Evolutionarily Informed Psychotherapy

Evolutionarily informed psychotherapy refers to a variety of contemporary psychotherapeutic approaches that integrate evolutionary principles to conceptualize psychopathology and outline treatment plans.[1][2][3][4][5] The term "evolutionarily informed" rather than the more standard "evolutionary" emphasizes that psychotherapy is guided by evolutionary theory while also incorporating clinical processes that extend beyond basic evolutionary principles.[6][7] Unlike traditional models that define psychological distress through diagnostic categories, evolutionarily informed approaches conceptualize symptoms and behavioral traits as non-optimal adaptations, defense mechanisms, or functional outcomes of evolved strategies operating within specific ecological and social contexts.[2][8][9] More specifically, these approaches seek to explain human behavior through both phylogenetic evolution (the evolutionary history of our species) and ontogenetic development (the history of the individual).[10][11] A classic example is the persistence of highly painful mechanisms such as self-criticism: these mechanisms evolved to promote adaptation to a primarily social living environment, but when they become rigid or exaggerated, they are associated with forms of psychopathology such as depression.[12][13]

Theoretical Background and Core Tenets

Although Charles Darwin never made explicit reference to mental health and psychopathology, his work laid the groundwork for comprehending psychological functions.[14] As he famously noted: "In the distant future I see open fields for far more important researches. Psychology will be based on a new foundation, that of the necessary acquirement of each mental power and capacity by gradation. Light will be thrown on the origin of man and his history."[15]

Numerous models concerning the development and maintenance of psychopathology have been formulated from an evolutionary perspective, particularly starting in the 1990s. Authors such as Randolph Nesse[16] have offered evolutionarily informed explanatory models, specifically focusing on the persistence of psychopathology. In particular, the core question pursued is how alleles associated with severe mental disorders, such as schizophrenia, are maintained over time.[17]

Evolutionarily informed approaches to psychotherapy seek to integrate, in various and not necessarily all-encompassing ways, the following core tenets:

  • Evolutionary-based principles: In various forms, these models refer to the three basic principles of natural and sexual selection, and genetic drift. Mutations relate to the persistence of traits that favor survival and/or reproduction, as well as random variation.[11] For instance, the higher prevalence of aggressive behaviors in males is understood as an outcome of evolutionary pressures related to sexual selection and intrasexual competition.[18]
  • Evolutionary ethology: Reference is frequently made either to Niko Tinbergen's matrix of the four questions[19] or to more complex models, such as Melvin Konner's framework.[20] For example, the persistence of schizophrenia despite its fitness costs (such as reduced survival and reproductive success) is investigated using Tinbergen's four questions framework, suggesting that, phylogenetically, it may be associated with advantageous functions such as the evolution of the social brain.[21]
  • Life History Theory: The development of complex traits, such as personality traits, is explained with reference to Life History Theory (LHT), which posits that resources are limited and are allocated in one direction or another.[22] For example, autism and psychopathy are viewed as representing extreme manifestations of "slow" life history strategies (risk minimization, delayed reproduction, few partners, etc.) and "fast" life history strategies (risk-taking, early and opportunistic reproduction, multiple partners, etc.), respectively.[23]
  • Cultural evolution and the social brain: Some authors emphasize the importance of our species' social and cultural dimension in explaining psychopathology and informing psychotherapy[24]. For example, significant emphasis is placed on how cultural differences interact with specifically evolved psychological mechanisms or shape different functions of the same mechanisms. As highlighted in comparative psychological literature, studies examining Western and Eastern populations have found that the levels and functions of perfectionism differ significantly across cultures.[25]

Clinical Models and Frameworks

When defining evolutionarily informed approaches to psychotherapy, two groups can be distinguished.[26] The first group includes non-"native" approaches—that is, those that did not originally incorporate evolutionarily informed explanatory models in formulating their conceptualization and treatment. Among these, we find in particular Cognitive-Behavioral Therapy (CBT)[27] for disorders such as anxiety and phobias (in which symptoms and disorders are also explained through evolved mechanisms), as well as Process-Based CBT,[28] or Control Mastery Theory,[29] which have sought to integrate clinical sciences with an evolutionary perspective at a theoretical level. A distinct position is held by Mike Abrams's revision of CBT, which utilizes evolutionary psychology to better outline clinician training and psychoeducation for patients.[30] More specifically, understanding the phylogenetic and ontogenetic origins of traits like depression helps reduce patients' tendency to self-blame, framing these difficulties as products of evolutionary mechanisms rather than personal faults. Consistently, as highlighted in clinical literature evaluating psychoeducational interventions, using an evolutionarily informed approach to psychoeducation—regardless of the therapeutic model or profession—is associated with a reduction in patient stigmatization.[31]

In the second group, we find fully "native" approaches—meaning those that, from their inception, have formulated case conceptualization and treatment in an evolutionarily informed key. Among these, we mention:

  • Cognitive Evolutionary Therapy for Depression (CETD): An evolutionarily informed CBT model developed specifically for the treatment of depression, whose core tenets are primarily evolutionary-based principles.[32] In CETD, the exposure techniques typical of CBT for depression are tailored to behaviors aimed at increasing fitness (e.g., a healthy sexual life, couple life projects, etc.).[33]
  • Compassion-Focused Therapy (CFT): An integrative psychotherapy created by Paul Gilbert to treat patients in whom self-criticism and shame are central to functioning, with core tenets based on evolutionary-based principles and cultural evolution and the social brain.[34] CFT posits that a central target of psychotherapy should be the soothing system, an evolved mammalian system that is primarily activated by cues of social safety.[35]
  • Evolutionary Systems Therapy (EST): An integrative psychotherapy primarily tested on patients with personality pathology, whose core tenets encompass all of those previously listed (i.e., evolutionary-based principles, evolutionary ethology, cultural evolution and the social brain).[36] In EST, the case conceptualization shared with the patient aims to help them understand that their basic temperament is not inherently wrong or pathological, but that in coping with stressful conditions it may have developed maladaptive strategies targeted by the therapy.[37]

Regarding efficacy, CFT has demonstrated good effect sizes across various disorders according to available meta-analytic reviews,[32][38] EST has been included in syntheses of treatment outcomes although with limited sample sizes,[39][40] and CETD has thus far been documented in preliminary clinical reports.[41]

References

  1. ↑ Shackelford, Todd (2021). The SAGE Handbook of Evolutionary Psychology. doi:10.4135/9781529739435. ISBN 978-1-5264-8915-9.
  2. 1 2 Brüne, Martin; Cheli, Simone, eds. (2026). The Evolution of Psychotherapy: Applying Evolutionary Theory to Mental Health Care. Cham: Springer Nature Switzerland. doi:10.1007/978-3-032-27009-2. ISBN 978-3-032-27008-5.
  3. ↑ Gilbert, Paul; Bailey, Kent G., eds. (2014-07-10). Genes on the Couch. doi:10.4324/9781315783314. ISBN 978-1-317-71114-8.
  4. ↑ Hayes, Steven C; Sanford, Brandon T (2015-04-01). "Modern psychotherapy as a multidimensional multilevel evolutionary process". Current Opinion in Psychology. Third wave behavioral therapies. 2: 16–20. doi:10.1016/j.copsyc.2015.01.009. ISSN 2352-250X.
  5. ↑ Ryle, Anthony (March 2005). "The Relevance of Evolutionary Psychology for Psychotherapy". British Journal of Psychotherapy. 21 (3): 375–388. doi:10.1111/j.1752-0118.2005.tb00225.x. ISSN 0265-9883.
  6. ↑ Carvalho, Sérgio A.; Seabra, Daniel (March 2025). "A call for an evolutionarily informed multilevel approach to the mental health of sexual and gender minority individuals". Translational Issues in Psychological Science. 11 (1): 18–30. doi:10.1037/tps0000417. ISSN 2332-2179.
  7. ↑ Gilbert, Paul (September 2002). "Evolutionary Approaches to Psychopathology and Cognitive Therapy". Journal of Cognitive Psychotherapy. 16 (3): 263–294. doi:10.1891/jcop.16.3.263.52515. ISSN 0889-8391.
  8. ↑ Gilbert, Paul (2019). "Psychotherapy for the 21st century: An integrative, evolutionary, contextual, biopsychosocial approach". Psychology and Psychotherapy: Theory, Research and Practice. 92 (2): 164–189. doi:10.1111/papt.12226. ISSN 2044-8341. PMC 6593829. PMID 30932302.
  9. ↑ BrüNe, Martin; Belsky, Jay; Fabrega, Horacio; Feierman, Hay R.; Gilbert, Paul; Glantz, Kalman; Polimeni, Joseph; Price, John S.; Sanjuan, Julio; Sullivan, Roger; Troisi, Alfonso; Wilson, Daniel R. (February 2012). "The crisis of psychiatry — insights and prospects from evolutionary theory". World Psychiatry. 11 (1): 55–57. doi:10.1016/j.wpsyc.2012.01.009. ISSN 1723-8617. PMC 3266750. PMID 22295011.
  10. ↑ Del Giudice, Marco (2018). Evolutionary Psychopathology: A Unified Approach. Oxford University Press. ISBN 9780190246846.
  11. 1 2 Brüne, Martin (2026), Brüne, Martin; Cheli, Simone (eds.), "Human Evolutionary Biology for Psychotherapists", The Evolution of Psychotherapy, Cham: Springer Nature Switzerland, pp. 3–27, doi:10.1007/978-3-032-27009-2_1, ISBN 978-3-032-27008-5, retrieved 2026-08-21{{citation}}: CS1 maint: work parameter with ISBN (link)
  12. ↑ Gilbert, Paul; Woodyatt, Lydia (2017), Woodyatt, Lydia; Worthington, Everett L.; Wenzel, Michael; Griffin, Brandon J. (eds.), "An Evolutionary Approach to Shame-Based Self-Criticism, Self-Forgiveness, and Compassion", Handbook of the Psychology of Self-Forgiveness, Cham: Springer International Publishing, pp. 29–41, doi:10.1007/978-3-319-60573-9_3, ISBN 978-3-319-60572-2, retrieved 2026-08-24{{citation}}: CS1 maint: work parameter with ISBN (link)
  13. ↑ Sturman, Edward; Mongrain, Myriam (2005). "Self-criticism and major depression: An evolutionary perspective". British Journal of Clinical Psychology. 44 (4): 505–519. doi:10.1348/014466505X35722. ISSN 2044-8260. PMID 16368030.
  14. ↑ Darwin, Charles (1871). The descent of man, and selection in relation to sex. London: J. Murray. doi:10.5962/bhl.title.2092.
  15. ↑ Darwin 1871, p. 488
  16. ↑ Nesse, Randolph M. (2023). "Evolutionary psychiatry: foundations, progress and challenges". World Psychiatry. 22 (2): 177–202. doi:10.1002/wps.21072. ISSN 2051-5545. PMC 10168175. PMID 37159362.
  17. ↑ Mitteroecker, Philipp; Merola, Giuseppe Pierpaolo (May 2024). "The cliff edge model of the evolution of schizophrenia: Mathematical, epidemiological, and genetic evidence". Neuroscience & Biobehavioral Reviews. 160 105636. doi:10.1016/j.neubiorev.2024.105636. PMID 38522813.
  18. ↑ Buss, David M. (1995). "Psychological sex differences: Origins through sexual selection". American Psychologist. 50 (3): 164–168. doi:10.1037/0003-066X.50.3.164. ISSN 0003-066X. PMID 7726470.
  19. ↑ Tinbergen, N. (1963-01-12). "On aims and methods of Ethology". Zeitschrift für Tierpsychologie. 20 (4): 410–433. Bibcode:1963Ethol..20..410T. doi:10.1111/j.1439-0310.1963.tb01161.x. ISSN 0044-3573.
  20. ↑ Konner, Melvin (December 2021). "Nine Levels of Explanation: A Proposed Expansion of Tinbergen's Four-Level Framework for Understanding the Causes of Behavior". Human Nature. 32 (4): 748–793. doi:10.1007/s12110-021-09414-8. ISSN 1045-6767. PMID 34739657.
  21. ↑ (WPA), World Psychiatric Association (2018-02-06). "World Psychiatric Association Declaration on Participation of Psychiatrists in Interrogation of Detainees". Torture Journal. 27 (3). doi:10.7146/torture.v27i3.103980. ISSN 1997-3322.
  22. ↑ Del Giudice, Marco (2014-10-02). "An Evolutionary Life History Framework for Psychopathology". Psychological Inquiry. 25 (3–4): 261–300. doi:10.1080/1047840X.2014.884918. hdl:2318/1852748. ISSN 1047-840X.
  23. ↑ Maguire, Kate; Warman, Hayley; Blumenfeld, Frances; Langdon, Peter E. (2024-03-27). "The relationship between psychopathy and autism: a systematic review and narrative synthesis". Frontiers in Psychiatry. 15 1375170. doi:10.3389/fpsyt.2024.1375170. ISSN 1664-0640. PMC 11004474. PMID 38600985.
  24. ↑ Cheli, Simone (2026), Brüne, Martin; Cheli, Simone (eds.), "A Psychotherapist's Look into the Social Brain", The Evolution of Psychotherapy, Cham: Springer Nature Switzerland, pp. 61–85, doi:10.1007/978-3-032-27009-2_3, ISBN 978-3-032-27008-5, retrieved 2026-08-21{{citation}}: CS1 maint: work parameter with ISBN (link)
  25. ↑ Stoeber, Joachim; Kobori, Osamu; Tanno, Yoshihiko (January 2013). "Perfectionism and Self–Conscious Emotions in British and Japanese Students: Predicting Pride and Embarrassment after Success and Failure". European Journal of Personality. 27 (1): 59–70. doi:10.1002/per.1858. ISSN 0890-2070.
  26. ↑ Kennair, Leif Edward Ottesen; Larsen, Simen Mjøen; Kleppestø, Thomas H. (2021), "Evolutionary Clinical Psychology", The SAGE Handbook of Evolutionary Psychology, 1 Oliver's Yard, 55 City Road London EC1Y 1SP: SAGE Publications Ltd, pp. 152–171, doi:10.4135/9781529739435.n7, ISBN 978-1-5264-8915-9, retrieved 2026-08-24{{citation}}: CS1 maint: location (link) CS1 maint: work parameter with ISBN (link)
  27. ↑ Kennair, Leif Edward Ottesen (March 2007). "Fear and fitness revisited". Journal of Evolutionary Psychology. 5 (1): 105–117. doi:10.1556/JEP.2007.1020. ISSN 1789-2082.
  28. ↑ McCracken, Lance M. (October 2021). "Cognitive behavioral therapy, process-based approaches, and evolution in the context of physical health". World Psychiatry. 20 (3): 383–385. doi:10.1002/wps.20891. ISSN 1723-8617. PMC 8429312. PMID 34505357.
  29. ↑ Gazzillo, Francesco; Fimiani, Ramona; De Luca, Emma; Dazzi, Nino; Curtis, John T.; Bush, Marshall (January 2020). "New developments in understanding morality: Between evolutionary psychology, developmental psychology, and control-mastery theory". Psychoanalytic Psychology. 37 (1): 37–49. doi:10.1037/pap0000235. ISSN 1939-1331.
  30. ↑ Abrams, Mike (2021). The new CBT: clinical evolutionary psychology. San Diego (Calif.): Cognella. ISBN 978-1-5165-2162-3.
  31. ↑ Hunt, Adam D.; Carpenter, Tom; Brar, Gurjot; Katiyar, Tanay; Al-Shawaf, Laith; Gillett, George; Chaudhary, Nikhil; Boyle, Diarmuid; Butler, Matt; Das, Agnish; de Blaquiere, Bruno; Eaton, Anna; Golchinheydari, Sirous; Griffin, Benjamin; Ibrahim, Baher (June 2026). "Clinicians' attitudes to evolutionary versus genetic explanations for anxiety: cluster-randomised study of stigmatisation". The British Journal of Psychiatry. 228 (6): 539–547. doi:10.1192/bjp.2026.10615. ISSN 0007-1250. PMID 42093273.
  32. 1 2 Giosan, Cezar (2020). Cognitive Evolutionary Therapy for Depression: Therapy Manual. SpringerBriefs in Psychology. Cham: Springer International Publishing. doi:10.1007/978-3-030-38874-4. ISBN 978-3-030-38873-7.
  33. ↑ Giosan, Cezar (2020), Giosan, Cezar (ed.), "The Concept of Fitness in Evolutionary Psychology", Cognitive Evolutionary Therapy for Depression: Therapy Manual, SpringerBriefs in Psychology, Cham: Springer International Publishing, pp. 7–9, doi:10.1007/978-3-030-38874-4_2, ISBN 978-3-030-38874-4, retrieved 2026-08-24{{citation}}: CS1 maint: work parameter with ISBN (link)
  34. ↑ Gilbert, Paul (May 2009). "Introducing compassion-focused therapy". Advances in Psychiatric Treatment. 15 (3): 199–208. doi:10.1192/apt.bp.107.005264. ISSN 1355-5146.
  35. ↑ Gilbert, Paul (June 2010). "An Introduction to Compassion Focused Therapy in Cognitive Behavior Therapy". International Journal of Cognitive Therapy. 3 (2): 97–112. doi:10.1521/ijct.2010.3.2.97. ISSN 1937-1209.
  36. ↑ Cheli, Simone (2026), Brüne, Martin; Cheli, Simone (eds.), "Evolutionary Systems Therapy for Personality Pathology", The Evolution of Psychotherapy, Cham: Springer Nature Switzerland, pp. 197–217, doi:10.1007/978-3-032-27009-2_9, ISBN 978-3-032-27008-5, retrieved 2026-08-21{{citation}}: CS1 maint: work parameter with ISBN (link)
  37. ↑ Cheli, S.; Goldzweig, G.; Hewitt, P. L.; Bui, S.; Cavalletti, V. (2025). "https://guilfordjournals.com/action/cookieAbsent". Journal of Personality Disorders. 39 (1): 61–76. doi:10.1521/pedi.2025.39.1.61. PMID 40014388. Retrieved 2026-08-24. {{cite journal}}: External link in |title= (help)
  38. ↑ Millard, L. A.; Wan, M. W.; Smith, D. M.; Wittkowski, A. (2023-04-01). "The effectiveness of compassion focused therapy with clinical populations: A systematic review and meta-analysis". Journal of Affective Disorders. 326: 168–192. doi:10.1016/j.jad.2023.01.010. ISSN 0165-0327. PMID 36649790.
  39. ↑ Gundersen, Kristina Ballestad; Arnfred, Benjamin; Albert, Nikolai; Rasmussen, Andreas Rosén; Ebdrup, Bjørn H.; Polari, Andrea; Nelson, Barnaby; Glenthøj, Louise Birkedal (2026-02-01). "Treatment of schizotypal disorder: A systematic review and GRADE evaluation of the certainty of evidence". Schizophrenia Research. 288: 3–17. doi:10.1016/j.schres.2025.12.008. ISSN 0920-9964. PMID 41421074.
  40. ↑ Cheli, Simone; Wisepape, Courtney N.; Witten, Chelsea D. Y.; Floridi, Marta; Cavalletti, Veronica; Hasson-Ohayon, Ilanit; Brüne, Martin; Ottaviani, Cristina (November 2025). "Psychosocial and pharmacological interventions for cluster a personality disorders: A systematic review and two exploratory meta-analyses". Personality Disorders: Theory, Research, and Treatment. 16 (6): 589–602. doi:10.1037/per0000732. ISSN 1949-2723. PMID 40111791.
  41. ↑ Giosan, Cezar; Muresan, Vlad; Moldovan, Ramona (2014). "Cognitive evolutionary therapy for depression: a case study". Clinical Case Reports. 2 (5): 228–236. doi:10.1002/ccr3.131. ISSN 2050-0904. PMC 4302631. PMID 25614817.

Further reading

  • Abrams, M. (2020). The New CBT: Clinical Evolutionary Psychology. Cognella Academic Publishing.
  • Brüne, M., & Cheli, S. (Eds.) (2026). The Evolution of Psychotherapy: : Applying Evolutionary Theory to Mental Health Care. Springer Nature Switzerland.
  • Cheli, S. (2026). Evolutionary Systems Therapy for Personality Pathology. In M. Brüne & S. Cheli (Eds.), The Evolution of Psychotherapy: Applying Evolutionary Theory to Mental Health Care. Springer. OSF Open access preprint.
  • Gilbert, P., & Bailey, J. (Eds.) (2000). Genes on the Couch: Explorations in Evolutionary Psychotherapy. Routledge.
  • Gilbert, P., & Simos, G. (Eds.). (2022). Compassion focused therapy: Clinical practice and applications. Routledge.
  • Giosan, C. (2020). Cognitive Evolutionary Therapy for Depression: Therapy Manual. Springer.
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