Compassionate mind training for people with high shame and self‐criticism: overview and pilot study of a group therapy approach

Abstract

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.

Having a word with yourself: Neural correlates of self-criticism and self-reassurance

“…Lateral OFC (BA 47) activation was also found to positively correlate with high RS scores for the self-critical condition, suggesting that additional recruitment of inhibitory control processes was instigated during self-critical thoughts in these individuals. This finding could be used as evidence to help build towards improved targeting in psychotherapy, as focused therapeutic exercises designed to develop self-reassurance may aid regulation in the face of setbacks (Gilbert and Procter, 2006;Gilbert, 2009).…”

“…The ability to be selfreassuring in the face of setbacks is believed to be the result of both temperament and early attachment experiences (Mikulincer and Shaver, 2007) and result in resilience (Masten, 2001). Furthermore, new developments in psychotherapy are beginning to focus on the possibility of training people in self-reassurance and self-compassion with beneficial effects (Gilbert and Irons, 2005;Gilbert and Procter, 2006;Leary et al, 2007;Lutz et al, 2008). Gilbert (1989Gilbert ( , 2000 and Gilbert and Irons (2005) suggested that self-criticism and self-reassurance may stimulate the same neurophysiological systems as criticism and reassurance generated externally, i.e., by others.…”

Cognitive factors maintaining persecutory delusions in psychosis: The contribution of depression.

“…It is likely that increasing positive beliefs about the self has an indirect effect on negative beliefs, but the implication of the present findings is that explicitly targeting negative beliefs might bring about symptom benefits more directly. One example of a psychological intervention that might achieve therapeutic effects by breaking down negative self-evaluations is Compassionate Mind Training (Gilbert & Procter, 2006).…”

Efficacy and cost-effectiveness of a specialist depression service versus usual specialist mental health care to manage persistent depression: a randomised controlled trial

“…Primary outcome measures were changes in assessment scores of HDRS 17 and GAF, 12 from baseline to 6, 12, and 18 months, with a prespecified primary outcome assessment at 6 months and 12 months. However, the original protocol allowed SDS treatment for longer than 12 months so that planned transfer of care could be graduated for up to 3 months for these patients, from the SDS to a primary or secondary mental health clinical team.…”

“…When clinically indicated, the psychological interventions were augmented as part of relapse prevention (within the timeframe of the overall intervention) with mindfulness-based cognitive therapy. 16 Additionally, when the clinical presentations identified high levels of shame and self-criticism, compassion-focused therapy 17 integrated within a CBT framework was used as part of relapse prevention. Further, when clinically indicated, social inclusion initiatives were used in the context of CBT, which included vocational-based and occupational-based activities.…”