Scared of compassion: Fear of compassion in anxiety, mood, and non‐clinical groups
Abstract
Objectives: Fear of receiving compassion from others, expressing compassion to others, and being compassionate towards oneself have been identified as potentially important factors in the persistence of depression, stress disorders, and eating disorders. There is good reason to expect that these fears may play a role in anxiety and related difficulties, but there is little available information on the extent to which they are present and associated with symptom severity. Methods: This study compared the severity of the three fears of compassion (receiving, expressing to others, and showing to oneself) in those with a principal diagnosis of depression ( n = 34), obsessive–compulsive disorder (OCD; n = 27), social anxiety disorder (SAD; n = 91), generalized anxiety disorder (GAD, n = 43), and a control sample with no mental health difficulties ( n = 212). Results: Those with depression, OCD, SAD, and GAD exhibited greater fear of receiving compassion and fear of self‐compassion than controls, and the differences between anxious and control groups remained significant even when controlling for depressed mood. Whereas fears of compassion did not predict symptom severity over and above depressed mood in people with GAD, fear of receiving compassion uniquely predicted SAD symptom severity, and fear of expressing compassion for others uniquely predicted OCD symptom severity in those high on fear of self‐compassion. Conclusions: Fear of compassion is higher in those with anxiety and related disorders than non‐anxious controls. Although further research is needed, clinicians may benefit from assessing fear of compassion and addressing it in treatment. Practitioner points: Those with anxiety and related disorders may fear receiving compassion from others or expressing compassion for themselves, even when controlling for depression. It may be informative to assess for fear of compassion and incorporate discussions about these fears into treatment, as these fears may interfere with treatment progress.
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Fear of compassion is associated with OCD symptoms.
“Merritt and Purdon (2020) found that people with OCD had greater fear of self‐compassion and greater fear of receiving compassion than non‐clinical controls”
From A preliminary investigation of the relationships between attachment insecurity, fear of compassion, and <scp>OCD</scp> severity (2025) · cites this paper as Merritt and Purdon, 2020
Those with OCD did not differ from those with a principal diagnosis of depression or generalized anxiety disorder in fear of compassion.
“(although those with OCD did not differ from those with a principal diagnosis of depression or generalized anxiety disorder).”
From A preliminary investigation of the relationships between attachment insecurity, fear of compassion, and <scp>OCD</scp> severity (2025) · cites this paper as Merritt and Purdon, 2020
In those high in fear of self-compassion, fear of expressing compassion to others was associated with OCD symptoms, even when controlling for depression.
“Furthermore, in those high in fear of self‐compassion, fear of expressing compassion to others was associated with OCD symptoms, even when controlling for depression.”
From A preliminary investigation of the relationships between attachment insecurity, fear of compassion, and <scp>OCD</scp> severity (2025) · cites this paper as Merritt and Purdon, 2020
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“Furthermore, social anxiety disorder symptom severity was uniquely predicted by fears of receiving compassion (Merritt & Purdon, 2020).”
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“Recently Merritt and Purdon (2020) found that whereas socially anxious patients did not differ from controls or other clinical groups on a fear of extending compassion towards others they experienced high levels of fear of self- compassion and of receiving compassion from others.”
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“It is to be noted that, in the present study, scores at “negative” compassion related variables (inadequate-self and fears of compassion) appear to be lower than the ones reported in other studies with clinical populations (but similar scores at fears of compassion in clinical populations have been reported by (Merrit…”
ResultCompassion as a transdiagnostic target to reduce mental health symptoms and promote well-being
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“A recent study also found that fears of compassion are significantly higher in clinical populations such as those with Obsessive-Compulsive Disorder, Social Anxiety Disorder, and Generalised Anxiety Disorder compared to those with no current mental health difficulties (Merritt & Purdon, 2020).”
BackgroundCompassion Focused Therapy – What It Is, What It Targets, and the Evidence
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“Additionally, individuals with diagnoses of depression, obsessive-compulsive disorder, social-anxiety disorder and/or general anxiety disorder were found to have more fear of compassion (Merritt & Purdon, 2020).”
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“The researchers concluded by suggesting that assessing fears of compassion and incorporating discussions about fears of compassion into treatment are necessary, as these processes may interfere with treatment progress for mood and anxiety disorders (Merritt and Purdon 2020).”
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“Attachment theory provides a framework to understand how disruptions in early caregiving experiences might lead to difficulties with compassion (Merritt & Purdon, 2020).”
BackgroundTo avoid or not to avoid: impact of self-compassion on safety behaviors in social situations
Szczyglowski, K. A., & Kocovski, N. L. (2024) · Anxiety, Stress, & Coping · doi:10.1080/10615806.2024.2307466 · Cited by 6 · see citing works
“Finally, fear of compassion, which has been associated with social anxiety severity and treatment ambivalence (Merritt & Purdon, 2020), was not assessed in the present studies.”
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Fears of Compassion Scales: Cross-Cultural Adaptation and Validity Evidence for Use in Brazil
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“Associations of fears of compassion with symptoms of depression, anxiety, and stress are repeatedly reported (Kirby et al., 2019; Merritt & Purdon, 2020).”
Dr. Jack Rachman's contributions to our understanding and treatment of obsessive-compulsive disorder
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“…from others and for self were more strongly associated with selfrelated dysfunctions and psychopathological problems (e.g., alexithymia, phobias, eating disorders, depression and anxiety) compared to fear of compassion for others (Kelly et al., 2013; Merritt & Purdon, 2020; Naismith et al., 2019).”
BackgroundSituational assessment of empathy and compassion: Predicting prosociality using a video-based task
Górska, G., Berkovich‐Ohana, A., Klimecki, O., & Trautwein, F. (2023) · PLoS ONE · doi:10.1371/journal.pone.0289465 · Cited by 4 · see citing works
A House with Many Doors – Toward a More Nuanced Self-Compassion Intervention Science
Finlay‐jones, A. L. (2023) · Mindfulness in behavioral health · doi:10.1007/978-3-031-22348-8_24 · Cited by 4 · see citing works
Kindness as a public health action
Nguyen, T.-L., & Lee, J.-Y. (2025) · Communications Medicine · doi:10.1038/s43856-025-00861-3 · Cited by 3 · see citing works
“On theother hand, recentdatashows thatbarriers tokindness, such as fear of compassion, are associated with mental health conditions 26 .”
Gu, X., Wu, M. T., Zeng, X., Wang, Y., Zhang, Y., Dong, X., Liu, Y., Zheng, Y., & Zhou, J. (2025) · International Journal of Psychology · doi:10.1002/ijop.70076 · Cited by 2 · see citing works
Dificuldades no engajamento às medidas contra a COVID-19
Pfeiffer, S., & Lisbôa, C. S. D. M. (2021) · Psico · doi:10.15448/1980-8623.2021.3.41601 · Cited by 2 · see citing works
McNeil, A., & Purdon, C. (2025) · British Journal of Clinical Psychology · doi:10.1111/bjc.12533 · Cited by 1 · see citing works
“As such, avoidant attachment and fear of receiving compassion may be particularly important targets for the treatment of OCD, and they may be uniquely implicated in the disorder.”
InfluentialSelf-citationNavigating burnout in healthcare: the price of care in an uncaring system
Noor, Z., & Wallace, S. L. (2025) · Nature Reviews Urology · doi:10.1038/s41585-025-01006-w · Cited by 1 · see citing works
Marashi, M., Quesnel, D. A., O’Loughlin, E. K., Brown, D. M., & Sabiston, C. M. (2025) · Eating Behaviors · doi:10.1016/j.eatbeh.2025.101990 · Cited by 1 · see citing works
The Impact of Compassion in Multicultural, Multifaith Communities, and Workplace Environments
Lazzari, C. G., & Kotera, Y. (2026) · Advances in mental health and addiction · doi:10.1007/978-3-032-12438-8_2 · Cited by 1 · see citing works
The Fears, Blocks, and Resistances to Compassion
Gilbert, P., Basran, J. K., & Plowright, P. (2025) · Springer eBooks · doi:10.1007/978-3-031-47219-0_108 · Cited by 1 · see citing works
Merritt, O. A., Rowa, K., & Purdon, C. L. (2022) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465822000455 · Cited by 1 · see citing works
“…more physical hyperarousal (Antony et al., 1998); thus, we used scores on the DASS-S to select participants as it was thought to be more applicable to the broad types of anxiety characteristic of anxiety and related disorders that we aimed to study in this sample (as in Merritt and Purdon, 2020).”
MethodSelf-citationMerritt, O. A., Rowa, K., & Purdon, C. L. (2023) · Gezinstherapie Wereldwijd · doi:10.1007/s12440-023-00199-z
Self-citationVarley, D., Sherwell, C. S., & Kirby, J. N. (2024) · doi:10.31234/osf.io/zw27s
The Fears, Blocks, and Resistances to Compassion
Gilbert, P., Basran, J. K., & Plowright, P. (2023) · Springer eBooks · doi:10.1007/978-3-030-77644-2_108-1
Fears and Resistances to Mindfulness Scale (FRMS)
Gilbert, P., Plowright, P., Morter, K., & Basran, J. K. (2025) · Springer eBooks · doi:10.1007/978-3-030-77644-2_141-1
Fears and Resistances to Mindfulness Scale (FRMS)
Gilbert, P., Plowright, P., Morter, K., & Basran, J. K. (2025) · Springer eBooks · doi:10.1007/978-3-031-47219-0_141
Zolfaghari, F., Babaei, S., Nazari, F., & Momeni-Ghaleghasemi, T. (2025) · Journal of Nursing and Midwifery Sciences · doi:10.5812/jnms-157439
Howell, A. N., & Darnbush, A. (2025) · Cognition & Emotion · doi:10.1080/02699931.2025.2566303
“In line with these heightened fears of negative and positive evaluation, in general, individuals with SAD may exhibit specific fears of kindness and compassion (Ho et al., 2021; Merritt & Purdon, 2020).”
Research Progress on the Influence of People from Childhood Trauma to Fear of Compassion
Cheng, Z.-L. (2025) · Transactions on Materials, Biotechnology and Life Sciences · doi:10.62051/3k7msa11
“…although the main symptoms of patients (such as depression) can be controlled to a certain extent, patients in reality to harvest others' sympathy or sympathy for others still show varying degrees of worry and anxiety, which is also not conducive to the diagnosis and treatment of main symptoms [9].”
Gustafsson, M. V., Ismail, A., Støre, S. J., Blomqvist‐Storm, M., & Trindade, I. A. (2025) · Journal of Psychosocial Oncology Research and Practice · doi:10.1097/or9.0000000000000185
“20 Both these previous findings and the results from our study point toward fear of receiving compassion from others possibly being more relevant to the association between self-compassion and depression, compared with anxiety and stress.”
Future Directions and Recommendations
Kotera, Y., Beaumont, J., Colman, R. D., Rushforth, A., & Asano, K. (2026) · Advances in mental health and addiction · doi:10.1007/978-3-032-12438-8_10
Self-compassion and obsessive-compulsive disorder: A systematic review
Pandey, P., Ahmad, M., & Jha, S. (2026) · Industrial Psychiatry Journal · doi:10.4103/ipj.ipj_24_25
“[8,19,22,29] Impact of self‑compassion focused interventions on OCD: All three intervention‑based studies which were mainly focused on increasing self‑compassion reported a positive effect on reducing OCD symptoms.”
InfluentialDevelopment and Validation of the Parental Fears of Compassion Scale among Chinese Parents
Guo, M., Liu, K.-J., Kirby, J. N., Day, J., Huang, Y.-F., & Lin, Z. (2026) · Mindfulness · doi:10.1007/s12671-026-02824-8
“…et al., 2021); and second, creating items based on our previous semi-structured interviews with 17 parents diagnosed with an emotional disorder about their fears of compassion in a parenting context who are more likely to have fears of compassion in a parenting context (Merritt & Purdon, 2020).”
Adapting compassionate mind training into guided self‐help for parents of autistic children
Kemp, F. G., Hudson, M., Schroder, T. A., & Gale, C. (2026) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1111/papt.70060 · Cited by 1 · see citing works
“Therefore, a clinical implication concerns incorporating fears of compassion into screening procedures for PAC accessing CFT interventions to inform whether further intervention is required, echoing Merritt and Purdon (2020).”
Service evaluation into the effects of the compassion group on patients of Westerdale North
Muir, M., & Walker, V. (2026) · FPOP Bulletin: Psychology of Older People · doi:10.53841/bpsfpop.2026.1.174.56
Mitgefühl in der Psychotherapie
Aguilar-Raab, C. (2026) · Die Psychotherapie · doi:10.1007/s00278-026-00868-8
Johansen, F. T., Finsrud, I., Flo, E., & Kvamme, I. R. (2026) · Psychotherapy Research · doi:10.1080/10503307.2026.2732028
Exploring callousness as disengagement from suffering: development of a new self-report scale
Gilbert, P., Plowright, P., Morter, K., Gilbert, H., Gilbert, J. (. 1., Koller-Schlaud, K., & Basran, J. K. (2026) · Cogent Psychology · doi:10.1080/23311908.2026.2733816
- Authors
- Merritt, O. A., & Purdon, C. L.
- Affiliations
- University of Waterloo (CA)
- Corresponding author
- Merritt, Olivia A.
- Venue
- British Journal of Clinical Psychology
- Publisher
- Wiley
- Published
- 2020-05-04
- Volume
- 59
- Issue
- 3
- Pages
- 354-368
- ISSN
- 0144-6657 (ISSN-L)
- 2044-8260
- OpenAlex
- W3023565866
- Cited by
- 54
- References
- 57
- Citations by year
- 2026: 9 · 2025: 13 · 2024: 4 · 2023: 9 · 2022: 8 · 2021: 8 · 2020: 3
- FWCI
- 6.77
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- British Journal of Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- UWSpace (University of Waterloo) (submittedVersion)
- Funders
- Social Sciences and Humanities Research Council of Canada (118049)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- fear of compassion, self-compassion, anxiety disorders, obsessive-compulsive disorder, social anxiety disorder, generalized anxiety disorder, depression, symptom severity, treatment resistance
- MeSH terms
- Phobia, Social, Adult, Affect, Anxiety, Depression, Empathy, Fear, Female, Humans, Male, Obsessive-Compulsive Disorder
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