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A Pilot Investigation of Emotion-Focused Two-Chair Dialogue Intervention for Self-Criticism
Clinical Psychology & Psychotherapy
Abstract
Unlabelled:
Self-criticism plays a key role in many psychological disorders and predicts poor outcome in psychotherapy. Yet, psychotherapy research directly targeting self-critical processes is limited. In this pilot study, we examined the efficacy of an emotion-focused intervention, the two-chair dialogue task, on self-criticism, self-compassion and the ability to self-reassure in times of stress, as well as on depressive and anxiety symptoms among nine self-critical clients. Results showed that the intervention was associated with significant increases in self-compassion and self-reassuring, and significant reductions in self-criticism, depressive symptoms and anxiety symptoms. Effect sizes were medium to large, with most clients exhibiting low and non-clinical levels of symptomatology at the end of therapy, and maintaining gains over a 6-month follow-up period. Although preliminary, these finding suggest that emotion-focused chair work might be a promising intervention addressing self-criticism.
Key practitioner message:
Self-criticism is an important process in a variety of clinical disorders and predicts poor outcome in brief therapy for depression. Yet, little is known about how self-criticism can be effectively addressed in psychological treatment. Practitioners can benefit from increasing their awareness of self-critical processes in their clinical work, and from directly working with emotions in addressing self-criticisim. Emotion-focused two-chair dialogue intervention can be effective in reducing self-criticism, increasing self-compassion, and decreasing depressive and anxiety symptoms, and these improvements are largely maintained six months after therapy.
... While EFT (e.g., as treatment of depression or anxiety) typically includes the work with the critic (among other targets of the treatment such as work on emotional injuries), there have also been several EFT studies that have focused specifically on EFT as a treatment of selfcriticism as the primary target of the treatment. In particular, B. Shahar et al. (2012) conducted five to eight therapy sessions in which the EFT two-chair (self-critic) task was used with 10 participants in order to work with self-criticism in a one-group pre-post and follow-up design. The participants were people with high levels of self-criticism. ...
... While EFT, together with other approaches (see Kannan & Levitt, 2013), sees self-criticism as an important transdiagnostic construct associated with a number of psychopathological symptoms and the focus on self-criticism as part of a typical course of EFT (e.g., Greenberg et al., 1993), there have been few specific studies on EFT as a treatment of self-criticism, with the exception of B. Shahar et al. (2012), Stiegler et al. (2018), and Thompson and Girz (2020). None of these three studies utilized a randomized controlled trial design, which is seen as a standard for evaluating psychotherapy efficacy. ...
... To be eligible for participation, they had to score more than one standard deviation above the mean on one of the two factors of the FSCRS scale (Gilbert et al., 2004), according to the López-Cavada (2020) adaptation with the general population, that is, 19.0 in IS or 4.9 in HS. Other similar studies have established this cutoff point based on the mean and standard deviation obtained in the general population (e.g., B. Shahar et al., 2012). In order to participate, participants could not attend parallel psychotherapy until the end of the 3-month followup, although prior therapy was not an exclusion criterion. ...
Self-criticism is a transdiagnostic phenomenon associated with different psychopathological manifestations in clinical and nonclinical samples. This fact has led to an increase in research on its measurement and treatment. This study seeks to examine the effects of emotion-focused therapy on self-criticism in a nonclinical population through pretreatment, posttreatment, and follow-up questionnaires. The study was designed as a randomized control trial comparing emotion-focused therapy for self-criticism (n = 24) versus a wait-list control group (n = 28). The efficacy was evaluated using Inadequate Self and Hated Self scales of Forms of Self-Criticizing/Attacking and Self-Reassuring scale, as well as measures of depression, general distress, and interpersonal problems. The results showed significant improvements on the inadequate self, depression, general distress, self-compassion, and self-reassuring measures at the end of the treatment for emotion-focused therapy condition in comparison with the control, with most of the changes also being maintained in the follow-up. The results show the promise of emotion-focused therapy as a way of treating self-criticism.
... The attachment lens has been used to understand the development of the most disparate personality constructs, with useful implications for clinical practice. Among these, the scientific community is paying a growing interest to SC (Krueger & Eaton, 2015), which several authors consider a transdiagnostic risk factor and a relevant predictor of poor treatment outcomes (Rector et al., 2000;Rose & Rimes, 2018;Shahar et al., 2012). ...
... A rapid glance at the literature discussing the roots of SC evidences that the most influential theories argue the crucial role of the quality of the attachment bond with the caregiver in shaping the proneness to SC, regardless of its type (Blatt, 2004;Blatt & Homann, 1992;Shahar et al., 2012). However, because of the heterogeneity of SC definition(s) illustrated above, it is still not clear if the different forms of SC (e.g. ...
... The growing interest in SC can be attributed to its transdiagnostic nature and its predictive power of outcome treatment (Rector et al., 2000;Rose & Rimes, 2018;Shahar et al., 2012). This systematic review and meta-analysis summarize and extend the knowledge of the roots of SC by analyzing its relationships with attachment, another influential construct in clinical psychology. ...
Several contributions argue that insecure attachment accounts for the development of self-criticism. However, advances in the field are replete with theoretical issues that limit the integration of past results. This work estimates the strength of the associations between attachment and self-criticism and examines which theoretical and methodological features impact these estimations. A PRISMA systematic search was conducted. A three-level meta-analytic approach has been used to estimate effect sizes and the role of theoretical and methodological moderators. Low levels of secure attachment and high levels of insecure attachment were both positively associated with self-criticism. The type of insecure attachment significantly moderated this result, with attachment anxiety being more strongly associated with self-criticism than avoidant attachment. In some cases, the conceptualization and operationalization of both attachment and self-criticism were significant moderators. Self-criticism is likely to be rooted in insecure attachment, supporting most theoretical models and clinical indications. However, results regarding anxious attachment call for an additional theoretical effort to extend the current model. Furthermore, the bi-dimensional conceptualization of insecure attachment may lead to an overestimation of the association between avoidant attachment and self-criticism. The different nature of the emotional components involved may impact observations, suggesting the need to use multidimensional measures.
... The EFT sequential model of emotional processing aims to help clients to transform maladaptive emotions with primary adaptive emotions such as self-compassion and self-protection (also known as protective anger) [6]. EFT therapists facilitate self-compassion and self-protection capacities as primary adaptive emotions by implementing specific two-chair interventions [7,[12][13][14]. The EFT model distinguishes between two sorts of two-chair dialogues: empty-chair dialogues with a significant other, also known as unfinished business [15,16], and two-chair dialogues used for self-critical dialogues between the critical and the experiential part of the self [14,17]. ...
... EFT therapists facilitate self-compassion and self-protection capacities as primary adaptive emotions by implementing specific two-chair interventions [7,[12][13][14]. The EFT model distinguishes between two sorts of two-chair dialogues: empty-chair dialogues with a significant other, also known as unfinished business [15,16], and two-chair dialogues used for self-critical dialogues between the critical and the experiential part of the self [14,17]. The marker for an empty-chair dialogue is interpersonal problems such as lingering negative feelings towards a significant other, e.g., a mother or father [11,16]. ...
... The marker for an empty-chair dialogue is interpersonal problems such as lingering negative feelings towards a significant other, e.g., a mother or father [11,16]. The marker for a two-chair dialogue is intrapersonal problems such as conflicts within the client's self in the form of self-criticism [14,18], or as maladaptive anger towards oneself [10]. The purpose of both chair dialogues is to help clients to evoke self-compassion as the ability to internally comfort and soothe themselves and self-protection as a feeling of entitlement to identify and express unmet needs [7,8]. ...
Clients’ facial expressions allow psychotherapists to gather more information about clients’ emotional processing. This study aims to examine and investigate the facial Action Units (AUs) of self-compassion, self-criticism, and self-protection within real Emotion-Focused Therapy (EFT) sessions. For this purpose, we used the facial analysis software iMotions. Twelve video sessions were selected for the analysis based on specific criteria. For self-compassion, the following AUs were significant: AUs 4 (brow furrow), 15 (lip corner depressor), and the AU12_smile (lip corner puller). For self-criticism, iMotions identified the AUs 2 (outer brow raise), AU1 (inner brow raise), AU7 (lid tighten), AU12_smirk (unilateral lip corner puller), and AU43 (eye closure). Self-protection was combined using the occurrence of AUs 1 and 4 and AU12_smirk. Moreover, the findings support the significance of discerning self-compassion and self-protection as two different concepts.
... The self-critical split is a conversation between two aspects of the self: the critical voice and the criticised self. The key marker is an inner critical voice [6][7][8]. The empty-chair work is a dialogue with an imaginary other [3,9]. ...
... Within the self-critical split, the EFT therapist encourages the client to express the anger, hate, contempt, or disgust of the critical voice towards the criticised self. Afterwards, the client is asked to change sides and respond as the criticised part of the self to the critic [7,8]. During the empty-chair dialogue, the client is encouraged to first express secondary emotions, such as rejecting anger, and then the client is guided to articulate more primary emotions, such as unmet needs and grief, about the losses and/or compassion for the wounded inner child [9]. ...
... The findings characterize the compassionate voice as caring, positive, and supportive, and focusing on resources and positive qualities [14]. Another study examines the efficacy of the self-critical two-chair dialogue in EFT [8]. The work of Shahar et al. [8] supports the two-chair dialogue as a promising intervention on decreasing self-criticism and increasing self-compassion. ...
One of the key elements of Emotion-Focused Therapy (EFT) is decreasing self-criticism as a secondary, maladaptive emotion within two-chair interventions while simultaneously increasing self-compassion and self-protection as primary, adaptive emotions. Though the concepts of self-compassion, self-protection, and self-criticism are highly acknowledged within psychotherapy research, the verbal articulation of these constructs within therapy sessions is underinvestigated. Thus, this qualitative study aims to examine how self-criticism, self-protection, and self-compassion are articulated by clients in EFT video sessions. Consensual qualitative research was used for data analysis performed by two core team members and one auditor. Three similar domains were considered for all three concepts: behavioural, emotional, and cognitive aspects. The number of self-protection statements was the highest among the states. The behavioural aspect was the most dominant domain for self-protection with the major subdomain ‘I tell you what I need’. For self-compassion, the cognitive aspect was the most significant domain containing eight subdomains, such as ‘I see your bad circumstances’. The most frequent domain for self-criticism was the behavioural aspect consisting of the two subdomains ‘I point out your wrong behaviours and I give you instructions’. The findings demonstrate the significance of promoting both self-compassion and self-protection to combat self-criticism. More studies of categorising a broader number of cases among various therapy approaches are necessary to develop a more detailed understanding of clients’ verbalisation of self-compassion, self-protection, and self-criticism within therapy.
Keywords: emotion-focused therapy; self-compassion; self-criticism; self-protection; consensual qualitative analysis
... The authors' clinical observations suggest that relating to the self-critical process as if it were a semi-autonomous personality can enhance an ability to externalise the process, to step aside from it for a moment, and wrestle with it. The inner critic is often considered one side of an internal split, whereby the aim is to develop a dialogue between the critical, judgemental, and evaluating aspect of self and the more submissive part of self that repeatedly experiences the judgement (Shahar et al., 2012). ...
... The third stage of integration occurs when the critic and the self have expressed their feelings and associated needs, and the critic begins to soften or become more self-soothing and less evaluative, harsh or blaming. Shahar et al. (2012) showed that an EFT two-chair dialogue achieved increased self-compassion and reduced self-criticism, depressive symptoms, and anxiety symptoms. ...
Research and methodology on the treatment of self-criticism in counselling is limited in the recent literature. This article describes how harsh automatic self-criticism became viewed within several theoretical frameworks as a sub-personality with a purpose rather than a simple psychological mechanism. The article reviews a number of approaches to therapeutic work with clients experiencing habitual self-criticism. It outlines eight therapeutic steps to gaining freedom from the inner critic, including getting to know self-critical “voices”, understanding their origins, recognising what activates escalation of self-criticism, and making efforts that create distance from the corrosive effect of self-criticism. Ways to become grounded and self-compassionate, and to develop an individualised wellbeing plan are discussed as components of gaining freedom from self-critical dominance.
... EFT is particularly known in the couple therapy format, but it was also successfully studied in the context of other presentations that include depression (e.g., Watson et al., 2003), complex trauma (Paivio et al., 2010), or generalized and social anxiety (Shahar et al., 2017). It was also studied in non-diagnostic presentations such as self-criticism (Shahar et al., 2012), interpersonal emotional injury (Paivio & Greenberg, 1995). EFT was formulated in a number of treatment manuals, many of which were designed to describe therapeutic work with presentations meeting clinical criteria for a disorder, e.g., depression (Greenberg & Watson, 2006), complex trauma (Paivio & Pascual-Leone, 2023), generalized anxiety (Timulak & McElvaney, 2018), or as a transdiagnostic treatment for the whole suite of mood and anxiety related difficulties , but essentially and in its original form it is primarily a treatment of chronic painful feelings linked to problematic self-treatment (e.g., self-criticism) or pivotal emotional interpersonal injuries (Greenberg et al., 1993). ...
... EFT, even without personalization as outlined in this paper, is thus a suitable option for a range of presentations (with hope that the P-EFT version of EFT can even maximize this potential). For instance, EFT is relatively well established as a therapy for self-criticism (e.g., Shahar et al., 2012), an issue common to many formal DSM diagnoses. Similarly, it is well established as a therapy for interpersonal emotional injury (e.g., Paivio & Greenberg, 1995), traditionally referred to as unfinished business. ...
Despite the many years of research dedicated to psychotherapy, therapy outcomes do not seem to be improving over the years. One of the approaches that are trying to address this issue is the personalization of therapy according to client characteristics. Most of the approaches to personalization in psychotherapy are atheoretical, i.e., attempting to be applicable across theoretical approaches. There are limited attempts to develop theoretically coherent personalization within existing therapeutic approaches. This paper attempts to outline a framework for a theoretically coherent approach to personalization in emotion-focused therapy (EFT) that would also account for the client’s everyday-life interactions. EFT is an experiential-humanistic approach and thus a framework for personalization in EFT is also relevant for personalization approaches in other exploratory therapies. This paper introduces a framework for personalized, context-sensitive, emotion-focused therapy EFT (P-EFT). The framework covers three domains: (1) appropriate indication and adjustment of EFT to client goals, preferences, characteristics; (2) optimizing the therapist’s therapeutic work and being with the client; and (3) supporting in-session processes by facilitating outside-session client engagement/practices in the client’s everyday life. An outline of how research findings as well as a data informed approach could inform all of these three domains is also provided.
... Self-criticism has been defined as a constant state of selfconsciousness, fear of punishment, and dread of criticism and disapproval (Blatt, 2004(Blatt, , 2008. This trait, associated with various psychiatric disorders (depression, anxiety, eating disorders etc.; Werner, Tibubos, Rohrmann, & Reiss, 2019), also predicts poor outcomes in a psychotherapy (Löw, Schauenburg & Dinger, 2020;Shahar et al., 2011). Shahar (2015) further characterized self-criticism as a tendency to set unreasonably high standards (perfectionism) and to act punishingly towards oneself when these standards are not attained. ...
... It should be mentioned that, in literature, the terms self-criticism, negative rumination, self-judgment, self-hatred, self-contempt, selfattack, the inner critic, or self-shame are often used interchangeably, underscoring their interconnected nature (Gilbert, 2018;Gilbert, Clarke, Hempel, Miles, & Irons, 2004;Harvey, Watkins, Mansell, & Shafran, 2004;Marchetti, Mor, Chiorri, & Koster, 2018;Nolen-Hoeksema;Wisco;Lyubomirsky, 2008;Shahar et al., 2011;Smart et al., 2016;Stone, 1992). Within emotion-focused therapy, the development of self-compassion and the practice of self-protection are recognized as crucial processes to counteract the discomfort caused by self-criticism or negative self-treatment (Greenberg, 2016;Timulak & Pascual-Leone, 2015). ...
... Additionally, Shahar and colleagues demonstrated within a pilot study that the two-chair technique could effectively reduce symptoms of self-criticism and enhance self-compassion in a subclinical sample of participants displaying depressive and anxiety symptoms. 21 The reported effect sizes were medium to large, with results being maintained at a 6-month follow-up. Moreover, the same technique has proven to reduce global distress, thought suppression, and rumination. ...
... One randomised controlled trial (RCT) implementing chairwork, however, the researchers did not solely administer the chairwork technique, but also other CBT-based cognitive interventions. 25 Furthermore, convenience samples 23 and subclinical samples 21 were used, while studies investigating clinical samples did not implement structured diagnostic interviews to establish diagnosis. 26 27 Lastly, the above-stated studies are characterised by small sample sizes. ...
Introduction: Self-criticism is a key feature in people diagnosed with depression, resulting in significant psychological distress. Despite the fact that cognitive–
behavioural treatments are readily available, a significant number of patients report experiencing cognitive, but not emotional, change following therapy, resulting in the
maintenance of psychological symptoms. Additionally, interventions targeting emotional experiencing, such as chairwork, are generally implemented within large-scale therapeutic treatments. Therefore, within the present study, we aim to evaluate the efficacy and safety of a short intervention using emotion-focused
chairwork to target self-criticism in patients diagnosed with depression.
Methods and analysis: The study is designed as a randomised controlled trial with two parallel arms. 62 patients diagnosed with depression will be randomised
to the intervention group or the waiting-list control group receiving treatment as usual. The intervention comprises of three treatment sessions using the chairwork technique over the course of 3 weeks. Outcome assessments will take place 1 week before the first treatment session, as well as 1 week and 3 months after the last treatment session. The primary outcomes are self-criticism and self-compassion.
Secondary outcomes assess depressive symptoms, emotion regulation and overall self-esteem. Statistical analysis will be performed using intention-to-treat analysis, as well as per-protocol analysis implementing linear-mixed models.
Ethics and dissemination: The study was approved by the Ethics Committee of the State Chamber of Physicians in Baden-Wuerttemberg,
Germany (approval number: F-2023-12). Scientific findings shall be published in peer-reviewed journals to inform prospective clinical studies focusing on the implementation of chairwork within clinical practice.
Trial registration number German Clinical Trials Register (DRKS00031307; https://drks.de/search/de/trial/DRKS00031307).
... Self-criticism and self-reassurance According to Kannan and Levitt (2013, p. 166), self-criticism is 'conscious evaluation of oneself that can be healthy and reflexive behaviour, but also can have harmful effects and consequences for an individual' . Furthermore, self-criticism is one factor in all sorts of psychiatric diagnoses (Longe et al., 2010;Kelly and Carter, 2012;Kannan and Levitt, 2013;Castilho et al., 2015), and greatly impacts on an individual's emotions (Kramer and Pascual-Leone, 2016) and responses to all kinds of treatment (Shahar et al., 2012). Often, it is also related to perfectionism (Cheli et al., 2020). ...
... The two-chair technique may increase self-compassion and selfprotection, and reduce the intensity of the self-criticism (Shahar et al., 2012). Other studies have shown it can help in the treatment of attachment issues manifested in unresolved anger (Narkiss-Guez et al., 2015) or in touching in with some basic human needs like safety, love, competence, affiliation, nurturance, or identity (Pascual-Leone and Greenberg, 2007). ...
Introduction
As self-rating scales are prone to many measurement distortions, there is a growing call for more objective measures based on physiological or behavioural indicators. Self-criticism is one of the major transdiagnostic factor of all mental disorders therefore it is important to be able to distinguish what are the characteristic facial features of self-criticizing. To the best of our knowledge, there has been no automated facial emotion expression analysis of participants self-criticising via the two-chair technique. The aim of this study was to detect which action units of facial expressions were significantly more often present in participants performing self-criticism using the two-chair technique. The broader goal was to contribute to the scientific knowledge on objective behavioural descriptions of self-criticism and to provide an additional diagnostic means to the existing self-rating scales by exploring facial behavioral markers of self-criticism.
Methods
The non-clinical sample consisted of 80 participants (20 men and 60 women) aged 19 years to 57 years (M = 23.86; SD = 5.98). In the analysis we used iMotions’s Affectiva AFFDEX module (Version 8.1) to classify the participants’ actions units from the self-criticising videos. For the statistical analysis we used a multilevel model to account for the repeated-measures design.
Results
Based on the significant results the self-critical facial expression may therefore comprise the following action units: Dimpler, Lip Press, Eye Closure, Jaw Drop, and Outer Brow Raise, which are related to contempt, fear, and embarrassment or shame; and Eye Closure and Eye Widen (in rapid sequence Blink), which are a sign that highly negative stimuli are being emotionally processed.
Discussion
The research study need to be further analysed using clinical samples to compare the results.
... Only one study examined the improvements of a multisession treatment of chairwork. Clients with high levels of self-criticism engaged in five to eight sessions using the two-chair task, in which the first session was used to build therapeutic alliance (Shahar et al., 2012). Results showed a significant improvement on anxiety (n = 10; d = .71) ...
... and depressive symptoms over the course of treatment (d = 1.31). Posttreatment reductions in anxiety and depression brought clients to a nonclinical range and were maintained at a 6-month follow-up (Shahar et al., 2012). ...
The present study examines (a) the unique effects of chairwork on emotional process and intervention outcomes across treatments in the context of individual psychotherapy and (b) how these effects compare to other treatment interventions. Based on the appropriateness of the data available, meta-analyses with estimated effect sizes and narrative syntheses were conducted for psychotherapy process as well as symptom outcomes. Single-session chairwork was found to be more effective in deepening client experiencing than empathic responding (d = .90), although it may have an effectiveness similar to other interventions for facilitating emotional arousal or shifting the credibility of core beliefs. A single session of chairwork also has noteworthy pre-to-post symptom change (d = 1.73), although these improvements may be comparable to other methods of intervention (d = .02). However, when chairwork was used multiple times over the course of a treatment, it accumulated a meaningful effect (d = .40) compared to treatments that did not use chairwork. Therapeutic orientation emerged as a potential moderator. Incorporating chairwork into treatments may bolster process and intervention outcomes. We conclude the article with training implications and therapeutic practices.
... Long-term living in an environment of abuse, neglect, or indifference will cause children to have a strong sense of incompetence, which will be transformed into internal "self-aggression," and frequent depression. Shahar et al. (2012) confirmed the relationship between self-compassion and depression in an intervention experiment aimed at self-compassion. They stated that selfcompassion can significantly reduce depression symptoms. ...
... They stated that selfcompassion can significantly reduce depression symptoms. In other words, the lower a person's level of self-compassion, the greater the likelihood of depression (Shahar et al., 2012). In addition, the learned helplessness theory points out that when individuals suffer from long-term criticism, , 2008). ...
Numerous studies have shown that childhood emotional neglect experiences are an important risk factor for later physical and mental health problems. However, previous studies have not fully clarified the underlying mechanisms between childhood emotional neglect and depression, especially for adolescents in vocational schools. In the present study, we examined the mediating role of self-compassion in the association between childhood emotional neglect and depression and the moderating role of friendship quality in the direct and indirect relations involved. The participants were 848 vocational school adolescents, aged 14 to 20, who completed the questionnaires about childhood emotional neglect, self-compassion, depression, and friendship quality. The results showed that self-compassion partially mediated the relationship between childhood emotional neglect and adolescent depression. Importantly, friendship quality moderated the direct link between childhood emotional neglect and depression, and the indirect link between childhood emotional neglect and self-compassion, but not the indirect link between self-compassion and depression. Especially, adolescents in vocational school with high friendship quality displayed higher levels of self-compassion and lower levels of depression after experiencing childhood emotional neglect than those with low friendship quality. These findings highlight the mechanisms underlying the relationship between childhood emotional neglect and depression in vocational school adolescents.
... There are relatively few studies that directly examined interventions specifically designed to reduce self-criticism, as opposed to treating psychopathological symptoms, although several groups have examined whether specific therapies reduce self-criticism. Shahar et al. (2012; also see Shahar, 2015 for a review) examined whether two-chair dialogue therapy, an intervention used in emotion-focused therapy, leads to reductions in self-criticism. Emotion-focused therapy (EFT; Greenberg et al., 1993;Greenberg & Watson, 2006) is an empirically supported, process-experiential therapy that emphasizes a strong therapeutic relationship based on the client-centered principles of empathy, genuineness, and unconditional acceptance given by Carl Rogers (1951). ...
... During the dialogue, the client switches chairs whenever the roles are switched, using empathic guidance and emotion coaching from the therapist to explore, process, and provide space for expressing emotions and needs associated with each part of the self (Elliott et al., 2004;Greenberg et al., 1993). Shahar et al. (2012) found that this approach led to reductions in self-criticism 6 months later, which were in turn linked to reductions in depression. ...
In this chapter, we review theory and evidence pertaining to the complex associations between parenting, offspring temperament, and offspring risk for internalizing disorders, including major depression and anxiety disorders. Understanding these complex associations is important for multiple reasons. First, a large body of literature has confirmed that individual differences in children’s and youths’ temperament or pertsonality traits can elucidate which youth are potentially vulnerable to internalizing disorders. More recent research has also begun to clarify the complex pathways and interactions with environmental factors, such as parenting and life stress, through which temperament may confer risk for internalizing disorders. It is also well-established that internalizing disorders are frequently heterogeneous in terms of the nature and severity of symptom presentation. Children’s personality traits may be useful in understanding this heterogeneity as certain traits may be associated with a relatively more or less severe presentation or course of a disorder. Moreover, identifying parenting behaviors or styles that confer risk for the development of maladaptive temperament traits may lead to interventions to prevent the development of these maladaptive traits, and potentially mitigate the vulnerability to mood and anxiety disorders. There is additional evidence that personality traits may be useful in tailoring treatment approaches as well as predicting who will best respond best to different therapeutic approaches. Here, we review specific models pertaining to parenting, temperament, and internalizing disorders grounded in psychoanalytic, humanistic, and cognitive–behavioral perspectives as well as developmental, social, and personality psychologists’ theories related to parenting and temperamental development. Throughout this chapter, we adopt a dynamic-interactionist framework that considers the complex interactions between these factors, as opposed to models that view one factor as simply an outcome of another. We review evidence regarding the influence of parenting on the development of children’s temperamental traits, and evidence that children’s traits are not only linked to internalizing symptoms but these traits also predict increases in symptoms over time as well as the onset of diagnosable episodes of internalizing disorders. However, we also review a growing body of literature that suggests children’s temperament traits and symptoms influence the parenting they receive, thus creating a pernicious cycle. We then review a large body of research examining diathesis-stress models, or the possibility that individual differences in personality traits may exacerbate or buffer the effects of parenting on psychopathological outcomes. We also consider evidence that mood and anxiety disorders may have a “scarring” effect on children’s temperament traits. Additionally, we discuss evidence about “pathoplasty” models, which propose that temperament traits may contribute to the severity or pattern of symptomatology, course, and response to treatment. Next, we discuss implications for clinicians, parents, and educators in terms of the early identification and prevention of mood and anxiety disorders in youth based on the parenting they receive and the nature of their temperamental traits. We conclude with a case example elucidating these complex associations between personality traits, parenting, and the development of internalizing disorders.
... Also, we recorded a significant increase in the level of self-compassion on the part of our participants, who received the intervention training, confirming the research results of Halamová et al. [38]. Numerous authors have recorded similar improvements in self-compassion following intervention based on therapy focused on emotions or self-compassion (EFT/CFT) [25,48,[52][53][54]. The short-term interventions, lasting from three days [52] to three weeks [25,38] share one common thread: daily exercise. ...
... Therefore, we confirmed the assumption that the degree of self-criticism can be effectively reduced by means of an intervention based on Emotion Focused Therapy [37,50,54] and using the expressive writing paradigms [38,51]. In view of the growing documentation about the advantageous effects of self-compassion on mental health, we consider it important to find a relatively quick and simple way of improving it. ...
Aim of the study
Dissatisfaction with one’s own body represents one of the main sources of suffering for women in various age categories. One of the potential factors reducing dissatisfaction with one’s own body is self-compassion. The aim of this study was to determine if a short-term two-week emotion focused training for self-compassion and self-protection, will reduce self-criticism in women, increase their self-compassion and improve satisfaction with their own body image.
Subject or material and methods
The research sample consisted of 64 women aged 18-55 years, mean age 31.73 yrs. (SD = 8.48), randomized into experimental and control group. Self-compassion, self-criticism and body shape dissatisfaction were measured before and after the intervention.
Results
Data analysis indicated significant changes in the degree of self-compassion, self-criticism and dissatisfaction with body image on the part of the group undergoing intervention.
Discussion
Similarly as in previous research, emotion focused training for self-compassion and self-protection turned out to be the effective tool for increasing compassion, decreasing self-criticism and enhancing body dissatisfaction.
Conclusions
The study confirms the assertion that cultivating self-compassion can lower dissatisfaction with body image, and at the same time, it proves that cost-effective, distance intervention, without direct contact with a specialist, can be effective.
... Shi et al. (2015) concluded that more anxious individuals reported more frequent self-critical practice. A similar association between self-criticism and anxiety was also confirmed by Shahar et al. (2012). Although self-planning for favored activities brings happiness, the interviewees argue that consulting experienced people is necessary. ...
As a necessary skill for learners to express themselves proficiently, speaking has always been an important goal in EFL learning. Despite its importance, many learners experience varying levels of anxiety that disturbs or even constrains their speaking performance. This study aims to examine levels of public speaking anxiety among Saudi EFL university students and frequencies of different types of self-talk implementation. The study also investigates the relationship between self-talk and PSA and the learner’s perceptions of these two variables. The results of the study showed that more than half of the participants (53.2%) were highly anxious while the remaining participants were either moderate or low anxious as represented by almost equal percentages (24.8%), (22%) respectively. The study also indicated that all participants had either moderate or high frequency of self-talk and its subcategories while no participants had low frequency of both total and subcategories of self-talk. The findings also proved that there was a negative correlation between public speaking anxiety and self-reinforcement. Qualitative analysis supported quantitative results in this study and some important recommendations were suggested based on the findings.
... To the best of our knowledge, there is no empirical study that has previously tested this model, but some clinical observational studies are consistent with previous studies (Masterson 1998, Rappoport 2005 suggesting that children who grow up with parents with pathologically narcissistic traits tend to be highly critical of themselves. Furthermore, the existing literature consistently indicates that adverse childhood experiences foster the internalization of a self-critical thinking style, often resulting in self-blame (Gibb 2002, Sachs-Ericsson et al. 2006) and the formation of negative self-schemas (Glassman et al. 2007, Lassri andShahar 2012). The empirical findings of this study also demonstrate that children raised by mothers exhibiting high levels of narcissistic traits tend to adopt a self-critical thinking style towards themselves. ...
Objective: This study aims to examine the mediating role of self-criticism in the relationship between narcissistic traits perceived from the mother in childhood and symptoms of depression and anxiety disorders in adulthood. Method: A total of 512 adults aged between 18 and 45 years (mean age= 31.47, SD= 10.37) were included in the study. Participants completed the Socio-demographic Information Form, Scale of Narcissitic Traits Perceived from Mother, Forms of Self-Criticism and Self-Relief Scale, and Brief Symptom Inventory. Results: In the model tested using Structural Equation Modeling, perceived maternal narcissism during childhood predicted self-criticism, depression and anxiety disorder symptoms. In addition, self-criticism predicted both depression and anxiety disorder symptoms. Indirect effects were examined with the bootsrap method and self-criticism was found to have a mediating role. Conclusion: The results suggest that self-criticism mediates the relationship between narcissistic traits perceived from the mother in childhood and symptoms of depression and anxiety disorders. These findings suggest that a mother's narcissistic traits may have a negative impact on mother-child interaction and influence the child's development of a self-critical style. Moreover, high maternal narcissistic traits may increase the risk of depression and anxiety disorder symptoms by contributing to a self-critical thinking style.
... The HS form is more strongly linked to self-harm than the IS form (Ammerman & Brown, 2018;Gilbert et al., 2010), with non-suicidal self-injury being a physical expression of self-attack possibly used to regulate HS emotions such as shame, disgust and anger (Xavier et al., 2016). Although many interventions aiming to promote self-compassion improve rates of both forms of self-criticism, HS can be harder to treat, with some studies finding improvements in IS but not HS (Halamová et al., 2018b;McEwan & Gilbert, 2016;Shahar et al., 2012Shahar et al., , 2015. ...
Two studies explored whether Hated Self and Inadequate Self forms of self-criticism demonstrate different relationships to self-critical rumination (SCR), metacognitive beliefs, decentering and psychopathology. In study 1, 137 community participants experiencing SCR completed an online questionnaire battery. Self-hate was associated with higher SCR, stronger positive and negative metabeliefs about SCR, higher psychopathology and nonreactivity to internal experiences. Effects of Inadequate Self on psychopathology were fully mediated by SCR whereas Hated Self exerted direct effects on psychopathology alongside indirect effects via SCR. Study 2 explored whether higher self-hate attenuated the ability to detach from SCR triggers. Twenty-three participants received a single-session detached mindfulness intervention; pre-post changes in study 1 questionnaires and daily diary ratings of study 1 constructs in the week before and after the intervention were compared. Most measures improved; higher self-hate was not associated with reduced response. Although self-hate confers risk for psychopathology outside SCR, metacognitive interventions both undermine uncontrollability beliefs and facilitate decentering, so should continue to be investigated as interventions for SCR.
... Chairwork refers to a group of action-based psychotherapeutic techniques which utilise chairs and movement between chairs for therapeutic ends [23]. Chairwork methods originated in psychodrama [24][25][26] and have since been incorporated into a broad range of contemporary evidence-based therapies [27][28][29]. Pugh and Bell [30] have proposed general principles (self-multiplicity, information exchange, and transformation) and processes (separation, animation, and dialogue) which underly the application of chairwork methods across varying conceptual landscapes. Self-multiplicity refers to the notion that the self is made up of multiple and often conflicting parts. ...
Compassion-focused chairwork has become a recent focus of empirical investigation. This study extended this area of research by exploring how participants with depression experienced the 'compassionate other' imagery exercise enacted via chairwork methods. Eight individuals from primary care NHS mental health services were interviewed about their experience of the practice. The resultant data were analysed using interpretive phenomenological analysis (IPA). Three group experiential themes were identified: care that feels real, chairwork processes and encountering challenges on the road to discovery. The findings indicate that the intervention has therapeutic utility both as an intervention for cultivating compassion and as means of assessing for and identifying blocks to compassion. The results also suggest that there is potential value in enacting compassion-focused imagery techniques through chairwork methods, especially for those who have difficulty accessing mental imagery practices. The findings are contextualised within broader theory and literature, and clinical and research implications are discussed.
... Chairwork refers to a group of action-based psychotherapeutic techniques which utilise chairs and movement between chairs for therapeutic ends [23]. Chairwork methods originated in psychodrama [24][25][26] and have since been incorporated into a broad range of contemporary evidence-based therapies [27][28][29]. Pugh and Bell [30] have proposed general principles (self-multiplicity, information exchange, and transformation) and processes (separation, animation, and dialogue) which underly the application of chairwork methods across varying conceptual landscapes. Self-multiplicity refers to the notion that the self is made up of multiple and often conflicting parts. ...
Compassion-focused chairwork has become a recent focus of empirical investigation. This study extended this area of research by exploring how participants with depression experienced the ‘compassionate other’ imagery exercise enacted via chairwork methods. Eight individuals from primary care NHS mental health services were interviewed about their experience of the practice. The resultant data were analysed using interpretive phenomenological analysis (IPA). Three group experiential themes were identified: care that feels real, chairwork processes and encountering challenges on the road to discovery. The findings indicate that the intervention has therapeutic utility both as an intervention for cultivating compassion and as means of assessing for and identifying blocks to compassion. The results also suggest that there is potential value in enacting compassion-focused imagery techniques through chairwork methods, especially for those who have difficulty accessing mental imagery practices. The findings are contextualised within broader theory and literature, and clinical and research implications are discussed.
... Despite a widespread and effective use of chairwork in reducing self-criticism and guilt (e.g., Shahar et al., 2012), its systematic application in the psychological treatments of OCD is described only in a small number of studies (Basile et al., 2018b;Thiel et al., 2016). ...
Objective: Fear of moral guilt and conseque:nt increased attention to personal actions and intentions are the main ingredients of the self-criticism in patients suffering from obsessive-compulsive disorder (OCD). This pathogenic attitude takes shape in a typical guilt-inducing self-talk. The purpose of this work is to describe in detail a novel cognitive therapeutic procedure for OCD called "Dramatized Socratic Dialogue" (DSD). Method: DSD is a theory-oriented intervention that combine elements of Socratic dialogue, chairwork, and cognitive acceptance strategies derived from Mancini's model, which posits that obsessive-compulsive (OC) symptoms stem from a fear of deontological guilt. Results: DSD appears to have many strengths, being a theory-oriented treatment and focusing, as a therapeutic target, on the cognitive structures that determine pathogenic processes and OC symptoms. Furthermore, it is a short, flexible and tailor-made intervention. Conclusions: Detailed description of the intervention could foster future research perspectives and thus be used in evidence-based effectiveness studies to establish whether DSD reduces OC symptoms and to investigate its mechanism of action.
... The two personality vulnerabilities of dependency and self-criticism have been associated with depression in cross-sectional, longitudinal, and neuroimaging studies (Campos et al., 2010;Doerig et al., 2014;Falgares et al., 2018;Longe et al., 2010;Mauas et al., 2014;Yao et al., 2009), across ages, cultures, and clinical settings (Kopala-Sibley et al., 2017;Shahar et al., 2012;Sobrinho et al., 2016;Zuroff et al., 2015). Personality vulnerability has also been conceptualized transdiagnostically (Blatt & Luyten, 2009;Schanche, 2013). ...
Personality vulnerabilities (i.e., dependency and self-criticism) have been established as critical risk factors for psychopathology in general and for depression in particular. However, research does not address ways of treating those who score high on both dependency and self-criticism, or mixed-vulnerability individuals. To benefit these individuals, we developed an online, group-administered, multi-component positive psychology intervention (MPPI) and tested its effects and mechanisms. Participants (N = 70) were randomly assigned to either receive the MPPI or an active placebo control. The six-session intervention took place over three weeks, and measures were completed at baseline, midtest, posttest, and one-month follow-up stages. Compared to the control condition, the MPPI significantly attenuated self-criticism and dependency for up to one month. The intervention also decreased depression and promoted self-esteem and subjective well-being (SWB). Parallel mediation analyses revealed that lower self-criticism mediated the intervention’s effects on depression, self-esteem, and SWB, while lower dependency mediated effects on self-esteem. This study highlights how an MPPI can decrease personality vulnerability in mixed-vulnerability individuals, and how this change can have further positive effects.
... 4 Saya lebih memilih menyelesaikan tugas hingga selesai daripada tidur. 5 Butuh waktu yang lama untuk belajar dari kegagalan. Saya sulit melupakan kegagalan yang pernah saya alami. ...
This study aims to examine the ability of self-criticism in individuals through the construction of scale. Preparation of scale using the theory of self-criticism from G. Shahar (2016). Self-Criticism is an intense and persistent relationship with oneself which can be revealed through two aspects, namely (1) demanding oneself to achieve high performance standards; (2) expressions of self-hatred and humiliation when these high standards are not met. Scaling in the initial stage involved 62 items consisting of 31 items for the first aspect and 32 items for the second aspect. The field test for the construction of scale involved 94 active students withdiploma, graduate and postgraduate students from various universities in Indonesia. A series of psychometric processes included a validity test with Aiken's V and Cronbach Alpha reliability (α = 0.92). The final stage of the scale development process produces 32 valid and reliable items. The results showed that 71.3% of students had high self-criticism abilities. Students tend to set targets for very high achievement and not in accordance with their potential. When students cannot reach the targets, they will punish themselves for that disability.
... Selfcriticism, a rigid and automatic way of thinking, becomes exacerbated in the face of improper emotional regulation strategies (Daros & Ruocco, 2021). If one is able to process their emotions, the effects of self-criticism can then be mitigated (Shahar et al., 2012), and attentional control remains unchanged. Thus, self-criticism might not necessarily cause attentional difficulties unless there are simultaneous processing impairments. ...
Self-criticism is known to contribute to the development and maintenance of various psychological disorders. Previous research has identified positive correlations between anxiety and attentional control, making the connection between self-criticism and attentional control likely. Mentalization, defined as an ability to make sense of ourselves and others, has been shown to reduce symptoms of psychological distress and increase tolerance to difficult thoughts and feelings. One dimension of mentalization, mentalized affectivity, is a form of emotional regulation that can be further broken down as identifying, processing, and expressing emotions. This study first examined the relationship between self-criticism and attentional control, and then investigated the indirect effect of mentalization, or more specifically mentalized affectivity, on that relationship. Participants (N = 215) completed measures of mentalization, self-criticism, and attentional control. Mediation analysis revealed that one dimension of mentalized affectivity, processing ability, produced a statistically significant partial indirect effect. When looking more specifically at attentional control, shifting attention produced a full indirect effect, whereas focusing attention maintained a partial effect. Our study highlights the role of processing emotion in maintaining self-criticism and affecting cognitive strategies. The current research bears important clinical implications, potentially how addressing mentalized affectivity may ameliorate self-critical thinking and, subsequently, attentional deficits.
... However, due to their negative bias of self-evaluation, such as in selfdeprecation and self-condemnation [6,23], depressed individuals often report low levels of self-compassion [45,46], which may explain their lower subjective well-being. Meanwhile, some intervention studies [47,48] focusing on the connotation of self-compassion have also found that the improvement of self-compassion has a significant positive effect on relieving depressive symptoms. Therefore, the lower subjective well-being of trait depressive individuals may be the result of their lower self-compassion, which is unable to effectively transform negative emotion into positive emotion. ...
Although subjective well-being has been widely discussed as being one of the important indicators of clinical depression, few studies have explored how it relates to trait depression. In particular, increasing the number of positive experiences has long been a potential goal for depression-related clinical interventions, but the mechanisms by which such interventions work in countering depression have been poorly studied. Grounded in the cognitive theory of depression, the current study aimed to address this specific gap by testing the mediating effects of community feeling and self-compassion between trait depression and subjective well-being. A survey of 783 college students found that trait depression was not only able to directly and negatively predict individual subjective well-being but also indirectly predict individual subjective well-being through the mediating role of community feeling and self-compassion alone and through the chain mediating role of self-compassion from community feeling. These findings reveal the internal mechanisms of trait depression that, to some extent, impede subjective well-being and offer certain guiding significance for the self-regulation of interventions for clinical and non-clinical individuals with trait depression.
... The empty chair technique has proven to be useful in anger reduction (Conoley et al., 1983), solving "unfinished business" (Paivio & Greenberg, 1995), and facilitating forgiveness (Greenberg et al., 2008). The two-chair technique was observed to be helpful in overcoming decisional conflicts (Clarke & Greenberg, 1986), reducing self-criticism (Shahar et al., 2012), and resolving partnership ambivalence (Trachsel et al., 2012). Chair-based techniques have been adopted and applied to various psychological problems and by psychotherapists and coaches of different theoretical orientations, including Voice Dialogue, compassion focused therapy, cognitive behavioral therapy, and schema therapy (e.g., Pugh, 2019Pugh, , 2021. ...
The Dialogical Dilemma Solution (DDS) technique is a psychological method based on dialogical self theory which aims to support decision-making processes. In the DDS technique problems are operationalized as intrapersonal decisional struggles – dilemmas between different self-aspects, each having its origin in a relationship with a particular person significant for the individual. Two studies examined the effectiveness of the DDS technique. The first pilot study was a quasi-experimental design with repeated measurements on one research group (N = 15) to which the DDS technique was applied during a 60-minute session with the psychologist. In the second study - a randomized controlled trial experiment (N = 76) performed over the Internet, the effectiveness of the DDS technique was compared with a standard CBT technique. Both studies showed that the technique was effective in facilitating problem-solving. The application of the DDS technique in Study 2 showed a higher degree of problem solution than the CBT technique and according to participants’ subjective appraisal it was more helpful in understanding the problem.
... Results by Gilbert et al. (2011) showed that some individuals, particularly those high in self-criticism, can find self-compassion challenging and even can be fearful of it. Self-criticism has been identified as a trans-diagnostic process related to a variety of negative clinical outcomes (Shahar et al., 2012). Brinthaupt (2019) found that experiencing negative emotions is most strongly associated with the frequency of self-critical self-talk. ...
The aim of the study was to investigate the role of temporal dialogues and self-compassion in coping with emotions connected to difficult past situations. In this study, we used the dialogical chair procedure, where we asked participants to narrate a difficult, past negative experience by moving from “here and now” to that time and place (Suffering-I/past-I), and to narrate the same past event from a current perspective (Distanced-I/current-I). Additionally, fifty seven participants completed three measures: The Positive and Negative Affect Schedule (PANAS); the Self-Compassion Scale (SCS); and the rating scales for functions of dialogue (criticism, support, instruction, and evaluation). The study showed that self-compassion predicts lower negative affect after an internal dialogue about difficult past events, but this effect is not mediated by functions of dialogue. On the other hand, dialogue functions are associated with higher levels of positive affect after dialogue, while self-compassion does not appear to be significant here.
... The way in which people speak with themselves, known as inner speech, has an enormous impact on their well-being, and mental and physical health (e.g., Zessin, Dickhauser, & Garbade, 2015) and on their responsiveness to medical as well as psychological treatment (Shahar et al., 2012;Shahar et al., 2015). Inner speech can take the form of cruel self-critical inner speech, which is one of the key risk factors for different kinds of psychopathology (e.g., Falconer, King, & Brewin, 2015) while self-compassionate inner speech works as an antidote to self-critical speech (e.g., 2010). ...
As self-criticism is considered to be the major underlying factor of all sorts of psychopathology, it is meaningful to explore the differences between how people deal with their self-criticism based on their level of self-criticism. The aim of this study was to categorise descriptions and investigate differences between 5 high and 5 low self-critical participants in their self-critical, self-protective and self-compassionate imageries. The total sample consisted of 10 university students, who were selected from a larger sample of 88 participants based on their extreme score from The Forms of Self-Criticising/Attacking and Self-Reassuring Scale. For analysis, we exploited Consensual Qualitative Research with two assessors and one auditor. The compassionate imagery was used to evoke the inner critic, protector and compassionate voice. The results showed differences in the imageries based on the level of self-criticism. Both high and low self-critics displayed difficulties in overcoming their self-criticism. Contrary to high self-critics, low self-critics showed more constructive and positive strategies for dealing with their self-criticism. Our study presented several different patterns between high and low self-critical participants in self-critical, self-compassionate, and self-protective imagery which could be used for diagnostic purposes in the future.
... In the therapeutic model of Emotion-focused Therapy [21], self-criticism, self-compassion, and self-protection are meaningfully tied together, and working with them is central to building one's empowered and resilient self [20]. Emotion-focused Therapy's efficiency for the treatment of self-criticism was supported, for example, by Shahar et al. [22,23], Thompson and Girz [24], and Timulak et al. [25]. ...
Background:
Virtual reality used for the treatment of mental health disorders is showing promising potential in clinical practice. Increasing self-compassion and self-protections and decreasing self-criticism have been identified as trans-diagnostic mechanisms helping to build a resilient self. The goal of this systematic review was to provide an overview of research studies about virtual reality while exploring its effectiveness in increasing self-compassion and self-protection and decreasing self-criticism.
Methods:
On 6 December 2022, titles, abstracts, and, where available, keywords were searched in the following databases: PubMed, Scopus, and Web of Science. The inclusion criteria were: empirical study; quantitative methodology; outcomes measured, including self-compassion and/or self-protection, and/or self-criticism; pre/post and/or control group intervention measures of selected outcomes; participants aged 18 and above; application of virtual reality technology as part of the intervention; full study availability; and English language. Exclusion criteria were: ruminations related only to physical pain; self-protection in the context of physical survival; VR used to increase ruminations.
Results:
Selection criteria were met by 19 studies (two randomized controlled trials, 16 longitudinal studies, and one case study) with an overall number of 672 participants. Results suggest that VR interventions targeting self-criticism, self-compassion, and self-protection might be effective for non-clinical (self-compassion) as well as clinical (self-criticism and self-protection) samples.
Discussion:
The present systematic review partially supports the effectiveness of VR interventions on self-criticism, self-protection, and self-compassion. To properly answer the question of its effectiveness, more randomized control trials with larger samples from different populations are needed. The results are also limited by the variability of intervention protocols and the amount of exposure to VR. Other: This work was supported by the Vedecká grantová agentúra VEGA under Grant 1/0075/19. This systematic review has not been pre-registered.
... While providing psychological counselling or mental health treatment, service providers should be aware of the potential negative emotions resulting from self-criticism of gay and bisexual men seeking professional psychological help (Whelton & Greenberg, 2005). An increasing number of interventions to reduce self-criticism, based on cognitive-behavioural therapy (Craig et al., 2012) and emotion-focused therapy (Shahar et al., 2012), have been shown to have significant effects in relieving depressive symptoms. Assessing self-critical traits and providing targeted treatments as a potential intervention mechanism could further help clinicians improve the mental health of gay and bisexual men (Löw et al., 2020). ...
A growing number of studies has shown that gay and bisexual men are more likely to experience adverse mental health status than their heterosexual counterparts. Stigma‐related stress and self‐criticism are believed likely to exacerbate depressive symptoms among gay and bisexual men. This research used cross‐sectional findings to illustrate the mediating role of internalized self‐stigma and self‐criticism in the association between perceived public stigma and depressive symptoms. A total of 317 Chinese gay and bisexual men (267 gays and 50 bisexuals with a mean age of 25.29) were invited to participate in this study from October to November 2021. Sociodemographic characteristics, perceived public stigma, internalized self‐stigma, self‐criticism and depressive symptoms were measured through self‐reported online questionnaires. The results indicated that the association between perceived public stigma and depressive symptoms was sequentially mediated by internalized self‐stigma and self‐criticism. The findings indicated that public stigma, as a distal stressor, was perceived and internalized as self‐stigma by gay and bisexual men. This self‐stigma may pose a risk for depressive symptoms via self‐criticism (a maladaptive consequence of their attempts to reduce cognitive dissonance). These results highlight the necessity of reducing sexual minority‐related stigma and self‐criticism to reduce depressive symptoms. Our findings appeal to society to further decrease prejudice and stigma, increase tolerance, and focus on the negative mental health status of gay and bisexual men.
... According to the newest research finding of Emotion-focused therapy (EFT), effective combating self-criticism must also include self-protection or in other words assertive anger, so the person is able to stand up for themselves and not only self-compassion to sooth themselves (Greenberg, 2011;Pascual-Leone, 2017). EFT effectiveness for the treatment of self-criticism was supported by for example the work of Shahar et al. (2012Shahar et al. ( , 2017, Thompson and Girz (2020), and Timulak et al. (2022), EFT is a humanistic experiential therapy based on personcentered therapy, Gestalt therapy, systemic therapy, and attachment theory (Greenberg, 2011). EFT works on the premise that human emotions are linked to human needs, and therefore emotions have an innately adaptive potential that, if activated and worked through, can help people change problematic emotional states and interpersonal relationships (Elliott et al., 2004). ...
Introduction
The aim of this study was to examine the short- and long-term effectiveness of the novel Emotion-focused Training for Helping Professions on levels of compassion fatigue (secondary traumatic stress & burnout), self-criticism, self-compassion, and compassion for others.
Methods
A randomized controlled trial study was conducted. A total of 253 participants were recruited and randomly assigned to either the experimental group or the control group. The experimental group attended a 14-day online training. The control group did not perform any tasks.
Results
Results showed that after completing the intervention the experimental group participants reported significantly lower scores for secondary traumatic stress, burnout and self-criticism, and higher scores for self-compassion and that these lasted for two months after completion. Compared to the control group, the experimental group participants had significantly lower scores of secondary traumatic stress, burnout, self-criticism, and higher scores of self-compassion after the intervention. No significant changes were found for the control group, except a significant increase in time in the reported score for one dimension of burnout – exhaustion.
Discussion
The novel EFT-HP training was shown to be effective in reducing levels of compassion fatigue (secondary traumatic stress and burnout) and self-criticism and increasing self-compassion.
... Gilbert, 2010) and emotion-focused therapy (B. Shahar et al., 2012). Each of intervention has advantages and limitations. ...
Bidayuh is an indigenous group living in Sarawak, Malaysia. The study examined the perceptions of Bidayuh people on the importance of the Bidayuh language. The specific aspects studied were the reasons for the importance of the Bidayuh language and the connotative meanings of the language. Questionnaire data were obtained from 61 Bidayuh participants from Sarawak. Results showed the participants felt that the Bidayuh language is important because of government agencies and non-governmental organisations looking after the customary laws, culture and language of the Bidayuh. They also felt that the presence of highly-educated Bidayuh and Bidayuh leaders in the community, as well as the Bidayuh population in Sarawak, contributed to the importance of the Bidayuh language. These could have led to perceptions of Bidayuh as a prestigious language. The participants felt that the Bidayuh language will be stronger if it is taught in school because there are currently inadequate written materials in Bidayuh. The Bidayuh language is valued as an ethnic marker but not for instrumental purposes. The Bidayuh language is not seen as a language for rural and old people, suggesting that there is room for the intergenerational transmission of the Bidayuh language to the younger generation in urban areas.
... The emotional arousal during the twochair work eases the awareness of the arguments from each voice and the dialogue between them, putting the patient in a better position to resolve his/her ambivalence. Research has suggested the effectiveness of the two-chair technique not only addresses personal conflicts (Greenberg & Webster, 1982) but also to works with other transdiagnostic processes (e.g., Shahar et al., 2012). For instance, Clarke and Greenberg (1986) developed a study with subjects who sought counseling to resolve conflictual decisions and were randomly allocated to two sessions of the two-chair work, two sessions of CBT, or no-treatment. ...
Clients may be more or less motivated at the start of psychotherapy, and participation may fluctuate at different stages of the psychotherapy process. This kind of motivation is what people usually associate with the term psychotherapy motivation. Ideally, clients are willing to work hard all through the therapeutic process and invest a lot of effort into changing their lives, behaviors, and associated experiences. This chapter reviews various motivational concepts and explains how they might become relevant in psychotherapy. To better understand motivation in the psychotherapy context, it introduces some basic motivational constructs: needs, motives, personal goals, and autonomous motivation. The chapter discusses selected empirical findings on how different aspects of a client's motivation may affect the process and outcome of psychotherapy. It addresses practical ways of detecting and addressing motivationally challenging situations in psychotherapy.
... A significant CA level is identified with a combination of maladaptive works, including anomalous measures of self-input, advancing social anxiety, depression, and self-harm. These are ordinary miracle associations and social correspondence (Shahar, Carlin, Engle, Hegde, Szepsenwol & Arkowitz, 2012). Besides, CA identified with an elevated level of opposite thinking and adverse perspectives toward self just as others (Shi et al., 2015). ...
Language Anxiety is acknowledged as an impediment in second language learning. In addressing the issue, this study aimed to explore the English language Apprehension among Education Students. This study utilized qualitative design using a phenomenological method involving one focus group discussion with 10 participants and in-depth interviews with eight informants from the College of Teacher Education at the University of Mindanao. The results of this study reveal that the apprehensions experienced by the participants are caused by being measured against a standard, being a laughingstock or a sorry spectacle, being unable to deliver the required performance, and dealing with their insecurities and self-doubt. In coping with the challenges, the participants engage in activities that provide needed exposure, reinforcement through reading and listening to exercises, and being open and positive. Also, they resort to withdrawal and disengagement. The implications of this study must be a well-established intervention program; also, students should improve their skills through constant practice and exposure to the language.
... Finally, few studies and few clients in them who reported chair and experiential work as unhelpful described the interventions as embarrassing and/or unengaging, with clients unable to tolerate the experience or unable or unwilling to engage in the imaginary intervention. These findings and the variance displayed support the existing literature across EFT and other psychotherapies which suggests that experiential and chair work is often intense for clients, with those who are able to tolerate the intensity and challenge experiencing it as productive(Bell et al., 2020;Shahar et al., 2012;Shearing et al., 2011). ...
Objective
Client experience of psychotherapy is an important resource for our understanding of psychotherapy and deserves relevant attention in psychotherapy research. Emotion‐focused therapy (EFT) is a relatively new adaptation of a humanistic therapy that has a tradition of giving a voice to the clients in therapy. Despite the number of qualitative studies looking at the experience of clients in EFT, there was no formal qualitative meta‐analysis conducted synthesizing the existing qualitative research on the clients' experience of EFT.
Method
A sample of 11 primary qualitative studies was selected through a systematic search of the literature. Primary studies were critically appraised, and data (findings) from them extracted and meta‐analysed.
Results
All 11 studies featured experiences of helpful aspects of therapy, with difficult but helpful aspects reported in seven studies and unhelpful aspects reported in six studies. Most studies reported chair and experiential work and intense emotional work in EFT as helpful, with fewer reports and fewer clients finding them difficult but helpful or unhelpful. The multidimensional nature of the therapist and therapeutic relationship in EFT included emotional connection and support, validation and understanding and was commonly experienced as helpful to clients. Other client experiences reported included practical aspects of EFT such as session length, in‐session outcomes such as clients' transformative experiences, and internal and external factors which were experienced by clients such as determination or reluctance to commit to therapy.
Conclusions
Most clients experience EFT as an intense, challenging, but productive psychotherapy, but it appears a minority of clients experience aspects of EFT as challenging.
Self-criticism is considered an important vulnerability factor for the development and maintenance of psychopathological symptoms. Mostly assessed as trait via self-report, information about its linguistic features is rare. The following study explored individual differences of self-criticism of 184 university students (84.2% female) and 45 in-patients in treatment for a depressive disorder (62.2% female). Participants verbalized self-critical thoughts after a standardized induction of negative emotions talking out load to themselves acting as their “inner critic”. Participants’ self-criticism was analyzed by conducting a linguistic analysis with a quantitative word count tool (Linguistic Inquiry and Word Count – LIWC). Self-criticism was also measured with an established self-report instrument alongside with symptoms of depression and self-compassion for validation. Non-parametric Spearman rank correlations between the linguistic features of the “inner critic”, self-reported self-criticism, self-compassion, and depressive symptoms have been conducted. Furthermore, group differences between university students and patients have been explored. In both subsamples, small significant relations between the language categories and self-reported self-criticism, self-compassion, and depressive symptoms became evident ranging from |ρ|=.13 to |ρ|=.39, with slightly different patterns in students and patients, indicating qualitative differences in clinically relevant self-criticism and non-pathogenic self-reflection. University students used significantly less pronouns than patients with depression when they acted as their “inner critic” (t = -5.14, p <.001) and used overall less negative emotion words (t = -4.19, p <.001), particularly less words indicating sadness (t = -3.18, p =.003).Using different assessment methods of self-criticism and comparing clinical and non-clinical samples add valuable information to a better understanding of the cognitive-affective processes in self-criticism and can inform clinical practice and innovative public mental health strategies on preventing mental disorders.
Bereavement-related regret addresses the experience of the "I could have" in a grief context surrounding a deceased loved one. This "I could have" notion of regret emerges from interaction of the "I can" of the past and the "I cannot" of the present. This study aimed to understand six participants' lived experiences of bereavement-related regret through a qualitative, semi- structured interview and two-chair exercise. Hermeneutic phenomenological analysis revealed key features of bereavement-related regret as: (a) tangible and sensed embodiment, (b) an active entity that requests engagement, (c) a permanent yet dynamic presence, (d) a complex network connecting to other people, memories, and feelings, and (e) a dialogical phenomenon revealed between interaction of one's present self and past self. This study demonstrates the promise of a novel method for exploring dialogical phenomena and an expansive understanding of regret as an inherently relational, dynamic invitation to attend to and express our values.
Çalışmanın amacı, üniversite öğrencilerinde aile öngörülemezliği ile yeme tutumları arasındaki ilişkide kendini eleştirinin aracılık rolünü incelemektir. Çalışmanın örneklem grubunu 2022-2023 eğitim öğretim döneminde üniversiteye devam eden 307 üniversite öğrencisi (240 kadın, 67 erkek) oluşturmuştur. Katılımcıların yaş ortalaması 26,27 (SD = 5,21) olarak belirlenmiştir. Öğrencilere kolayda örnekleme yöntemiyle ulaşılmıştır. Araştırmaya katılım gönüllülük esasına göre olup, anketler çevrimiçi olarak toplanmıştır. Çalışmada veri toplama araçları olarak Geçmişe Dönük Aile Öngörülemezliği Ölçeği, Yeme Bozukluğu Değerlendirme Ölçeği, Kendini Eleştirinin Formları ve Kendini Rahatlatma Ölçeği kullanılmıştır. Değişkenler arasındaki ilişkiler Pearson korelasyon testi ile analiz edilmiştir. Çalışma kapsamında aracılık etkilerinin değerlendirilmesi için Yapısal Eşitlik Modellemesi kullanılmıştır. Yapılan analizler sonucunda aile öngörülemezliğinin kendini eleştiri ve yeme tutumlarını pozitif olarak yordadığı belirlenmiştir. Ayrıca kendini eleştirinin de yeme tutumlarını pozitif yönde yordadığı görülmektedir. Model testi sonucunda aile öngörülemezliği ile yeme tutumları arasındaki ilişkide kendini eleştirinin kısmi aracılık etkisinin olduğu belirlenmiştir. Elde edilen bulgular ilgili alanyazın çerçevesinde tartışılmıştır.
Self-criticism, considered as a transdiagnostic concept in the emergence of various psychopathologies, is considered as negative evaluations directed towards oneself especially in perceived failure situations. In literature various views regarding self-criticism, suggesting it as a personality trait, a style of relating to oneself, a coping response to various situations, or a safety strategy developed to restrain negative experiences, exist. In this regard, various researchers have conceptualized self-criticism with different dimensions and structures, leading to the development of various measurement tools. Findings obtained from these scales indicate that self-criticism is a risk factor for psychopathology and a factor that affects individuals to experience difficult emotions and their engagement in various challenging behaviors such as perfectionism and emotional eating. For this reason, several interventions aimed at reducing individuals' levels of self-criticism have been conducted in the literature. In this study the scales developed based on different conceptualizations of self-criticism were introduced, the effects of self-criticism on individuals were presented by compiling results of studies in which the relationships between self-criticism and various variables were examined and finally the results of intervention studies based on Cognitive Therapy, Emotion-Focused Therapy, and Compassion-Focused Therapy were summarized. It is believed that providing comprehensive theoretical and empirical knowledge related to self-criticism will contribute to future studies in the field.
Introduction
Individuals diagnosed with depression frequently experience self-criticism, leading to considerable psychological distress. Despite the availability of cognitive-behavioral treatments, a notable proportion of patients indicate that they solely experience cognitive improvements, without the corresponding emotional changes, following therapy. As a result, their psychological symptoms persist. Interventions that specifically target emotional experiencing, such as the chairwork technique, are exclusively included within long-term therapeutic procedures. Hence, the objective of this study is to assess the efficacy as well as the acceptability, feasibility, and safety of a brief intervention utilizing emotion-focused chairwork to treat self-criticism in individuals diagnosed with depression.
Methods
A pre-post A-B design with two post-treatment assessments (one week- and one month post-intervention) was implemented. Seven patients received three sessions of manualized emotion focused chairwork. Symptomatic change was evaluated using the Beck Depression Inventory II (BDI-II), the emotion regulation questionnaire (SEK-27), the Forms of Self-Criticizing/Reassuring Scale (FSCRS), the Self-Compassion Scale (SCS-D), as well as the Rosenberg Self-Esteem Scale (RSES). Patient satisfaction was evaluated using a self-developed questionnaire. Safety was assessed by the Beck Suicidality Inventory (BSI).
Results
There was a significant improvement in depressive symptoms and self-compassion at both follow-up assessment time-points. Moreover, emotion regulation as well as self-esteem improved significantly. Self-criticizing decreased significantly, while self-reassuring increased. Patients were very satisfied with the intervention. Intervention safety was given at all time-points. There were no drop-outs.
Conclusion
The implemented chairwork short-intervention is a feasible and safe therapeutic technique. The treatment was highly accepted revealing significant symptomatic improvements. Large-scale randomized controlled trials (RCTs) are necessary to investigate the treatment’s effectiveness.
Penelitian ini bertujuan untuk mengembangkan sebuah buku bantuan diri sebagai referensi dalam mengurangi tingkat kritik diri pada mahasiswa. Penelitian ini menggunakan metode Penelitian berbasis Desain atau Design Based Research (DBR) yang dikembangkan oleh McKenney & Reeves. Tahapan dalam penelitian ini meliputi, analisis dan eksplorasi, desain dan konstruksi, serta evaluasi dan refleksi. Pada tahap analisis, peneliti melakukan studi pendahuluan pada 329 mahasiswa Universitas Negeri Jakarta yang meliputi Fakultas Bahasa dan Seni, Fakultas Ekonomi, Fakultas Ilmu Pendidikan, Fakultas Ilmu Olahraga, Fakultas Ilmu Sosial, Fakultas Matematika dan Ilmu Pengetahuan Alam, Fakultas Pendidikan Psikologi, dan Fakultas Teknik. Hasil rata-rata kritik diri yaitu, sebesar 38. Selanjutnya pada tahap evaluasi, produk divalidasi oleh dua validator ahli yaitu, validator ahli media dan ahli materi. Penelitian ini menghasilkan sebuah buku bantuan diri yang berjudul “Berdamai dengan Jejak Kritik Diri”. Hasil persentase kelayakan buku dari masing-masing validator yaitu, validator ahli media menilai sebesar 75% (Layak) dan validator ahli materi menilai sebesar 95% (Sangat Layak). Kesimpulan dari penelitian ini yaitu, buku bantuan diri ini dapat dikategorikan Sangat Layak dengan rata-rata persentase sebesar 85%. Diharapkan buku bantuan diri untuk mengurangi tingkat kritik diri dapat diujicoba sehingga semakin efektif saat digunakan.
Introduction
When it comes to the non-verbal communication of emotions, it is apparent that the human voice is one of the main ways of expressing emotion and is increasingly important in psychotherapeutic dialog. There is ample research focusing on the vocal expression of emotions. However, to date the analysis of the vocal quality of clients’ in-sessional emotional experience remains largely unexplored. Moreover, there is generally a gap within the psychotherapy literature in the understanding of the vocal character of self-compassion, self-criticism, and protective anger.
Methods
In this study we investigated how clients vocally convey self-compassion, self-protection and self-criticism in Emotion Focused therapy sessions. For this purpose we investigated 12 commercially available Emotion Focused Therapy videos that employed a two chair or empty chair dialog. Praat software was used for the acoustic analysis of the most common features – pitch (known as fundamental frequency or F0) and intensity (voice amplitude, i.e., loudness).
Results
Results showed that intensity was significantly higher for self-criticism and self-protection than for self-compassion. Regarding pitch the findings showed no significant differences between the three states.
Discussion
More research analyzing acoustic features in a larger number of cases is required to obtain a deeper understanding of clients’ vocal expression of self-compassion, self-protection and self-criticism in Emotion Focused Therapy.
Background: Ample studies have focused on the negative consequences of COVID-19 on mental well-being, but fewer have explored the specific role of childhood abuse and neglect in the context of risk and resilience during this unprecedented crisis. Objective: We aimed to identify distinct profiles of individuals based on their experiences of childhood abuse and neglect, coping strategies, and psycho-social transdiagnostic risk and protective factors, using a person-centered approach. Participants and Setting: A convenience sample of 914 Israelis completed self-report questionnaires during the second wave of COVID-19. Methods: Latent Profile Analysis was employed based on levels of childhood abuse and neglect, coping strategies, and established factors underpinning risk and resilience in mental health: dissociation, self-criticism, self-efficacy, self-compassion, attachment insecurity, psychological resilience, mentalizing, distress disclosure, psychopathology, and relationship satisfaction. Profiles were compared in COVID-19-related distress and well-being using ANOVAs. Results: A four-profile solution was found to be optimal for describing individuals with different profiles of risk and resilience: “risk” (5.1%)–individuals with meaningfully high levels of childhood abuse and neglect and dissociation; “vulnerable” (14.2%)–individuals high in risk factors and low in protective factors; “moderately resilient” (47.6%)–those with moderate levels of protective and risk factors; “highly resilient” (33.1%)–individuals high in protective factors and low in risk factors; groups differed in mental well-being and COVID-19-related distress. Conclusions: Results highlight the importance of childhood abuse and neglect in differentiating between the two distinct profiles of at-risk individuals. Implications for risk assessment and treatment in the context of potential traumatic stress are discussed.
Summary:
Perfectionism and self-critical tendencies increase the risk of developing depression. Selfcriticism is a way to avoid maladaptive shame and fear for rejection, which originates from unfulfilled emotional needs in relation to important care takers. In psychotherapy, this shame can be transformed by bringing the client in contact with alternative, healthy feelings of pride, self-compassion or assertive anger. Based on a case study, this article discusses how selfcompassion can be cultivated in Emotion-focused therapy, for example by being creative in using the compassionate self-soothing task.
Keywords: self-criticism, perfectionism, self-compassion, self-soothing, emotion-focused therapy
As demonstrated by the chapters in this Handbook, self-compassion is associated with myriad benefits for mental health and psychological well-being. The beneficial impact of self-compassion is perhaps even more evident in psychotherapy, where self-compassion has long held a role under the umbrella of “self-acceptance.” Drawing primarily on compassion-focused therapy and the mindful self-compassion program, this chapter provides guidance on how to integrate self-compassion into psychotherapy and provides and overview of the evidence connecting self-compassion with therapeutic processes and outcomes.The chapter begins by locating self-compassion in the context of psychotherapy, past and present. Next, we outline the evidence for self-compassion as a transdiagnostic and transtheoretical mechanism of action in therapy. The majority of this chapter describes three levels by which self-compassion can be integrated into psychotherapy—compassionate presence, compassionate relationship, and compassionate interventions—along with supporting research. When all three levels are part of treatment, it can be considered fully self-compassion based. Finally, we explore emotion regulation as the basic mechanism by which self-compassion works in psychotherapy, along with underlying neurophysiological and psychological processes, especially the cultivation of secure attachment and the alleviation of shame.KeywordsSelf-compassionPsychotherapyTherapeutic relationshipTherapeutic allianceEmotion regulation
We review recent research on humanistic-experiential psychotherapies (HEPs), which include person-centered therapy (PCT), emotion-focused therapy (EFT), gestalt, and psychodrama approaches, along with generic relationship control conditions characterized as supportive or nondirective. A key part of this review is a meta-analysis of 91 studies of the effectiveness/efficacy of HEPs, published between 2009 and 2018, which produced the following results: (1) HEPs were associated with large pre-post client change (d = .86). (2) In controlled studies, clients in HEPs generally showed large gains relative to clients who received no therapy (.88). (3) In comparative outcome studies, HEPs in general were statistically and clinically equivalent in effectiveness to other therapies (-.08). (4) Overall, CBT appeared to have an equivocal advantage over HEPs (-.26). However, these studies were overwhelmingly delivered by CBT researchers in largely non-bona fide versions of HEPs as comparison conditions. Overall, the strongest results were found for EFT, followed by PCT; generic supportive-nondirective approaches were least effective, especially when compared to CBT. HEPs appeared to be most effective with relationship/interpersonal difficulties, self-damaging activities, coping with chronic medical conditions, and psychosis. Findings were more mixed for depression and anxiety. In addition, we offer an updated meta-synthesis of the qualitative outcomes of these therapies, which fell into three main categories: appreciating experiences of self; appreciating experience of self in relationship to others; and changed view of self/others. We also provide narrative reviews of recent qualitative research on helpful and unhelpful factors in HEPs, along with quantitative process-outcome research on HEPs including process-outcome research and work on mediating processes. In an integrative summary we identify a core set of interwoven client change processes involving emotional expression, deepening and transformation, the emergence of new client narratives, and the assimilation of problematic experiences. We conclude with a set of recommendations for research, practice and mental health guideline development. Humanistic-Experiential Psychotherapies Update, p. 2 Content Outline
Patients in the National Institute of Mental Health Treatment of Depression Collaborative Research Program (TDCRP) were administered at intake with the Dysfunctional Attitude Scale (DAS; A. N. Weissman & A. T. Beck, 1978). Factor analyses of the DAS in the TDCRP data as well as in several independent samples reveal two primary factors: an interpersonal factor, Need for Approval, and a self-critical factor, Perfectionism. This study explored the hypotheses that these factors, assessed prior to treatment, would have differential interactions with the two forms of psychotherapy evaluated in the TDCRP as well as differential relationships to various outcome measures (depression, clinical functioning, and social adjustment). DAS Perfectionism had consistently significant negative relationships with all the outcome measures in all four treatment conditions. Contrary to expectations, however, there were no significant interactions between the two DAS factors and the four types of brief treatment (cognitive–behavioral therapy, interpersonal therapy, imipramine, and placebo).
Investigated depression as a normal affect state that could have continuity with types of clinical depression. A 66-item Depressive Experiences Questionnaire (DEQ) was constructed to assess a wide range of experiences that, though not direct symptoms of depression, are frequently associated with it. The DEQ, the Wessman-Ricks Mood Scale, a version of the semantic differential, and the Death-Concern Questionnaire were administered to 500 female and 160 male college students. In another sample, 128 college students were given the DEQ and the Zung Self-Rating Depression Scale. Three highly stable factors emerged from the DEQ: Dependency, Self-Criticism, and Efficacy. These factors had significant differential correlations with other measures, which support the interpretation of the factors derived from the items. These data indicate the need to consider dependency and self-criticism as 2 primary dimensions of depression and the value of investigating the continuity between normal mood states and the clinical phenomena of depressions. (38 ref)
The literature is replete with evidence that the stress inherent in health care negatively impacts health care professionals, leading to increased depression, decreased job satisfaction, and psychological distress. In an attempt to address this, the current study examined the effects of a short-term stress management program, mindfulness-based stress reduction (MBSR), on health care professionals. Results from this prospective randomized controlled pilot study suggest that an 8-week MBSR intervention may be effective for reducing stress and increasing quality of life and self-compassion in health care professionals. Implications for future research and practice are discussed.
When things go wrong for people, those who are self-critical, compared to those who self-reassure, are at increased risk of psychopathology. However, little is known of the internal processes involved in self-criticism and self-reassurance, such as the ease of eliciting critical imagery, and the power, emotion and vividness of self-criticalness and self-reassurance. This study used a self-imagery task to investigate trait self-criticism and trait self-reassurance in relation to the ease and clarity of generating self-critical and self-reassuring images, and the felt power and emotion of self-critical and self-reassuring imagery. We also explored these in relation to depressive symptoms in students. Results suggested that trait self-criticism is associated with ease and clarity in generating hostile and powerful self-critical images, while trait self-reassurance is associated with ease and clarity of generating warm and supportive images of the self. Data analysis using structural equation models also suggests that difficulties in generating self-reassurance and compassionate images about the self with self-directed warmth, may also contribute to depressive symptoms. Thus self-critics may not only suffer for elevated negative feelings about the self but may also struggle to be able to generate self-supportive images and feelings for the self, and these difficulties could be a focus of therapeutic interventions.
This study examined the role of intensive mindfulness training on changes in day-to-day experiential processing, psychological symptoms, resilience, and well-being in two groups of community adults (N = 69). Using both quasi-experimental and longitudinal methods, the study found that intensive training, operationalized as 10–12 hours of formal mindfulness practice per day for 1 month, was significantly related to increases in training-specific experiential processing capacities, namely trait mindfulness and decentering (reperceiving), in comparison to pre–post-training wait-list controls. In both training groups combined, mindfulness, decentering, and acceptance increased over the pre-training to 1-month follow-up period. Intensive mindfulness training was also related to declines in anxiety and enhanced both subjective well-being and self-compassion from pre-training to follow-up in the two training groups. Finally, increases in trait mindfulness and acceptance were related to improvements in psychological symptoms, well-being, and resilience. Future directions for this novel area of mindfulness research are discussed.
Presents an intensive analysis of 9 events in which 3 clients were working on resolving "splits" by means of the Gestalt "2 chair method." These events had previously been shown to contain good therapeutic process as measured by the Experiencing Scale, and the purpose of this analysis was to discover performance patterns associated with resolution. A model of "split" resolution, constructed from Voice Quality and Depth of Experiencing data (indices of productive therapeutic process), shows that resolution occurs by integration. The softening of the internal critic emerges as a key factor in resolving intrapsychic splits. (16 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
31 clients (aged 17–65 yrs) completed a 6-wk program using Gestalt 2-chair dialog to work on intrapsychic conflict related to the making of a decision. Ss were classified as resolvers or nonresolvers based on a pattern of in-session process indicators. Resolvers were those Ss who had manifested 3 components of a proposed model of conflict resolution: the expression of criticism by one part of the personality, the expression of feeling and wants by another, and the softening in attitude of the "critic." These attributes were measured in terms of voice quality, depth of experience, and structural analysis of social behavior. Resolvers were significantly less undecided and less anxious after treatment and reported greater improvement on target complaints and behavior change. In addition, after the session in which the "critic" softened, resolvers reported greater conflict resolution, less discomfort, greater mood change, and greater goal attainment than nonresolvers. (36 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Compared 14 Gestalt 2-chair dialog conflict resolution performances with 14 nonresolution performances on structural analysis of social behavior, depth of experiencing, and voice quality. These performances were used to test a proposed 3-stage sequential model of conflict resolution. 28 21–52 yr old clients in therapy were assessed with a battery of tests that included the Experiencing Scale and Structural Analysis of Social Behavior Scale. The pattern of results within the resolution group supported the 3 phase model of conflict resolution. It was found that the degree of affiliation in the previously harsh critic in the dialog clearly distinguished resolvers from nonresolvers. In addition, in all the resolution performances, the 2 sides of the conflict appeared to first go through a stage of opposition and then entered a merging phase, in which the critic softened its attitude as measured by degree of affiliation, voice, and depth of experiencing. The final integration phase, in which the 2 chairs become more autonomous and affiliative and engage in a negotiation, marked the resolution of the conflict. An example of a dialog is provided to indicate some of the processes discussed. (21 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Preparation for the role of therapist can occur on both professional and personal levels. Research has found that therapists are at risk for occupationally related psychological problems. It follows that self-care may be a useful complement to the professional training of future therapists. The present study examined the effects of one approach to self-care, Mindfulness-Based Stress Reduction (MBSR), for therapists in training. Using a prospective, cohort-controlled design, the study found participants in the MBSR program reported significant declines in stress, negative affect, rumination, state and trait anxiety, and significant increases in positive affect and self-compassion. Further, MBSR participation was associated with increases in mindfulness, and this enhancement was related to several of the beneficial effects of MBSR participation. Discussion highlights the potential for future research addressing the mental health needs of therapists and therapist trainees. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Discusses the therapeutic use of the 2-chair operation in treating a split, which is a verbal performance pattern in which a client reports a division between 2 aspects of self. The distinctive features of 3 types of splits, conflict, subject/object, and attribution, are described to aid process diagnosis. Each split is characterized by the nature of the 2 parts, relationship between the parts, and the client's subjective experience of the split. Five principles of the Gestalt method for resolving splits—separation and contact, responsibility, attending, heightening, and expressing—are presented. The nature of the client process in each chair in the dialog is described in terms of depth of experiencing and voice quality. (15 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
As we shall see, the powerful theoretical models and research techniques that make up the social-cognitive perspective can be, and have been, fruitfully applied to the study of interpersonal experience. People have relational schemas--or cognitive structures representing patterns of interpersonal relatedness--for such common interpersonal experiences as "being criticized by an authority figure" or "being unconditionally accepted by a romantic partner," as well as for specific relational patterns in specific relationships. These self-with-other schemas serve as filters on interpersonal experience by guiding attention to relevant information, influencing the perception and interpretation of ambiguous information, providing default values to allow people to fill in the blanks of partial information, serving as organizing frameworks for the encoding and later memory of interactions, and so on. In this chapter we begin with a brief examination of some of the theoretical foundations of our perspective, present the assumptions of our model, and review almost two decades of research into the basic workings of relational schemas. Then we turn to our most recent research, in which we have examined the possibility of modifying relational knowledge structures. We have come to believe that the next step for the social cognitive perspective is to embrace the insights of learning theory, which from its earliest days has been focused on the processes of change in the acquisition and modification of behavior and cognition. We describe our recent efforts to apply basic learning principles, such as classical conditioning, to the issue of changing relational cognition. We have examined these questions primarily in the context of the cognitive structures underlying experiences of security and insecurity, with the goal of identifying means of decreasing the influence of insecurity-producing cognitive processes and increasing the influence of security-producing processes. Before addressing these issues of schema change, though, we begin with a review of some basic theory and research about relational schemas. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The premise of this paper is that multivocality (multiple internal voicedness) is an essential part of being human and should be regarded as a therapeutic resource, to be nurtured and valued. Consistent with this view, the authors argue that therapists can benefit their clients by helping them to discover and use the variety and conflict that exists within them. In particular, when clients present conflicts or other contrasts between internal self-aspects or voices, therapists can help them enter into a variety of constructive "dialogues" with each other. Moving to the application of this view to practice, the authors discuss one particular therapeutic task in greater detail and three others to a lesser extent, providing the basis for a general model of the resolution of therapeutic tasks involving contrasting self aspects or voices. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Self-critical individuals are more likely to become and remain depressed (Blatt, Experiences of depression: Theoretical, research and clinical perspectives, American Psychological Association Press, Washington, DC, 2004). This vulnerability to depression may reflect the association
of trait self-criticism with difficulties self-soothing and resisting self-attacks. The current study tested the impact of
two self-help interventions designed to reduce depression by improving these two intrapersonal deficits. The first was designed
to foster compassionate self-relating whereas the second was designed to foster resilient self-relating. Seventy-five distressed
acne sufferers were assigned to one of three conditions: a self-soothing intervention, an attack-resisting intervention, or
a control condition. The interventions consisted of daily imagery-based self-talk exercises inspired by Gilbert’s (Genes on the couch: Explorations in evolutionary psychotherapy, Brenner-Routledge, Hove, 2000) social mentatlities theory and compassionate mind training (Gilbert and Irons, Compassion: Conceptualisations, research and use in psychotherapy, Brunner-Routledge, London, 2005). In two weeks, the self-soothing intervention lowered shame and skin complaints. The attack-resisting
intervention lowered depression, shame, and skin complaints, and was especially effective at lowering depression for self-critics.
Implications for the treatment of self-criticism and depression are discussed.
The current study aimed to assess the role of self-criticism and dependency in response to cognitive therapy (CT) or pharmacotherapy (PT). It was hypothesized that (a) self-criticism would moderate treatment outcome to CT and PT, and (b) the degree of change in self-criticism and the relationship of this change to treatment response would be greater for patients treated with CT than for patients treated with PT. A sample of outpatients with unipolar major depression received either CT (n = 51) or PT (n = 58). Neither pretreatment self-criticism and dependency scores nor self-criticism and dependency change scores were found to predict response to PT. Treatment response to CT, however, was associated with pretreatment self-criticism scores and pre- and post-self-criticism change scores. Although highly self-critical patients were more likely to have a poor response to CT, the degree to which self-criticism was successfully reduced in treatment was shown to be the best predictor of treatment response to CT.
Two studies are presented to examine the relation of self-compassion to psychological health. Self-compassion entails being kind and understanding toward oneself in instances of pain or failure rather than being harshly self-critical; perceiving one’s experiences as part of the larger human experience rather than seeing them as isolating; and holding painful thoughts and feelings in mindful awareness rather than over-identifying with them. Study 1 found that self-compassion (unlike self-esteem) helps buffer against anxiety when faced with an ego-threat in a laboratory setting. Self-compassion was also linked to connected versus separate language use when writing about weaknesses. Study 2 found that increases in self-compassion occurring over a one-month interval were associated with increased psychological well-being, and that therapist ratings of self-compassion were significantly correlated with self-reports of self-compassion. Self-compassion is a potentially important, measurable quality that offers a conceptual alternative to Western, more egocentric concepts of self-related processes and feelings.
The development of a 21-item self-report inventory for measuring the severity of anxiety in psychiatric populations is described. The initial item pool of 86 items was drawn from three preexisting scales: the Anxiety Checklist, the Physician’s Desk Reference Checklist, and the Situational Anxiety Checklist. A series of analyses was used to reduce the item pool. The resulting Beck Anxiety Inventory (BAI) is a 21-item scale that showed high internal consistency (α = .92) and test—retest reliability over 1 week, r (81) = .75. The BAI discriminated anxious diagnostic groups (panic disorder, generalized anxiety disorder, etc.) from nonanxious diagnostic groups (major depression, dysthymic disorder, etc). In addition, the BAI was moderately correlated with the revised Hamilton Anxiety Rating Scale, r (150) = .51, and was only mildly correlated with the revised Hamilton Depression Rating Scale, r (153) = .25.
Abstract The relationship between theme-related depth of experiencing (EXP) and outcome was explored in experiential therapy with depressed clients. The study sought to investigate whether depth of EXP predicts outcome, whether change in depth of EXP over therapy predicts outcome, and how these factors compare with the therapeutic alliance as predictors of outcome. The sample consisted of 35 clients, each of whom received 16 to 20 weeks of therapy. Themes that had emerged across therapy were identified. Depth of EXP was measured in relation to themes in one early session and in three sessions sampled from blocks across the last half of therapy. Analyses revealed that EXP on core themes in the last half of therapy was a significant predictor of reduced symptom distress and increased self-esteem. EXP did not correlate significantly with changes on the Inventory of Interpersonal Problems. EXP on core themes also accounted for outcome variance over and above that accounted for by early EXP and alliance.
The aim of the study was to evaluate the effectiveness of a recovery group intervention based on compassionate mind training, for individuals with psychosis. In particular, the objective was to improve depression, to develop compassion towards self, and to promote help seeking.
A within-subjects design was used. Participants were assessed at the start of group, mid-group (5 weeks), the end of the programme and at 6 week follow-up. Three group programmes were run over the course of a year. Nineteen participants commenced the intervention and 18 completed the programme.
Significant improvements were found on the Social Comparison Scale; the Beck Depression Inventory; Other As Shamer Scale; the Rosenberg Self-Esteem Inventory and the General Psychopathology Scale from the Positive and Negative Syndrome Scale.
The results provide initial indications of the effectiveness of a group intervention based on the principles of compassionate focused therapy for this population. The findings of this study, alongside implications of further research are discussed.
In this study, 34 clients with unresolved feelings related to a significant other were randomly assigned to either experiential therapy using a Gestalt empty-chair dialogue intervention or an attention-placebo condition. The latter was a psychoeducational group offering information about "unfinished business." Treatment outcomes were evaluated before and after the treatment period in each condition and at 4 months and 1 year after the experiential therapy. Outcome instruments targeted general symptomotology, interpersonal distress, target complaints, unfinished business resolution, and perceptions of self and other in the unfinished business relationship. Results indicated that experiential therapy achieved clinically meaningful gains for most clients and significantly greater improvement than the psychoeducational group on all outcome measures. Treatment gains for the experiential therapy group were maintained at follow-up.
Patients in the National Institute of Mental Health Treatment of Depression Collaborative Research Program (TDCRP) were administered at intake with the Dysfunctional Attitude Scale (DAS; A. N. Weissman & A. T. Beck, 1978). Factor analyses of the DAS in the TDCRP data as well as in several independent samples reveal two primary factors: an interpersonal factor, Need for Approval, and a self-critical factor, Perfectionism. This study explored the hypotheses that these factors, assessed prior to treatment, would have differential interactions with the two forms of psychotherapy evaluated in the TDCRP as well as differential relationships to various outcome measures (depression, clinical functioning, and social adjustment). DAS Perfectionism had consistently significant negative relationships with all the outcome measures in all four treatment conditions. Contrary to expectations, however, there were no significant interactions between the two DAS factors and the four types of brief treatment (cognitive-behavioral therapy, interpersonal therapy, imipramine, and placebo).
The steps of a task-analytic research program designed to identify the in-session performances involved in resolving lingering bad feelings toward a significant other are described. A rational-empirical methodology of repeatedly cycling between rational conjecture and empirical observations is demonstrated as a method of developing an intervention manual and the components of client processes of resolution. A refined model of the change process developed by these procedures is validated by comparing 11 successful and 11 unsuccessful performances. Four performance components-intense expression of feeling, expression of need, shift in representation of other, and self-validation or understanding of the other-were found to discriminate between resolution and nonresolution performances. These components were measured on 4 process measures: the Structural Analysis of Social Behavior, the Experiencing Scale, the Client's Emotional Arousal Scale, and a need scale.
This study related the process of the resolution of unfinished business with a significant other to therapeutic outcome in a population of 26 clients who suffered from various forms of interpersonal problems and childhood maltreatment. Clients were treated in emotion-focused, experiential therapy with gestalt empty-chair dialogues. Those clients who expressed previously unmet interpersonal needs to the significant other, and manifested a shift in their view of the other, had significantly better treatment outcomes. The presence of the specific process of resolution in the clients' empty-chair dialogues was also found to be a better predictor of outcome than the working alliance. Degree of emotional arousal was found to discriminate between resolvers and nonresolvers.
This article defines the construct of self-compassion and describes the development of the Self-Compassion Scale. Self-compassion entails being kind and understanding toward oneself in instances of pain or failure rather than being harshly self-critical; perceiving one's experiences as part of the larger human experience rather than seeing them as isolating; and holding painful thoughts and feelings in mindful awareness rather than over-identifying with them. Evidence for the validity and reliability of the scale is presented in a series of studies. Results indicate that self-compassion is significantly correlated with positive mental health outcomes such as less depression and anxiety and greater life satisfaction. Evidence is also provided for the discriminant validity of the scale, including with regard to self-esteem measures.
Depression may be the most common serious illness seen by primary care physicians and mental health clinicians today. Depression is a major public health problem, still increasing in incidence. Depression in-curs both direct (public health money) as well as in-direct (e.g., time lost from work) costs totaling billions of dollars per year. The cost in human an-guish is immeasurable. Roughly 15% of patients with a major depressive disorder eventually commit sui-cide, resulting in many deaths every year. Appropri-ate treatments could help the majority of those with severe depression, but unfortunately, not everyone with depression seeks help. Without treatment, symptoms can last weeks, months, years, or even a lifetime. In our depressogenic era, mental health practitioners can turn to Sidney J. Blatt's stimulating expertise to facilitate their clinical efforts. Blatt, one of the leading psychoanalytic research-ers of our time, has written a lucid guide for clini-cians interested in understanding depression and improving their therapeutic treatment of it. Blatt elu-cidates the psychological and interpersonal worlds and the life experiences that contribute to the spe-cific nature of depressive experiences. Experiences of Depression efficiently leads the reader, via a con-structive dialectic integration of theory, research, and therapeutic implications, to an understanding of Blatt's integration of his theory concepts with thera-peutic practice and therapeutic changes. In Experiences of Depression, Blatt unites nearly thirty years of distinguished psychiatric practice and research, during which he has written prolifically. In-tegrating psychoanalytic ego psychology with devel-opmental-cognitive theory, Blatt proposed a model that characterizes personality development as a dialectical interweaving between development of in-terpersonal relatedness (the capacity to establish in-creasingly mature, reciprocal, and satisfying interpersonal relationships) and self-definition (the development of a realistic, essentially positive, and increasingly integrated self-definition and self-iden-tity). An adequate balance between the develop-ments of these two capabilities contributes to an evolving identity and self-sufficiency that in turn fa-cilitates the establishment of stable interpersonal re-lationships. However, excessive emphasis on only one of these dimensions has been found to predis-pose individuals to depression. Beginning with case studies of two depressed patients in long-term treat-ment, the book demonstrates the value of consider-ing the psychological dimensions of depression. Blatt identifies two types of depression that, despite a common set of symptoms, have distinct roots. Over-emphasis on the relatedness dimension is character-ized by excessive preoccupation with the availability of love, nurturance, and support, a heightened need for closeness and interpersonal support, and vulner-ability to feelings of interpersonal loss. Blatt termed this type of depression anaclitic depression. Exagger-ated stress on self-definition is associated with harsh standards, heightened strivings for mastery and achievement, a marked need for acknowledgment, and vulnerability to feelings of failure. Blatt termed this type of depression introjective depression. Blatt argues that recognizing these fundamen-tally different depressive experiences has important clinical implications. According to Blatt, an individ-ual's self-definition and relatedness capabilities de-velop primarily in the context of early interpersonal relationships. Therefore, the core aim of Blatt's sug-gestions for treatment goals is to enable patients to appreciate and understand, as fully as possible, how their early interpersonal experiences contribute to impairment in their capacities to develop satisfac-tory interpersonal relations and a realistic and affec-tive sense of self, as well as the multiple ways in
In
Emotion-Focused Therapy for Depression, Leslie S. Greenberg and Jeanne C. Watson provide a manual for the emotion-focused therapy (EFT) of depression. Their approach is supported by studies in which EFT for depression was compared with cognitive-behavioral therapy and client-centered therapy. The approach has been refined to apply specifically to the treatment of this pervasive and often intractable disorder. The authors discuss the nature of depression and its treatment, examine the role of emotion, present a schematic model of depression and an overview of the course of treatment, and suggest who might benefit. Written with a practical focus rather than the more academic theoretical style of previous books that established the theoretical grounds and scientific viability of working with emotion in psychotherapy, this book aims to introduce practitioners to the idea of using this approach to work with a depressed population. The book covers theory, case formulation, treatment, and research in a way that makes this complex form of therapy accessible to all readers. Particularly valuable are the case examples, which demonstrate the deliberate and skillful use of techniques to leverage emotional awareness and thus bring about change. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
This chapter describes and evaluates the Beck Anxiety Inventory (BAI), a 21-item self-report instrument for measuring the severity of anxiety in adolescents and adults. A summary of the research investigating the reliability, internal consistency, test-retest reliability, content validity, construct and convergent validity, discriminant validity, and factorial validity is offered. Sex, age, ethnic, and diagnostic effects of the BAI are also presented. The chapter concludes with applications, benefits and limitations of the BAI. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Compassionate mind training (CMT) was developed for people with high shame and self-criticism, whose problems tend to be chronic, and who find self-warmth and self-acceptance difficult and/or frightening. This paper offers a short overview of the role of shame and self-criticism in psychological difficulties, the importance of considering different types of affect system (activating versus soothing) and the theory and therapy process of CMT. The paper explores patient acceptability, understanding, abilities to utilize and practice compassion focused processes and the effectiveness of CMT from an uncontrolled trial. Six patients attending a cognitive–behavioural-based day centre for chronic difficulties completed 12 two-hour sessions in compassionate mind training. They were advised that this was part of a research programme to look at the process and effectiveness of CMT and to become active collaborators, advising the researchers on what was helpful and what was not. Results showed significant reductions in depression, anxiety, self-criticism, shame, inferiority and submissive behaviour. There was also a significant increase in the participants' ability to be self-soothing and focus on feelings of warmth and reassurance for the self. Compassionate mind training may be a useful addition for some patients with chronic difficulties, especially those from traumatic backgrounds, who may lack a sense of inner warmth or abilities to be self-soothing. Copyright © 2006 John Wiley & Sons, Ltd.
This study investigated the possibility that inducing a state of self-compassion would attenuate the tendency for restrained eaters to overeat after eating an unhealthy food preload (the disinhibition effect). College women completed measures of two components of rigid restrained eating: restrictive eating (desire and effort to avoid eating unhealthy foods) and eating guilt (tendency to feel guilty after eating unhealthily). Then, participants were asked either to eat an unhealthy food preload or not and were induced to think self-compassionately about their eating or given no intervening treatment. Results showed that the self-compassion induction reduced distress and attenuated eating following the preload among highly restrictive eaters. The findings highlight the importance of specific individual differences in restrained eating and suggest benefits of self-compassionate eating attitudes.
This study explores the relationship between dimensions of perfectionism, forms and functions of self-criticism/reassurance, and how people attribute blame for external criticism. Previous research has linked perfectionism dimensions with self-criticism, but not investigated the different forms and functions of self-criticism. One hundred and twenty six participants took part in this study. Socially prescribed perfectionism was significantly correlated with all self-critical variables and depression. Other-oriented and self-oriented perfectionism were only associated with the self-correcting function of self-criticism. Blaming self for being criticised by others was associated with all forms and functions of self-criticism/reassurance and socially prescribed perfectionism. In contrast, blaming others for being criticised was negatively associated with the various forms and functions of self-criticism and socially prescribed perfectionism. When self-criticism was entered into a multiple regression the link between perfectionism and depression disappeared. Also when self-criticism is excluded, self-blame for being criticised becomes a predictor of depression but perfectionism does not. This study suggests that it may be self-critical elements associated with forms of perfectionism, and how individuals react to being criticised that is key to depressive symptoms.
This paper reviews recent research that indicates the importance of differentiating subtypes of depression based on two types of experiences that lead individuals to become depressed: (a) disruptions of interpersonal relations and (b) threats to self-integrity and self-esteem. We review research with clinical and nonclinical samples that investigated the relationships of these distinctions to the quality of current interpersonal relationships and to differential sensitivity to various types of stressful life events, as well as to aspects of early life experiences, especially the quality of the parent-child relationship. We also evaluate research evidence that considers the role of these two dimensions in clinical depression. In addition to proposing an etiologic model about aspects of the onset and recurrence of depression based on the interaction between personality predispositions and types of stressful life events, we place these observations about depression in a broad theoretical context of contemporary personality theory which defines two primary dimensions of personality development and psychopathology.
A sample of college students was selected as high or low in self-criticism using the Depressive Experiences Questionnaire. These students were videotaped criticizing themselves and responding to the criticism after an imagination exercise which recalled an experience of failure. Observer codings of emotion showed that Self-Critics displayed more contempt and disgust for the self in their self-criticism than did Controls. Observer codings also revealed that Self-Critics were less self-resilient than Controls in response to the criticism: They were less assertive, more submissive and more sad and ashamed than Controls. These results support the importance of emotion as well as negative cognition in the genesis of depressive states, particularly the emotions of contempt and disgust for the self. Furthermore, these findings suggest the need for a model of depressive vulnerability which more adequately accounts for emotional processes and which can account for self-resilience in the generation of vulnerable or invulnerable self-states.
An emotion‐focused approach to the treatment of eating disorders and to case formulation is described in an individual with anorexia nervosa (AN). The basic theory of emotion‐focused therapy (EFT), the steps of case formulation and an outline of the tasks and course of treatment of an individual recently hospitalized on an inpatient unit for eating disorders highlight key aspects of the approach. The transformation in this individual, in terms of gaining access to her internal experience, understanding and tolerating her emotions, and working through her core themes of insecure attachment and worthlessness, is described. Weight and scores on self‐report measures at the outset of treatment and at 18 months are provided. Copyright © 2009 John Wiley & Sons, Ltd.
Key Practitioner Message: Guidelines for treating eating disorders are tenuous and new approaches showing promise must be developed.
Emotion‐focused therapy (EFT) shows promise in the treatment of eating disorders.
Description of the case shows the application of EFT to anorexia nervosa and illustrates the change in the individual in terms of recognizing and coping with emotional experience.
Studies on suicide have often been inadequate in the sense of failing to understand or conceptualize the dynamics of suicidal behavior from a comprehensive theoretical basis. The aim of the present study was therefore to examine Blatt's theory of Dependent and Self-critical personality dimensions (Blatt, 1974, Blatt & Shichman, 1983) in the context of actual suicidal behavior, and also to utilize these dimensions to facilitate our understanding of suicidal action. Ninety-six undergraduate students who had attempted suicide in the past were administered a series of measures related to suicidal behavior, involving impulsivity, intent, and lethality. Participants were also identified as Dependent or Self-critical in their basic personality orientation. Dependents and Self-critics engaged in contrasting suicidal behaviors along several parameters, with Self-critical individuals generally posing greater risk. These differences were congruent with Blatt's theoretical framework. Implications for suicide risk assessment, management, and treatment are discussed, with special reference to the importance of identifying distinctive suicidal subgroups identified by Dependent and Self-critical personality dimensions.
This paper presents a series of case studies to explore the understanding, acceptance and value of compassionate mind training (CMT) with psychotic voice hearers. We were interested in the degree to which such people are able to access and feel the positive emotions of 'warmth' and 'contentment' to become more self-compassionate. We also explored how CMT affected participants' hostile voices, their levels of anxiety, depression, paranoia and self-criticism. Participants were invited to offer suggestions for tailoring this approach for voice hearers. Results showed decreases for all participants in depression, psychoticism, anxiety, paranoia, Obsessive-Compulsive Disorder and interpersonal sensitivity. All participants' auditory hallucinations became less malevolent, less persecuting and more reassuring.
Investigated depression as a normal affect state that could have continuity with types of clinical depression. A 66-item Depressive Experiences Questionnaire (DEQ) was constructed to assess a wide range of experiences that, though not direct symptoms of depression, are frequently associated with it. The DEQ, the Wessman-Ricks Mood Scale, a version of the semantic differential, and the Death-Concern Questionnaire were administered to 500 female and 160 male college students. In another sample, 128 college students were given the DEQ and the Zung Self-Rating Depression Scale. Three highly stable factors emerged from the DEQ: Dependency, Self-Criticism, and Efficacy. These factors had significant differential correlations with other measures, which support the interpretation of the factors derived from the items. These data indicate the need to consider dependency and self-criticism as 2 primary dimensions of depression and the value of investigating the continuity between normal mood states and the clinical phenomena of depressions. (38 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The authors' goal was to test empirically a commonly held assumption that the depression in borderline personality disorder is primarily anaclitic.
The Depressive Experiences Questionnaire and the Hamilton Rating Scale for Depression were administered to 26 patients with borderline personality disorder (16 of whom were depressed) and 12 depressed patients without borderline personality disorder.
Patients with borderline personality disorder showed more self-criticism but did not endorse more anaclitic items than depressed patients without borderline personality disorder.
These findings suggest that self-criticism is an underemphasized characteristic of depression in borderline personality disorder.
This study further examined the diagnostic specificity of the self-critical personality dimension, as measured by the Depressive Experiences Questionnaire (DEQ; Blatt et al., 1976. The Depressive Experiences Questionnaire. Yale University Press, New Haven).
Patients with major depression (n=26) were compared to social phobia patients (n=32).
Depressed patients scored significantly higher on the DEQ Self-Criticism dimension. However, when current level of depressed mood was controlled for, self-criticism was not a significant predictor of diagnostic status. Further, the level of DEQ self-criticism reported by patients with social phobia was almost three times greater than the level reported in an earlier diagnostic specificity study with panic disorder patients [Bagby et al., 1992. Diagnostic specificity of the dependent and self-critical personality dimensions in major depression. J. Affect. Disord. 26, 59-64].
Only one measure of self-criticism was used in this study, and the research design was cross-sectional rather than prospective.
Self-criticism is not unique to major depression, and this personality dimension may be implicated in other forms of psychopathology [Blatt, 1991. A cognitive morphology of psychopathology. J. Nerv. Ment. Dis. 179, 449-458]. Some cognitive features believed to play an important role in depression may also be salient in persons with social phobia.
Broad and specific psychological traits may uniquely differentiate trauma victims with PTSD from trauma victims without PTSD, but there is a need for representative, population-based research. We investigated elevated neuroticism and self-criticism in association with the presence versus absence of PTSD in a nationally representative sample of adults who experienced a traumatic stressor. Respondents were from the National Comorbidity Survey Part II (N=5877) (). Individuals who experienced one or more traumatic events were selected (N=3238). In separate regression analyses, elevated levels of neuroticism and self-criticism were each significantly associated with PTSD among men and women who had experienced one or more traumatic events. After controlling for types of traumas experienced and other previously identified factors (Bromet, Sonnega, & Kessler, 1998. American Journal of Epidemiology, 147, 353-361), neuroticism remained significantly associated with PTSD in women and both neuroticism and self-criticism remained significant in men. Evidence from this nationally representative sample of adults who experienced traumatic events suggests that self-criticism and especially the broad personality domain of neuroticism may represent robust psychological dimensions associated with the presence of PTSD.