Using virtual reality to increase self-compassion in the helping professions

 What do we mean by self-compassion?

The idea of 'compassion' is often misunderstood as just being kind and nice to others, practising self-love or being 'soft' in character. However, being compassionate involves a lot of courage. The Compassionate Mind Foundation defines compassion as a 'sensitivity to suffering in self and others, with a commitment to alleviate and prevent it'. A key element of compassion is actively turning towards distress and having the courage to do what is needed to alleviate suffering, rather than avoiding what is difficult.

Research and personal experience show that it is often much easier to be compassionate towards others than yourself. One of the biggest obstacles to self-compassion is self-criticism. We might be critical towards ourselves for a number of reasons, including how others are currently treating us or have treated us in the past, which may lead to a negative internal dialogue or few experiences of trust and safeness. Society also often tells us that improvement and success only come from working and pushing ourselves harder and harder. 

While it is only natural to want to better ourselves, and to an extent it can be self-protective to anticipate and point out our own flaws, talking to ourselves in an angry, unkind and hurtful manner can contribute to experiences of depression, anxiety and burnout. This is paradoxical because regular self-compassion practice is shown to be hugely beneficial for our overall wellbeing and quality of life and can alleviate common mental health difficulties.

Why do we think self-compassion is important in the helping professions?

Working in a helping profession ourselves as trainee clinical psychologists at University College London (UCL), we have experienced how deeply rewarding supporting others can be, though the work is often challenged by some very present pressures faced across health and social care, education and frontline settings – not least being exposed to risk, uncertainty, trauma, interpersonal challenges with staff and clients, or, at times, unsupportive environments and organisational issues. 

Research has consistently found that working or training within a helping profession, such as psychology, psychological therapies and their various disciplines, can be associated with various negative emotional and physical outcomes. These may include stress, anxiety, poor sleep, moral injury, self-criticism and exhaustion. 

When working conditions are particularly hostile or unsupportive, and employees are made to feel unappreciated, devalued, ostracised or conflicted in their values, self-criticism can run rife in a person's life and self-compassion can seem further away than ever. Yet, there are often little structures in place within services to truly support staff, improve working conditions and address these outcomes. 

In recent years, there has been a growing body of research showing promising results for how increasing self-compassion within the workforce can help to improve self-criticism, psychological wellbeing, professional quality of life and experiences of burnout.

We understand and acknowledge that there are often systemic issues underlying many of these experiences, such as understaffing, lack of resources, harassment and discrimination, to name a few, which cannot be understated nor specifically addressed by self-compassion. 

However, we do know that showing ourselves compassion for what we are facing, rather than self-criticism, can help to relieve some of the additional suffering we might experience both inside and outside of work. We also know from research that those who are higher in self-criticism are more likely to experience burnout at work compared to those who have higher levels of self-compassion. 

This research has led to recommendations for effective and feasible self-compassion interventions which can be accessed by those working in the helping professions.

Why do we think virtual reality could be a helpful solution?

Compassion-Focused Therapy (CFT) is an evidence-based approach to working with self-criticism and suffering. One of the aims of CFT is to help people cultivate a more compassionate self-to-self relationship by acquiring various skills and attributes, such as practising compassionate imagery. 

However, research suggests that people who are currently feeling under threat may find it particularly difficult to engage in imagery-related work and to both give and receive compassion towards themselves, potentially fearing the idea of compassion. 

For people with higher levels of self-criticism in particular, self-compassion may also evoke negative emotional states such as sadness, anger or feeling undeserving of it. This may create physiological reactions to the imagery that can create a block or resistance to CFT techniques. 

Similarly, there may be a subset of people who have few experiences of receiving compassion from others, leaving little to no emotional memories of safeness to draw upon.

Novel research by Dr Caroline Falconer, Professor Paul Gilbert and Professor John King in 2014 and 2016, among other authors, has shown that VR can help to overcome some of the common fears, blocks and resistances to CFT. 

This research used the idea of 'embodiment' – that is, referring to the perceptual illusion of body ownership which arises when a virtual body is spatially coincident with a person's real body and first-person perspective, with various degrees of synchronous multisensory correlation such as visuomotor feedback – to indirectly encourage people scoring high in self-criticism to show compassion towards themselves in place of a virtual 'other'. 

The experience of hearing and seeing oneself give compassion to themselves was found to improve self-compassion, feelings of safe and relaxed affect, and self-criticism over time. These findings are supported by several subsequent studies in clients with depression.

Our current research

Given the multitude of pressures faced in the workplace by helping professionals, and the range of threat-based experiences they are likely to endure, we believe that engaging regularly in compassionate imagery and related ideas are likely to be difficult and that staff would benefit from VR interventions aimed to improve fears, blocks and resistances. 

We have adapted the original intervention for helping professionals in recognition of the unique pressures they face, and are now recruiting for our doctoral research testing the effect of this intervention on levels of self-compassion, self-criticism, safeness, psychological wellbeing and professional quality of life. 

We passionately believe that VR presents an innovative, affordable and scalable way to deliver talking therapy and could be utilised well by workplaces of the future. As the demands on helping professionals continue to grow, the importance of cultivating employees' self-compassion, in tandem with wider systemic change, cannot be overstated. We hope to find out more about the long-term and tangible benefits that a VR intervention for self-compassion could have for helping professionals. 

We are currently recruiting individuals aged 18+, training or working in a helping profession, and living in or near London. Participants will attend a VR session in-person and engage in brief daily self-practice. There will also be the opportunity to participate in follow-up interviews about the intervention and subsequent workplace impact.

If you would like to find out more about our area of research, or to express interest in being a participant in our study, please feel free to get in touch with us at: [email protected]

Author biographies

Emily Gosden is a final year trainee on the doctorate in clinical psychology course at University College London, having previously studied her undergraduate degree in psychology at the University of Portsmouth. Following this, Emily worked as an assistant psychologist in a community mental health team, adult mental health inpatient wards and home treatment teams. 

Alongside this, Emily was an honorary research assistant with the University of Southampton. Since starting her training, Emily has gained further experience with working age and older adult mental health, in a forensic learning disability service and a specialist child and adolescent feeding and eating disorder service. Emily has a particular interest in staff wellbeing, which has led to this being the focus of her doctoral thesis and final specialist placement on training.   

LinkedIn Profile: www.linkedin.com/in/emily-gosden

Kaan Gulum is a final year trainee clinical psychologist with University College London, having previously studied at University of Sussex for his BSc and MSc degrees. Prior to training, Kaan worked as a healthcare assistant and assistant psychologist across adult crisis and inpatient settings, and as a research & development facilitator on a trauma pathway spanning the NHS and third sector. He also has over five years' experience as a Samaritans volunteer and mentor. His training placements to date have included adult and children's mental health, learning disabilities, and the homelessness sector. Kaan has particular interests in compassion-focused therapy, trauma-informed care and digital interventions. 

LinkedIn Profile: www.linkedin.com/in/kaangulum

Mahum Mustafa is a final year trainee clinical psychologist at University College London (UCL), having previously studied at the University of Bristol for a liberal arts degree, followed by a psychology conversion and Masters at UCL. Before training, Mahum was an assistant psychologist on a child and adolescent neurodevelopmental team and an adolescent crisis team in the NHS. 

She also worked as an assistant psychologist at the Anna Freud Centre, in the early years team. Her training placements have consisted of adult inpatient, specialist child and adolescent trauma settings and community psychology. Mahum has particular interests in preventative interventions, particularly those utilising a trauma-informed lens and is especially interested in working with young people with developmental trauma and neurodiversity. 

Linkedin Profile: https://www.linkedin.com/in/mahum-mustafa-402025170/