Psilocybin is a classic psychedelic known to alter subjective experience and induce lasting psychological changes, including increased cognitive flexibility and reduced rigid self-related beliefs. Contextual factors, including preparatory mental states, are thought to play a key role in shaping these effects. Compassion imagery, which engages care-affiliative motivational systems, may represent a promising priming approach in this context. Here, we investigated the neural and psychological effects of psilocybin under compassion imagery priming using self-report questionnaires and functional magnetic resonance imaging (fMRI) in a naturalistic sample of 105 participants. Participants were primed with either compassion imagery or attention to breathing prior to psilocybin intake. We observed sustained increases in absorption over time, particularly in the high-dose compassion imagery condition. Additional within-group increases were found in measures of decentering and self-compassion. Using functional connectivity features, fMRI-based classifiers distinguished between resting state and compassion imagery conditions prior to intake, and between priming conditions following psilocybin, with significant classification performance observed only in the high-dose group. These findings suggest that psilocybin is associated with lasting changes in absorption and may be modulated by contextual priming to shape both psychological outcomes and large-scale brain network dynamics. More generally, our results highlight the potential role of compassion-based practices as preparatory interventions in psychedelic contexts. Future confirmatory studies are needed to further characterize these effects and their underlying mechanisms.

This study conducted an initial psychometric evaluation of the Japanese version of the Social Safeness and Pleasure Scale (SSPS-J). In Study 1 (N = 477), exploratory factor analysis supported a single-factor structure with excellent internal consistency (alpha = 0.95, omega = 0.95). Significant correlations with depression (r = -0.53), anxiety (r = -0.26), stress (r = -0.36), life satisfaction (r = 0.67), and social support (r = 0.47-0.52) demonstrated robust convergent validity. In Study 2, confirmatory factor analysis (N = 262) confirmed the reproducibility of the single-factor model with an acceptable overall fit (CFI = 0.943, SRMR = 0.036, RMSEA = 0.108). Test-retest reliability over a three-week interval (N = 113) was also high (ICC = 0.88). These results suggest that the SSPS-J is a reliable and valid preliminary measure for assessing social safeness in the Japanese general population.

Live music interventions are increasingly employed in healthcare settings through a range of models, including clinical music therapy and Arts-in-Health musician programs. This study examines patient responses to live music delivered by trained professional orchestral musicians within an outpatient chemotherapy infusion unit. Although a substantial body of research associates music with reductions in anxiety, pain, and distress, findings remain heterogeneous, and the mechanisms underlying these outcomes remain incompletely understood. This is particularly true in live music settings, where musical experience is inseparable from interpersonal encounter. The aim of this study was to explore whether Compassion Focused Therapy (CFT), the psychotherapeutic model developed by Paul Gilbert, offers a useful interpretive framework for understanding patient experiences of live music delivered by Arts-in-Health musicians. Drawing upon qualitative patient reflections collected through a service-evaluation questionnaire, the study examines how processes associated with emotional regulation, social safeness, connection, comfort, and self-soothing may emerge within live musical encounters. Viewed through a compassion science perspective, patient accounts frequently reflected experiences of meaningful autobiographical connection, reduced isolation, emotional comfort, and feelings of being cared for. These observations suggest that some benefits of music in healthcare may arise not solely from acoustic properties of the music itself, but also from relational processes embedded within the musical encounter. The purpose of this study is not to apply CFT as an intervention, but to use it as an interpretive framework for examining patient experiences of live music within an oncology setting. Through this lens, the findings contribute to emerging discussions concerning music, compassion, and human connection within healthcare.

Background:Life confronts us with many aversive events, including injuries, diseases, losses, decay and death. These life realities often stimulate compassion motives orientated to try to alleviate and prevent suffering. While concepts of 'stress' and 'fear' have dominated the discourse on responses to 'traumatic events', a less common narrative is that of 'tragedy'. Tragedy narratives focus on the empathic sensitivities to the 'suffering and traumas of life' and hence are related to compassion motives. Tragedy has a long history with complex meanings and is focused on sadness and loss, rather than fear. Hence, it invites a different language of experiences requiring grief work rather than (just) fear exposure work. While the experiences of healthcare professionals (HCPs) working with COVID-19 patients have been studied regarding stresses and fear-based traumas, HCPs were also witness to, and experienced these traumas, in terms of tragedy. This study developed a multicomponent survey to explore different dimensions and patterns of HCPs' experiences with a focus on issues of sadness, grief and tragedy. Focusing on the tragic elements of a trauma invites a different narration, language and way of working through trauma. Methods:From informal discussions with colleagues working in high impact COVID-19 environments, such as intensive care units, and with psychologists who supported those staff, we identified a non-exclusive and non-exhaustive set of themes that textured their experience. We were particularly interested in experiences that could be seen as descriptions of tragedy-based trauma. These were presented as novel self-report surveys to HCPs in British and Portuguese samples. This sought to explore diverse patterns of experiences and responses beyond diagnostic criteria like posttraumatic stress disorder (PTSD). Measures of social safeness, trauma, posttraumatic growth and burnout were also given to explore these themes using standard scales. Results:Our survey suggested key compassion themes of: high levels of empathic distress for the suffering of others and being more fearful of passing the virus to friends and close others than being infected oneself. As suggested by a tragedy focus, sadness and tearfulness were as prevalent as fear. The compassionate support of others, i.e., family, friends and colleagues, were central for coping. Reflecting on how they had changed over time, many HCPs noted personal growth. In terms of their emotions, the strongest ones HCPs wanted help with were 'finding joy', indicating perhaps that loss of textures of positive affect can be a consequence of these events, as in 'sadder but wiser' sentiments. These data indicate that the impacts of these types of events are richly textured and extend beyond issues of threat and PTSD symptom-focused approaches. It invites clinicians to explore and contextualise some trauma experiences as tragedy, which facilitates a different languaging and processing of such events. Conclusion:The way we use language and narrate traumatic events can have a major impact on how we come to process and make sense of them, and how we can help people going through these experiences. This paper suggests that narrating certain types of loss-based trauma events, particularly those linked to health and death (as in COVID-19) can be regarded as forms of human tragedy, which links to more ancient ways of addressing life's suffering, including the importance of shared compassion and communal grieving. This is an initial exploration of potential experiences of HCPs that can distinguish concepts of tragedy-based trauma from fear-based trauma. Clarity on these variations can offer opportunities for new insights into sources of distress, and therapeutic interventions.

Psilocybin is a classic psychedelic drug known to alter subjective experience and elicit long-term psychological changes, enhancing cognitive flexibility and reducing rigid self-related beliefs. Combined with compassion motivational primes that involve generating mental representations of compassion, it may increase the potential for activating the care-affiliative motivational systems, linked to several important biopsychosocial processes underpinning social safeness, social connection and mental wellbeing. We investigated the synergetic effects of psilocybin and compassion imagery with self-reported questionnaires and functional resonance imaging data (fMRI) in a sample of 105 participants. Participants were primed with either attention to breathing or a short compassion focused imagery prime. We found a long-term synergetic effect of compassion imagery and psilocybin on cognitive absorption, as well as changes relative to baseline self-compassion and decentering. Based on functional interactions between attentional, executive and default mode networks, fMRI-based classifiers detected participant engagement in compassion focused imagery before psilocybin intake and distinguished compassion imagery vs. attention to breathing priming only the high dose of psilocybin. Our results support the potential for synergistic effects from combinations of psilocybin and compassion-based interventions to induce long-term psychological changes, reshaping the functional organization of large-scale brain networks. Future confirmatory studies of our exploratory analyses should be conducted to determine whether the combination of psilocybin and compassion-based practices promotes increases in caring and contemplative abilities, enhanced psychological flexibility and well-being.

BACKGROUND:Physiological signals conveyed by the vagus nerve may generate quiescent psychological states conducive to contemplative practices. This suggests that vagal neurostimulation could interact with contemplative psychotherapies (e.g. mindfulness and compassion-based interventions) to augment their efficacy. METHODS:In a fully factorial experimental trial, healthy adults (n = 120) were randomized to transcutaneous vagus nerve stimulation (tVNS) plus Self-Compassion-Mental-Imagery Training (SC-MIT) or alternative factorial combinations of stimulation (tVNS or sham) plus mental imagery training (MIT: SC-MIT or Control-MIT). Primary outcomes were self-reported state self-compassion, self-criticism, and heart rate variability (HRV). Exploratory outcomes included state mindfulness and oculomotor attentional bias to compassion-expressing faces. Most outcomes were assessed acutely on session 1 at the pre-stimulation (T1), peri-stimulation (T2), and post-MIT + stimulation (T3) timepoints, and after daily stimulation+MIT sessions (eight sessions). RESULTS:During session 1, a significant Timepoint × Stimulation × MIT interaction (p = 0.025) was observed, reflecting a larger acute T1→T3 increase in state self-compassion after tVNS+SC-MIT, with similar rapid effects on state mindfulness. Additionally, significant Session × MIT and Session × Stimulation interactions (p ≤ 0.027) on state mindfulness (but not self-compassion) suggested that tVNS+SC-MIT's effects may accumulate across sessions for some outcomes. By contrast, changes in state self-criticism and compassion-related attentional bias were only moderated by MIT (not stimulation) condition. HRV was unaffected by stimulation or MIT condition. CONCLUSION:tVNS augmented the effects of SC-MIT and might, therefore, be a useful strategy for enhancing meditation-based psychotherapies. Our findings also highlight the value of oculomotor attentional metrics as responsive markers of self-compassion training and the continued need for sensitive indices of successful vagal stimulation.

This study aimed to develop the Italian version of the Compassionate Engagement and Action Scales (CEAS) and examine its validity and reliability among Italian-speaking adults. A total of 374 (mean age = 23.11) Italian speaking participants took part in the study. All of them completed a questionnaire comprising the CEAS, together with measures of self-compassion, self-criticism, social support, empathy, well-being and general distress, used to estimate the scale's convergent and criterion-related validity. Confirmatory Factor Analysis (CFA) revealed a satisfactory fit for a model in which three second-order factors (Self-compassion, Compassion for others and Compassion from others) were further articulated in two first-order factors (Engagement and Action). All the scales presented good reliability in terms of internal consistency. Correlations with measures of social support, empathy, self-compassion, self-criticism, well-being, and general distress indicated good convergent and criterion-related validity of the Italian version of the CEAS. Taken together, these results suggest that the CEAS can be properly used with Italian-speaking individuals in order to assess the three compassion flows in terms of both engagement and action.

Compassion has been a subject of extensive scientific research for over two decades. There is clear evidence that our capacity for compassion evolved out of care motivation. Like all motivations it is operated via stimulus response algorithms. For compassion motivation stimulus sensitivity focuses on the processing of indicators of suffering, distress and need, called engagement. The response functions switch attention and processing to what is likely to be helpful in alleviating suffering, distress and need, called action. The Compassion Engagement and Action Scales (CEAS) were developed to measure the S-R algorithm of compassion. Because compassion, like other psychological phenomena can operate interpersonally and intrapersonally, there are three scales that give separate assessments for directing compassion to 1. the self, 2. others and 3. responsiveness to compassion from others. They have been used in many international studies and there is now substantial evidence. The research aimed to validate the CEAS within a Polish population. The three cross-sectional studies involved a total of 1,219 participants from Poland. Confirmatory factor analysis conducted on two separate samples indicates that bifactor models provide the best fit for both the Compassion for Others scale and the Compassion from Others scale. In the first, the model includes a general compassion for others factor alongside specific factors for engagement and actions. Similarly, the second features a general compassion from others factor with the same specific factors. This means that being sensitive to suffering and taking action represent specific components of compassion. However, the bifactor model for Compassion for Self requires further refinement due to lower fit indices and the need for item adjustments. The study results generally support the reliability and validity of the CEAS-PL across diverse samples, aligning with findings from previous studies on the original tool and its language adaptations. Notably, tests of validity-including correlations with emotion regulation, well-being, and attachment styles-highlighted distinct patterns for the three flows of compassion, underscoring their conceptual independence. The CEAS-PL shows promise as a valuable tool for psychological research and practice, especially in the areas of pro-social behaviour and helping people with mental health problems, facilitating the assessment of compassion across different orientations. It may support practitioners in identifying individual competencies and tailoring interventions to enhance compassion-related competencies to address particular difficulties.

BACKGROUND:It is clinically recognised that some people find it difficult to engage with, or commit to, self-help for life difficulties. This may be due to various reasons such as experiences of helplessness, feeling overwhelmed and lacking skills, and low confidence in the process. Another reason can be beliefs of 'needing others' to bring change about; that they are not able to do it for themselves and are 'hoping and waiting' for others to 'rescue' them. OBJECTIVES:This study developed a new self-report scale to explore people's experiences of hoping and waiting to be rescued from distressing mental states. Second, we sought to explore how this orientation links to mental health, social relating, early life experiences, and emotion dysregulation. METHODS:The scale comprised 18 items derived from clinical experiences and was completed online by two general population samples from the United Kingdom (total n = 445). Participants also completed measures of emotion dysregulation, reassurance-seeking, depression, anxiety, stress, self-other relating, social comparison, social safeness, early memories of warmth and parental bonding. RESULTS:Exploratory and confirmatory factor analyses revealed a good factor structure that separated into two key themes: 1. Hoping and waiting for rescue from others and 2. Self-reliance. Hoping and waiting for rescue was negatively correlated with self-reliance. It was also correlated with parental over-protection (but not care), lack of feeling socially safe, higher reassurance-seeking, depression, anxiety, stress, and emotion dysregulation. Network analysis revealed a stable network in which hoping and waiting for rescue is a central node with direct connections to variables of mental health, social relating, and early life experiences. The scales demonstrated good test-retest reliability and internal consistency. CONCLUSIONS:This study suggests that individuals who feel they need others to rescue them from distressing mental states are less oriented to self-reliance and self-help. Moreover, this coping style is associated with a range of mental health difficulties. Therapists can be alert to these difficulties regarding why clients might not engage in self-help and help clients address them, including linking them to other issues such as unprocessed emotions associated with early attachment difficulties.

Abstract The last one hundred years have seen a proliferation of different schools of psychotherapy. While this diversity can be seen as the vitality of the field, it can also be seen as a serious problem of fragmentation. This is partly the result of psychotherapy lacking an agreed upon scientific framework for understanding basic mental processes and functions, and partly due to “individual” focused therapies, that only attend to what happens “inside” an individual, are socially decontextualized and fail to address the social causes of mental health problems and their prevention. This chapter explores a framework for an integrative, evolution informed biopsychosocial science approach and one that forms the basis for compassion focused therapy (CFT) (see Chapter 10), emphasizing four functions of mind: motives, emotions, competencies, and behaviors. Understanding and affecting these functional processes, and their psychophysiological infrastructures, can significantly advance the effectiveness of psychotherapy.

Objectives The current study aimed to examine the mechanisms of change of a compassionate mind training intervention for teachers (CMT-T). In particular, we examined whether changes in the three flows of compassion, fears of compassion, and emotions at work (safe, drive, and threat) mediated the effects of the CMT-T in burnout, depression, anxiety, and stress, and in overall positive affect.Methods As part of a two-arm randomized controlled trial and a stepped-wedge design, the study included all participants who completed the 8-week CMT-T intervention either at Time 1 or at Time 2 (n = 103). At pre- and post-intervention, participants completed measures of compassion, fears of compassion, emotional climate in the workplace, burnout, psychopathological symptoms, and positive affect.Results Mediation analyses revealed that increases in the flows of compassion and reductions in fears of compassion from others mediated the effects of CMT-T on teachers' depression, anxiety, stress, and burnout levels. In the case of the reduction in stress symptoms from pre- to post-intervention, compassion for self, fears of self-compassion, and fears of receiving compassion from others emerged as significant mediators of this change. The three flows of compassion and fears of compassion (for self and from others) were significant mediators of the impact of CMT-T on changes in teachers' anxiety levels from baseline to post-intervention. A decrease in fears of compassion from others and an increase in drive emotions mediated changes in depressive symptoms following CMT-T. Concerning burnout, all flows of compassion and fear of compassion from others mediated the changes from baseline to post-intervention. Changes in positive affect following CMT-T were mediated by increases in the flows of compassion, and emotions related to soothing-safeness and drive systems in the workplace. Serial mediational models showed that the effect of CMT-T on teachers' burnout was partially mediated by reductions in fears of compassion (for self and from others) and stress.Conclusions CMT-T effectively improves teachers' wellbeing and reduces burnout and psychological distress through the cultivation of their ability to experience, direct, and be open to compassion, and the strengthening of the soothing-safeness and the drive systems in the school context.Preregistration The study was registered at ClinicalTrials.gov: identifier, NCT05107323; Compassionate Schools: Feasibility and Effectiveness Study of a Compassionate Mind Training Program to Promote Teachers Wellbeing.

During the last four decades there has been a significant growth of interest in mindfulness-based practices and their potential to foster improvements in health, wellbeing and human functioning in a variety of clinical and nonclinical populations. With this growth has come a renewed interest in understanding the psychological processes involved as well as the neuropsychological mechanisms by which such practices operate and effect transformative personal experiences and positive change. The current perspective paper (i) presents a basic taxonomy of meditation types and the structure and function of the processes believed to be involved, (ii) describes these components in terms of key neuroanatomical regions of interest, and (iii) critically appraises current findings regarding EEG measures as they relate to different aspects of meditation, functional activity and connectivity across regions of interest. The correlates between mindfulness and EEG are well described in terms of attentional and interoceptive processes and neuroanatomical regions of interest. To a lesser extent, there is also a growing understanding of such correlates for meditation techniques centred on compassion and loving-kindness meditation. However, the same does not apply to wisdom-based and null-state meditation practices where consistent associations between neuropsychological processes and EEG characteristics have proven elusive. These latter practices are viewed by many as key to fostering the deeper transformative experiences underlying psychological and spiritual development, and although studies of null-state meditation have yielded promising theoretical developments, more research is required. Future research could also benefit from better standardisation of EEG measures and analytic techniques to allow more robust metanalyses, and greater consistency of terminology regarding the fundamental components of meditation practice.

Abstract Mammals are confronted with a number of life tasks to support their survival and reproduction. A core reproductive task is care of offspring. This requires competencies for detecting offspring needs, distress protecting from harm. Later evolved motives to care and support allies and in-group members. Guilt evolved with caring motives and alerts to the possibility of causing harm or not preventing it (for example by not meeting needs). It triggers urgent action if harm could or has occurred. Guilt can therefore arise when one has caused unintended harm or allowed harm to occur that one could have prevented. It is very different to shame. The chapter also discusses how some forms of antisocial behavior are associated with diminished care and compassion motives and an absence of guilt. Here the therapeutic task is to facilitate care and compassion motives and hence capacities to experience the remorse and sadness of guilt.

In 1993, the British Journal of Clinical Psychology published my paper titled 'Defence and safety: Their function in social behaviour and psychopathology'. The paper highlights that to understand people's sensitivity to threat, we also need to understand their ability to identify what is safe. This paper offers an update on these concepts, highlighting distinctions that were implicit but not clearly defined at the time. Hence, the paper seeks to clarify distinctions between: (i) threat detection and response, (ii) safety and safety seeking, (iii) safeness and (iv) their social and non-social functions and forms. Threat detection and response are to prevent or minimize harm (e.g., run from a predator or fire). Safety checking relates to monitoring for the absence and avoidance of threat, while safety seeking links to the destination of the defensive behaviour (e.g., running home). Safety seeking also relates to maintaining vigilance to the appearance of potential harms and doing things believed to avoid harm. Threat-defending and safety checking and seeking are regulated primarily through evolved threat processing systems that monitor the nature, presence, controllability and/or absence of threat (e.g., amygdala and sympathetic nervous system). Safeness uses different monitoring systems via different psychophysiological systems (e.g., prefrontal cortex, parasympathetic system) for the presence of internal and external resources that support threat-coping, risk-taking, resource exploration. Creating brain states that recruit safeness processing can impact how standard evidence-based therapies (e.g., exposure, distress tolerance and reappraisal) are experienced and produce long-term change.

OBJECTIVE:Traditional masculinity norms displayed by men attempt to signal a dominance or 'toughness' to others; however, traditional masculine norms are associated with a range of mental health difficulties, including depression and anxiety. Based on social rank theory, we tested the mediating role of insecure striving, social safeness and fears of compassion on the relationship between masculinity, anxiety and depression. We also examined whether compassionate goals were negatively correlated with masculine norm adherence. DESIGN:We used a cross-sectional survey design recruiting 844 men, aged 18-60 years (M = 34.0, SD = 14.4). RESULTS:Our results replicated previous findings with masculine norms significantly associated with depression and anxiety. Extending on previous work, we found insecure striving, social safeness and fears of compassion fully mediated these relationships for anxiety and partially for depression. This relationship was strongest for the masculinity subtypes of self-reliance and emotional control. Compassionate goals were negatively associated with masculine norm adherence. CONCLUSIONS:Social rank theory offers a helpful explanatory framework to understand the links between traditional masculinity and mental health, highlighting the importance of social safeness and insecure striving for men.