Wednesday, August 27, 2014

Can Mindfulness Create Compassion?

See Updates at the end of this post--most recent 9 December, 2014

The most dangerous hypotheses are the ones you really want to be true.

I was re-tantalized by one of these thanks to an article on the "Greater Good" website (affiliated with UCal Berkeley's  Greater Good Science Center.) Therapist and psychology researcher, Hooria Jazaieri,
wrote about a Swedish study* investigating whether training in meditation could increase compassion and altruism.

I speculated about this in my blog in December, 2012. These were just personal ramblings -- wondering if mindfulness meditation training might offer me an escape hatch from self-preoccupation to the fresh air of concern for others. I really hoped it might, and imagined it could--perhaps through mindful,  intentional focusing of attention on others rather than self. Instead of focusing on breath, sensations, or gentle yoga movements--as you do in Mindfulness-Based Stress Reduction (MBSR)--I imagined directing my full and kind attention to another person-- i.e. deep listening.

Jazaieri describes how the Swedish study compared altruism in 20 people randomly assigned to an eight-week course in Buddhist meditation with 22 "control" subjects randomly assigned to the waiting list for the class. At the start and end of the eight weeks, the investigators surveyed the participants'
"...levels of empathy, stress, mindfulness, self-compassion, and ...  'altruistic orientation'—the ability to feel empathic concern rather than personal distress when faced with the suffering of others."
The meditation training sounds like it is similar to MBSR in teaching the value and practice of meditation; in the length of the course, its meditation and gentle movement exercises, and required home practice.

But the program departs somewhat from MBSR in being more explicitly grounded in Buddhism's "four immeasurables" -- loving-kindness, compassion, empathetic joy, and equanimity.  Jon Kabat-Zinn, one of the founders of MBSR, developed mindfulness meditation by rejigging aspects of Buddhist meditation. The Swedish researchers likewise drew on Buddhist practices, but particularly those thought to foster altruism. For example, meditation exercises included imagining the presence of another person and directing compassion to him or her. Gradually the exercises moved from envisioning empathic concern for a loved one to empathic concern for a "neutral" stranger, and finally to a disliked or non-valued person.

 Jazaieri says the key item of interest in the study was whether people with eight weeks of this training would be more altruistically-oriented than the wait-list group. The abstract of the study reports:
 "Results indicated a trend towards increases in altruistic orientation in the intervention group—an increase that significantly correlated with meditation time, decreases in perceived stress, and increases in self-compassion and mindfulness." 
Depending on your outlook, the good or bad news is that both the wait-listed group and the compassion-trained group improved their scores on the Five-Facet Mindfulness Questionnaire (FFMQ).  And in a twist that spoils the picture I wanted to emerge, the experimental group, although improving in altruistic orientation (defined as "empathic concern" minus "personal distress"), ends up at a point less altruistically-oriented than the wait-listed group--which started out with higher values and declined slightly over the eight weeks. 

 The trained group improved their mindfulness, self-compassion, and decreased stress compared to the control group (consistent with data on the effects of MBSR). And the increase in altruistic orientation in the experimental group was correlated with how much time was spent practicing meditation. The increases in altruistic orientation were also correlated with the other benefits of mindful mediation (reduced stress, and increased mindfulness and self-compassion).

Another trait that increased for the experimental group was "perspective taking" -- flexibility to see things from another vantage point. Improvements in this trait were significantly related to increases in one facet of FFMQ mindfulness. The researchers speculate that mindful detachment from one's own issues might enhance "the ability to adopt the perspective of another" and may thus be the way mindfulness promotes perspective taking. Other studies have linked perspective taking to "reducing prejudice ... and promoting greater social connectedness..."

The authors of the pilot study acknowledge it has limitations -- many shared with a lot of research in the young field of mindfulness. The study was small and looked at quite a few variables, so it is not surprising that some significant differences turned up. While these may have been statistically significant, it is disappointing that the magnitude of the changes from the eight weeks of instruction and practice did not even compensate for initial differences in altruism between the study participants and the control group.

As with many mindfulness studies, the control group did not participate in an active intervention and the study was not blinded -- that is, subjects (and researchers, presumably) knew participants' group assignments. These factors could bias results (for example when the researchers discarded "outliers" in the data) and could permit placebo effects to color participants' responses. The study looked for correlations--not causation, so it's possible the results are actually due to some unstudied factor. The selected participants were predominantly women, and may not have been representative.

Jazaieri writes,
"Although the conclusions that can be drawn from this study are limited, likely due to the small number of participants, the results add to a growing body of evidence suggesting a relationship between mindfulness meditation and altruism or compassion."
As part of this growing body of evidence, Jazaieri cites research by Paul Condon and David DeSteno at Northeastern University in Boston, and Gaelle Desbordes and Willa Miller at Mass General and Harvard, respectively. She also cites a study from the University of Wisconsin. These studies were published last year. 

The Swedish investigators connect their findings to research on psychotherapists who did mindfulness meditation, and were found to be 
"...more successful in therapy as compared to non-meditators. Patients of meditating therapists showed a significant decrease in symptom severity and rated their therapist significantly higher on clarification and problem-solving skills as compared to patients treated by non-meditating therapists."
The web page with Jazaieri's article also includes a link to a YouTube video by Shauna Shapiro, How Mindfulness Cultivates CompassionShapiro, an associate professor of psychology at Santa Clara University, mentions six or seven randomized controlled trials she's conducted over the past 15 years showing that mindfulness significantly increases compassion for others. Accepting the claimed link between mindfulness and compassion, Shapiro says she is playing with ideas about mechanisms for how mindfulness leads to compassion.  The Swedish study may lend some insight into this. 

I haven't been digging into all these studies yet -- but am hopeful that these or future studies will hold more meaty data and a clear, credible mechanism for the hypothesis I've wanted to believe all along -- that meditation really can reprogram the brain to compassion, just as it can reprogram away from anxiety and depression. As I wrote here previously, mindfulness research is still a wild frontier.  Until I see more solid evidence, I remain apprehensive that the connection between mindfulness and compassion -- at least for me -- still owes a debt to wishful thinking.
*Promoting Altruism Through Meditation: An 8-Week Randomized Controlled Pilot Study. Mindfulness 2013 4:223-234. Erik Wallmark, Kousha Safarzadeh, Daiva Daukantaite and Rachel E. Maddux



Today I spotted a really good example of how people fell into the very trap I fear above, namely being too quick to embrace science that appears to support our wishful thinking on the social benefits of positive psychology.

In this case it was a take-down of a paper published in 2013 in the prestigious Proceedings of the National Academy of Sciences. The original study of 80 healthy volunteers claimed to find that people who seek happiness by pursuing pleasure -- as opposed to pursuing deeper meaning in their lives--show changes in the expression of genes similar to those found in people experiencing chronic stress.

 The new study re-analyzed the data and concluded that the "widely publicized claims about the effects of different dimensions of well-being on health-related gene expression are merely artifacts of dubious analyses and erroneous methodology."

The researchers who debunked the study found that replacing the psychological data just with random numbers still yielded "large numbers of apparently statistically significant effects" when they did the sorts of analyses performed in the flawed study. The authors of the new paper -- an international team from England, The Netherlands, and the United States -- write beautifully about the response to the first paper and their motivation for looking again at the data:
"...Given the apparent importance of their findings, which appeared to amount to nothing less than a true breakthrough in behavioral genomics research, we eagerly and with great earnest read the article with the hope that science might finally have been able to illuminate true pathways to 'the good life' (or at least help to divert people from a not so good life). Unfortunately, what we encountered did not strike us as a breaktrhough. In fact, after an extensive reanalysis of of Fredrickson et al.'s data, we concluded that their study suffers from numerous problems that render its conclusions unfounded and potentially misleading..."
I am not saying the paper on mindfulness and compassion that I write about above has the same statistical flaws as were found in the first PNAS paper --I'm too puny a statistics midget and this is complicated stuff. But I do worry that investigators in the young field of mindfulness research might easily stray into  "a nebulous and largely exploratory correlational study without any solid founding in available theory and research"-- as the 2013 PNAS study was branded.

UPDATE TWO: ON the other hand ...  A  "Fast Company" post about research from the Center for Investigating Healthy Minds (CIHM) at the Waisman Center, University of Wisconsin-Madison, suggests they were successful in training people to be more compassionate Please see my post for 9 December 2014.

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