CPXXXX10.1177/2167702618812438Kirschner et al.Experimental Paradigm to Study Self-Compassion 812438research-article2019 ASSOCIATION FOR Empirical Article PSYCHOLOGICAL SCIENCE Clinical Psychological Science 2019, Vol. 7(3) 545 –565 Soothing Your Heart and Feeling © The Author(s) 2019 Connected: A New Experimental Article reuse guidelines: sagepub.com/journals-permissions Paradigm to Study the Benefits of DOI:https://doi.org/10.1177/2167702618812438 10.1177/2167702618812438 www.psychologicalscience.org/CPS Self-Compassion Hans Kirschner1,3, Willem Kuyken1,2, Kim Wright1, Henrietta Roberts1, Claire Brejcha1, and Anke Karl1 1Mood Disorder Centre, College of Life and Environmental Sciences, University of Exeter; 2Department of Psychiatry, University of Oxford; and 3Institute of Psychology, Otto-von-Guericke University Abstract Self-compassion and its cultivation in psychological interventions are associated with improved mental health and well- being. However, the underlying processes for this are not well understood. We randomly assigned 135 participants to study the effect of two short-term self-compassion exercises on self-reported-state mood and psychophysiological responses compared to three control conditions of negative (rumination), neutral, and positive (excitement) valence. Increased self-reported-state self-compassion, affiliative affect, and decreased self-criticism were found after both self- compassion exercises and the positive-excitement condition. However, a psychophysiological response pattern of reduced arousal (reduced heart rate and skin conductance) and increased parasympathetic activation (increased heart rate variability) were unique to the self-compassion conditions. This pattern is associated with effective emotion regulation in times of adversity. As predicted, rumination triggered the opposite pattern across self-report and physiological responses. Furthermore, we found partial evidence that physiological arousal reduction and parasympathetic activation precede the experience of feeling safe and connected. Keywords self-compassion, self-criticism, psychophysiology, positive affiliative affect Received 9/12/17; Revision accepted 9/6/18 Self-compassion has been defined as being kind to growing evidence that self-compassion has beneficial one’s self (Neff, 2003b) and being able to use self- effects on mental health and well-being (e.g., Galante, reassurance and soothing in times of adversity (Gilbert, Galante, Bekkers, & Gallacher, 2014) from two lines of 2009; Neff, 2003b). It includes being nonjudgmental research. Cross-sectional, correlational studies investi- about one’s self (Gilbert, 2009; Neff, 2003b) and recog- gating the associations between dispositional levels of nizing one’s experience as part of the human condition self-compassion and psychological health using the Self- (Neff, 2003b). Self-criticism, on the other hand, is char- Compassion Scale (Neff, 2003a) revealed that higher acterized by maladaptive emotion-regulation strategies levels of trait self-compassion are associated with higher such as being harsh and judgmental about one’s self levels of well-being (Zessin, Dickhauser, & Garbade, (Gilbert, 2009; Neff, 2003b). It is associated with feeling 2015) and quality of life (Wei, Liao, Ku, & Shaffer, 2011), isolated (Neff, 2003b) and being in flight or fight or health-related behaviors such as exercising (Magnus, social rank mode, therefore exacerbating a sense of threat in difficult times (Gilbert, 2009). Whereas self-criticism has been associated with a Corresponding Author: Hans Kirschner, University of Magdeburg, Institute of Psychology, number of mental health problems, such as depression Building 24, Room 011, Universitätsplatz 2, 39106 Magdeburg, Germany and anxiety (Clark, Watson, & Mineka, 1994), there is E-mail: [email protected] 546 Kirschner et al. Kowalski, & McHugh, 2010) or seeking medical treatment self-compassion (Ashar et al., 2016; Hutcherson et al., (Terry & Leary, 2011), and enhanced interpersonal func- 2008; Kok et al., 2013; Weng et al., 2013). The few stud- tioning (Neff, 2003a; Neff & Beretvas, 2013). In contrast, ies that did (Kearney et al., 2013; Neff & Germer, 2013) lower levels of self-compassion were associated with relied on trait-level measures that may not be sensitive mental health problems such as posttraumatic stress dis- to transient state changes and, like all self-report mea- order (Thompson & Waltz, 2008) and depression (Kuyken sures, may be biased by demand characteristics (Orne, et al., 2015). The correlational nature of these studies 1962). Finally, these studies do not allow conclusions prevents causal conclusions of these associations. about the underlying mechanisms of the beneficial A better understanding of the possible directionality effects of self-compassion. comes from experimental and clinical studies assessing A better understanding of underlying mechanisms the effects of psychological interventions that directly may come from research suggesting that compassion or indirectly cultivate self-compassion and identify exerts its protective effects by stimulating physiological associated changes in psychological health. For exam- systems associated with stress reduction and social ple, kindness-based meditations drawing from Bud- affiliation (Engen & Singer, 2015; Gilbert, 2009) and by dhists traditions, such as loving-kindness meditation reducing threat and excessive motivational drive-related (i.e., an exercise oriented toward enhancing uncondi- arousal (Gilbert, 2009). Compassion has been posi- tional kindness toward oneself and others), have been tioned within the soothing and contentment system of found to cultivate self-compassion (Galante et al., 2014; the tripartite affect-regulation system model (Gilbert, Neff & Germer, 2013) and self-acceptance (Fredrickson, 2009). Activating this system is proposed to enhance Cohn, Coffey, Pek, & Finkel, 2008), increase positive feeling safe, securely attached, and affiliated with oth- (Fredrickson et al., 2008; Hofmann, Grossman, & ers, and to enable self-soothing when stressed (Porges, Hinton, 2011; Klimecki, Leiberg, Lamm, & Singer, 2013; 2007). It is further proposed to enhance parasympa- Kok et al., 2013) and decrease negative affect (Hofmann thetic activity that gives rise to the beat-to-beat vari- et al., 2011; Klimecki et al., 2013), increase empathy or ability in heart rate known as heart rate variability warmth toward others (Ashar et al., 2016; Klimecki (HRV), which has been linked to adaptive emotion et al., 2013), and increase social connectedness regulation in threat contexts (Thayer & Lane, 2000). (Hutcherson, Seppala, & Gross, 2008; Kok et al., 2013). This system is also suggested to promote interpersonal In addition, mindfulness-based cognitive therapy approach and social affiliation (Depue & Morrone- (MBCT), an 8-week psychosocial program particularly Strupinsky, 2005) mediated by activations in the central designed for the treatment of depressive relapse (Segal, oxytocin-opiate system (Carter, 1998; Depue & Morrone- Teasdale, & Williams, 2002; Segal, Williams, & Teasdale, Strupinsky, 2005; Insel, 2010; Porges, 2007). 2013), has been shown to increase self-compassion, The contentment system is distinguished from a which in turn predicted well-being 15 months later negative threat-focused affect system and from another (Kuyken et al., 2010). MBCT uses mindfulness practices positive affect system that is associated with stimulation such as the body scan1 and breath awareness2 to teach and excitement, the drive system; compassion is theo- mindfulness skills. Interestingly, even though it is not rized to have a downregulating effect on both (Gilbert, an explicit skill taught in MBCT, self-compassion is 2014). To date, direct support for the complete tripartite implicitly interwoven into the mindfulness instructions model is scarce. Kelly, Zuroff, Leybman, and Gilbert (e.g., “Whenever you notice that the mind has wan- (2012) found psychometric evidence for three distinct dered off, bring it back with gentleness and kindness.”). factors—negative affect, excited positive affect, and This suggests that self-compassion can also be culti- social safeness—and for an association between low vated via more indirect interventions. Although it is daily levels of social safeness with low levels of self- unknown if the directness of the intervention is associ- esteem and high levels of self-criticism and anxious ated with differential processes, this may be important attachment. because direct cultivation of self-compassion could be More indirect evidence for the model’s two positive- more challenging when there is an underlying psycho- affect systems comes from emerging neuroscience pathology such as depression (Gilbert, McEwan, Matos, research. First, research studying the underpinnings of & Rivis, 2010). Therefore, there is a need for research compassion identified higher HRV (Arch et al., 2014; about the benefits of more indirect ways to cultivate Kok et al., 2013; Rockliff, Gilbert, McEwan, Lightman, self-compassion (e.g., via a compassionate body scan) & Glover, 2008; Tang et al., 2009), reduced sympathetic in order to improve the acceptability of self-compassion activity as indicated by reduced skin conductance interventions in these populations. (Ortner, Kilner, & Zelazo, 2007; Tang et al., 2009) and Critically, most of the above-mentioned experimental lower salivary α-amylase responses (Duarte, McEwan, and clinical studies did not specifically assess Barnes, Gilbert, & Maratos,