The Social Brain and Heart Rate Variability: Implications for Psychotherapy

Author: Nicola Petrocchi, Simone Cheli
1 Economics and Social Sciences, John Cabot University, Rome, Italy.
2 Compassionate Mind Italia, Rome, Italy.
3 School of Human Health Sciences, University of Florence, Italy.
4 Center for Psychology and Health, Tages Onlus, Florence, Italy.
Conference/Journal: Psychol Psychother
Date published: 2019 Jun
Other: Volume ID: 92 , Issue ID: 2 , Special Notes: doi: 10.1111/papt.12224. , Word Count: 313

PMID: 30891894 DOI: 10.1111/papt.12224

Purpose: Humans evolved within the mammalian line as a highly social species. Indeed, sociality has been a major driver of human social intelligence. From birth, social relationships have emotional and self-regulating properties and operate through different body systems. This paper will explore how heart rate variability (HRV), an index of the vagal regulation of the heart and a central element of the physiological underpinnings of sociality, is related to mental health problems, with important implications for psychotherapy.

Methods: We conducted a narrative review of the literature on the bi-directional links between prosocial motivations, HRV, and psychophysiological functioning.

Results: HRV is associated not only with the ability to downregulate physiological arousal, but also with a variety of psychological and behavioural variables which are usually the target of psychotherapeutic interventions. A modern neurovisceral integration model can be employed to explain the complex intercorrelation between HRV and psychophysiological functioning. In particular, the link between HRV, the experience of inter- and intrapersonal safeness, and the inhibitory function of the prefrontal cortex will be explored in the context of prosocial motives, such as compassion, that alleviate and help prevent mental health difficulties.

Conclusions: Our knowledge of the social brain and its physiological underpinnings might influence important elements of a therapeutic intervention, from the initial assessment of patient's difficulties to the evaluation of therapy outcomes.

Practitioner points: Social relationships have emotional and self-regulating properties. The experience of inter- and intrapersonal safeness is connected to prosocial motives, such as compassion, and the inhibitory function of the prefrontal cortex. Social relationships and compassion influence different body systems, such as the vagus nerve. Many forms of psychopathology represent the activation of evolved, defensive strategies especially in contexts where there are few stimuli indicating safeness and social support. Heart rate variability predicts psychotherapy outcome.

Keywords: compassion; compassion-focused therapy; heart rate variability; neurovisceral integration model; safeness.

© 2019 The British Psychological Society.