Cognitively-Based Compassion Training: A meditation program to strengthen compassion, health and relationships Overview, Rationale and Results Tim Harrison Mary Hebblewhite Brendan Ozawa-de Silva

“Compassion and love are not mere luxuries. As the source both of inner and external peace, they are fundamental to the continued survival of our species. On the one hand, they constitute non-violence in action. On the other hand, they are the source of all spiritual qualities: of forgiveness, tolerance, and all the virtues. Moreover, they are the very thing that gives meaning to our activities and makes them constructive.” H.H. the Dalai Lama

Key Questions Can prosocial emotions like compassion and empathy be taught and developed in a secular way? Would such training have any positive impact on body, mind and relationships? Could such training be implemented with children in educational settings?

“ A human being is part of the whole called by us universe, a part limited in time and space. We experience ourselves, our thoughts and feelings, as something separate from the rest. A kind of optical delusion of consciousness. This delusion is a kind of prison for us, restricting us to our personal desires and to affection for a few persons nearest to us. Our task must be to free ourselves from the prison by widening our circle of compassion to embrace all living creatures and the whole of nature in its beauty. The true value of a human being is determined by the measure and the sense in which they have obtained liberation from the self. We shall require a substantially new manner of thinking if humanity is to survive”. Albert Einstein

“As man advances in civilization, and small tribes are united into larger communities, the simplest reason would tell each individual that he ought to extend his social instincts and sympathies to all members of the same nation, though personally unknown to him. This point being once reached, there is only an artificial barrier to prevent his sympathies extending to the men of all nations and races… Sympathy beyond the confines of man, that is humanity to the lower animals, seems to be one of the latest moral acquisitions… This virtue, one of the noblest with which man is endowed, seems to arise incidentally from our sympathies becoming more tender and more widely diffused, until they extend to all sentient beings.” - Charles Darwin

Cognitively-Based Compassion Training: CBCT was developed as a protocol for research at Emory University in 2005 by Geshe Lobsang Tenzin Negi, and has been employed in various settings since. It was adapted from the Tibetan practice of lojong (mind training), rendered into secular form. CBCT includes the practice of “mindfulness” as a key component, but it also uses analytical styles of meditation to develop unbiased compassion. CBCT recognizes a biologically-given potential for compassion in all of us, but employs deliberate training to expand this capacity beyond the limits of in-group/out-group bias.

Why use analytical meditation? View, Behavior and Meditation (lta-spyod-sgom-gsum) B y fine-tuning our understanding or view to better accord with the reality of our situations, we can alter our affective and behavioral responses. This new understanding must become deeply engrained through immersive meditative training. “I believe strongly that there is an intimate connection between one’s conceptual understanding of the world, one’s vision of human existence and its potential, and the ethical values that guide one’s behavior. How we view ourselves and the world around us cannot help but affect our attitudes and our relations with our fellow beings and the world we live in. This is in essence a question of ethics.” His Holiness the Dalai Lama, Universe in a Single Atom

Key components of CBCT  Developing Attentional Stability  Self-Compassion  Impartiality  Affectionate Love and Empathy  Strengthening Compassion

Key components of CBCT 1. Developing Attentional Stability Mindfulness of the breath Mindfulness and introspective vigilance “Decisively tying the unruly elephant mind, To the firm pillar of the object of attention, With the rope of mindfulness, Gradually bring it under control with the hook of introspection.” Bhavaviveka; Madhyamakahrdayakarika

Key components of CBCT 2. Self-Compassion Realizing that the chief causes of happiness and suffering are internal, not external Gaining the insight that the conditions leading to suffering can be transformed Gaining confidence in one’s ability to transform them Resolving to emerge from them (akin to “the mind of definite emergence”) Self-compassion is not only self-acceptance

Key components of CBCT 3. Developing Impartiality Dismantling bias based on the categories of friend, stranger and enemy Recognizing the equality of all based on their common aspiration for happiness and to avoid suffering Recognizing the shortsightedness of basing one’s attitude on the categories of friend, stranger and enemy Expanding kinship with others

Key components of CBCT 4. Developing Affectionate Love and Empathy Cultivating gratitude by reflecting on the kindness of others Reflecting on how interdependent we are with others Expanding reciprocal altruism Reflecting upon the shortcomings of self-centered attitudes and behaviors, and the benefits of altruism Tuning in to the suffering of others “All happiness in the world arises from wishing happiness for others; all suffering in the world arises from the selfish wish of happiness for oneself.” Shantideva, Bodhicaryavatara

Key components of CBCT 5. Strengthening Compassion Compassion is the natural outcome of empathy, arising from attending to the suffering of those one holds with affection. This emotion can unfold in three degrees of intensity: feeling how wonderful it would be if others were free from suffering and its causes; deeply wishing that they were free from suffering and its causes; taking responsibility on oneself to help others become free from suffering and its causes.

Mary

TSST log plasma IL-6, pg/ ml Time (min) Control (n = 28) Compassion meditation (n = 16) (high practice) Compassion meditation (n = 17) (low practice) Compassion meditation (n = 33) TSST Increasing inflammation Effect of Meditation Practice on IL-6 Responses to the TSST when Compared to Control Subjects Pace et al., Psychoneuroendocrinology, 2008

Increasing Distress POMS - Total Mood Distribution Score Time (min) Compassion meditation (n = 16) (high practice) Compassion meditation (n = 17) (low practice) Control (n = 28) STRESSOR Effect of Meditation Practice on Distress Responses to the TSST when Compared to Control Subjects

Desbordes, Negi, et al., Frontiers in Human Neuroscience, 2012 Different effects of mindful-attention training vs. compassion training Amygdala response Before After Depression score Mindful-Attention Training * Compassion Training Before After

CBCT Group Control Group Findings from CBCT Research on Empathic Accuracy Inferior frontal gyrus brain activation and “Reading the Mind in the Eyes” task Mascaro et al. SCAN 2012: Epub

Lower inflammation and greater hope in foster care adolescents who practiced CBCT more Pace, Negi, Dodson-Lavelle, Ozawa-de Silva, Reddy, Cole, Danese, Craighead & Raison. Psychoneuroendocrinology, July 2, 2012 higher inflammation lower inflammation less hope more hope saliva C-reactive protein controlling for baseline change in Children’s Hope Scale Score from before to after training Reddy, Negi, Dodson-Lavelle, Ozawa-de Silva, Pace, Cole, Raison, Craighead. Journal Child Family Studies, February 21, 2012 high CBCT practice* low CBCT practice* high CBCT practice* low CBCT practice* *below or above median practice sessions

Social Circles Task: Number of In-Class Friendships This measure assesses the number of subjects who mention a classmate in their social network before and after the CBCT program. Children in the treatment (CBCT) group are 2.25 times more likely to name a peer as a friend than were children in the control (mindfulness only) group.

Social Circles Task: Consistency of Friendships CBCT children tended to increase their number of close friends while also decreasing the number of not-close friends over the course of the study. They also had more mutual friendships.

Findings thus far: Teaching children, teenagers, and adults the skills for cultivating compassion… decreases stress responses enhances well-being improves mood improves interpersonal skills, such as empathy improves number and consistency of friendships can be implemented at elementary and higher education levels

Thank You To learn more: Visit tibet.emory.edu/cbct/