Self-Compassion and Mental Health: A Systematic Review and Transactional Model on Mechanisms of Change

Abstract Objectives Self-compassion is characterized by a self-directed sense of kindness, recognition of common humanity, and mindfulness in times of suffering or perceived inadequacy. There is strong evidence that self-compassion improves both facets of mental health, including higher psychological well-being and lower levels of psychopathology. However, the specific mechanisms through which self-compassion improves mental health are still subject to study and debate. Methods This systematic review examined mediators and neurophysiological processes in this relationship according to the PRISMA guidelines. All types of empirical studies were included, as long as a mediation analysis was performed, and studies examining potential neurophysiological mechanisms had to be experimental or longitudinal in design. A total of 85 studies ( n = 26,187) of different designs and age groups were included. Based on our review, we introduce a transactional model that links self-compassion and mental health. Results We argue that changes in self-compassion, psychological coping, and emotion regulation, self-concept, and changes in cognitive style mutually enhance each other. We further propose that changes in self-compassion and emotion regulation are mediated through different neurophysiological processes that initiate a cascade of physiological adjustments. Conclusions This review integrates research on the mechanisms linking self-compassion and mental health and presents insights for researchers, clinicians, and other practitioners. Through an improved theoretical understanding of how self-compassion affects mental health, interventions can be improved to benefit both clinical and non-clinical populations. Preregistration This study was preregistered at PROSPERO (CRD42024507763).