It is well known that group living poses certain challenges in that some individuals will be potentially threatening (eliciting either fight and flight or submissive responses), while others offer potential opportunities for reproduction, and forming cooperative, sharing alliances (requiring approach and display behaviour). The navigation of these challenges has led to the evolution of mechanisms for the estimation of threat versus opportunity (approach and avoidance). This chapter explores social anxiety in this evolutionary context. It highlights recent adaptations to social competition by which social rank and position are competed for with demonstrations of attractiveness (e.g., talent, physical beauty, humour, intelligence, personality, altruism). This is competition to be chosen by others for various roles (e.g., as friends, team mates, sexual partners, work employees). This chapter builds on earlier models of social anxiety which focused on impression management, and links them to evolutionary concepts of social status and desirability competition.

There is general agreement that styles of leadership evolved from mammalian group living strategies that form social ranks. In both non-human primates and humans, different styles of hierarchical dominant-subordinate and leader-follower behavior can be observed. These can be described in terms of dimensions of antisocial (relatively self-focused, aggressive and threat-based) and prosocial (relatively empathic, caring, and supportive) interpersonal styles. The aim of this study was to explore how a set of established self-report questionnaires might relate to these two dimensions. Two hundred and nineteen students completed questionnaires assessing ruthless self-advancement, coalition building, and dominant leadership styles, as well as hypercompetitiveness, narcissism, striving to avoid inferiority, compassion focused and ego focused goals, fears of compassion, social safeness and attachment (in)security. A principal component analysis supported an antisocial leadership style factor which comprised of ruthless self-advancement, narcissism and hypercompetitiveness. This was significantly correlated with fears of compassion, ego focused goals, insecure striving (striving to avoid inferiority), fears of losing out, fears of being overlooked, fears of being rejected, and avoidant relating in close relationships. It was significantly negatively correlated with compassionate goals. As the results did not reveal a clear factor solution for a prosocial leadership style, we chose to use the coalition building leadership style variable. This showed the opposite pattern, being significantly negatively correlated with narcissism, hypercompetitiveness, fears of compassion, fears of active rejection, and avoidance in close relationships. It was significantly positively correlated with secure striving, compassionate goals, and social safeness. We also found that fears of compassion for others was a partial mediator of the relationship between insecure striving with antisocial leadership style. Moreover, lower fears of compassion for the self emerged as a key mediator for the relationship between non-avoidant attachment with coalition building leadership style and, secure non-striving with coalition building leadership style. While the motive to accumulate social power, resources and dominance may be linked to antisocial forms of leadership, the intensity of the drive may also be linked to unaddressed threats and fears of rejection and fears of compassion. Efforts to promote more ethical, moral and prosocial forms of leadership may falter if such fears are left unaddressed.

Chair-work is an experiential method used within compassion-focused therapy (CFT) to apply compassion to various aspects of the self. This is the first study of CFT chair-work and is focused on clients’ lived experiences of a chair-work intervention for self-criticism. Twelve participants with depression were interviewed following the chair-work intervention and the resulting data was examined using Interpretative Phenomenological Analysis (IPA). Three superordinate themes were identified: ‘embodiment and enactment’, ‘externalizing the self in physical form’ and ‘emotional intensity’. The findings suggest the importance of accessing and expressing various emotions connected with self-criticism, whilst highlighting the potential for client distress and avoidance during the intervention. The role of embodying, enacting and physically situating aspects of the self in different chairs is also suggested to be an important mechanism of change in CFT chair-work. The findings are discussed in terms of clinical implications, emphasizing how core CFT concepts and practices are facilitated by the chair-work process.

Hoarding disorder (HD) was recognized as a psychiatric disorder in 2013. Existing literature suggests room for improvement in its treatment. The current pilot study aimed to provide an initial evaluation on the potential of compassion‐focused therapy (CFT) as an intervention for HD, with the primary aim being assessing its feasibility and acceptability, and the secondary being evaluating its effects. Both CFT and a second round of the current standard of treatment and cognitive behavioural therapy (CBT) were investigated in the current study as follow‐up treatment options for individuals who had completed CBT but were still significantly symptomatic. Forty eligible individuals were enrolled (20 in each treatment). Treatment feasibility and acceptability were assessed by quantitative and qualitative measures. To explore treatment effects, HD symptom severity, HD‐related dysfunctions, and their underlying mechanisms were assessed pre‐treatment and post‐treatment. Retention rates were 72% for CFT and 37% for CBT. All participants and 79% of the participants rated CFT and CBT, respectively, as good or excellent. After receiving CFT as a follow‐up treatment, HD symptom severity dropped below the cut‐off point for clinically significant HD for 77% of the treatment completers, and 62% achieved clinically significant reduction in symptom severity. In contrast, after completing a second course of CBT, 23% had HD symptom severity dropped below the cut‐off threshold, and 29% achieved clinically significant symptom reduction. The current study showed satisfactory feasibility and acceptability of CFT. Moreover, it also found promising effects of CFT in addressing hoarding‐related mechanisms that may not have been sufficiently addressed by CBT. The results suggest promising potential of CFT as a treatment for HD. Further investigation on this intervention is needed. CFT may be a promising treatment option, particularly for those who do not respond well to CBT. Improving emotion regulation and negative self‐perception by applying CFT interventions may help relieve hoarding symptoms. Generalization of the findings should be applied with caution given the small convenience sample of the current study. Statistical comparison on treatment effect measures between CFT and CBT as follow‐up treatments was not available due to small sample size. Therefore, the comparative conclusions based on this pilot study should be made with caution.

There is increasing evidence that when people focus on being a certain kind of person, for example optimistic, this changes how they engage with life difficulties. We explored individuals’ experiences in thinking about a small life difficulty before and then after being guided through a compassionate self exercise. During a compassion focused therapy workshop (2016), 95 participants were guided through a Compassionate Mind Training practice that enables them to compare and contrast thinking about a life difficulty from a natural position and then a compassionate self mental state. Following the exercises, individuals completed a short evaluation form exploring the impact of switching to a compassionate mental state when thinking about the life difficulty. All 95 participants rated switching to a compassionate self as increasing their abilities to be empathic to their difficulty, generate more insight into their difficulty, feel better able to cope and feel encouraged about the future. Results suggest guiding people to generate a compassionate sense of self is experienced as having a number of helpful outcomes. It is these outcomes generated by the compassionate self that may be useful to people.

This commentary paper reviews the recently made claims by Wilson et al. (Mindfulness, 2018) from their meta-analysis of what they call self-compassion therapies. They argue that a range of different therapy modalities can be classified as self-compassion therapies, including compassion-focused therapy, dialectical behaviour therapy, acceptance and commitment therapy and mindfulness-based interventions. The results from their meta-analyses found that these self-compassion therapies were effective at increasing self-compassion and reducing depressive and anxiety symptoms. This meta-analysis also found that self-compassion-related therapies did not produce better outcomes than active control conditions. This indicates that such self-compassion therapies are unlikely to have any specific effect over and above the general benefits of any active treatment. We will indicate a number of reasons why this conclusion is not warranted. We first contextualise what is meant by compassion-focused therapies, and we then discuss four key concerns: (1) the heterogeneity and classification of the “self-compassion therapies”; (2) the measure used to assess self-compassion; (3) the comparison to the active control conditions; and (4) the inaccurate comments made about the Kirby et al. (Behavior Therapy, 2017b) meta-analysis. Although it is encouraging to see the increasing number of randomised controlled trials, and now meta-analyses of compassion-focused therapies, the conclusions made by Wilson et al. (Mindfulness, 2018) in their meta-analysis are misleading.