Loving-kindness and compassion meditations (LKCM) are practices that involve generating positive attitudes, such as friendliness, compassion, and empathy, towards oneself and others. These meditations aim to cultivate prosocial emotions and reduce negative feelings, ultimately promoting mental well-being and interpersonal relationships.
Lv, J., Jiang, Y., Li, R., Chen, Y., Gu, X., Zhou, J., Zheng, Y., Yan, L., Chen, Y., Zhang, X., Zhao, X., Luo, W., Lang, Y., Wang, Z., Gao, C., & Zeng, X. (2024). Effects of loving-kindness and compassion meditations on self-compassion: A systematic review and meta-analysis. Clinical Psychology: Science and Practice, 31(1), 19–35. https://doi.org/10.1037/cps0000177
Key Points
- Loving-kindness and compassion meditations (LKCM) effectively cultivate self-compassion in adults across healthy and clinical samples, with medium effect sizes (d = 0.56 for randomized controlled trials, d = 0.69 for uncontrolled trials).
- Factors like participant type, control conditions, focus of LKCM, and specific protocols significantly impact the effectiveness of LKCM interventions on self-compassion.
- While the review provides valuable insights, it has limitations, such as the small number of studies for certain analyses, subjective coding of some variables, and the exclusion of studies not using the Self-Compassion Scale.
- Cultivating self-compassion is a crucial aspect of psychological well-being, and understanding the effectiveness and mechanisms of LKCM interventions can inform clinical practice and future research.
Rationale
Self-compassion, which involves treating oneself with kindness, recognizing common humanity, and maintaining a balanced awareness of suffering, has been associated with numerous psychological benefits such as protecting self-esteem, regulating emotions, and promoting well-being (Miyagawa et al., 2021; Diedrich et al., 2014; Zessin et al., 2015).
While LKCM is considered an important practice to cultivate self-compassion (Germer & Neff, 2019), previous meta-analyses on compassion-based interventions and self-compassion-related therapies (Kirby et al., 2017; Wilson et al., 2018) had limitations such as few studies, lack of moderator analyses, and the exclusion of uncontrolled trials.
Given the growing interest in LKCM and self-compassion in recent years, a comprehensive review of the effects of LKCM interventions on self-compassion was needed to deepen the understanding of their effectiveness and inform future research and practice.
Method
This systematic review and meta-analysis followed the PRISMA guidelines. A literature search was conducted on March 3, 2022, using PsycInfo, Web of Science Core Collection, Medline, Cochrane Central Register of Controlled Trials, and ProQuest Dissertations and Theses.
Studies were included if they were published in English, focused on LKCM interventions, and measured self-compassion using the Self-Compassion Scale or its modifications.
Exclusion criteria included interventions with few LKCM components, one-time LKCM practice in laboratory settings, practices not considered as LKCM, and measures not based on the Self-Compassion Scale.
Risk of bias was assessed using the Cochrane Handbook for Systematic Reviews of Interventions and Risk of Bias in Nonrandomized Studies of Interventions.
Effect sizes were analyzed using a random-effects model, with subgroup analyses for categorical moderators and meta-regressions for continuous moderators.
Results
Overall Effects of LKCM on Self-Compassion
- The meta-analyses revealed that LKCM interventions effectively cultivate self-compassion in adults across both healthy and clinical samples.
- The effect sizes were medium for randomized controlled trials (d = 0.56) and uncontrolled trials (d = 0.69).
- The effects were maintained at follow-up measures. While the overall effectiveness was expected, the effect sizes were heterogeneous across studies, indicating that various factors might impact the effectiveness.
The Impact from Components of the Intervention
- The review found that specific protocols had significantly different effect sizes in both RCT and uncontrolled trials, suggesting that the characteristics of the interventions influence the effectiveness of LKCM interventions on self-compassion.
- Subgroup analyses revealed that interventions focusing on LKCM for the self had larger effect sizes compared to those focusing on LKCM for others.
- The inclusion of mindfulness meditation did not significantly moderate the effect sizes in primary analyses but might be beneficial in studies with active control conditions.
- Intervention length and the inclusion of mindfulness meditation were not significant moderators.
Impacts of Participant Type
- LKCM interventions effectively cultivated self-compassion among both healthy and clinical samples.
- However, the effect sizes among clinical samples were smaller than those of healthy samples, possibly due to the difficulties in developing self-compassion among individuals with mental disorders or high self-criticism.
- The review highlighted the need for further evaluation of the effectiveness of LKCM interventions among specific clinical samples.
Contribution of Meditation Practice
- Only 13 out of 62 studies explored the relationship between meditation practice and effects on self-compassion, with mixed findings.
- Five studies found significant associations between the amount of LKCM practice and self-compassion, while five studies did not find such associations.
- The inconsistent results might be influenced by factors such as the focus of LKCM and participant type. More research is needed to understand the optimal dose of LKCM for cultivating self-compassion, especially among healthy adults.
Mediator and Moderator of Self-Compassion
- The review did not find any study reporting psychological variables as mediators of self-compassion, which is reasonable considering that self-compassion is directly taught and generated through LKCM.
- Only three studies attempted to explore potential moderators of self-compassion, such as baseline self-compassion, perfectionism, and previous participation in mindfulness-based stress reduction.
- The review also found that self-compassion mediated the improvements in various outcomes, such as depression, mindfulness, and burnout, in 14 out of 16 studies. However, the specific outcomes and the role of self-compassion compared to other potential mediators require further evaluation.
Insight
This review provides the most comprehensive evidence to date for the effectiveness of LKCM interventions in cultivating self-compassion.
The findings suggest that LKCM can be a valuable tool for promoting self-compassion in various populations, including healthy individuals and those with clinical conditions.
However, the results also highlight the importance of considering factors such as participant characteristics, control conditions, and the focus of LKCM when designing and implementing interventions.
The nonsignificant but large variations in effect sizes across self-compassion dimensions indicate a need for further research to understand how LKCM impacts specific components of self-compassion.
Future studies should also explore potential mediators and moderators of the effects on self-compassion and investigate the role of self-compassion in mediating other outcomes of LKCM interventions.
Strengths
- The study had several methodological strengths, including a comprehensive literature search, adherence to PRISMA guidelines, assessment of risk of bias, and the use of subgroup analyses and meta-regressions to explore potential moderators.
- The inclusion of both randomized controlled trials and uncontrolled trials provided a more comprehensive understanding of the effects of LKCM interventions on self-compassion.
Limitations
- The review had some limitations, such as the small number of studies for certain analyses (e.g., effect sizes for self-compassion dimensions), which reduced the power of the meta-analyses.
- The coding of some variables (e.g., inclusion of studies, intervention components) may have been subjective due to the lack of full details in some studies.
- The review also excluded studies using measures other than the Self-Compassion Scale, which may have overlooked relevant information.
Implications
The results of this review have significant implications for clinical psychology practice and research. The findings support the use of LKCM interventions as an effective means to cultivate self-compassion, which is associated with numerous psychological benefits.
Clinicians can consider incorporating LKCM into their practice, tailoring the interventions based on participant characteristics and treatment goals.
Researchers should further investigate the mechanisms underlying the effects of LKCM on self-compassion, explore potential mediators and moderators, and examine the long-term effects of these interventions.
Future studies should also address the limitations identified in this review, such as increasing sample sizes and providing more detailed information about intervention components.
References
Primary reference
Lv, J., Jiang, Y., Li, R., Chen, Y., Gu, X., Zhou, J., Zheng, Y., Yan, L., Chen, Y., Zhang, X., Zhao, X., Luo, W., Lang, Y., Wang, Z., Gao, C., & Zeng, X. (2024). Effects of loving-kindness and compassion meditations on self-compassion: A systematic review and meta-analysis. Clinical Psychology: Science and Practice, 31(1), 19–35. https://doi.org/10.1037/cps0000177
Other references
Diedrich, A., Grant, M., Hofmann, S. G., Hiller, W., & Berking, M. (2014). Self-compassion as an emotion regulation strategy in major depressive disorder. Behaviour Research and Therapy, 58, 43–51. https://doi.org/10.1016/j.brat.2014.05.006
Germer, C., & Neff, K. (2019). Mindful self-compassion (MSC). In I. Ivtzan (Ed.), Handbook of mindfulness-based programmes (pp. 357–367). Routledge. https://doi.org/10.4324/9781315265438
Kirby, J. N., Tellegen, C. L., & Steindl, S. R. (2017). A meta-analysis of compassion-based interventions: Current state of knowledge and future directions. Behavior Therapy, 48(6), 778–792. https://doi.org/10.1016/j.beth.2017.06.003
Miyagawa, Y., Niiya, Y., & Taniguchi, J. (2021). Compassionate goals and responses to social rejection: A mediating role of self-compassion. Current Psychology, 42(13), Article 10692. https://doi.org/10.1007/s12144-021-02345-8
Wilson, A. C., Mackintosh, K., Power, K., & Chan, S. W. (2018). Effectiveness of self-compassion related therapies: A systematic review and meta-analysis. Mindfulness, 10(6), 979–995. https://doi.org/10.1007/s12671-018-1037-6
Zessin, U., Dickhäuser, O., & Garbade, S. (2015). The relationship between self-compassion and well-being: A meta-analysis. Applied Psychology: Health and Well-Being, 7(3), 340–364. https://doi.org/10.1111/aphw.12051
Keep Learning
- How can clinicians tailor LKCM interventions based on participant characteristics and treatment goals?
- What are some potential mediators and moderators of the effects of LKCM on self-compassion that future research should explore?
- Given the nonsignificant but large variations in effect sizes across self-compassion dimensions, what implications does this have for understanding the impact of LKCM on specific components of self-compassion?
- How can future studies address the limitations identified in this review, such as increasing sample sizes and providing more detailed information about intervention components?
- What are some practical ways to incorporate the findings of this review into clinical psychology practice and training programs?
Example LKCM Protocol
LKCM protocols can vary in their specific steps, but here is a general outline of the common elements found in most LKCM practices:
- Setting the intention: Participants are guided to set an intention for the practice, such as cultivating compassion, kindness, or empathy towards oneself and others.
- Grounding and relaxation: The practice often begins with a brief relaxation or mindfulness exercise to help participants settle into the present moment and create a calm, receptive state of mind.
- Generating positive emotions: Participants are instructed to evoke feelings of warmth, kindness, compassion, or love, often by visualizing or recalling a person, place, or experience that embodies these qualities.
- Directing positive emotions towards oneself: Participants are guided to extend the positive emotions they have generated towards themselves, often using phrases or imagery that express kindness, understanding, and support.
- Directing positive emotions towards others: The practice then expands to include directing positive emotions towards others, typically starting with loved ones, then neutral individuals, and finally, those with whom the participant may have difficulties.
- Expanding the scope of compassion: Some protocols include a step of extending compassion to all beings, recognizing the shared human experience of suffering and the desire for happiness.
- Resting in the experience: Participants are encouraged to rest in the feelings of compassion and kindness they have generated, allowing these emotions to permeate their being.
- Dedicating the merits: The practice often concludes with a dedication of the positive intentions and emotions generated during the meditation to the well-being of all beings.
- Returning to daily life: Participants are encouraged to carry the feelings of compassion and kindness cultivated during the practice into their daily lives and interactions with others.
It’s important to note that the specific order, duration, and emphasis on each step may vary depending on the particular LKCM protocol or teacher. Some protocols may also include additional elements, such as forgiveness practices or incorporating mindfulness techniques.
