Compassion-focused Imagery Research Articles

“Seeing Myself Through Someone Else’s Eyes”: Embodying the Perfect Nurturer in Compassion Focused Therapy

Compassion-focused chairwork has become a recent focus of empirical investigation. This study extended this area of research by exploring how participants with depression experienced the ‘compassionate other’ imagery exercise enacted via chairwork methods. Eight individuals from primary care NHS mental health services were interviewed about their experience of the practice. The resultant data were analysed using interpretive phenomenological analysis (IPA). Three group experiential themes were identified: care that feels real, chairwork processes and encountering challenges on the road to discovery. The findings indicate that the intervention has therapeutic utility both as an intervention for cultivating compassion and as means of assessing for and identifying blocks to compassion. The results also suggest that there is potential value in enacting compassion-focused imagery techniques through chairwork methods, especially for those who have difficulty accessing mental imagery practices. The findings are contextualised within broader theory and literature, and clinical and research implications are discussed.

Enhancing athletes’ self-compassion and psychological well-being through imagery

Abstract This review examines the extant literature advocating for enhanced self-compassion as an accessible means to foster psychological well-being (e.g., reduced self-criticism, rumination, and anxiety symptom; enhanced hope, emotion regulation, self-acceptance, self-efficacy). The case for athletes as a special population who can benefit from strengthening this asset is made; Compassion-Focused Imagery (CFI) is introduced as an effective tool for developing self-compassion; and a case scenario and sample CFI script are presented. Gaps in the current understanding of and empirical investigations of CFI use in athletes are identified, along with unique challenges the sport context provides for self-compassion-focused interventions.

Can compassion-focused imagery be used as an attention bias modification treatment?

Compassion focused-imagery (CFI), one of the psychological interventions of compassion-focused therapy, is receiving increasing attention. It is a therapeutic tool that targets the process of self-criticism by prompting individuals to imagine themselves as compassionate or to imagine receiving compassion from an ideal compassionate other. This research examines the role of self-criticism in the attentional processing of emotional stimuli, namely, critical and compassionate facial expressions. It is hypothesized that the activation of positive social emotions through CFI plays a role in broadening attention in the processing of emotional stimuli. The McEwan Faces stimulus set, which includes critical, neutral and compassionate faces, was used to create an attentional bias task called the dot probe task. The processing of emotional faces was assessed before and after exposure to either CFI or neutral imagery, controlling for the process of sensory integration (n = 80). A between-subject analysis was used to test the hypothesis. Before the imagery task, participants tended to look away from critical faces, and their level of self-criticism played a role. Both types of imagery significantly reduced the bias away from critical faces when the stimuli were presented for 1200 ms. This effect was reversed in the neutral condition for participants with high levels of self-criticism but not in the CFI condition. Interestingly, self-criticism impacts the attentional treatment of critical faces and the effect of imagery entailing sensory integration on this treatment. CFI seems to preserve this effect for participants with high levels of self-criticism, possibly due to the activation of positive social emotions.

Brief Compassion-Focused Imagery Dampens Physiological Pain Responses

ObjectivesAffiliative processes are postulated to improve pain coping. Comparatively, compassion-focused imagery (CFI) also stimulates affiliate affect systems with a burgeoning behavioural, cognitive and physiological evidence base. Thus, the purpose of the present research was to investigate if engaging in brief CFI could improve pain coping.MethodsUtilising a randomised repeated measures crossover design, 37 participants were subjected to experimental pain (cold pressor) following counter-balanced engagement with CFI or control imagery, 1 week apart. Salivary alpha-amylase (sAA) and questionnaire measures of emotional responding were taken: at baseline, following introduction to the imagery condition (anticipation), and immediately after the cold pressor pain task (actual).ResultsParticipants exhibited increases in sAA levels in response to pain following control imagery but, no such changes were observed following CFI (i.e. there was a significant time-by-condition interaction). Pain tolerance (the length of time participants immersed their hands in the cold pressor) did not differ by imagery condition. However, sAA responses to actual pain predicted decreased pain tolerance in the CFI condition. Additionally, anticipatory sAA response predicted increased pain tolerance across both conditions. None of the emotional measures of well-being differed by imagery condition, nor by condition over time.ConclusionsThese data demonstrate that using CFI can curtail a physiological stress response to pain, as indicated by increases in sAA in the control imagery condition only, following pain; pain tolerance was not influenced by CFI. Compassion-based approaches may therefore help people cope with the stress associated with pain.

A thematic analysis of compassion‐focused imagery for people with personality disorder: Inhibitors, facilitators and clinical recommendations

BackgroundCompassion‐focused therapy (CFT) is increasingly being offered for a range of conditions, including personality disorders (PDs). A key process in CFT is to identify inhibitors to developing compassion and helping clients to overcome these. This study explores inhibitors and facilitators for clients with PD trialling compassion‐focused imagery (CFI) over 1-week.MethodsFifty‐three participants with a diagnosis of at least one PD engaged in CFI for the first time, before and after a negative mood‐manipulation. Semi‐structured group interviews and written open‐response questions were used to collect data on experiences of CFI, immediately following CFI and after 1-week of daily practice. Participants were invited to practice CFI daily for 1-week then complete further open‐response questions online. Data were analysed using thematic analysis.ResultsCFI generated both positive and negative experiences for clients. Six superordinate themes were identified regarding inhibitors of CFI: weak imagery ability, fear of compassion (with multiple subthemes), lack of compassionate experiences, and psychological symptoms. Most inhibitors remained following 1-week of practice. Several facilitators of CFI were identified.ConclusionsClients with PD diagnoses face numerous inhibitors to CFI that occur transdiagnostically. Others may be more specific to this population, such as fear of compassion focused on a dangerous “other.” Some inhibitors are not overcome with practice alone, including weak imagery. Failure to assess for and address inhibitors prior to introducing CFI in this population risks causing harm to clients.

Attachment and compassion-threat: Influence of a secure attachment-prime.

The present paper proposed and tested a methodology for reducing individual's threat response to compassion-imagery, by increasing their levels of state attachment-security. A total of 68 University students (63% female, mean age=25) completed an experimental study, where they were randomly assigned to either a 10-min attachment-prime (to enhance attachment-security) or an interpersonal skills module (control condition). Participants completed a compassion-focused imagery exercise before and after the manipulation, to determine the effects of the attachment-prime. To measure the effects of the manipulation on individual's threat response, heart rate variability data were collected at baseline and during both compassion exercises. As predicted, individuals who reported higher levels of anxious and avoidant attachment styles were more likely to display a threat response (decreases in heart rate variability), to the first compassion-focused imagery. After receiving an attachment-prime, heart rate variability increased suggesting that individual's experienced greater self-soothing responses and decreased threat responses to the second compassion-focused imagery. The present findings suggest that individuals with insecure attachments are likely to require additional support increasing their attachment-security, before they can successfully engage in compassion-based exercises or therapies. Compassion-based exercises may result in fear and consequently avoidance in some populations of individuals. Threat responses to compassion can be reduced by using attachment-based techniques. Research findings will help inform and broaden the clinical applicability of compassion-based therapies.

Compassion-focused imagery reduces shame and is moderated by shame, self-reassurance and multisensory imagery vividness.

Compassion-focused imagery (CFI) is an emotion-regulation technique involving visualization of a person, animal or object offering one compassion, to generate feelings of safeness. It is proven to increase self-compassion and reduce negative affect. This study explores two hypotheses not previously investigated: i) which sensory modalities can stimulate compassionate affect; and ii) whether presentation of pictorial stimuli can enhance CFI. Additionally, we examine iii) whether CFI can reduce shame and iv) whether self-criticism inhibits CFI, since previous studies have involved small samples or methodological limitations. After completing measures of self-criticism, selfreassurance and imagery abilities in five sensory modalities, participants (n=160) were randomly assigned to look at compassionate images during CFI (visual input), compassionate images before CFI (priming), or abstract images (control). Participants trialled CFI then rated compassionate affect and completed open-response questions. Before and after CFI, participants recalled a shame-based memory and rated state shame. Correlational analyses explored whether self-criticism, self-reassurance, and multisensory imagery abilities moderated outcomes. CFI significantly reduced shame regarding a recalled memory, particularly for those high in shame. Compassionate affect was predicted by imagery vividness in visual and bodily-sensation modalities. Self-criticism predicted poorer CFI In multiple regressions, self-reassurance predicted poorer CFI outcomes but self-criticism did not. Between-group effects did not emerge. Qualitative data suggested that pictures helped some participants but hindered others. CFI is a promising technique for shame-prone clients, but may be challenging for those with low imagery abilities or unfamiliar with self-reassurance. Multiple senses should be engaged.

Inhibitors and facilitators of compassion-focused imagery in personality disorder.

Compassion-focused therapy (CFT) has potential to benefit clients with a personality disorder (PD), given the inflated levels of shame and self-criticism in this population. However, clinical observation indicates that clients with PD may find techniques from this approach challenging. The aim of this study is to trial one aspect of CFT, compassion-focused imagery (CFI), with this population, and identify factors that predict clients' ability to generate CFI and experience self-compassion during the task, including type of CFI exercise and, second, to establish whether CFI outcomes increase with practice. In Study 1, 53 participants with a diagnosis of PD completed measures of self-compassion, self-reassurance, shame, self-criticism, fear of self-compassion, affect, anxious and avoidant attachment, and mental imagery abilities. Participants were assigned to trial CFI from memory (n=25) or from imagination (n=28), then rated their image's vividness, its compassionate traits, and ease of experiencing compassion. A negative mood manipulation was carried out, and CFI tasks and outcome measures were repeated. For Study 2, self-compassion and self-criticism were measured before and after 1week of daily CFI practice. Study 1 found that negative mood and low mental imagery ability are significant inhibitors to generating compassionate images and affect. The 2 CFI exercises were equally effective. Study 2 suffered from high attrition, but regular practice was associated with significant improvement in self-compassion (though not self-criticism). CFI appears to be effective in improving self-compassion for some clients. However, it is less effective in the presence of negative affect. Clients with low mental imagery ability may benefit more from alternative CFT techniques.

Brief compassion focused imagery for treatment of severe head injury

ABSTRACTObjective: To determine whether participants with severe head injury (SHI) allocated to a brief compassion focused imagery (CFI) intervention show greater change in compassion than those exposed to relaxation imagery (RI).Method: Participants were exposed to a preparatory video to promote engagement and then randomly allocated to intervention. Pre- and post-preparatory measures were Motivation for Intervention and Fears of Compassion Scales, State-Trait Anxiety Inventory (STAI) and PANAS. Pre- and post-intervention self-report measures were the Empathy Quotient, Self-Compassion Scale, STAI and Relaxation Scale. Heart rate variability (HRV) was monitored throughout.Results: Motivation for therapy increased after the preparatory video (z = 3.44, p = 0.001). Across the intervention, group differences were not found on self-report measures or HRV changes. When CFI and RI groups were pooled, improvement in relaxation (r = .41, p < 0.01) and state anxiety (r = .29, p < 0.05) were found across the intervention; these outcomes were not associated with changes in self-compassion or HRV.Conclusion: Brief CFI, a central aspect of compassion focused therapy, did not produce a reliable change in people with SHI. Enhanced motivation for psychological therapy after a brief preparatory video is relevant and underlines the need to understand mechanisms of action rather than the pursuing whole protocol approaches to therapy.

The role of oxytocin and alexithymia in the therapeutic process.

The role of oxytocin and alexithymia in the therapeutic process.

Effects of intranasal oxytocin on 'compassion focused imagery'.

This study explored the effects of oxytocin on Compassion Focused Imagery (CFI), that is, imagining another "mind" being deeply compassionate to oneself, and the interaction of these effects with self-criticism and feeling socially safe with others. Forty-four healthy participants (29 men and 15 women) completed self-report measures of self-criticism, attachment style, and social safeness before taking part in a double-blind randomized placebo controlled study. They attended two imagery sessions, receiving oxytocin in one and a placebo in the other. Positive affect was measured before and after each imagery session, and "imagery experience" was assessed after each session. Overall, oxytocin increased the ease of imagining compassionate qualities but there were important individual differences in how CFI was experienced. Participants higher in self-criticism, lower in self-reassurance, social safeness, and attachment security had less positive experiences of CFI under oxytocin than placebo, indicating that the effects of oxytocin on affiliation may depend on attachment and self-evaluative styles.

Compassion-Focused Imagery for Use within Compassion Focused Coaching

This article describes compassion-focused imagery. This technique can help coachees to feel more compassionate towards themselves. It can be used specifically in compassion focused coaching or integrated within other forms of coaching.