Institutionen för psykologi The Four Immeasurables Program: Training empathy and promoting altruism through meditation. An eight-week randomized controlled pilot study Kousha Safarzadeh & Erik Wallmark MASTER THESIS, Spring 2011 Supervisor: Daiva Daukantaitė Co-supervisor: Rachel Maddux Examinator: Roger Sages 2 3 Tack… Eva Månsson Carleheden och Svenska Kyrkan Lunds stift som så generöst hjälpte oss med lokal och material. Vi är er evigt tacksamma! Daiva Daukantaitė, vår handledare för din ovärderliga sakkunskap och ditt varma hjärta. Rachel Maddux, vår handledare för din varma uppmuntran, stöd och inspiration. till vår pilotgrupp, Lukas Kornfeld, Maryam Haghighi och Elin Bergelin, som gett oss hjälp, uppmuntran och stöd. till alla kursdeltagare, som tålmodigt lät sitt liv präglas av meditation i två månader. till vår familj och våra vänner för allt stöd och all uppmuntran. till de buddhistiska lärare som genom gränslös kärlek gynnar andra. 4 5 Abstract The general purpose of this randomized controlled pilot study was to investigate the potential effects of The Four Immeasurables Program on empathy and measures assumed to be related to the development of empathy and empathic concern for others such as perceived stress, mindfulness, and self-compassion. Of primary interest was to study whether the program can alter the dispositional tendency to feel empathic concern rather than personal distress when perceiving another as in need, termed other-orientation. In a randomized controlled study, an experimental group (n=21) was enrolled in an 8-week Four Immeasurables Program based on the Buddhist meditations of loving-kindness, compassion, joy and equanimity, as well as the practice of Tonglen (“taking and sending”). The control group (n=25) was assigned to a waiting-list condition. After controlling for pre-test scores, post-intervention results showed a trend towards increases in other-orientation in the experimental group - an increase that significantly correlated with meditation time and with decreases in perceived stress as well as increases in self-compassion and mindfulness. Additionally, significant increases in mindfulness and self-compassion and a significant decrease in perceived stress were obtained for the experimental group when compared to the controls. Keywords: empathy, altruism, stress, mindfulness, self-compassion, loving-kindness, compassion, empathetic joy, equanimity, the Four Immeasurables, meditation, empathic concern, personal distress, perspective taking 7 Table of Contents Introduction .............................................................................................................................. 9 Theory .................................................................................................................................. 10 Altruism. .......................................................................................................................... 10 Definitions of egoism and altruism. ................................................................................. 10 Empathy: a conceptual jungle. ......................................................................................... 11 Definition of empathy. ..................................................................................................... 12 A functional model of empathy. ...................................................................................... 13 Affective arousal sharing ............................................................................................. 14 Emotional awareness. .................................................................................................. 15 Self-regulation. ............................................................................................................. 16 The Empathy-induced Altruism Hypothesis. ................................................................... 17 Empathic concern and personal distress. ......................................................................... 18 Training empathy through meditation. ............................................................................ 19 Stress. ........................................................................................................................... 19 Self-compassion. .......................................................................................................... 20 Mindfulness. ................................................................................................................. 21 The Four Immeasurables Program (FIP). ........................................................................ 23 Meditation of the Four Immeasurables ........................................................................ 23 Why the Four Immeasurables? .................................................................................... 24 Loving-kindness ........................................................................................................... 25 Compassion. ................................................................................................................. 25 Empathetic joy ............................................................................................................. 26 Equanimity ................................................................................................................... 27 Tonglen. ....................................................................................................................... 28 Studies on the Four Immeasurables meditations ......................................................... 29 Meditation procedure in FIP ....................................................................................... 30 Research question and hypothesis. .................................................................................. 31 Method .................................................................................................................................... 32 Participants ........................................................................................................................... 32 Recruitment. ..................................................................................................................... 32 Screening and Randomization Procedure ........................................................................ 33 Materials and Procedure ...................................................................................................... 34 Statistical procedures. ...................................................................................................... 37 The Four Immeasurables program. .................................................................................. 38 Measures .............................................................................................................................. 39 The Interpersonal Reactivity Index. ................................................................................. 39 The Perceived Stress Scale. ............................................................................................. 39 The Self-Compassion Scale. ............................................................................................ 40 The Five Facet Mindfulness Questionnaire. .................................................................... 40 Social Desirability ............................................................................................................ 41 Ethical considerations .......................................................................................................... 41 Instructor qualifications ....................................................................................................... 42 Results ..................................................................................................................................... 43 Randomization check ........................................................................................................... 43 A post-intervention change in other-oriented tendency (EC-PD) ........................................ 43 8 Changes in empathy, perceived stress, self-compassion and mindfulness .......................... 44 Relationship between meditation time and pre-post changes .............................................. 51 Relationships between pre-post change scores for empathy related measures and other variables ............................................................................................................................... 52 Program evaluation .............................................................................................................. 53 Discussion ............................................................................................................................... 55 Results discussion ................................................................................................................ 55 Changes in other-orientation. ........................................................................................... 55 Changes in pre- post measures. ........................................................................................ 56 Empathic concern. ....................................................................................................... 56 Personal distress. ......................................................................................................... 56 Perspective taking. ......................................................................................................