When Compassion And Criticism Look Alike


With certain survivors of abuse, it is a struggle to process facial expressions such as a smile. A new therapy could help train the brain to recognize compassion.

Patients suffering from anxiety or depression, such as incest survivors and people with attachment disorders, can harbor highly self-critical attitudes and can feel threatened by compassionate facial expressions, often responding with fear or grief.

It can have crippling consequences for patients’ recovery, resulting in limited ability to form meaningful relationships with others and difficulties in relating to their environment.

Kirsten McEwan from Cardiff University School of Medicine has developed a facial stimulus set to assess the degree to which individuals who score highly in self-criticism, depression, and anxiety may struggle to process and receive compassion.

The research found that individuals who score highly in self-criticism did indeed struggle to process and pay attention to compassionate emotions. This could be a maintaining factor in mood disorders and a block to therapeutic interventions.

Compassion Games

McEwan and her team of researchers developed a “compassion game” which trains individuals to recognize kindness and compassion. This was achieved using a visual search task to re-train the automatic, unconscious biases towards threatening stimuli commonly shown by people with mood disorders.

In the compassion game, participants in a study were asked to identify the compassionate faces amid a number of images of actors displaying critical expressions. McEwan explains:

“We found that the more self-critical participants were, the less able they were to find kind and compassionate faces when amongst an array of more critical expressions. Conversely, participants of a less self-critical disposition demonstrated an enhanced awareness of kind faces.

The new facial stimulus set was used in a Cognitive Bias Modification Task (CBMT) comprising an online compassion game.

Participants practiced this CBMT compared with a control condition online for two weeks. We found significant improvements across a variety of self-reported well-being outcome measures including self-criticism, depression, anxiety, and stress. The aim of the game is to desensitize patients to compassionate images and rid them of threatening feelings.”

The inspiration for this research came from anecdotal evidence taken from clinicians at Derbyshire Healthcare NHS Foundation Trust, who observed that difficulties in processing the emotions of others were a big hindrance to patient recovery.

“There is increasing evidence to show that the ability to process compassion from others triggers the release of natural chemicals such as endorphins and opiates which aides a significant reduction in anxiety, depression, and self-criticism, and regulates how threatened patients feel during therapy,” says McEwan.

  1. McEwan K, Gilbert P, Dandeneau S, Lipka S, Maratos F, et al. (2014). Facial Expressions Depicting Compassionate and Critical Emotions: The Development and Validation of a New Emotional Face Stimulus Set.. PLoS ONE 9(2): e88783. doi:10.1371/journal.pone.0088783

Last Updated on November 24, 2023