Evolved Brian - Social Mind: Implications for Cognitive Therapy Paul Gilbert FBPsS Mental Health Research Unit Kingsway Hospital Derby

Evolutionary and Social Contexts for Compassion

Paul Gilbert PhD, FBPsS, OBE Mental Health Research Unit, Kingsway Hospital Derby p.gilbert@derby.ac.uk

www.compassionatemind.co.ukwww.compassionatewellbeing.com

Compassion begins with a reality checkInsight builds wisdomWe are gene-built - with evolved brains designed to struggle to survive, to want, grasp and avoid pain

We are all born, grow, decay and die - and are susceptible to many diseases and injuries life with tragedy pain and suffering

We are socially shaped from our gene expressions, to our sense of self and values

Not our fault but how to choose to train the mind (powerful de-shame process)

22Compassion: Challenges of Our Evolved Brainand the Distressed Mind

33Sources of behaviour

EmotionsFear, Anxiety, Anger, Lust, JoySocial Motives Closeness, Belonging, Sex, Status, RespectOld BrainOld Brain PsychologiesSources of behaviour

New BrainImagination, Planning, Anticipation Rumination, ReflectionPurposeful focusing of the mindIntegrationSymbol userSelf IdentityNew Brian AbilitiesGetting SmartSources of behaviour

Old Brain: Emotions, Motives, Relationship Seeking-CreatingArchetypalNew Brain: Imagination, Planning, Rumination, IntegrationInteraction of old and new psychologiesGlitches

TrThinking brain can cause serious problems in using old affect and motive systems (trade off)Built in Biases Compassion insights

Biased learning e.g., fear of snakes not electricityBiases can be implicit (non-conscious) or explicit (Conscious)

Self-focusedKin preferences (nepotism)In-group preferences (tribalism)

A mind that does not know itselfDangerous, Cruel and Crazy Mind?Compassion and cruelty(Gilbert 2005)To understand compassion requires us to understand how compassion gets turned on and off, people can literally disassociate from pain and suffering

This is no ones fault but it is linked to how the brain works in certain contexts but it carries huge implications and responsibilities for how we build compassionate societies.

Mental HealthLife risk of disorder %MenWomenAny disorder48.747.30Depression14.723. 9Anxiety19.230.5

Alcohol 20.18.2

Source: National Comorbidity studyHigh variability with type of community

Leading causes of World DALYs, est. 2020 Murray and Lopez (W.H.O.), Science 274:741, 1996The disability-adjusted life year is an indicator of the time lived with a disability and the time lost due to premature mortality

Leading DALYs for Women ages 14-45 in Developed CountriesThe Social Contexts

Evolutionary ProcessCulture can render an adaptive phenotype highly maladaptive, e.g. food seeking

Human evolved in times of scarcityAdapted for the see food and eat it diet Adapted for energy conservationNot adapted for quick/internal limitation

Modern Culture: High available cheap and aesthetically enhanced taste and textured food

OBESITY, DIABETES, HEART DISEASEScience of compassion must begin with an understanding of

The complex and often chaotic nature of the human mind

The components that create a compassionate mind

How to cultivate a compassionate mind

What undermines a compassionate mindMESSAGE:

MOTIVES ORGANISE THE MIND

1818Sources of behaviour

Old Brain: Emotions, Motives, Relationship Seeking-CreatingCOMPASSIONNew Brain: Imagination, Planning, Rumination, IntegrationNeed compassion for a very tricky brainMindful BrainSources of behaviour

Old Brain: Emotions, Motives, Relationship Seeking-CreatingCompetitiveNew Brain: Imagination, Planning, Rumination, IntegrationNeed compassion for a very tricky brainMindful BrainThe Em0tions

Understanding our Motives and EmotionsMotives evolved because they help animals to survive and leave genes behind

Emotions guide us to our goals and respond if we are succeeding or threatened

There are three types of emotion regulation

Those that focus on threat and self-protectionThose that focus on doing and achievingThose that focus on contentment and feeling safe

22Types of Affect Regulator SystemsIncentive/resource- focusedWanting, pursuing, achieving ActivatingNon-wanting/Affiliative focused

Safeness-kindness

SoothingThreat-focused

Protection andSafety-seekingActivating/inhibitingAnger, anxiety, disgustDrive, excite, vitalityContent, safe, connected23Threat systems and phenotypesEarly stress changesGene expression and Neuro-developmentSocial contextsoffer different environments thataddress, ignore or create stress

Threat-focused

Protection andSafety-seekingActivating/inhibitingAnger, anxiety, disgust24Types of Affect Regulator SystemsIncentive/resource- focusedWanting, pursuing, achieving ActivatingNon-wanting/Affiliative focused

Safeness-kindness

SoothingThreat-focused

Protection andSafety-seekingActivating/inhibitingAnger, anxiety, disgustDrive, excite, vitalityContent, safe, connected25Lottery $ $ $Safeness, Affiliation and affect regulation

Types of Affect Regulator SystemsIncentive/resource- focusedWanting, pursuing, achieving ActivatingNon-wanting/Affiliative focused

Safeness-kindness

SoothingThreat-focused

Protection andSafety-seekingActivating/inhibitingAnger, anxiety, disgustDrive, excite, vitalityContent, safe, connected29

Between self and othersThreatAffiliative/ SoothingCalms120 Million year evolving system to regulate threatSelf-to selfSelf to self30

Internal Threat and SoothingThreatAffiliative/ SoothingCalmsInternal representations of helpful others and sources of comfortEmotional memories of soothingNeurophysiological networksSelf-affiliation experiences a lovable self31

Internal Threat and More threatThreatAffiliative/ SoothingCalmsOthers are threats or alarmingEmotional memories of no soothingNeurophysiological networksNo self-affiliation experiences a unlovable self32Being cared for and PhysiologyThe evolution of caring brings major changes in physiological regulation Relationships are physiological regulators

Gene expression Stress reactivityImmune system functionFrontal cortexIllness and recoveryCore valuesSelf-identitiesCompassion and empathysoHumans function best (frontal cortex, stress hormones, immune systems and cardiovascular) when they are

loving affiliative and caring (rather than hating)

Feel loved and valued (rather than unloved and de-valued)

Self and others Self and selfThreatAffiliative/ SoothingShame120 Million year evolving systems to regulate threatSocial relationships are the most important sources of meaning, self regulation and learning Self-to self35Compassion solutions to the reality of sufferingAncient wisdom: Compassion is the road to happiness (most spiritual traditions)

Evolution: Evolution has made our brains highly sensitive to external and internal kindness

Neuroscience: Specific brain areas are focused on detecting and responding to kindness and compassion

Social and developmental Psychology: History of affiliation affects brain maturation, emotion regulation, pro-social behaviour and sense of self36Compassionand CaringThe Two Psychologies of CompassionCompassion can be defined in many ways: As a sensitivity to the suffering of self and others with a deep commitment to try to relieve and prevent it

Two different Psychologies To approach, understand and (how to) engage with suffering To work/study to alleviate and prevent suffering to nurture

Each more complex that might at first seem3838Compassion as Flow Different practices for each

Other SelfSelfOtherSelf Self

Evidence that intentionally practicing each of these can have impacts on mental states and social behaviour3939Compassion Focused Therapy: and Social Mentality TheoryCaring/HelpGiving

Specific Competenciese.g., attention empathy

Facilitators vs InhibitorsCare/Help Seeking/Receiving

Specific Competencies e.g., openness responsive

Facilitators vs Inhibitors

Not just interested in what compassion is but how it is experienced as a recipient experienced are being cared aboutThe Competencies of Compassion

Engagement and AlleviationCompassionate Mind - EngagementCare for well-beingSensitivitySympathyDistress toleranceEmpathyNon-JudgementCompassionATTRIBUTESWarmthWarmthWarmthWarmth4242Compassionate Mind - AlleviationImageryAttentionReasoningFeelingBehaviourSensoryCare for well-beingSensitivitySympathyDistress toleranceEmpathyNon-JudgementCompassionATTRIBUTESSKILLS -TRAININGWarmthWarmthWarmthWarmth4343CULTIVATIONPractice of imagining compassion for others produces changes in frontal cortex and immune system (Lutz et al., 2009)

Loving kindness meditation (compassion directed to self, then others, then strangers) increases positive emotions, mindfulness, feelings of purpose in life and social support and decreases illness symptoms (Frederickson et al., 2008, JPSP)

Compassion self-goals in contrast to self-image goals are associated with feelings of connectedness and well-being (Crocker, J & Canevello (2008 JPSP) voluntarily helping others boost positive emotions

Compassionate mind training reduces shame and self-criticism in chronic depressed patients (Gilbert & Proctor, 2006, CPP),4444Build the Compassionate SelfMethod acting techniques to pull on inner feeling and memories of a character enter into the role but why do itTrain in Wisdom Evolved nature of mind and social construction to the selfSense of calm mindful inner authority body postures breathing, grounding and attention courage to engageCommitment to compassionate focus and actionActual and imagery practices.Compassion ProcessGiving/doingMindful Acts of kindnessEngagement with the feared

Receiving/soothingSBR/CalmGrounding/stabilityValidationGratitude appreciationThreatMindful awarenessTriggersIn the bodyRuminationLabellingCompassionate Self46Compassion as Ascent or Decent?Compassion is not getting rid of the difficult contents of the mind but mindfully engaging with them (e.g., rage, fear prejudice) going into, not away from

Compassion is becoming mindful and then being able to choose because it is not blaming but containing

Compassion as Flow Different practices for each

Other SelfSelfOtherSelf Self

Evidence that intentionally practicing each of these can have impacts on mental states and social behaviour4848Data From Group Study

49Data From Group Study

50ReflectionsI would just like to tell you all here today what (CMT) means to me. It seemed to awaken a part of my brain that I was not aware existed.The feeling of only ever having compassion for other people and never ever contemplating having any for myself.Suddenly realising that its always been there, just that I have never knew how to use it towards myself.

It was such a beautiful, calming feeling to know it was Ok to feel like this towards myself without feeling guilty or bad about it.Being able to draw on this when I was frightened and confused, to calm myself down and to put things in prospective and say to myself ITS OK TO FEEL LIKE THIS. 51ReflectionsHaving compassion for myself means I feel so much more at peace with myself. Knowing that it is a normal way of life to have compassion for myself and its not an abnormal way of thinking, but a very healthy way of thinking. It felt like I was training my mind to switch to this mode when I start to feel bad about myself or life situations were starting to get on top of me.

What is striking about this, and what other participants thought, was how much they had (previously) felt that being self-compassionate and empathic to ones distress was a self-indulgence or weakness and definitely not something to cultivate. 52Sources of behaviour

Old Brain: Emotions, Motives, Relationship Seeking-CreatingCOMPASSIONNew Brain: Imagination, Planning, Rumination, IntegrationNeed compassion for a very tricky brainMindful BrainSources of behaviour

Old Brain: Emotions, Motives, Relationship Seeking-CreatingCompetitiveNew Brain: Imagination, Planning, Rumination, IntegrationNeed compassion for a very tricky brainMindful BrainConclusionHumans are capable of wonderful things, but also terrible things. Very mixed mind many seeds

Our minds are really a mixed range of potential motives, ways of thinking and behaving and we easily dissociate one state of mind from another

By improving our understanding of the nature of compassion, its facilitators and inhibitors, both as a giver and receiver, we may be better placed to cultivate the good in us. This is our responsiblity

How to bring this about?55Some ReferencesGilbert, P (2009). The Compassionate Mind: A New Approach to the Challenge of Life. London: Constable & Robinson.Gilbert, P. (2010) Compassion Focused Therapy: The CBT Distinctive Features Series. London: Routledge.Gilbert, P & Choden. (2013). Mindful Compassion. London: Constable Robinson

See also the Compassionate Mind Series by New harbinger With other author books on anxiety (Tirch), anger (Kolts), trauma (Lee), eating (Goss) and othersChart50.50.61.11.11.61.922.32.42.62.72.83.13.23.24.24.55.25.75.9

Chart70.20.60.711.822.52.62.73.63.63.8556.519.5

Percent of totalLeading DALYs for Women ages 14-45 in Developed Countries

Chart10.50.61.11.11.61.922.32.42.62.72.83.13.23.24.24.55.25.75.9

Chart20.50.61.11.11.61.922.32.42.62.72.83.13.23.24.24.55.25.75.9

Percent of total

Sheet1AnaemiaMalnutritionMeaslesMalariaFallsLung cancerSelf injuriesCongenitalViolencePerinatalHIVDiarrheaWarTBPneumoniaCOPDStrokeCar accidentsDepressionHeart disease0.50.61.11.11.61.922.32.42.62.72.83.13.23.24.24.55.25.75.9TBMaternal sepsisAbortionWarIron deficiency anaemiaObstructed LaborRheumatoid arthritisSelf-inflicted injuriesChlamydiaAlcohol useOsteoarthritisOCDTraffic accidentsBipolar disorderSchizophreniaUnipolar depression0.20.60.711.822.52.62.73.63.63.8556.519.5

Sheet2

Sheet3

Chart50.50.61.11.11.61.922.32.42.62.72.83.13.23.24.24.55.25.75.9

Chart70.20.60.711.822.52.62.73.63.63.8556.519.5

Percent of totalAnaemiaSelf injuriesDepression

Chart10.50.61.11.11.61.922.32.42.62.72.83.13.23.24.24.55.25.75.9

Chart20.50.61.11.11.61.922.32.42.62.72.83.13.23.24.24.55.25.75.9

Sheet1AnaemiaMalnutritionMeaslesMalariaFallsLung cancerSelf injuriesCongenitalViolencePerinatalHIVDiarrheaWarTBPneumoniaCOPDStrokeCar accidentsDepressionHeart disease0.50.61.11.11.61.922.32.42.62.72.83.13.23.24.24.55.25.75.9TBMaternal sepsisAbortionWarIron deficiency anaemiaObstructed LaborRheumatoid arthritisSelf-inflicted injuriesChlamydiaAlcohol useOsteoarthritisOCDTraffic accidentsBipolar disorderSchizophreniaUnipolar depression0.20.60.711.822.52.62.73.63.63.8556.519.5

Sheet2

Sheet3

Chart254.410.218.956.3

BeforeAfterScalePre and Post Compassionate Mind Training18.854.256.4

Sheet1self criticalself compassionate11378123771348141451131548716321017104118399193915BEGINNING1103617self criticalself compassionateEND111522011378self criticalself compassionate112123932517112123931..415973122153325175160741249503347771572151267034497915977101262354614total3235791267036577total1063443760738..3103523Self criticismSelf compassion3111745Beginning323573122153End1063444159742597BeginningEnd43607Self criticism32310644577Self compassion5734445567BeforeAfter46537Self criticism54.410.247497Self compassion18.956.348493449..410..411..41249505160752587535421544020555015563045572252586705913705102370511..512670715721723977363874..75677654777604378655795477101262711..712..91597926079364494557953025966797343998658994553910..9116069912670

Sheet10000

BeforeAfterScalePre and Post Compassionate Mind Training53.83(8.86)17.67(16.31)9.5(5.65)57.33(12.26)

Sheet2

Sheet311378113781237732517134814415971451135160715487715721163210915971710413235718399193915112123911036173122153111522041249501121239512670total710126231..912670325171063443347734497354614bef3235736577aft1063443760738..310352331117453122153total3834159742597436074457745567465374749748493449..410..411..4124950total51607525875354215440205550155630455722525867059137051023705...512670total715721723977363874..756776547776043786557954771012627...total.915979260793644945579530259667973439986589945539...9116069912670total

Chart114.676.8310.334.3

BeforeAfterSubscaleScoreHADS10.33(2.67)14.67(3.78)4.3(2.73)6.83(2.93)

HADSAnxietyDepression111093116124119135117137110891167Total88621275321174221AnxietyDepression5261Before14.6710.337275After6.834.392874126

HADS0000

BeforeAfterSubscaleScoreHADS10.33(2.67)14.67(3.78)4.3(2.73)6.83(2.93)

Functions&FormssasrissasrrssasrhsfuncscfuncspsasrissasrrssasrhsfuncscfuncspInadequate Self (form)Reassure Self (form)Hated self (form)Self Correction (function)Self Persecution (function)Inadequate Self (form)Reassure Self (form)Hated self (form)Self Correction (function)Self Persecution (function)113301918131133019181331334142626313341426264135513442541355134425513201533513201533712114103417712114103417913414204321913414204321total1883791168105121991328131219913281332623116342221310382142221310382152830081528300819211272103326231163921127210372211782717871193412758Inadequate SelfReassure SelfHated selfSelf CorrectionSelf PersecutionBefore1883791168105After871193412758Inadequate SelfHated selfReassure SelfBefore31.3315.176.17After14.55.6719.83Self CorrectionSelf PersecutionBefore2817.5After21.679.6Inadequate SelfHated selfReassure SelfBefore31.3315.176.17After14.55.6719.83

Functions&Forms000000

BeforeAfterScoreForms of Self-to-Self Relating6.17(6.40)15.17(3.76)31.33(5.16)19.83(8.21)5.67(5.40)14.5(7.01)

OAS, SUB B, SOC COMP0000

BeforeAfterScoreFunctions of Self-to-Self Relating17.5(8.62)28(15.79)9.6(8.45)21.67(11.74)

Social comparisonSubmissive Behaviouroas112411581156312331453168411641464165512751475138714571367140917491249124209256291122612561243423842394249529752115223927692179222726572377233325032203248352180218Social comparisonSubmissive BehaviourOthers as ShamersBefore34.83Before42.67Before48.5After58.67After30After36.33

00

BeforeAfterScoreSocial Comparison34.83(21.50)58.67(26.00)

00

BeforeAfterScoreSubmissive Behaviour42.67(11.52)30(16.95)

00

BeforeAfterScoreOthers as Shamer48.5(17.27)36.33(12.13)

MBD001094E2.xlsChart1

42.6730

Before

After

Score

Submissive Behaviour

Sheet1

depressionanxiety

11910

311216

411319hads anxietyhads depression

5113176288

718101933

91716

6288

1257DepressionAnxiety

3257Before10.314.6

42711After3.86.6

5212

9216

1933

Sheet1

00

00

Before

After

Subscale

Score

HADS Scores Pre and Post Compassionate mind Training

Sheet2

sasrissasrrssasrhsfuncscfuncspsasrissasrrssasrhsfuncscfuncsp

Inadequate Self (form)Reassure Self (form)Hated self (form)Self Correction (function)Self Persecution (function)Inadequate Self (form)Reassure Self (form)Hated self (form)Self Correction (function)Self Persecution (function)

1133019181311331909191318281313

31334142626313364231412616263

41355134425413522513131044382521

513201533513280301503831

712114103417712114103417

91341420432191341114272024310213

total1886637102912616810010541

1219913281312199132813

326231163326231163

422213103821422213103821

5283008152830081

92112721039211272103

Inadequate SelfReassure SelfHated selfSelf CorrectionSelf Persecution

Before1883791168105

After661022610041

Inadequate SelfHated selfReassure Self

Before31.315.176.17

After13.25.220.4

Self CorrectionSelf Persecution

Before2817.5

After208.2

Inadequate SelfHated selfReassure Self

Before31.315.176.17

After13.25.220.4

Sheet2

00

00

00

Before

After

Score

Forms of Self-to-Self Relating Scores Pre and Post Compassionate Mind Training

Sheet3

00

00

Before

After

Score

Functions of Self-to-Sefl Relating Scores Pre and Post Compassionate Mind Training

Social comparisonSubmissive Behaviouroas

112411581156

312331453168

411641464165

512751475138

714571367140

917491249124

209256291

122612561243

423842394249

529752115223

927692179222

726572377233

325032203248

352180218

Social comparisonSubmissive BehaviourOthers as Shamers

Before34.83Before42.67Before48.5

After58.67After30After36.33

00

Before

After

Score

Social Comparison Scores Pre and post Compassionate Mind Training

00

Before

After

Score

Submissive Behaviour Scores Pre and Post Compassionate Mind Training

00

Before

After

Score

Others as shamers Score Pre and Post Compassionate Mind Training