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Cited by 22Bipolar Disorder and TreatmentMindfulness and Compassion InterventionsPersonality Disorders and Psychopathology

Compassion Focused Group Therapy for People With a Diagnosis of Bipolar Affective Disorder: A Feasibility Study

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Gilbert, Paul, Basran, Jaskaran K., Raven, Joanne, Gilbert, Hannah, Petrocchi, Nicola, Cheli, Simone, Rayner, Andrew, Hayes, Alison +6 more·2022·Frontiers in Psychology
DOI 10.3389/fpsyg.2022.841932PMC PMC9347420
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Abstract

Background: Compassion focused therapy (CFT) is an evolutionary informed, biopsychosocial approach to mental health problems and therapy. It suggests that evolved motives (e.g., for caring, cooperating, competing) are major sources for the organisation of psychophysiological processes which underpin mental health problems. Hence, evolved motives can be targets for psychotherapy. People with certain types of depression are psychophysiologically orientated towards social competition and concerned with social status and social rank. These can give rise to down rank-focused forms of social comparison, sense of inferiority, worthlessness, lowered confidence, submissive behaviour, shame proneness and self-criticism. People with bipolar disorders also experience elevated aspects of competitiveness and up rank status evaluation. These shift processing to a sense of superiority, elevated confidence, energised behaviour, positive affect and social dominance. This is the first study to explore the feasibility of a 12 module CFT group, tailored to helping people with a diagnosis of bipolar disorder understand the impact of evolved competitive, status-regulating motivation on their mental states and the value of cultivating caring and compassion motives and their psychophysiological regulators. Methods: Six participants with a history of bipolar disorder took part in a CFT group consisting of 12 modules (over 25 sessions) as co-collaborators to explore their personal experiences of CFT and potential processes of change. Assessment of change was measured via self-report, heart rate variability (HRV) and focus groups over three time points. Results: Although changes in self-report scales between participants and across time were uneven, four of the six participants consistently showed improvements across the majority of self-report measures. Heart rate variability measures revealed significant improvement over the course of the therapy. Qualitative data from three focus groups revealed participants found CFT gave them helpful insight into: how evolution has given rise to a number of difficult problems for emotion regulation (called tricky brain) which is not one’s fault; an evolutionary understanding of the nature of bipolar disorders; development of a compassionate mind and practices of compassion focused visualisations, styles of thinking and behaviours; addressing issues of self-criticism; and building a sense of a compassionate identity as a means of coping with life difficulties. These impacted their emotional regulation and social relationships. Conclusion: Although small, the study provides evidence of feasibility, acceptability and engagement with CFT. Focus group analysis revealed that participants were able to switch from competitive focused to compassion focused processing with consequent improvements in mental states and social behaviour. Participants indicated a journey over time from ‘intellectually’ understanding the process of building a compassionate mind to experiencing a more embodied sense of compassion that had significant impacts on their orientation to (and working with) the psychophysiological processes of bipolar disorder.

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  • The present findings are consistent with existing qualitative research on CMT, which highlights shifts in self-relating, including development of a more compassionate inner dialogue and increased capacity to respond to distress with warmth and understanding.

    “The present findings are also consistent with existing qualitative research on CMT, highlighting shifts in self- relating, including the development of a more compassionate inner dialogue and an increased capacity to respond to distress with warmth and understanding (Gilbert et al. 2022; Brun etal.2023).”

    From A Mixed Methods Evaluation of a Compassionate Mind Training Group Intervention for Adults in a Primary Mental Health Service. (2026) · cites this paper as Gilbert et al. 2022

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Authors
Gilbert, P., Basran, J. K., Raven, J., Gilbert, H., Petrocchi, N., Cheli, S., Rayner, A., Hayes, A., Lucre, K., Minou, P., Giles, D., Byrne, F., Newton, E., & McEwan, K.
Affiliations
  • University of Derby (GB)
  • University of Roehampton (GB)
  • John Cabot University (IT)
  • University of Florence (IT)
  • Birmingham and Solihull Mental Health NHS Foundation Trust (GB)
Corresponding author
Gilbert, Paul
ORCID
Venue
Frontiers in Psychology
Publisher
Frontiers Media SA
Published
2022-07-20
Volume
13
Pages
841932-841932
ISSN
1664-1078 (ISSN-L)
DOI
10.3389/fpsyg.2022.841932
PMC
PMC9347420
OpenAlex
W4286002051
Cited by
22
References
37
Citations by year
2026: 4 · 2025: 8 · 2024: 6 · 2023: 4
FWCI
2.93
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Psychology (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
University of Derby
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Keywords
compassion-focused therapy, bipolar disorder, group therapy, social status, competitiveness, self-criticism, heart rate variability, emotion regulation, compassion, feasibility, treatment engagement, interpersonal relationships

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