Compassion: Origins & Application in Psychotherapy

clasping hands

In these first decades of the twenty-first century, compassion and self-compassion are increasingly being researched and applied as active, empirically supported process variables in psychotherapy. This might not seem surprising, given that compassion has been at the center of contemplative practices for emotional healing for at least 2,600 years. Shakyamuni, or Gautama Buddha, taught that cultivating  compassion could transform the mind, and his philosophical descendants have built upon his observations and insights ever since. Furthermore, most of the world’s major religions have specific prayers and imagery practices that involve the experience of compassion as a source of emotional comfort or redemption. In terms of psychotherapy, for some sixty years, starting with the work of Carl Rogers (1965), it has been proposed that empathy is central to psychotherapy. Since Rogers’s work, different therapies have explored the value of warmth and empathy in the psychotherapeutic relationship (Gilbert & Leahy, 2007; Greenberg & Paivio, 1997). However, compassion, as a process in itself, has only recently come to be seen as a core focus of psychotherapeutic work.

As cognitive behavioral therapy (CBT) has increased its emphasis on applied mindfulness and acceptance-based approaches, it makes sense that mental training designed to intentionally foster a compassionate mind would become a growing trend in contextual behavior therapies like ACT and FAP. Contextual behavior therapies inherently address the interconnectedness between an organism and its context in a way that resonates with Buddhist psychology and the science of compassion. Additionally, this emphasis on compassion within behavioral therapies is a part of a trend toward greater integration of compassion-focused methods and Buddhist influences within psychotherapy across many theoretical approaches (Germer, Seigel, & Fulton, 2005). An effective approach to therapy that is grounded in compassion would target cultivation of compassion as a key process for enhancing emotion regulation, increasing psychological flexibility, and furthering well-being. Compassion-focused therapy provides us with a rapidly growing, evidence-based model of psychotherapy that pursues these aims and is highly compatible with contextual behavioral approaches. 

The Two Psychologies of Compassion and ACT

The emerging common ground across psychological science is that compassion is a complex and multimodal organization of human behaviors with clear antecedents in human evolution and emotional processes rooted in inheritable response patterns that develop even prior to birth. However, compassion also involves verbal learning and specific developmental experiences that occur in a social context. Understandably, the emphasis within ACT and contextual CBT upon the prediction and influence of human behavior with precision, depth, and scope is highly relevant to broadening our understanding of compassion. The contextual behavioral science (CBS) approach that underpins ACT invites us to examine the precise dynamics of both the verbal learning involved in human compassion and the emotional, biological, and inherited response patterns that contribute to our awareness of suffering and our efforts to address the pain we encounter in the world. In some instances, compassion can be viewed as involving a skill set that can be cultivated through mental training and serve as a significant part of the emotional healing process (Davidson, 2003; Gilbert, 2009b; Lutz, Brefczynski-Lewis, Johnstone, & Davidson, 2008). Importantly, compassion involves the activation of the emotions that arise in connected, intimate, and close relationships. We refer to these emotions, which involve empathy, warmth, and care, as affiliative emotions. Activation of networks of affiliative emotions can promote focused, flexible attention and a broadening of the range of possible actions in the presence of stimuli that typically narrow  behavioral repertoires. Indeed, research has increasingly established that compassion can facilitate lasting change in the way we experience and respond to suffering (Gumley, Braehler, Laithwaite, MacBeth, & Gilbert, 2010; Hofmann, Grossman, & Hinton, 2011).

Gilbert (2009a) defines the essence of compassion as “a basic kindness, with deep awareness of the suffering of oneself and of other living things, coupled with the wish and effort to relieve it” (p. 13). This definition involves two central dimensions of compassion. The first is known as the psychology of engagement and involves sensitivity to and awareness of the presence of suffering and its causes. The second dimension is known as the psychology of alleviation and constitutes both the motivation and the commitment to take actual steps to alleviate the suffering we encounter (Gilbert & Choden, 2013). Here we will briefly conceptualize this definition of compassion and its two dimensions in terms of acceptance and commitment processes, and in accord with functional contextual assumptions.

The psychology of the engagement with suffering

This dimension involves the ability to notice, turn toward, pay attention to, and engage with suffering. Engagement with compassion involves several aspects, all of which facilitate awareness of and sensitivity to suffering. These processes relate to experiential acceptance rather than experiential avoidance: turning toward the things that are difficult to bear with a motivation to engage with the suffering we encounter. In terms of the ACT model of psychological flexibility, processes that emphasize acceptance, willingness, and awareness are clearly related to the CFT psychology of engagement.

The psychology of the alleviation of suffering

This dimension involves developing and maintaining the wisdom, skill, and behavioral capacity to take effective and personally meaningful action in the presence of suffering. Such action may involve direct steps to alleviate suffering and its causes, yet it may also involve developing the commitment to remain in the presence of difficult emotions with compassionate acceptance. The ACT processes of owning one’s values and making a commitment to embodying those values are related to the psychology of alleviation. 

Speaking to the healing quality of the experience of compassion, Christopher Germer states that “compassion is a quality of mind that can transform the experience of pain, even making it worthwhile. When we open to pain in a compassionate way, there is a feeling of freedom— of nonresistance, noncontraction— and a deep sense of connection to others— of expanding beyond ourselves” (Germer, 2012, p. 93). When flexible perspective taking affords us an opportunity to turn compassion inward, phenomenological qualities of mindful awareness, loving-kindness, and a broader sense of an interconnected self may become more apparent (Neff, 2011). This is territory that will likely be quite familiar to the experienced ACT practitioner, and that merits further expansion and exploration within the CBS rubric. As we approach a functional understanding of compassion, there is a striking continuity between compassion and other concepts derived from contemplative practice that can contribute to well-being. Mindfulness, acceptance, and compassion are often described as interrelated processes. For example, several writers have established that training in mindfulness involves a willingness to contact the present moment just as it is and effects an emergent form of self-kindness and self-validation (Kabat-Zinn, 2009). Other writers have highlighted the ways in which mindfulness and compassion are complementary core processes in psychological health that remain distinct, describing mindfulness and compassion as two wings of a bird— a classic Buddhist metaphor (Germer, 2012). While these processes can be construed as interconnected or discrete to varying degrees, mindfulness training has  been used as a preparatory practice for the cultivation of compassion and a healthy psychological perspective throughout thousands of years of contemplative practice (Tirch, 2010; Wallace, 2009). And although mindfulness and other healthy qualities of mind may be involved in the experience of compassion, we suggest that compassion is a distinct process, with a distinct evolutionary trajectory, quality, and functional application.  

This article has been adapted from The ACT Practitioner’s Guide to the Science of Compassion by Dennis Tirch, Benjamin Schoendorff, and Laura Silberstein.


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