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The Current and Future Role of Heart Rate Variability for Assessing and Training Compassion
Open accessAbstract
The evolution of mammalian caregiving involving hormones, such as oxytocin, vasopressin, and the myelinated vagal nerve as part of the ventral parasympathetic system, enables humans to connect, co-regulate each other's emotions and create prosociality. Compassion-based interventions draw upon a number of specific exercises and strategies to stimulate these physiological processes and create conditions of "interpersonal safeness," thereby helping people engage with, alleviate, and prevent suffering. Hence, compassion-based approaches are connected with our evolved caring motivation and attachment and our general affiliative systems that help regulate distress. Physiologically, they are connected to activity of the vagus nerve and corresponding adaptive heart rate variability (HRV). HRV is an important physiological marker for overall health, and the body-mind connection. Therefore, there is significant value of training compassion to increase HRV and training HRV to facilitate compassion. Despite the significance of compassion in alleviating and preventing suffering, there remain difficulties in its precise assessment. HRV offers a useful form of measurement to assess and train compassion. Specific examples of what exercises can facilitate HRV and how to measure HRV will be described. This paper argues that the field of compassion science needs to move toward including HRV as a primary outcome measure in its future assessment and training, due to its connection to vagal regulatory activity, and its link to overall health and well-being.
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“Recent studies on compassion using alternate forms of measurement, for example physiological measures such as heart-rate variability, provide important additional data to this debate [124–129].”
From Validation of the compassionate engagement and action scales, compassion scale, and Sussex-Oxford compassion scales in a French-Canadian sample (2024) · cites this paper as [126]
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Cites
The Development and Validation of a Scale to Measure Self-Compassion
NEFF, K. D. (2003) · Self and Identity · doi:10.1080/15298860309027 · Cited by 6,436 · cited 2×
“For example, trait self-compassion, measured by the Self-Compassion Scale (37) was found to be correlated to resting HRV and an increase in parasympathetic nervous system tone (43).”
MethodPorges, S. W. (2007) · Biological Psychology · doi:10.1016/j.biopsycho.2006.06.009 · Cited by 3,415 · cited 8×
“Indeed, there are times when high sympathetic tone is desired, for example, when helping to target states of helplessness (14).”
BackgroundInfluentialA model of neurovisceral integration in emotion regulation and dysregulation
Thayer, J. F., & Lane, R. D. (2000) · Journal of Affective Disorders · doi:10.1016/s0165-0327(00)00338-4 · Cited by 3,092 · cited 3×
“Each of these approaches have been examined in randomized controlled trials, with early findings indicating compassion-based interventions are a promising intervention to help increase well-being and reduce suffering (28).”
BackgroundInfluentialThayer, J. F., Hansen, A. L., Saus-Rose, E., & Johnsen, B. H. (2009) · Annals of Behavioral Medicine · doi:10.1007/s12160-009-9101-z · Cited by 1,872
The origins and nature of compassion focused therapy
Gilbert, P. (2014) · British Journal of Clinical Psychology · doi:10.1111/bjc.12043 · Cited by 1,593 · cited 12×
“Furthermore, in CFT a focus of intervention is to help improve safeness for the client, and although this is hypothesized to generally be associated with higher HRV, it may also help a client feel empowered and give them confidence to challenge themselves, which could be linked to a higher resting sympathetic tone.”
BackgroundInfluentialSelf-citationProsocial Motivation: Is it ever Truly Altruistic?
Batson, C. (1987) · Advances in experimental social psychology · doi:10.1016/s0065-2601(08)60412-8 · Cited by 1,178
What is compassion and how can we measure it? A review of definitions and measures
Strauss, C., Lever Taylor, B., Gu, J., Kuyken, W., Baer, R., Jones, F., & Cavanagh, K. (2016) · Clinical Psychology Review · doi:10.1016/j.cpr.2016.05.004 · Cited by 1,021 · cited 2×
“The assessment methods used in compassion training relies predominantly on self-report measures, such as the Self-Compassion Scale (37), and a recent review that critically examined the assessment measures for compassion concluded that self-report questionnaires assessing compassion have serious psychometric weaknesse…”
BackgroundMethoddepue, R. A., & morrone-strupinsky, J. V. (2005) · Behavioral and Brain Sciences · doi:10.1017/s0140525x05000063 · Cited by 958 · cited 1×
“Polyvagal theory, outlined by Porges (14), details how the activation of the myelinated parasympathetic nervous system helps in the regulation of the fight/flight response (autonomic sympathetic nervous system), thus enabling calmness and soothing to be achieved through having close proximity to others, giving/receivi…”
BackgroundAutonomic characteristics of generalized anxiety disorder and worry
Thayer, J. F., Friedman, B. H., & Borkovec, T. D. (1996) · Biological Psychiatry · doi:10.1016/0006-3223(95)00136-0 · Cited by 857 · cited 1×
“To date, there have been several cross-sectional studies demonstrating lower levels of HRV in conditions, such as depression (39), anxiety (40), rumination (41), and self-criticism (42).”
BackgroundSoftware for advanced HRV analysis
Niskanen, J., Tarvainen, M. P., Ranta-aho, P. O., & Karjalainen, P. A. (2004) · Computer Methods and Programs in Biomedicine · doi:10.1016/j.cmpb.2004.03.004 · Cited by 789 · cited 1×
“A time domain measure of HRV (root mean square successive differences) were obtained using HRV Analysis Software (48).”
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Flagged first, then by citations
11 of the 53 references couldn’t be matched to a known paper.
Research works printed but not linked: 9
- Bowlby, 1969, Attachment: Attachment and Loss
- Doty, 2015, Into the Magic Shop
- Armstrong, 2011, Twelve Steps to a Compassionate Life
- Jinpa, 2015, A Fearless Heart
- Davidson, 2012, The biology of compassion, 111
- Cozolino, 2007, The Neuroscience of Human Relationships: Attachment and the Developing Brain
- Conway, 2016, Genetics and genomics of prosocial behavior, 151
- Rockliff, 2008, A pilot exploration of heart rate variability and salivary cortisol responses to compassion-focused imagery, J Clin Neuropsychiatr, 5, 132
- Gilbert, 2013, Mindful Compassion
Cited by
Sorted by citations
A Meta-Analysis of Compassion-Based Interventions: Current State of Knowledge and Future Directions
Kirby, J. N., Tellegen, C. L., & Steindl, S. R. (2017) · Behavior Therapy · doi:10.1016/j.beth.2017.06.003 · Cited by 827
“CFT is notably different from the other interventions, as the theoretical underpinning also includes a combination of evolutionary psychology, attachment theory, and social mentality theory (Gilbert, 2014; Kirby, Doty, Petrocchi, & Gilbert, 2017).”
Self-citationSelf-compassion interventions and psychosocial outcomes: a meta-analysis of RCTs
Ferrari, M., Hunt, C., Harrysunker, A., Abbott, M. J., Beath, A. P., & Einstein, D. A. (2019) · Mindfulness · doi:10.1007/s12671-019-01134-6 · Cited by 740
“More recently, a meta-analysis found compassion-based interventions led to benefits for both self-reported compassion (Cohen’s d = 0.55) and selfcompassion (d = 0.70) and mental health outcomes such as depression (d = 0.64), anxiety (d = 0.49), and well-being (d = 0.51) (Kirby et al. 2017b).”
BackgroundInfluentialThe development of compassionate engagement and action scales for self and others
Gilbert, P., Catarino, F., Duarte, C., Matos, M., Kolts, R., Stubbs, J., Ceresatto, L., Duarte, J., Pinto-Gouveia, J., & Basran, J. (2017) · Journal of Compassionate Health Care · doi:10.1186/s40639-017-0033-3 · Cited by 527
“Indeed, there is good evidence that compassion training changes a range of physiological systems [68] including the immune and cardiovascular system, and areas in the frontal cortex due to neuroplasticity (see [108] for reviews).”
BackgroundSelf-citationExplorations into the nature and function of compassion
Gilbert, P. (2019) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2018.12.002 · Cited by 250
Self-citationKirby, J. N., Day, J., & Sagar, V. (2019) · Clinical Psychology Review · doi:10.1016/j.cpr.2019.03.001 · Cited by 232
Self-citationMatos, M., Duarte, C., Duarte, J., Pinto‐Gouveia, J., Petrocchi, N., Basran, J. K., & Gilbert, P. (2017) · Mindfulness · doi:10.1007/s12671-017-0745-7 · Cited by 246
“Physiologically, CMT practices aim to stimulate the parasympathetic system, and are thought to correspond to adaptive HRV (Kirby et al. 2017).”
BackgroundInfluentialSelf-citationDi Bello, M., Carnevali, L., Petrocchi, N., Thayer, J. F., Gilbert, P., & Ottaviani, C. (2020) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2020.06.016 · Cited by 154
Self-citationBrain-heart interaction in perseverative cognition
Ottaviani, C. (2018) · Psychophysiology · doi:10.1111/psyp.13082 · Cited by 129
Neurophysiological and behavioural markers of compassion
Kim, J. J., Parker, S. L., Doty, J. R., Cunnington, R., Gilbert, P., & Kirby, J. N. (2020) · Scientific Reports · doi:10.1038/s41598-020-63846-3 · Cited by 153
Self-citationMascaro, J. S., Florian, M. P., Ash, M. J., Palmer, P. K., Frazier, T., Condon, P., & Raison, C. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.547241 · Cited by 118
The social brain and heart rate variability: Implications for psychotherapy
Petrocchi, N., & Cheli, S. (2019) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1111/papt.12224 · Cited by 146
Self-citationGilbert, P. (2019) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1111/papt.12226 · Cited by 134
Self-citationKim, J. J., Cunnington, R., & Kirby, J. N. (2019) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2019.10.023 · Cited by 125
Self-citationCompassionate Mind Training: An 8‐week group for the general public
Irons, C., & Heriot‐Maitland, C. (2021) · Psychology and Psychotherapy: Theory, Research and Practice · doi:10.1111/papt.12320 · Cited by 79
Compassion Focused Approaches to Working With Distressing Voices
Heriot-Maitland, C., McCarthy‐Jones, S., Longden, E., & Gilbert, P. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.00152 · Cited by 92
Self-citationThe role of social connection on the experience of COVID-19 related post-traumatic growth and stress
Matos, M., McEwan, K., Kanovský, M., Halamová, J., Steindl, S. R., Ferreira, N., Linharelhos, M., Rijo, D., Asano, K., Vilas, S. P., et al. (2021) · PLOS ONE · doi:10.1371/journal.pone.0261384 · Cited by 73
“Thus, fears of compassion inhibit one’s ability to activate compassion across the three flows which negatively affects physiological and psychological health and wellbeing [86].”
BackgroundSelf-citationMorton, L., Cogan, N., Kolacz, J., Calderwood, C., Nikolič, M., Bacon, T., Pathe, E., Williams, D., & Porges, S. (2021) · Psychological Trauma · doi:10.31219/osf.io/tpe5j · Cited by 62
“Compassionate interventions, such as the use of soothing voice tones and breathing, reduce the fight/flight response, decelerate heartbeat and facilitate parasympathetic rest and restoration (Kirby et al., 2017).”
BackgroundMatos, M., Albuquerque, I., Galhardo, A. B., Cunha, M. I. V. A., de Lima, M. P., Palmeira, L., Petrocchi, N., McEwan, K., Maratos, F. A., & Gilbert, P. (2022) · PLoS ONE · doi:10.1371/journal.pone.0263480 · Cited by 93
“Furthermore, the present study aimed to explore the impact of the CMT-T on heart rate variability (HRV), an indicator of vagal regulatory activity and a physiological marker of a person’s ability to flexibly respond to environmental challenges and regulate emotional responses [56, 75], which has been proposed as a pri…”
BackgroundInfluentialSelf-citationDuarte, J., & Pinto‐Gouveia, J. (2017) · Psychiatry Research · doi:10.1016/j.psychres.2017.07.077 · Cited by 66
Self‐reassurance, not self‐esteem, serves as a buffer between self‐criticism and depressive symptoms
Petrocchi, N., Dentale, F., & Gilbert, P. (2018) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1111/papt.12186 · Cited by 56
Self-citationSommers‐Spijkerman, M., Trompetter, H. R., Schreurs, K. M. G., & Bohlmeijer, E. T. (2018) · Frontiers in Psychology · doi:10.3389/fpsyg.2018.02442 · Cited by 63
Matos, M., & Steindl, S. R. (2020) · Journal of Clinical Psychology · doi:10.1002/jclp.23055 · Cited by 43
Integrating Breathing Techniques Into Psychotherapy to Improve HRV: Which Approach Is Best?
Steffen, P. R., Bartlett, D., Channell, R., Jackman, K. N., Cressman, M., Bills, J., & Pescatello, M. S. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.624254 · Cited by 62
“(2008) along with various other studies show that engagement in self-compassion exercises is positively associated with HRV (Kirby et al., 2017).”
BackgroundInfluentialMatos, M., McEwan, K., Kanovský, M., Halamová, J., Steindl, S. R., Ferreira, N. B., Linharelhos, M., Rijo, D., Asano, K., Gregório, S., et al. (2021) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2601 · Cited by 59
Self-citationChou, C., Tsoh, J. Y., Shumway, M., Smith, L. C., Chan, J., Delucchi, K., Tirch, D., Gilbert, P., & Mathews, C. A. (2020) · British Journal of Clinical Psychology · doi:10.1111/bjc.12228 · Cited by 38
Self-citationThe compassionate kitbag: a creative and integrative approach to compassion-focused therapy
Lucre, K., & Clapton, N. (2021) · Psychology and Psychotherapy: Theory, Research and Practice · doi:10.1111/papt.12291 · Cited by 38
Empathy, sympathy, and altruism—An evident triad based on compassion. A theoretical model for caring
Arman, M. (2023) · Scandinavian Journal of Caring Sciences · doi:10.1111/scs.13163 · Cited by 54
Steindl, S. R., Tellegen, C. L., Filus, A., Seppala, E. M., Doty, J. R., & Kirby, J. N. (2021) · Australian Psychologist · doi:10.1080/00050067.2021.1893110 · Cited by 53
“As a result, the three-factor structure CMAS Compassion and Self-Compassion Scales was confirmed and represent common targets of compassion-based interventions (Kirby, 2016; Kirby et al., 2017c), and therefore we believe the structure of the CMAS is theoretically sound.”
BackgroundMethodInfluentialSelf-citationShame and the vulnerable self in medical contexts: the compassionate solution
Gilbert, P. (2017) · Medical Humanities · doi:10.1136/medhum-2016-011159 · Cited by 46
Self-citationArredondo, M., Sabaté, M., Valveny, N., Langa, M., Dosantos, R., Moreno, J., & Botella, L. (2017) · International Journal of Occupational and Environmental Health · doi:10.1080/10773525.2017.1386607 · Cited by 40
“Related to this, it has been reported that compassion-based practices can directly increase HRV and potentially other biological, physiological, and neurophysiological measures, such as cortisol [30].”
BackgroundKirby, J. N., & Gilbert, P. (2019) · Mindfulness · doi:10.1007/s12671-018-1088-8 · Cited by 34
Self-citationAttachment styles modulate neural markers of threat and imagery when engaging in self-criticism
Kim, J. J., Kent, K. M., Cunnington, R., Gilbert, P., & Kirby, J. N. (2020) · Scientific Reports · doi:10.1038/s41598-020-70772-x · Cited by 31
Self-citationSelf-Compassion and Depressive Symptoms in Chronic Pain (CP): A 1-Year Longitudinal Study
Carvalho, S. A., Trindade, I. A., Gillanders, D. T., Pinto‐Gouveia, J., & Castilho, P. (2019) · Mindfulness · doi:10.1007/s12671-019-01292-7 · Cited by 35
Beaumont, E., Bell, T., McAndrew, S., & Fairhurst, H. (2021) · Counselling and Psychotherapy Research · doi:10.1002/capr.12396 · Cited by 41
Darwin’s Other Dilemmas and the Theoretical Roots of Emotional Connection
Ludwig, R. J., & Welch, M. G. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.00683 · Cited by 42
Falconer, C. J., Lobmaier, J. S., Christoforou, M., Kamboj, S. K., King, J. A., Gilbert, P., & Brewin, C. R. (2019) · PLoS ONE · doi:10.1371/journal.pone.0210283 · Cited by 35
“The research field is dominated by self-report measures of compassion with few objective measures [40].”
BackgroundSelf-citationCompassion‐focused therapy for body weight shame: A mixed methods pilot trial
Carter, A., Gilbert, P., & Kirby, J. N. (2020) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2488 · Cited by 53
Self-citationHalamová, J., Koróniová, J., Kanovský, M., Túniyová, M. K., & Kupeli, N. (2019) · Research in Psychotherapy Psychopathology Process and Outcome · doi:10.4081/ripppo.2019.358 · Cited by 29
“For the purpose of this study we selected RMSSD as a measure of HRV because it is used to estimate the shortterm component of HRV (Malik et al., 1996) and a recent review of self-compassion intervention studies found that this is one of the most frequently used measure (Kirby et al., 2017).”
BackgroundMethodCarter, A., Hoang, A., Gilbert, P., & Kirby, J. N. (2021) · Journal of Health Psychology · doi:10.1177/13591053211027641 · Cited by 29
“Recent work has shown that heart rate variability (HRV) is an important physical and mental health indicator (Kirby et al., 2017).”
BackgroundSelf-citationSaarinen, A. I. L., Keltikangas‐Järvinen, L., Pulkki-Råbäck, L., Cloninger, C. R., Elovainio, M. J., Lehtimäki, T. J., Raitakari, O. T., & Hintsanen, M. (2019) · The Journal of Positive Psychology · doi:10.1080/17439760.2019.1663251 · Cited by 35
“Evidence suggests that interventions including compassion training effectively promote subjective well-being (Kirby, 2017; Kirby et al., 2017b).”
BackgroundInfluentialBuilding an integrative science for psychotherapy for the 21st century: Preface and introduction
Gilbert, P., & Kirby, J. (2019) · Psychology and psychotherapy · doi:10.1111/papt.12225 · Cited by 24
Self-citationKirby, J. N., & Kirby, P. G. (2017) · Clinical Psychologist · doi:10.1111/cp.12129 · Cited by 31
Self-citationCarter, A., Gilbert, P., & Kirby, J. N. (2021) · Psychology and Health · doi:10.1080/08870446.2021.1955118 · Cited by 28
“, 2017), and improve heart rate variability (Kirby et al., 2017).”
BackgroundSelf-citationDuarte, C., Gilbert, P., Stalker, C., Catarino, F., Basran, J. K., Scott, S., Horgan, G. W., & Stubbs, R. J. (2019) · Journal of Health Psychology · doi:10.1177/1359105319890019 · Cited by 24
“…helping individuals develop self-reassurance and self-compassionate capabilities may help buffer against the pervasive effects of shame and self-criticism in a number of physical and mental health conditions (Kirby et al., 2017a), including eating and body image-problems (Steindl et al., 2017).”
BackgroundSelf-citationCompassion focused therapy for anger: A pilot study of a group intervention for veterans with PTSD
Grodin, J., Clark, J. L., Kolts, R. L., & Lovejoy, T. I. (2019) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2019.06.004 · Cited by 35
Gerbarg, P. L., Brown, R. P., Streeter, C. C., Katzman, M. A., & Vermani, M. (2019) · OBM Integrative and Complementary Medicine · doi:10.21926/obm.icm.1903045 · Cited by 28
Gilbert, P., Basran, J. K., Raven, J., Gilbert, H., Petrocchi, N., Cheli, S., Rayner, A., Hayes, A., Lucre, K., Minou, P., et al. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.841932 · Cited by 22
Self-citationFactor Structure of the Sussex-Oxford Compassion Scales
Halamová, J., & Kanovský, M. (2021) · Psihologijske teme · doi:10.31820/pt.30.3.5 · Cited by 21
“In future, it would be useful to analyse a triangulation of SOCS and non-self-reporting measures, such as heart rate variability (Halamová et al., 2019; Kirby et al., 2017), electromyography (Koróníová, Halamová, & Džongová, 2020), eye-tracking (Strnádelová et al.”
MethodGilbert, P. (2019) · The Bright Side of Shame · doi:10.1007/978-3-030-13409-9_27 · Cited by 20
“In this way the therapy seeks to change not only437 psychological processes but physiological ones too (Kirby et al., 2017).”
BackgroundSelf-citationCompassion as a transdiagnostic target to reduce mental health symptoms and promote well-being
Kirby, J. N. (2025) · Nature Reviews Psychology · doi:10.1038/s44159-025-00422-4 · Cited by 32
“Continued regulation of the soothing system helped to engage the parasympathetic nervous system in times of emotional distress 94,95,137 , and interventions aimed at cultivating compassion increased self-compassion and soothing affect, and improved state and trait heart-rate variability 97,138,139 .”
Self-citationGander, M., Karabatsiakis, A., Nuderscher, K., Bernheim, D., Doyen-Waldecker, C., & Buchheim, A. (2022) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2022.806987 · Cited by 19
Austin, J., Drossaert, C. H. C., van Dijk, J., Sanderman, R., Børøsund, E., Mirković, J., Schotanus-Dijkstra, M., Peeters, N. J., Klooster, J. W. J. R. V. '., Schroevers, M. J., et al. (2022) · JMIR Cancer · doi:10.2196/37502 · Cited by 25
“Other examples include the use of artificial intelligence to recognize the emotional load of text-based diary inputs [57] and the use of sensor-based technologies to track biomarkers related to emotional arousal [58].”
BackgroundNurturing self-compassionate performers
Walton, C. C., Osborne, M. S., Gilbert, P., & Kirby, J. N. (2022) · Australian Psychologist · doi:10.1080/00050067.2022.2033952 · Cited by 24
“Nurturing self-compassion in your practice There are number of systematic reviews and increasing meta-analytic evidence supporting the efficacy of compassion focused approaches for a range of populations and mental health difficulties (Craig et al., 2020; Kirby et al., 2017b).”
BackgroundSelf-citationNorthover, C., Deacon, J., King, J. A., & Irons, C. (2021) · OBM Integrative and Complementary Medicine · doi:10.21926/obm.icm.2104056 · Cited by 23
“Participants then engaged in an exercise called soothing rhythm breathing which is linked to accessing and developing the parasympathetic nervous system (which has been found, amongst other things, to be related to threat regulation and social connection - see [21]).”
BackgroundÇayır, E., Cunningham, T., Ackard, R., Haizlip, J. A., Logan, J. G., & Yan, G. (2021) · Western Journal of Nursing Research · doi:10.1177/01939459211027657 · Cited by 16
“Compared to the conventional use of self-report only measures, incorporating HRV into the outcome assessment provides researchers with more robust evidence toward the effectiveness of such practices on psychosocial health and well-being (Kirby et al., 2017).”
MethodCompassion Mediates Poor Sleep Quality and Mental Health Outcomes
Kim, J. J., Oldham, M., Fernando, A. T., & Kirby, J. N. (2021) · Mindfulness · doi:10.1007/s12671-021-01595-8 · Cited by 19
Self-citationAttachment and compassion‐threat: Influence of a secure attachment‐prime
Baldwin, S., Bandarian‐Balooch, S., & Adams, R. (2019) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1111/papt.12244 · Cited by 23
Sousa, R., Petrocchi, N., Gilbert, P., & Rijo, D. (2022) · Journal of Criminal Justice · doi:10.1016/j.jcrimjus.2022.101970 · Cited by 16
Self-citationCaycho‐Rodríguez, T., Vilca, L. W., Plante, T. G., Carbajal‐León, C., Cabrera-Orosco, I., Cadena, C. H. G., & Reyes-Bossio, M. A. (2020) · Current Psychology · doi:10.1007/s12144-020-00949-0 · Cited by 20
“The importance of compassion as a protective factor of health (Gilbert et al. 2011) has led to the creation of different psychotherapeutic interventions based on it to promote mental health (Kirby 2017; Kirby et al. 2017a).”
BackgroundNeuroception of psychological safety scale (NPSS): validation with a UK based adult community sample
Cogan, N. A., Morton, L., Campbell, J. R., Fitzpatrick, L. I., Lamb, D., Kock, J. H. D., Ali, A., Young, D., & Porges, S. W. (2025) · European Journal of Psychotraumatology · doi:10.1080/20008066.2025.2490329 · Cited by 49
“Compas-sionate interventions – such as the use of soothing voice tones and breathing techniques – reduce the fight/flight response, decelerate heartbeat, and facilitate parasympathetic rest and restoration (Crone et al., 2024; Kirby et al., 2017).”
Matos, M., Galhardo, A. B., Palmeira, L., Albuquerque, I., Cunha, M. I. V. A., de Lima, M. P., Maratos, F. A., & Gilbert, P. (2024) · Mindfulness · doi:10.1007/s12671-024-02360-3 · Cited by 26
“Burgeoning evidence has consistently pointed to a variety of benefits from intentionally developing compassion for oneself and others (e.g. Gilbert, 2017; Kirby et al., 2017a; Seppälä et al., 2017).”
Self-citationA Systematic Review of Respiratory Sinus Arrhythmia in Romantic Relationships
Han, S. C., Baucom, B., Timmons, A. C., & Margolin, G. (2021) · Family Process · doi:10.1111/famp.12644 · Cited by 17
“For instance, a randomized control trial of compassion-focused therapy showed that those who engaged in mindfulness and compassion showed increases in resting baseline RSA compared to the control group (Kirby et al., 2017).”
BackgroundPhysiological fractals: visual and statistical evidence across timescales and experimental states
Kim, J. J., Parker, S. L., Henderson, T., & Kirby, J. N. (2020) · Journal of The Royal Society Interface · doi:10.1098/rsif.2020.0334 · Cited by 15
“Heart-rate variability (HRV) is an indicator of variation in the beat-to-beat R-wave complex [1] and is a reputed marker of parasympathetic nervous system (PSNS) response [2,3].”
BackgroundSelf-citationLes dimensions incarnée et interpersonnelle de la compassion
Khoury, B., & Dionne, F. (2020) · Annales Médico-psychologiques revue psychiatrique · doi:10.1016/j.amp.2020.11.018 · Cited by 25
Anderson, M. R. (2020) · Religions · doi:10.3390/rel11100506 · Cited by 15
Zhang, N., Huang, J., & Yao, J. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1192265 · Cited by 15
Compassion-focused grief therapy
Harris, D. L. (2021) · British Journal of Guidance and Counselling · doi:10.1080/03069885.2021.1960948 · Cited by 17
“…training on heart rate variability (HRV), where the introduction of various compassion-oriented exercises has resulted in greater HRV. High HRV (relative to baseline) is associated with activation of the parasympathetic (rest, soothe, and digest) nervous system (Gilbert, 2014; Kirby et al., 2017).”
BackgroundLuo, X., Shen, Y., Sun, L., Qi, X., Hong, J., Wang, Y., Che, X., & Lei, Y. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.05.117 · Cited by 10
Brophy, K., Emery, M., MacDonald, C., Côté, C. I., & Körner, A. (2024) · PLoS ONE · doi:10.1371/journal.pone.0305776 · Cited by 10
Sousa, R., da Silva, D. R., Petrocchi, N., Gilbert, P., & Rijo, D. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.1032011 · Cited by 13
“, to be sensitive to the suffering of the self and others, allied with the wisdom, strength and commitment to prevent and/or alleviate that suffering), CFT has been shown to increase the capacity for emotion regulation as well as to have a positive impact in the stimulation and development of the soothing system (18,…”
BackgroundSelf-citationA Randomized Controlled Study of a French Compassionate Mind Training
Leboeuf, I., Andreotti, E., Irons, C., Beaumont, E., & Antoine, P. (2022) · Mindfulness · doi:10.1007/s12671-022-01987-4 · Cited by 19
Noh, S., & Cho, H. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.585743 · Cited by 13
Halamová, J., Kanovský, M., & Koróniová, J. (2019) · Adaptive Human Behavior and Physiology · doi:10.1007/s40750-019-00122-3 · Cited by 10
Opinion: “Heart Rate Variability, Health and Well-Being: A Systems Perspective” Research Topic
Grippo, A. (2017) · Frontiers in Public Health · doi:10.3389/fpubh.2017.00246 · Cited by 10
“As discussed, a better understanding of behavioral, social, and emotional factors that contribute to HRV will provide evidence for its utility as an outcome measure, a potential method for manipulating behavioral and emotional states, and an index for understanding the integration of autonomic regulation and emotional…”
BackgroundMethodSelf-Compassion and Social Anxiety: A Scoping Review
Slivjak, E. T., Majid, F. A., Wrigley, J., Russell, S., Zielony, L., & Arch, J. J. (2024) · Mindfulness · doi:10.1007/s12671-024-02450-2 · Cited by 15
“Candidate mechanisms might also include heart rate variability (Kirby et al., 2017), improved social connection or belonging (Kok et al., 2013), fear of negative and positive evaluation (Morrison et al., 2024), and emotion regulation (Finlay-Jones, 2017).”
Poli, A., Cappellini, F., Sala, J., & Miccoli, M. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1164527 · Cited by 47
“Being compassionate regulated our autonomic nervous system (Kirby, 2017; Kirby et al., 2017), while self-compassion promoted self-regulation through the reduction in symptoms of anxiety, depression, and maladaptive perfectionistic tendencies (Woodfin et al.”
BackgroundBrief Compassion-Focused Imagery Dampens Physiological Pain Responses
Maratos, F. A., & Sheffield, D. (2020) · Mindfulness · doi:10.1007/s12671-020-01485-5 · Cited by 16
Psychometric properties of the German version of the fears of compassion scales
Biermann, M., Bohus, M., Gilbert, P., Vonderlin, R., Cornelisse, S., Osen, B., Graser, J., Brüne, M., Ebert, A., Lyssenko, L., et al. (2020) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2496 · Cited by 14
“…affect and affiliation, feelings of relaxation and safety, self-compassion, compassion for others and from others (e.g., Gilbert & Procter, 2006; Klimecki et al., 2013; Leaviss & Uttley, 2015; Matos et al., 2017; Petrocchi et al., 2017), life satisfaction and well-being (e.g., Barnard & Curry,…”
BackgroundSelf-citationBeaumont, E., Dagnall, N., Massey, S., & Irons, C. (2024) · Counselling and Psychotherapy Research · doi:10.1002/capr.12841 · Cited by 11
Xavier, A., Vagos, P., Palmeira, L., Menezes, P. J., Patrão, B., Mendes, S. A., & Tavares, M. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1196457 · Cited by 16
“This soothing system plays a crucial role in regulating distress and feeling socially safe and connected (Kirby et al., 2017a).”
BackgroundGetting closer: compassion training increases feelings of closeness toward a disliked person
Curotto, P. C., Halperin, E., Sander, D., & Klimecki, O. (2023) · Scientific Reports · doi:10.1038/s41598-023-45363-1 · Cited by 9
“In addition, heart rate variability has been proposed as a useful way to measure compassion training outcome 64 .”
BackgroundCompassion in a heartbeat: Physiology during couples’ loss discussions
Corner, G. W., Saxbe, D., Chaspari, T., Rasmussen, H. F., Perrone, L., Pettit, C., Friendly, M., Timmons, A. C., & Margolin, G. (2018) · Journal of Social and Personal Relationships · doi:10.1177/0265407518770267 · Cited by 11
Compassion in Clinical Practice: Current Applications and New Directions
Finlay‐jones, A. L. (2017) · Clinical Psychologist · doi:10.1111/cp.12133 · Cited by 8
Kamboj, S. K., Peniket, M. J., & Simeonov, L. (2023) · PLoS ONE · doi:10.1371/journal.pone.0282861 · Cited by 8
Effectiveness of compassion-focused therapy on self-criticism of the women applying for divorce
Shavandi, H., & Veshki, S. K. (2021) · Journal of Education and Health Promotion · doi:10.4103/jehp.jehp_495_20 · Cited by 11
Saarinen, A. I. L., Keltikangas‐Järvinen, L., Hintsa, T., Pulkki-Råbäck, L., Ravaja, N., Lehtimäki, T. J., Raitakari, O. T., & Hintsanen, M. (2020) · International Journal of Behavioral Medicine · doi:10.1007/s12529-020-09886-5 · Cited by 25
“lower heart rate, higher respiratory sinus arrhythmia, and higher heart rate variability [51, 52] that, in turn, are linked with a lower risk for hypertension [53, 54].”
BackgroundSvendsen, J. L., Schanche, E., Osnes, B., Vøllestad, J., Visted, E., Dundas, I., Nordby, H., Binder, P., & Sørensen, L. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.00614 · Cited by 13
“Higher vmHRV may as such represent the physiological signature of a trait-like compassionate responding (Kirby et al., 2017).”
BackgroundAnthes, L. S., & Dreisoerner, A. (2026) · Mindfulness · doi:10.1007/s12671-025-02753-y · Cited by 19
Brain-Heart Interactions and Optimizing Psychotherapy
Moss, D. (2025) · Applied Psychophysiology and Biofeedback · doi:10.1007/s10484-025-09692-3 · Cited by 8
“Sherwell and Kirby ( 2024 ) and Kirby et al. ( 2017 ) summa - rized the evidence that HRV and compassion are intimately 1 3”
Spinoni, M., Zagaria, A., Pecchinenda, A., & Grano, C. (2024) · European Journal of Investigation in Health Psychology and Education · doi:10.3390/ejihpe14100178 · Cited by 6
“…is often communicated through compassion, employing interventions such as soothing voice tones and controlled breathing can reduce the fight-or-flight response (e.g., reduce the heartbeat), facilitate parasympathetic rest and repair, and subsequently promote psychophysiological well-being [16,17].”
BackgroundCompassion Focused Therapy for Groups: Transdiagnostic Treatment for Turbulent Times
Erekson, D. M., Griner, D., & Beecher, M. E. (2024) · International Journal of Group Psychotherapy · doi:10.1080/00207284.2024.2314278 · Cited by 9
“Over thousands of years, this system has evolved among mammals to sense distress in their young and work to alleviate it (Kirby, Doty, et al., 2017).”
BackgroundMethodInfluentialCompassion training influences heart-rate variability within severe depression
Kim, J. J., Sherwell, C. S., Parker, S. L., & Kirby, J. N. (2024) · Journal of Affective Disorders Reports · doi:10.1016/j.jadr.2024.100760 · Cited by 7
Self-citationAdvancing research and evidence for compassion-based interventions: A matter of the head or heart?
Mills, J. (2020) · Palliative Medicine · doi:10.1177/0269216320945970 · Cited by 6
Benito, E., & Rivera, P. R. (2019) · Revista de Investigación y Educación en Ciencias de la Salud (RIECS) · doi:10.37536/riecs.2019.4.s1.115 · Cited by 16
Impact of a 12-Week Group-Based Compassion Focused Therapy Intervention on Heart Rate Variability
Steffen, P. R., Foxx, J., Cattani, K., Alldredge, C. T., Austin, T. A., & Burlingame, G. M. (2020) · Applied Psychophysiology and Biofeedback · doi:10.1007/s10484-020-09487-8 · Cited by 44
Qi, X., Shen, Y., Che, X., Wang, Y., Luo, X., & Sun, L. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1483827 · Cited by 7
Morte, S. D., Berti, E., Lalli, C., Modugno, N., Morgante, F., Schrag, A. E., Makovac, E., & Ricciardi, L. (2024) · European Journal of Neurology · doi:10.1111/ene.16286 · Cited by 5
“…on psychological distress in people with PD [17], pointing to a potential benefit of CMT in PD. Recent studies have confirmed that CMT is effective in activating the soothing affect system which is connected with parasympathetic nervous system activity influencing heart rate variability (HRV) [18].”
BackgroundLiebmann, C., Konrad, A. C., Singer, T., & Kanske, P. (2023) · International Journal of Clinical and Health Psychology · doi:10.1016/j.ijchp.2023.100388 · Cited by 5
Development of a Nostalgic Remembering Intervention
Fleury, J., Komnenich, P., Coon, D. W., & Volk-Craft, B. E. (2020) · The Journal of Cardiovascular Nursing · doi:10.1097/jcn.0000000000000762 · Cited by 9
“Autonomic function is evaluated as HRV, a primary outcome in intervention research exploring the efficacy of approaches promoting feeling safe and socially connected.(69) HPA axis and immune response associated with HRVare evaluated as cortisol, C-reactive protein, and proinflammatory cytokines.”
BackgroundInvestigating the Psychophysiological Effects of Tonglen Compassion Meditation in Healthcare Workers
Andreu, C. I., Vidal, J., D’elia, Y., Lecuona, O. Z., Baños, R., Brito‐Pons, G., Goldin, P. R., & Cebolla, A. (2025) · Mindfulness · doi:10.1007/s12671-025-02601-z · Cited by 3
“Overall, evidence has shown that these interventions are effective in improving empathy and compassion towards oneself and others (Brito-Pons et al., 2018) and decreasing anxiety and depressive symptoms (Kirby et al., 2017a).”
Influential
Metadata
- Authors
- Kirby, J. N., Doty, J. R., Petrocchi, N., & Gilbert, P.
- Affiliations
- The University of Queensland (AU)
- Stanford University (US)
- John Cabot University (IT)
- University of Derby (GB)
- Corresponding author
- Kirby, James N.
- Venue
- Frontiers in Public Health
- Publisher
- Frontiers Media SA
- Published
- 2017-03-08
- Volume
- 5
- Pages
- 40-40
- ISSN
- 2296-2565 (ISSN-L)
- PMC
- PMC5340770
- OpenAlex
- W2593026410
- Cited by
- 152
- References
- 53
- Citations by year
- 2026: 7 · 2025: 14 · 2024: 18 · 2023: 22 · 2022: 11 · 2021: 15 · 2020: 28 · 2019: 20 · 2018: 6 · 2017: 11
- FWCI
- 13.76
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Frontiers in Public Health (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- University of Derby Online Research Archive. (University of Derby) (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Life Sciences › Neuroscience › Neurology › Vagus Nerve Stimulation Research
- Keywords
- heart rate variability, compassion, compassion training, vagus nerve, vagal regulation, oxytocin, vasopressin, prosocial behavior, well-being
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