Clinical Handbook of Mindfulness (32 page)

a greater willingness to remain in the presence of emotionally aversive stimuli

(Arch & Craske, 2006).
Similarly, research has demonstrated that individuals who completed an eight-week mindfulness training intervention reported

less-frequent negative automatic thoughts and believed that they were bet-

ter able to ‘let go’ of these thoughts when they encountered them. This

finding was supported by research on dispositional mindfulness, which indi-

cated that individuals exhibiting a higher level of dispositional mindfulness

reported fewer negative automatic thoughts and believed themselves capable

of ‘letting go’ of such thoughts
(Frewen, Evans, Maraj, Dozois, & Partridge,

2006).

Neuroimaging research has demonstrated that adept meditators practicing

a mindfulness of breathing exercise exhibit stronger activation in the anterior

cingulate cortex (ACC) during mindfulness of breathing, when compared

to controls
(Holzel, et al. 2007).
It has been hypothesised that this group difference may be attributed to a more effective processing of distracting

events and may involve more effective processing of emotional memories.

The ACC is theorised to be involved in the resolution of conflict, emotional

self-control and adaptive responses to changing conditions (Allman, Hakeem,

Erwin, Nimchinsky, & Hof,
2001).
It has been postulated that the ACC may be involved in a neural homeostatic mechanism that regulates an individual’s

response to distress
(Corrigan, 2004).

People present with varying degrees of innate or dispositional mindful-

ness, reflecting their capacity to employ a mindful state of awareness to

better address difficult emotional experiences and adapt to the presence

of their emotional memories. fMRI data suggests that dispositional mind-

fulness is correlated with stronger widespread prefrontal cortical activity

and reduced bilateral amygdala activity during the act of labelling emo-

tions
(Creswell, Way, Eisenberger, & Lieberman, 2007).
Mindfulness training frequently employs the labelling of phenomenal emotional experiences

(e.g. upon noticing a sad feeling, the meditator may label the experience

‘sadness’). These findings suggest a possible component of mindfulness,

this being enhanced prefrontal regulation of affect brought about through

the act of noting and then labelling of affect – which requires cognitive

work.

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Paul Gilbert and Dennis Tirch

Recent neuroimaging data also suggests that the effectiveness of mindful-

ness may involve a shift in the perceived sense of self that is experienced dur-

ing meditation. fMRI studies have contrasted the neural correlates involved

in a ‘narrative’ mode of self-reference and an ‘experiential’ mode of self-

reference
(Farb et. al., 2007).
A ‘narrative’ sense of self roughly corresponds to a conventional Western view of the self as a pervasive and ongoing separate individual identity enduring across time and situations. The narrative

mode of self-reference has been found to be correlated with the medial pre-

frontal cortex (mPFC), which is involved in maintaining a sense of self across

time, comparing one’s traits to those of others, and the maintenance of self-

knowledge
(Farb et. al., 2007).
The ‘experiential mode’ of self-reference corresponds to the present moment-focused awareness found in mindfulness

meditation and represents the mode of being that has been described as an

‘Observing Self’
(Deikman, 1982).

Farb et al.
(2007)
research examined the neurological activity involved

in these modes of self-reference among both experienced meditators and

novice participants in an 8 week mindfulness training. Novice meditators

exhibited a reduction in the activity of the mPFC while maintaining an expe-

riential focus, which may reflect a reduction in a narrative sense of self-

reference. More experienced mindfulness practitioners exhibited stronger

reductions in this mPFC activity. Further, the trained participants also exhib-

ited a more right lateralised network of cortical activity including the lateral

PFC, viscerosomatic areas, and the inferior parietal lobule. This network

of activity appeared to correlate with a phenomenology of an ‘observ-

ing self’ and may indicate a more effective mode of processing emotional

memories from a mindful stance. Additionally, novice meditators evidenced

a stronger coupling between areas of the PFC involved in narrative self-

reference (mPFC) and areas which may be involved in the translation of

visceral emotional states into conscious feelings (i.e. right insula)
(Damasio,

1999).

More experienced meditators exhibited weaker coupling between these

areas, which may reflect a cultivated capacity to disengage the habitual con-

nection between an identified sense of self across time and the processing of

emotional memories, yielding the previously described beneficial aspects of

the experience of mindfulness.

The above outlines a variety of avenues by which mindfulness may help

people recruit and train their brains to better ride the waves of emotions and

thoughts that are in constant flow. Also it offer ways that people can better

choreograph their affect regulation systems.

Compassion

Some practitioners of mindfulness suggest that compassion is an emergent

quality of mind that comes with ‘mindful practice’. This is in part because

mindfulness helps us experience the illusions of the grasping, bounded ego-

self, and instead experience insights/feelings of all being part and parcel of a

unifying consciousness that pervades the universe. However, other schools

of Buddhism (e.g. Mahayana) suggest it is important to specifically focus and

practice developing a ‘compassionate mind.’ To do this they have developed

Chapter 6 Emotional Memory, Mindfulness and Compassion

105

a range of concepts on the nature and benefits of compassion and ways

of thinking and behaving to practice and enhance compassion, including

a range of compassion-focused mediations and imagery exercises
(Leighton,

2003).
Interestingly, many of the writings of the Dalai Lama (e.g. 1995, 2001) have focused less on the processes of mindfulness and far more on the nature

and value of developing compassion.

There have been important explorations of Western and Eastern views of

compassion and how to enhance compassion in all walks of life as well as

personally
(Davidson & Harrington 2002;
Neff, 2003a,b).
In some forms of mindfulness training, loving-kindness (compassion) mediations are added to

standard procedures and may be one of the key ingredients of change (e.g.

Shapiro, Astin, Bishop, & Cordova, 2005).
Compassion-focused therapies are also emerging that specifically focus on developing compassion for self and

others as a therapeutic process
(Gilbert, 2000;
Gilbert & Procter, 2006;
Leary, Tate, Adams, Allen, & Hancock,
2007).
While some of these are directly linked to Buddhist traditions (e.g.
Neff
, 2003a;
Leary et al., 2007),
others are focused on evolutionary psychology (e.g. attachment theory), social neuroscience and affect regulation
(Gilbert, 2005,
2007).

Most theorists see compassion as a multifarious process. For example,

McKay and Fanning (1992)
view compassion as involving developing under-

standing, acceptance and forgiveness.
Neff (2003a,b),
from a social psychology and Buddhist tradition, has developed a self-compassion scale that sees

compassion as consisting of bipolar constructs related to kindness, common

humanity and mindfulness.
Kindness
involves understanding one’s difficul-

ties and being kind and warm in the face of failure or setbacks rather than

harshly judgemental and self-critical.
Common humanity
involves seeing

one’s experiences as part of the human condition rather than as personal,

isolating and shaming;
mindful acceptance
involves mindful awareness and

acceptance of painful thoughts and feelings rather than over-identifying with

them.
Neff, Kirkpatrick & Rude (2007)
have shown that self-compassion is different to self-esteem and is conducive to many indicators of well-being.

Gilbert’s (1989, 2005, 2007a,b) evolutionary model suggests that the

potential for compassion evolved with the caring-giving side of the attach-

ment system. Hence, receiving compassion has the same effects as being

cared for – that is it stimulates the soothing systems (see Figure
6.1)
in the recipients of compassion, helping people feel safe and calmed. In this model

human compassion-giving arises from specific motivational, emotional and

cognitive competencies that can be enhanced through training. The six main

components of compassion are as follows:

(1) Developing a motivation to care for one’s well-being and the well-being

of others. This motivational aspect also extends into a self-identity – that

is to develop and become more compassionate. With this motivation

people can then engage in seeking ‘knowledge’ and developing compas-

sion skills, that will include the following:

(2) Developing one’s sensitivity to one’s own distress and needs and those of

others; recognising how one’s own threat emotions (e.g., anger, anxiety)

can block such sensitivity

(3) Developing one’s capacity for sympathy, which involves the ability to be

emotionally open and moved by the feelings, distress and needs of others

106

Paul Gilbert and Dennis Tirch

(4) Developing one’s capacity for distress and emotional tolerance, which is

linked to the ability to ‘be with’ painful or aversive emotions within self

or others without avoiding them or trying to subdue them. Thus, this is

also linked to competencies for acceptance

(5) Developing empathy, which involves more cognitive and imaginal com-

petencies of putting ‘oneself in the shoes of the other’ and developing

insights into understanding why they may feel or act as they do. This is

also linked to what is sometimes called mentalising, or theory of mind

(6) Developing non-judgement is a way of refraining from condemning and

accusing. It evolved for empathy and deepening one’s understanding

of the human condition rather than being adopted as ‘an instruction’.

It does not mean non-preference. For example, the
Dalai Lama (2001)

would dearly love the world to be more compassionate.

When developing these qualities and competencies, they are all cultivated

in the emotional atmosphere of warmth and kindness. Hence in this sys-

tem, warmth and also mindfulness are ways of developing the compassion

qualities and competencies. These are viewed as being interconnected and

interdependent qualities – as shown in Figure
6.2.

Compassion training involves developing these qualities ‘for the self’. They

can then be utilised when individuals feel stressed but also to promote a

sense of well-being and contentment. This occurs because training our minds

for compassion can help us to stimulate these emotion systems and go some

way to facilitating a sense of well-being.

Hence, unlike mindfulness, which is not designed to stimulate any particu-

lar affect system (but rather to develop the observing self), compassion work

is design to stimulate the soothing system that evolved with attachment. This

is because, as noted above, it is the system that is a natural regulator of the

threat and drive systems, and underpins feelings of contentedness, connect-

edness and well-being.

There are many exercises and processes that can be used therapeutically to

stimulate compassion for others and self. These involve the therapeutic rela-

tionship
(Gilbert 2007b)
and helping people develop compassionate atten-

tion, compassionate thinking, compassionate behaviour and compassionate

Components of Compassion

from the Care Giving Mentality

Distress and needs sensitive

Sympathy

Care for well being

Distress tolerant

Compassion

Non-judgement

Empathy

Create opportunities for growth and change With

Warmth

Figure. 6.2.
Compassion circle.

Chapter 6 Emotional Memory, Mindfulness and Compassion

107

feelings. Breathing and body focus, method-acting techniques, imagery,

reframing and compassionate letter writing can all be used to advance these

abilities
(Gilbert 2007a
in press;
Gilbert & Irons 2005).
Compassion-focused therapy utilises mindfulness but is also very focused and active, and therefore different to mindfulness both in formulation and in process. The major

focus in compassion training is that whatever one undertakes and tries to

do to facilitate change, one does it via creating feelings of warmth and sup-

port within the self. Although research is limited, there is some evidence for

compassion development to be helpful
(Gilbert & Procter, 2006;
Mayhew