A study by Hutcherson and colleagues (2008)
recruited 93 participants and randomized subjects to receive either an exercise adapted from LKM (n
= 45) or an imagery condition (n
= 48). Participants in the LKM condition were instructed to imagine two loved ones standing to either side of the participant and sending their love. After four minutes, subjects were told to open their eyes and redirect these feelings of love toward the photograph of a stranger with a neutral emotional expression, appearing in the center of a computer screen. Participants were asked to repeat a series of phrases designed to bring attention to the other, and to wish them health, happiness, and well-being. Subjects in the imagery condition were instructed to imagine two acquaintances that they did not know very well and for whom they did not have strong feelings standing to either side of them. Participants were then instructed to focus on each acquaintance’s physical appearance. After 4 minutes, the participants were told to open their eyes, look at a photograph of a neutral stranger, focus their attention on the visual details of the stranger’s face and imagine details of the stranger’s appearance. Instructions of both conditions lasted for about seven minutes. The dependent variables included ratings of positive and negative mood and participants’ explicit and implicit evaluative responses to 6 photographs (picture of participant, a close other, three neutral strangers, and a lamp) before and after the visualization (LKM or imagery) directed toward a photograph of one of the neutral strangers (target). For each picture, participants indicated how connected, similar, and positive they felt toward the subject on a 7-point Likert scale. To assess implicit responses to each picture, an affective priming task was used (Fazio, Sanbonmatsu, Powell, & Kardes, 1986
) with one of the photographs as a prime, followed by positive or negative words. Participants were instructed to judge as quickly and accurately as possible whether the word was positive or negative. Implicit evaluations were determined by taking the difference between the average response time to positive and negative words following a particular prime. An implicit positive response manifests as a bias to respond faster to positive words, and slower to negative words, after the prime. The results revealed a significantly greater effect of LKM on both explicit and implicit positivity toward neutral strangers relative to imagery. LKM was associated with greater positive affect toward its target, as well as toward nontarget neutral strangers. For the implicit measure, however, the effect of meditation was only evident for its target, with little or no impact on responses toward strangers. LKM was also associated with greater implicit positivity toward the self. These findings suggest that even a brief (7-minute) exercise of LKM was sufficient to induce changes of small to moderate effect size.
A study by Fredrickson and colleagues (2008)
investigated the question of whether a modified LKM intervention enhances a person’s daily experiences of positive emotions, which, in turn, may increase personal resources that hold positive consequences for the person’s mental health. The study was conducted at a large business software and information technology services company. Employees who agreed to participate in this study were assigned to receive LKM (n
= 102) or were assigned to a waitlist control group (n
= 100). The study involved daily assessments of time spent meditating and a range of measures to assess positive and negative emotions. The intervention consisted of six 60-minute group sessions conducted over 7 weeks with 20–30 participants and 1 instructor per group. In the first session, participants received a CD with three recorded guided meditations. In Week 1, participants practiced a meditation directing love and compassion toward themselves. During subsequent weeks, the objects of LKM built from self, to loved ones, to acquaintances, to strangers, and to all living beings. The LKM periods were between 15–20 minutes in duration and were conducted in groups. Each session also included a 20 minute discussion to examine participants’ progress and answer questions, and 20 minutes for a didactic presentation about features of the meditation and how to integrate concepts from the workshop into one’s daily life. Participants were asked to practice LKM at home, with the guided recordings, at least 5 days per week. The results showed that LKM led to shifts in people’s daily experiences of a wide range of positive emotions, including love, joy, contentment, gratitude, pride, hope, interest, amusement, and awe. These increases in positive emotions could be observed both within the trajectories of change in daily emotions over the span of 9 weeks and also 2 weeks after formal training ended. These shifts in positive emotions were relatively small in magnitude. However, over the course of 9 weeks, they were associated with increases in a variety of personal resources, including mindful attention, self-acceptance, positive relations with others, and good physical health. Furthermore, the gains in personal resources led participants to become more satisfied with their lives and to experience fewer depressive symptoms. Interestingly, the effects of LKM were specific to positive emotions, because negative emotions did not show any substantial changes. In contrast, an earlier study by Carson and colleagues (2005)
showed that LKM was also associated with a decrease in trait anger, anxiety, and distress. Carson and colleagues (2005)
compared an 8-week LKM program (n
= 18) with standard care (n
= 25) for chronic low back pain. Dependent measures included the participants’ reported pain, anger, and distress. LKM initially involved patients recalling a time when they felt a very positive feeling of connection with a loved one, letting go of the content of this memory while remaining focused on the actual feelings of love and kindness elicited in the present moment by the memory, and employing silent mental phrases to direct these positive feelings, as best as possible, toward the loved one (i.e., may this person be at ease/content/happy/safe and secure) and then toward oneself. During the final minutes of the meditation, patients were asked to rest with attention to any feeling of love that remained from the practice. Note that the focus on affect is somewhat different from the cognitive focus that is more typical of other loving-kindness practices (e.g., Salzberg, 1995
Over the course of several weeks, this exercise was gradually extended to include directing positive feelings toward a neutral person (e.g., postman, store clerk); toward a person who harmed the patient or was a source of difficulty for them in the past in some way, and who they felt they could forgive to some extent (e.g., disrespectful former boss); and then toward all living beings. Along with the in-session practices of loving-kindness meditation, the protocol included psychoeducation, group discussions, and additional practices, such as body scan exercise that encourages patients to accept their bodies and to feel gratitude for what their bodies have enabled them to accomplish in life. As part of the homework assignments, patients were asked to spend 10 to 30 minutes daily practicing audiotape-guided loving-kindness strategies on their own.
Results from this small randomized pilot trial indicated that LKM reduced pain, anger, and psychological distress to a greater degree than standard care at post-test and follow-up. Multilevel analyses of daily recordings further showed that more LKM practices were related to less pain that day and less anger the following day. However, it should be noted that LKM may have led to a greater reduction in negative emotions as compared to other studies because participants might have had higher negative emotions at baseline. Future, well-controlled, studies would provide valuable information about the therapeutic effects of LKM.
In addition to studies examining the potential clinical utility of LKM, a number of authors have recently begun to examine self-directed compassion. Self-directed self-compassion refers to the compassion about one’s own suffering. The state of self-compassion involves generating the desire to alleviate one’s suffering, healing oneself with kindness, recognizing one’s shared humanity, and being mindful when considering negative aspects of oneself (Neff, 2003
; Neff & Vonk, 2009
; Thompson & Waltz, 2008
). Leary and colleagues conducted a number of studies with undergraduate student populations by using a self-report instrument to measure self-compassion as a trait variable (Leary, Tate, Adams, Allen, & Hancock, 2007
). These studies suggest that self-compassion moderates reactions to distressing events involving failure, rejection, and embarrassment. Specifically, Leary and colleagues (2007)
observed that individuals with high levels of self-compassion reported less negative emotion when confronting real, imagined, or remembered negative events, were more willing to accept responsibility for negative events, but were less likely to ruminate about unpleasant events compared to individuals low in self-compassion.
Mindfulness-based interventions, by themselves, may also serve as forms of compassion training as suggested by Kuyken and colleagues (2010)
. The authors provided evidence that mindfulness-based cognitive therapy, even without explicit CM training, enhanced self-compassion among patients with major depression in remission. Furthermore, changes in self-compassion appear to mediate benefits in depressive symptoms. These effects may result from applying just those affective qualities of kindness and acceptance- inherent to LKM and CM - to challenging momentary states. Concentrative and self-investigative skills, a quiet mind and self-compassion may conceivably be necessary prerequisites for the cultivation of compassion to others. This may also account for the fact that mindfulness meditation is typically first learned before LKM and CM are practiced (e.g., Kabat-Zinn, 1990