approach that highlights the coregulating processes of emotions and motives. In particular, it suggests that, although many mental health symptoms are commonly linked to threat processing, attention also needs to be directed to the major regulators of threat processing, ie, prosocial and affiliative interactions with self and others. Given that human sociality has been a central driver for a whole range of human adaptations, a better understanding of the effects of prosocial interactions on health is required, and should be integrated into psychiatric formulations and interventions. Insight into the coregulating processes of motives and emotions, especially prosocial ones, offers improved ways of understanding mental health difficulties and their prevention and relief.
... They detail cognitive and behavioural challenges that can be used to experiment with changing that dominant position. Alternatively, the individual might be encouraged to develop more decentred and metacognitive perspectives on the anorexic voice (e.g., Chadwick, 2006;Mayhew & Gilbert, 2008). Given the relatively low success rate with different therapies for anorexia nervosa (e.g., Fairburn et al., 2013;Schmidt et al., 2015), it will be necessary to determine whether voice characteristics moderate treatment effectiveness. ...
Key practitioner message:
Experiences of an internal 'anorexic voice' are common in anorexia nervosa. Clinicians should consider the role of the voice when formulating eating pathology in anorexia nervosa, including how individuals perceive and relate to that voice. Addressing the voice may be beneficial, particularly in more severe and enduring forms of anorexia nervosa. When working with the voice, clinicians should aim to address both the content of the voice and how individuals relate and respond to it.
... Gilbert and Procter reported reductions in depression, anxiety, inferiority, and shame using CMT to treat high self-criticism and shame in clients. A qualitative study with individuals experiencing auditory hallucinations reported that CMT aided participants in transforming perceived voices into being less malevolent (Mayhew & Gilbert, 2008). A ten-week group intervention based on CMT also demonstrated significant improvements in depression and social comparison measured by the Social Comparison Scale and the Beck Depression Inventory, respectively (Laithwaite et al., 2009). ...
Self-compassion denotes a compassionate and empathic attitude toward oneself (Neff, 2003b). In the past decade, the Self-Compassion Scale (SCS) has been used to measure self-compassion in individuals and its effects on social, psychological, and physiological functioning. While many studies have found positive effects of high self- compassion showing promise for the use of the construct in clinical and empirical applications, there is a dearth of literature regarding the psychometric properties of the SCS. Furthermore, previous studies have not evaluated the individual subscales of the SCS as they relate to other inventories. This study evaluated the SCS and its subscales in relation the to the well-established Beck Depression Inventory II (BDI-II). The study included 142 undergraduate Cal Poly students who completed both the SCS and the BDI- II. As predicted, a statistically significant negative correlation was found between total SCS and BDI-II scores (r = -.57). Statistically significant negative correlations were also found between BDI-II total scores and the Self-Kindness (r = -.35), Common Humanity (r = -.37), and Mindfulness (r = -.35) subscales of the SCS. Statistically significant positive correlations were found with BDI-II total scores and the Self-Judgment (r = .49), Isolation (r = .59) and Over-Identified (r = .43) subscales of the SCS. This study evaluated the convergent and discriminant validity of the SCS and its subscales as compared to the BDI-II.
... Competitive Memory Training uses imagery to weaken associations between voices and negative selfevaluations by strengthening access to positive self-esteem ( Van der Gaag et al. 2012). Approaches, such as acceptance and commitment therapy and compassion focused therapy (Mayhew and Gilbert 2008) aim at an acceptance of voices and an increased commitment to important real-life goals and activities. The research into these approaches is in its infancy and is, to date, supported only by small and underpowered studies, without active control conditions or a good understanding of potential action mechanisms . ...
Auditory verbal hallucinations (AVHs) are perceptive-like experiences happening without appropriate stimuli, occurring in two thirds of schizophrenia patients, where they often cause emotional suffering and dangerous behaviors, and interfere with social relationships. Patients with schizophrenia involving AVHs can also be drug-resistant or they may discontinue medications. The most well-known psychotherapeutic intervention for voice-hearing is cognitive behavioral therapy (CBT), which focuses on reducing distress by modifying hearers’ beliefs about their voices. We hypothesize that it is possible to reinforce the clinical approach to AVHs by taking into consideration (a) that patients generally hear voices in particular interpersonal contexts where they experience negative emotions; (b) the relationship between AVHs and metacognition, namely the ability to make sense of mental states. On this basis, AVHs can be seen not just as a cause of emotional distress as CBT postulates, but the outcome of difficulties in meta-cognitively making sense of interpersonal exchanges. In this paper, we describe the treatment of a young man at the onset of schizophrenia with pervasive negative AVHs. The patient was treated with metacognitive interpersonal therapy (MIT), aimed to promote the patient’s metacognition. With this aim, in the first part of the treatment, each time AVHs emerged, the patient’s level of arousal was high and his metacognitive ability very low, the therapist treated AVHs helping the patient to understand and cope with the emotional suffering connected with AVHs. At a more advanced stage of therapy, the therapist helped the patient reach the point of understanding the social triggers which, together with the patient’s self-schemas, ignited his auditory hallucinations; this created the conditions for a significant reduction of the pervasiveness of AVHs.
... In a single case series, Mayhew and Gilbert (2008) found that CFT was feasible and acceptable and that participants showed decreases in depression, psychoticism, anxiety, obsessive–compulsive symptoms, paranoia, and interpersonal sensitivity at post-inter- vention. Laithwaite et al. (2009) found improvements associated with a compassion-focussed intervention (20 group sessions) in terms of social comparisons, shame, depression, and self-esteem. ...
Objective: This study aimed to develop and apply a brief (five-session) group-based intervention called Compassionate, Mindful and Accepting approach to Psychosis (CMAP) for patients diagnosed with paranoid schizophrenia. Methods: The intervention was based on three major approaches: the mindfulness framework adapted for psychosis with the proposed modifications for meditation work, the rationales from Acceptance and Commitment Therapy, and Compassion-Focused Therapy adapted to psychosis. The intervention was in group format, with one therapist (five 1-hr sessions). Five patients (male, single, between 22 and 35 years old, Caucasian) completed the intervention. Participants completed self-report measures at baseline (1week prior to intervention) and post-treatment (1week-additionally the Satisfaction with Intervention Questionnaire). Results: The intervention seemed acceptable for all participants. For illustration of potential benefits of this approach, pre-post results are presented and discussed for two patients. Overall, there was improvement in both patients, although in different measures. Both patients' conviction in paranoid delusions decreased, while an increase in acting with awareness was observed. Conclusions: Although preliminary, the results are in line with previous research in psychosis. Future directions and clinical implications are discussed.
... Individuals are taught to use selfsoothing actions, adaptive coping strategies, courage, and acts of kindness. 24,33,34 Research within therapeutic practice demonstrates that developing compassion for oneself and others can be beneficial for individuals experiencing chronic mental health problems, 29,35 psychosis, [36][37][38] trauma, 27,39-41 and eating disorders. 42 The study by Gilbert 3 entails a comprehensive overview of the origins and nature of CFT. ...
Introduction:
There is a growing body of evidence within the health care community suggesting that developing feelings of compassion can profoundly affect physical and psychological health. This is an important area of work, and initial research with nonprofessional groups has found that practicing compassion through a variety of experiential practices and meditations can lead to higher levels of compassion for others, sensitivity to suffering, motivation to help, and altruism. This study examines outcome measures after a 3-day introductory workshop on compassion-focused therapy provided to health care providers and educators. The aim of the research is to explore whether the training would increase self-compassion and reduce self-criticism and self-persecution.
Methods:
A total of 28 participants who were classified into three groups "nurses and midwives," "counselors/psychotherapists," and "other health care providers" completed the Self-Compassion Scale and Functions of Self-Criticizing and Self-Attacking Scale before and after training.
Results:
Results reveal an overall statistically significant increase in self-compassion and statistically significant reduction in self-critical judgment after training. There was no statistically significant reduction in self-persecution or self-correction scores after training.
Discussion:
Developing self-compassion and compassionately responding to our own "self-critic" may lead the way forward in the development of more compassionate care among health care professionals. Training people in compassion-based exercises may bring changes in levels of self-compassion and self-critical judgment. The findings are exciting in that they suggest the potential benefits of training health care providers and educators in compassion-focused practices.
... Furthermore, increased self-compassion was found to predict psychological health (Gilbert and Procter 2006;Neff et al. 2007) and was also associated with superior emotional stability (Leary et al. 2007). In clinical settings, self-compassion has been used effectively as part of the Compassionate Mind Training (Gilbert and Irons 2004), which has been shown to reduce depression, anxiety, paranoia, and obsessive compulsive disorder (Gilbert and Procter 2006;Mayhew and Gilbert 2008). However, without the benefit of mindfulness (or of being mindfully aware of the present moment), self-compassion becomes more difficult to put into action. ...
The Self-Compassion Scale--Greek Version (Mantzios, Wilson, & Giannou, 2015) was developed to measure levels of self-compassion in Greek-speaking participants. The Self-Compassion Scale (SCS; Neff, 2003) was translated from English into Greek using the forward–backward translation process (Yu et al. 2004). Differences in items were retranslated until full agreement was achieved between the authors and the two independent translators who were employed. The psychometric properties of the Greek version were examined in samples of English as a second language teachers, university students, and military employees in Greece. Results confirmed that (a) the translated version was equivalent to the original, (b) factor analysis results established a similar factor solution to the English version (a 26-item scale comprised of six factors: Self-kindness, Self-judgment, Common humanity, Isolation, Mindfulness, and Over-identification), (c) reliability coefficients were satisfactory (i.e., Cronbach's α coefficients and test–retests), and (d) construct validity revealed similarities between the English and Greek version, replications consistent with past research, as well as differences explained through theoretical frameworks. (PsycTESTS Database Record (c) 2016 APA, all rights reserved)
This paper outlines the theoretical and empirical basis for a treatment of psychosis from an evolutionary model of emotional regulation: Compassion Focused Therapy (CFT) for recovery from psychosis. CFT was originally developed for people with high levels of shame and self-criticism. Along with stigma, these are common features in people who are recovering from psychosis, and who may also develop serious emotional regulation problems. Elements of attachment theory involved in the origin of these difficulties are explored and some empirical facts about the clinical utility and efficacy of this new treatment are presented. A brief description is given of a recent group protocol that has been subjected to randomized trial, obtaining promising results.
Background
Stress, and particularly burnout, is a major problem among healthcare workers and can lead to high staff turnover and low patient/client satisfaction.
Objective
To explore the impact of 3-day compassion-focused therapy training on those delivering education to healthcare students. The underpinning premise was that the training course could potentially be replicated through the participants’ work with students embarking on a career within the helping professions.
Design
Mixed-methods study, with the qualitative findings being presented in this paper.
Setting
Training course was delivered in one higher education institution in England.
Methods
In total, 44 healthcare lecturers attended the course, with 6 taking part in a reflective focus group.
Findings
The analysis highlighted four main themes: reassurance and increased knowledge, increased compassion towards others, self-compassion and empathy, and blocks to compassion.
Conclusion
Findings add to previous quantitative research findings showing that participants who undertook training were able to engage with their compassionate self and consider the importance of showing compassion towards the self and others in healthcare education.
Bu araştırmada, ergenlerdeki sosyal güvende hissetme ve memnuniyet ile problemli internet kullanımı arasındaki ilişkide sosyal medya tutumlarının aracı rolünün incelenmesi ve bu konuda yapılacak yeni çalışmalara yol göstermesi amaçlanmıştır.
Araştırmaya 2016-2017 eğitim öğretim yılında, Erzurum İli, Palandöken İlçesi’nde bulunan liselerin 9.,10.,11. ve 12.sınıflarında öğrenim gören toplam 461 öğrenci katılmıştır.
Araştırma verilerinin analizinde, SPSS 21.0 paket programından yararlanılarak frekans dağılımları, t testi, Pearson Momentler Çarpımı Korelasyon ve Hiyerarşik Regresyon Analizleri kullanılmıştır.
Bu araştırmada verileri toplamak için “Problemli İnternet Kullanım Ölçeği – Ergen Formu”, “Sosyal Güvende Hissetme ve Memnuniyet Ölçeği”, “Sosyal Medya Tutum Ölçeği” ve ergenlerin demografik özelliklerinin elde edilmesi için “Kişisel Bilgi Formu” kullanılmıştır.
Araştırma sonucunda, ergenlerde sosyal güvende hissetme ve memnuniyet ile problemli internet kullanımı arasındaki ilişkide sosyal medya tutumlarının (paylaşım ihtiyacı ve sosyal yetkinlik alt boyutları) aracı rolü olduğu görülmüştür. Ayrıca, sosyal güvende hissetme ve memnuniyet ile problemli internet kullanımı arasında negatif yönde; sosyal medya tutumlarının da hem sosyal güvende hisseetme ve memnuniyet ile hem de problemli internet kullanımı ile arasında pozitif yönde ilişkiler saptanmıştır.
Compassion-focused therapy was developed by Paul Gilbert as a means of addressing psychological difficulties underpinned by shame and self-criticism. The model draws on social, neurophysiological and evolutionary theory (especially attachment theory) to seek to understand emotional regulation and our basic social motivational systems. It postulates the benefit of mindfully developing compassion, thus activating our ‘affiliative/soothing system’, to balance our affect regulating systems, particularly in response to threat. In recent years there has been a growing evidence base for the approach, and the application of compassion- based initiatives has been used with NHS staff teams, the armed forces, business settings and within education. Compassion-based approaches within education settings offer a potential means of generating greater psychological well-being for students, staff, parents and the wider community whilst also protecting and enhancing the priorities of the settings in which they are applied. Thus they represent an intervention which is systemic and universal. This paper provides an overview of compassion-focused therapy together with examples of how compassion-based initiatives are carried out in contexts of relevance to the work of educational psychologists.
Keywords: Compassion; compassion-focused therapy; mindfulness.
Objectives:
This study aimed to examine the effectiveness of a compassion focused therapy (CFT) group with a transdiagnostic population, as compared to treatment as usual (TAU). A secondary aim was to explore the potential processes of change within the treatment.
Design:
A non-randomized control trial was used.
Method:
Fifty-eight participants who engaged in group CFT were compared to 29 participants receiving TAU. Group CFT consisted of 14 sessions twice weekly for 5 weeks and once weekly for 4 weeks. Participants completed measures of psychopathology, shame, self-criticism, fears of self-compassion, and social safeness, at pre-treatment, post-treatment, and 2-month follow-up. Potential processes of change were examined using correlations and regression analysis.
Results:
Significantly greater improvements were found for levels of psychopathology, fears of self-compassion and social safeness for CFT, compared to TAU. Additionally, analyses showed improvements in shame and self-criticism within the CFT group but not the TAU group. All improvements were maintained at 2-month follow-up. Improvements in psychopathology were predicted by changes in self-criticism and fears of self-compassion.
Conclusion:
Compassion focused therapy appears to be an effective group intervention for a range of mental health difficulties. The positive impact of the CFT model with a transdiagnostic group emphasizes the value of addressing underlying psychological process, rather than symptoms alone.
Practitioner points:
Compassion focused therapy is a multimodal therapy designed to target high levels of shame and self-criticism. Compassion focused therapy has been shown previously to have positive results within a range of diagnostic-specific populations. While there is an emerging research base, limited studies assessing effectiveness with transdiagnostic populations have been published. CFT was shown to have a significant effect in reducing levels of psychopathology, compared to TAU. A number of potential processes of change were identified: Changes in psychopathology were significantly correlated with changes in self-criticism and fears of self-compassion.
Hearing voices in the absence of another speaker-what psychiatry terms an auditory verbal hallucination-is often associated with a wide range of negative emotions. Mainstream clinical research addressing the emotional dimensions of voice-hearing has tended to treat these as self-evident, undifferentiated and so effectively interchangeable. But what happens when a richer, more nuanced understanding of specific emotions is brought to bear on the analysis of distressing voices? This article draws findings from the 'What is it like to hear voices' study conducted as part of the interdisciplinary Hearing the Voice project into conversation with philosopher Dan Zahavi's Self and Other: Exploring Subjectivity, Empathy and Shame to consider how a focus on shame can open up new questions about the experience of hearing voices. A higher-order emotion of social cognition, shame directs our attention to aspects of voice-hearing which are understudied and elusive, particularly as they concern the status of voices as other and the constitution and conceptualisation of the self.
Wie wird das Metakognitive Therapieprogramm (MKT+) konkret durchgeführt? Wie leitet man die Sitzungen ein? Wie können die Therapie- und Arbeitsblätter genutzt werden? Wie vermittelt man dem Patienten die wesentlichen Inhalte der Therapieeinheit und leitet die Übungen an? Kapitel 5 bietet mit seinen kleinschrittigen und praxisorientierten Anleitungen zur Durchführung der einzelnen Therapieeinheiten einen »Fahrplan«, der besonders unerfahrene Therapeuten beim Einstieg in die Therapie mit Psychosepatienten unterstützen soll. Für jede der 11 Therapieeinheiten gibt es neben einer Einführung in das Thema, welche das Ziel der Einheit verdeutlicht, Formulierungsvorschläge sowie differenzierte Anleitungen zur Nutzung der Therapie- und Arbeitsblätter.
Purpose. Over the last 10–15 years, there has been a substantive increase in compassion-based interventions aiming to improve psychological functioning and well- being.
Methods. This study provides an overview and synthesis of the currently available compassion-based interventions. What do these programmes looks like, what are their aims, and what is the state of evidence underpinning each of them?
Results. This overview has found at least eight different compassion-based interven- tions (e.g., Compassion-Focused Therapy, Mindful Self-Compassion, Cultivating Com- passion Training, Cognitively Based Compassion Training), with six having been evaluated in randomized controlled trials, and with a recent meta-analysis finding that compassion- based interventions produce moderate effect sizes for suffering and improved life satisfaction.
Conclusions. Although further research is warranted, the current state of evidence highlights the potential benefits of compassion-based interventions on a range of outcomes that clinicians can use in clinical practice with clients.
Investigated depression as a normal affect state that could have continuity with types of clinical depression. A 66-item Depressive Experiences Questionnaire (DEQ) was constructed to assess a wide range of experiences that, though not direct symptoms of depression, are frequently associated with it. The DEQ, the Wessman-Ricks Mood Scale, a version of the semantic differential, and the Death-Concern Questionnaire were administered to 500 female and 160 male college students. In another sample, 128 college students were given the DEQ and the Zung Self-Rating Depression Scale. Three highly stable factors emerged from the DEQ: Dependency, Self-Criticism, and Efficacy. These factors had significant differential correlations with other measures, which support the interpretation of the factors derived from the items. These data indicate the need to consider dependency and self-criticism as 2 primary dimensions of depression and the value of investigating the continuity between normal mood states and the clinical phenomena of depressions. (38 ref)
The study developed 2 measures of belongingness based on H. Kohut's (1984) self psychology theory. The Social Connectedness Scale and the Social Assurance Scale were constructed with a split-sample procedure on 626 college students. Internal reliability estimates for the 2 scales were .91 and .82, respectively. Test-retest correlations revealed good test stability over a 2-week period (
rs = .96 and .84, respectively). Cross-validation for the 2 measures was achieved with confirmatory factor analysis with an incremental fit index greater than .90. Scale functions are described and results are discussed in light of current research and theory. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Cognitive therapy for psychotic symptoms often embraces self-evaluative beliefs (e.g. self-worth) but whether and how such beliefs are related to delusions remains uncertain. In previous research we demonstrated that distress arising from voices was linked to beliefs about voices and not voice content alone. In this study we examine whether the relationship with the voice is a paradigm of social relationships in general, using a new framework of social cognition, 'ranking' theory.
In a sample of 59 voice hearers, measures of power and social rank difference between voice and voice hearer are taken in addition to parallel measures of power and rank in wider social relationships.
As predicted, subordination to voices was closely linked to subordination and marginalization in other social relationships. This was not the result of a mood-linked appraisal. Distress arising from voices was linked not to voice characteristics but social and interpersonal cognition.
This study suggests that the power imbalance between the individual and his persecutor(s) may have origins in an appraisal by the individual of his social rank and sense of group identification and belonging. The results also raise the possibility that the appraisal of voice frequency and volume are the result of the appraisal of voices' rank and power. Theoretical and novel treatment implications are discussed.
Self-criticism has long been associated with a variety of psychological problems and is often a key focus for intervention in psychotherapy. Recent work has suggested that self-critics have underelaborated and underdeveloped capacities for compassionate self-soothing and warmth. This pilot study developed a diary for monitoring self-attacking and self-soothing thoughts and images. It also explored the personal experiences of a group of volunteer self-critics from the local depression support group who were given training in self-soothing and self-compassion. Although using small numbers, this study suggests the potential value of developing more complex methodologies for studying the capacity for self-compassion, interventions to increase self-compassion (including imagery techniques), and their effects on mental health.
Self-critical people, compared with those who self-reassure, are at increased risk of psychopathology. However, there has been little work on the different forms and functions of these self-experiences. This study developed two self-report scales to measure forms and functions of self-criticism and self-reassurance and explore their relationship to depression.
A self-report scale measuring forms of self-criticism and self-reassuring, and a scale measuring possible functions of self-criticism, together with a measure of depression and another self-criticism scale (LOSC), were given to 246 female students.
Self-criticizing vs. self-reassuring separated into two components. Forms of self-criticizing separated into two components related to: being self-critical, dwelling on mistakes and sense of inadequacy; and a second component of wanting to hurt the self and feeling self-disgust/hate. The reasons/functions for self-criticism separated into two components. One was related to desires to try to self-improve (called self-improving/correction), and the other to take revenge on, harm or hurt the self for failures (called self-harming/persecuting). Mediation analysis suggested that wanting to harm the self may be particularly pathogenic and is positively mediated by the effects of hating the self and negatively mediated by being able to self-reassure and focus on one's positives.
Self-criticism is not a single process but has different forms, functions, and underpinning emotions. This indicates a need for more detailed research into the variations of self-criticism and the mechanisms for developing self-reassurance.
Some investigators have argued that emotions, especially animal emotions, are illusory concepts outside the realm of scientific inquiry. With advances in neurobiology and neuroscience, however, researchers are proving this position wrong while moving closer to understanding the biology and psychology of emotion. In Affective Neuroscience, Jaak Panksepp argues that emotional systems in humans, as well as other animals, are necessarily combinations of innate and learned tendencies; there are no routine and credible ways to really separate the influences of nature and nurture in the control of behavior. The book shows how to move toward a new understanding by taking a psychobiological approach to the subject, examining how the neurobiology and neurochemistry of the mammalian brain shape the psychological experience of emotion. It includes chapters on sleep and arousal, pleasure and pain systems, the sources of rage and anger, and the neural control of sexuality. The book will appeal to researchers and professors in the field of emotion.
This article defines the construct of self-compassion and describes the development of the Self-Compassion Scale. Self-compassion entails being kind and understanding toward oneself in instances of pain or failure rather than being harshly self-critical; perceiving one's experiences as part of the larger human experience rather than seeing them as isolating; and holding painful thoughts and feelings in mindful awareness rather than over-identifying with them. Evidence for the validity and reliability of the scale is presented in a series of studies. Results indicate that self-compassion is significantly correlated with positive mental health outcomes such as less depression and anxiety and greater life satisfaction. Evidence is also provided for the discriminant validity of the scale, including with regard to self-esteem measures.
ABSTRACT In this article we review the history of the scientific use of self-recording and conclude that there are three basic methods: (a) interval-contingent, in which respondents report on their experiences at regular intervals, (b) signal-contingent, in which respondents report when signaled, and (c) event-contingent, in which respondents report whenever a defined event occurs. We then discuss the relative merits of these techniques for answering different questions. Finally, we note that self-recording of small events is a departure from the science of psychology as typically practiced, requiring an acceptance of reality as defined by respondents.
Compassionate mind training (CMT) was developed for people with high shame and self-criticism, whose problems tend to be chronic, and who find self-warmth and self-acceptance difficult and/or frightening. This paper offers a short overview of the role of shame and self-criticism in psychological difficulties, the importance of considering different types of affect system (activating versus soothing) and the theory and therapy process of CMT. The paper explores patient acceptability, understanding, abilities to utilize and practice compassion focused processes and the effectiveness of CMT from an uncontrolled trial. Six patients attending a cognitive–behavioural-based day centre for chronic difficulties completed 12 two-hour sessions in compassionate mind training. They were advised that this was part of a research programme to look at the process and effectiveness of CMT and to become active collaborators, advising the researchers on what was helpful and what was not. Results showed significant reductions in depression, anxiety, self-criticism, shame, inferiority and submissive behaviour. There was also a significant increase in the participants' ability to be self-soothing and focus on feelings of warmth and reassurance for the self. Compassionate mind training may be a useful addition for some patients with chronic difficulties, especially those from traumatic backgrounds, who may lack a sense of inner warmth or abilities to be self-soothing. Copyright © 2006 John Wiley & Sons, Ltd.
Investigated depression as a normal affect state that could have continuity with types of clinical depression. A 66-item Depressive Experiences Questionnaire (DEQ) was constructed to assess a wide range of experiences that, though not direct symptoms of depression, are frequently associated with it. The DEQ, the Wessman-Ricks Mood Scale, a version of the semantic differential, and the Death-Concern Questionnaire were administered to 500 female and 160 male college students. In another sample, 128 college students were given the DEQ and the Zung Self-Rating Depression Scale. Three highly stable factors emerged from the DEQ: Dependency, Self-Criticism, and Efficacy. These factors had significant differential correlations with other measures, which support the interpretation of the factors derived from the items. These data indicate the need to consider dependency and self-criticism as 2 primary dimensions of depression and the value of investigating the continuity between normal mood states and the clinical phenomena of depressions. (38 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The present investigation was intended principally as a concurrent validation study for a new self-report symptom inventory: the SCL-90. A sample of 209 'symptomatic volunteers' served as subjects and were administered both the SCL-90 and the MMPI prior to participation in clinical therapeutic drug trials. The MMPI was scored for the Wiggins content scales and the Tryon cluster scales in addition to the standard clinical scales. Comparisons of the nine primary symptom dimensions of the SCL-90 with the set of MMPI scales reflected very high convergent validity for the SCL-90. Peak correlations were observed with like constructs on eight of the nine scales, with secondary patterns of correlations showing high interpretative consistency.
We describe the development and psychometric investigation of the Beliefs About Voices Questionnaire (BAVQ), a self-report measure of how people understand and respond to their voices. The measure is unique in being driven by and gathering data essential to a cognitive formulation of voices.
Sixty subjects with chronic hallucinatory voices took part.
Psychometric properties of the scales were established, including test-retest reliability (mean = 0.89), internal reliability (mean Cronbach's alpha = 0.85), and construct validity using factor analysis and the criterion group method.
The BAVQ was found to be easy to complete and the scale may aid clinical assessment of voices, not least because of the possible value of cognitive therapy as a treatment approach.
A preliminary report by the authors suggested that the range of affect generated by voices (anger, fear, elation) was linked not to the form, content or topography of voice activity, but to the beliefs patients held about them, in particular their supposed power and authority. We argued that this conformed to a cognitive model; that is, voice beliefs represent an attempt to understand the experience of voices, and cannot be understood by reference to the form/content of voices alone. This study puts this cognitive model to empirical test.
Sixty-two voice hearers conforming to ICD-10 schizophrenia or schizoaffective diagnoses were interviewed and completed standardized measures of voice activity; beliefs about voices and supporting evidence, coping behaviour; affect and depression.
Beliefs about the power and meaning of voices showed a close relationship with coping behaviour and affect (malevolent voices were associated with fear and anger and were resisted; benevolent voices were associated with positive effect and were engaged) and accounted for the high rate of depression in the sample (53%). Measures of voice form and topography did not show any link with behaviour or affect and in only one-quarter of cases did neutral observers rate voice beliefs as 'following directly' from voice content.
The study found support for our cognitive model and therapeutic approach. Factors governing the genesis of these key beliefs remain unknown. A number of hypotheses are discussed, which centre around the possibility that voice beliefs develop as part of an adaptive process to the experience of voices, and are underpinned by core beliefs about the individuals self-worth and interpersonal schemata.
The purpose of this paper is to review existing behavioral and neuroendocrine perspectives on social attachment and love. Both love and social attachments function to facilitate reproduction, provide a sense of safety, and reduce anxiety or stress. Because social attachment is an essential component of love, understanding attachment formation is an important step toward identifying the neurobiological substrates of love. Studies of pair bonding in monogamous rodents, such as prairie voles, and maternal attachment in precocial ungulates offer the most accessible animal models for the study of mechanisms underlying selective social attachments and the propensity to develop social bonds. Parental behavior and sexual behavior, even in the absence of selective social behaviors, are associated with the concept of love; the analysis of reproductive behaviors, which is far more extensive than our understanding of social attachment, also suggests neuroendocrine substrates for love. A review of these literatures reveals a recurrent association between high levels of activity in the hypothalamic pituitary adrenal (HPA) axis and the subsequent expression of social behaviors and attachments. Positive social behaviors, including social bonds, may reduce HPA axis activity, while in some cases negative social interactions can have the opposite effect. Central neuropeptides, and especially oxytocin and vasopressin have been implicated both in social bonding and in the central control of the HPA axis. In prairie voles, which show clear evidence of pair bonds, oxytocin is capable of increasing positive social behaviors and both oxytocin and social interactions reduce activity in the HPA axis. Social interactions and attachment involve endocrine systems capable of decreasing HPA reactivity and modulating the autonomic nervous system, perhaps accounting for health benefits that are attributed to loving relationships.
To review critically the evidence for three contemporary theories of delusions.
The theoretical approaches to delusions proposed by Frith and colleagues ('theory of mind' deficits), Garety and colleagues (multi-factorial, but involving probabilistic reasoning biases) and Bentall and colleagues (attributional style and self-discrepancies) are summarised. The findings of empirical papers directly relevant to these proposals are critically reviewed. These papers were identified by computerised literature searches (for the years 1987-1997) and a hand search.
The evidence does not unequivocally support any of the approaches as proposed. However, strong evidence is found to support modifications of Garety and colleagues' and Bentall and colleagues' theories. Studies have replicated a 'jumping to conclusions' data-gathering bias and an externalising attributional bias in people with delusions. There is preliminary evidence for a 'theory of mind' deficit, as proposed by Frith, although possibly related to a more general reasoning bias. Evidence for an underlying discrepancy between ideal and actual self-representations is weaker.
A multi-factorial model of delusion formation and maintenance incorporating a data-gathering bias and attributional style, together with other factors (e.g. perceptual processing, meta-representation) is consistent with the current evidence. It is recommended that these findings be incorporated into cognitive therapy approaches. However, there are limitations to existing research. Future studies should incorporate longitudinal designs and first episode studies, and should not neglect the co-morbidity of delusions, including affective processes, or the multi-dimensional nature of delusions.
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