QUALITATIVE ANALYSIS OF SELF-COMPASSION, SELFPROTECTION, AND SELF-CRITICISM IN EMOTIONFOCUSED THERAPY VIDEO SESSIONS

One of the goals of Emotion Focused Therapy (EFT) is to develop a more resilient self by increasing self-compassion and self protection and simultaneously decreasing self-criticism. Although self-compassion and self-protection tasks are one of the essential interventions in EFT, there is still little research about how they are articulated productively within a therapeutic session. Therefore, the goal of our study was to examine how self-criticism, self-protection, and self-compassion are expressed by a client within a therapeutic session. This is a single case study examining one session with the therapist Les Greenberg, who is the founder of EFT. The data were analyzed using consensual qualitative research (CQR). The team consisted of two core team members and one auditor. The video was transcribed and sentences that revealed aspects of the client’s experience of being self-critical, self-compassionate, and self-protective were extracted. Three similar domains were considered for all three concepts: behavioral, emotional, and cognitive aspects. Consequently, the findings showed the following subdomains for self criticism: What you did wrong, What you should do instead, Expectations, Blaming from the critic, and Negative emotions towards the self, for self-compassion: Empathy towards the self, Positive emotions towards the self, Confirmation, Self compassionate Advice, Self-acceptance, Motivation to alleviate suffering, Self-forgiveness, and for self-protection: Expressing needs, Protecting the self, Expressing emotions towards the self-critic, Understanding for the self, and Criticizing the critic. More studies of categorizing a broader number of cases of various therapeutic approaches are necessary to develop more detailed understanding of clients’ expression of self-compassion, self-protection, and self-criticism within therapy

Consensual Qualitative Research of Compassion and Self-Compassion Definitions: A General Public Perspective

Even though compassion for others and for the self are important indicators of mental and physical health and well-being, scientists vary greatly in defining them. Therefore, we examined how the public defines compassion for others and self and explore what are the similarities or differences between researchers´ definitions and public´s definitions of compassions as well as between compassion and self-compassion themselves. 305 members of public defined compassion and self-compassion using their own words, of which we randomly selected 35 for the analysis. The definitions have been analysed using the modified Consensual Qualitative Research (CQR-M) method. The research team composed of three researchers: two core team members and one auditor. Since the domains in both definitions of compassion and self-compassion emerged matching and their proportions turned out to be similar too, we are inclined to side with the proposition that these two constructs are comparable in certain, particularly cognitive, and behavioural areas. However, differences in some categories and subcategories make us believe that they are likely to be processed in a different way. Definitions provided by the study participants majorly correspond with theoretical concepts and definitions of compassion and self-compassion of Gilbert (2009) and Strauss et al. (2016)

Consensual Qualitative Analysis of Self-Criticizing Using the Two-Chair Technique

Level of self-criticism has a significant impact on people’s psychopathology because severe self-criticism activates the sympathetic nervous system, and that further stimulates the physiological and psychological stress response which lead to impairment of mental health and wellbeing (Singer & Klimecki, 2014). Therefore, self-criticism is widely studied, but authors use mainly quantitative approaches which allow generalisation of knowledge but do not allow in-depth insights into the phenomenon. Hence our research aim was to identify the kinds of statements individuals utter when self-criticizing using the two-chair dialogue technique which enable to expose inward dialogues people lead with their self-critical parts. Out of 80 participants, the 20 most expressive participants were selected for the analysis: 15 women and 5 men (M = 27.7; SD 7.60). The data were analysed using Consensual Qualitative Research (CQR; Hill et al., 1997) with three members of a core team and one auditor. We identified three domains of self-criticism – Emotional (mainly inadequacy, fear, contempt, and disgust), Behavioural (mainly hurting and neglecting others, stating one’s shortcomings and motivating oneself), and Cognitive (primarily generalized judgements about one’s negative traits and reactions, perceived judgements by others or based on comparisons with others, and judgements relating to criticized situations and the effects of these). Expanding on the qualitative knowledge in the area of self-criticism would make for better planning and the provision of better treatment for highly self-critical people by mental health professionals

Short version of the Scale for Interpersonal Behavior: Slovak translation and psychometric analysis

Assertiveness is a social communication skill and is related to the effectiveness of expressing oneself while respecting others. A lack of assertiveness is associated with various mental illnesses; hence the importance of being able to measure it reliably. The aim of the study was to translate the short version of the Scale for Interpersonal Behavior (s-SIB) into Slovak and subsequently test its factor structure and other psychometric properties. Our convenience sample consisted of 590 respondents from Slovakia, 22.71% of whom were men and 77.29% women. The data analysis consisted of a descriptive analysis, reliability analysis, factor structure analysis, Mokken analysis, and percentile norms. The scale showed good psychometric properties. Unlike the 4-factor solution for distress and performance in the original work, our findings showed that the general factor loadings were very good and that the bifactor model had the best fit in both cases (distress and performance). Mokken analysis indicated that the total scores for distress and perfromance and their constituent subscales can be used as proposed. In conclusion, the Slovak version of the s-SIB can be used as to measure the total score for assertiveness as well as the separate factors – Positive Assertion, Negative Assertion, Expression of and Dealing with Personal Limitations, and Initiating Assertiveness

The effect of The Loving Kindness Meditation intervention on the level of self-criticism and self-compassion

Štúdia skúma efekt 14 dňovej online intervencie Loving kindness meditation (LKM) na úroveň sebakritickosti a sebasúcitu na neklinickej vzorke. Pôvodných 120 participantov bolo náhodne rozdelených do experimentálnej a kontrolnej skupiny. Participanti v rámci experimentálnej skupiny absolvovali 14 dňový tréning LKM, ktorý sa zameriaval na podporu láskavosti, súcitu a starostlivosti o seba a iných. Rozdiely medzi skupinami sme skúmali prostredníctvom Škály foriem sebakritickosti a sebapotvrdenia – FSCRS a Škály sebasúcitu – SCS. Dotazníky sme administrovali tri krát, a to pred intervenciou, bezprostredne po intervencii a 2 mesiace od uplynutia intervencie. Predpokladali sme, že účasť na LKM zvýši sebasúcit a zníži sebakritiku v porovnaní s kontrolnou skupinou. Na testovanie rozdielov sme použili neparametrický Brunnerov test v programe R. Zistili sme, že participanti po absolvovaní intervencie LKM vykazovali v porovnaní s kontrolnou skupinou nižšiu mieru sebakritickosti. Tento efekt pretrvával aj 2 mesiace od jej ukončenia. Pozitívny efekt intervencie na zvýšenie miery sebasúcitu sa nám však nepodarilo potvrdiť, pretože zvýšené skóre sebasúcitu sa preukázalo i v kontrolnej skupine pravdepodobne v dôsledku senzitivizácie merania a upriamenia pozornosti na sebasúcit. Najväčším prínosom nášho výskumu je že aj online 14-dňová intervencia bez priameho zapojenia profesionála v oblasti mentálneho zdravia dokáže signifikantne znížiť úroveň sebakritickosti u neklinickej vzorky a táto znížená úroveň pretrváva aj po dvoch mesiacoch. Loving kindness meditation je teda sľubnou intervenciou pre tých, ktorí majú tendenciu byť k sebe kritickí a nevedia k sebe pristupovať so súcitom a zároveň je pre nich z akýchkoľvek dôvodov  náročné vyhľadať profesionálnu pomoc. Existujú dva hlavné limity výskumnej štúdie: dostupná vzorka a vysoký úbytok participantov.The study examines the effect of a 14-day online Loving kindness meditation (LKM) intervention on the level of self-criticism and self-compassion in a non-clinical sample. The original 120 participants were randomly divided into an experimental and control groups. Participants in the experimental group completed a 14-day LKM training, which focused on supporting kindness, compassion, and care for self and others. We studied the differences between the groups using the Forms of Self-Criticising and Self-Reassuring Scale (FSCRS) and the Self-Compassion Scale (SCS). We administered the questionnaires three times, immediately before the intervention, immediately after the intervention and 2 months after the intervention. We hypothetised that a participation in LKM would increase self-compassion and decrease self-criticism compared to a control group. We used nonparametric Brunner test in programme R to test the differences. We found that the participants after the LKM intervention showed significant decrease of self-criticism compared to the control group. This effect lasted for 2 months. However, we were not able to confirm the positive effect of the intervention on increasing the level of self-compassion, because the increased self-compassion score was also demonstrated in the control group, probably due to sensitization of the measurement and directing attention to self-compassion. The biggest benefit of our research is that even an online 14-day intervention without the direct involvement of a mental health professional can significantly reduce the level of self-criticism in a non-clinical sample, and this reduced level persists even after two months. Loving kindness meditation is therefore a promising intervention for those who tend to be critical of themselves and do not know how to cultivate compassion, and at the same time it is difficult for them for whatever reasons to seek professional help. There are two main limits of the research study: available sample and high attrition rate

Effect of a Short-Term Online Version of a Mindfulness-Based Intervention on Self-criticism and Self-compassion in a Nonclinical Sample

Our goal was to investigate the efficacy of a Mindfulness-Based Intervention (MBI) in the form of a short-term, online intervention using exercises from Mindfulness-Based Stress-Reduction program on self-compassion, self-reassurance and self-criticism in a non-clinical population. We conducted pre-, post- and two-month follow-up measures of self-compassion, self-reassurance and self-criticism. A total of 146 participants, recruited through convenience sampling, were randomly allocated to the intervention with daily exercises for consecutive 15 days and to a control condition with no treatment. The intervention group reported a significant reduction in self-criticism and self-uncompassionate responding with effects present at two-month follow- up. There was a short-term effect of the training on self-compassion with no effect present at the two-month follow-up and no significant effect on self-reassurance. A limitation of the study is that participants’ previous experience with meditation was not assessed, and thus the findings may be a result of previous meditation practice and not the intervention itself. Despite this limitation, the findings show that an online short-term MBI may be helpful in reducing selfcriticism in general population, but a larger study taking into account the limitations needs to be conducted to replicate this effect before recommendations for clinical practice can be made

Multiple Group IRT Measurement Invariance Analysis of the Forms of Self-Criticising/Attacking and Self-Reassuring Scale in Thirteen International Samples

The purpose of this study was to examine the measurement invariance of the Forms of Self-Criticising/Attacking & Self-Reassuring Scale (FSCRS) in terms of Item Response Theory differential test functioning in thirteen distinct samples (N = 7714) from twelve different countries. We assessed differential test functioning for the three FSCRS subscales, Inadequate-Self, Hated-Self and Reassured-Self separately. 32 of the 78 pairwise comparisons between samples for Inadequate-Self, 42 of the 78 pairwise comparisons for Reassured-Self and 54 of the 78 pairwise comparisons for Hated-Self demonstrated no differential test functioning, i.e. measurement invariance. Hated-Self was the most invariant of the three subscales, suggesting that self-hatred is similarly perceived across different cultures. Nonetheless, all three subscales of FSCRS are sensitive to cross-cultural differences. Considering the possible cultural and linguistic differences in the expression of self-criticism and self-reassurance, future analyses of the meanings and connotations of these constructs across the world are necessary in order to develop or tailor a scale which allows cross-cultural comparisons of various treatment outcomes related to self-criticism

The factor structure of the Forms of Self-Criticising/Attacking & Self-Reassuring Scale in thirteen distinct populations

There is considerable evidence that self-criticism plays a major role in the vulnerability to and recovery from psychopathology. Methods to measure this process, and its change over time, are therefore important for research in psychopathology and well-being. This study examined the factor structure of a widely used measure, the Forms of Self-Criticising/Attacking & Self-Reassuring Scale in thirteen nonclinical samples (N = 7510) from twelve different countries: Australia (N = 319), Canada (N = 383), Switzerland (N = 230), Israel (N = 476), Italy (N = 389), Japan (N = 264), the Netherlands (N = 360), Portugal (N = 764), Slovakia (N = 1326), Taiwan (N = 417), the United Kingdom 1 (N = 1570), the United Kingdom 2 (N = 883), and USA (N = 331). This study used more advanced analyses than prior reports: a bifactor item-response theory model, a two-tier item-response theory model, and a non-parametric item-response theory (Mokken) scale analysis. Although the original three-factor solution for the FSCRS (distinguishing between Inadequate-Self, Hated-Self, and Reassured-Self) had an acceptable fit, two-tier models, with two general factors (Self-criticism and Self-reassurance) demonstrated the best fit across all samples. This study provides preliminary evidence suggesting that this two-factor structure can be used in a range of nonclinical contexts across countries and cultures. Inadequate-Self and Hated-Self might not by distinct factors in nonclinical samples. Future work may benefit from distinguishing between self-correction versus shame-based self-criticism.Peer reviewe

Emotion-Focused Therapy

Na emócie zameraná terapia (v anglickom jazyku Emotion-focused therapy so skratkou EFT) alebo Proces-experienciálna terapia (v anglickom jazyku Process-experiential therapy) je v súčasnosti najznámejším terapeutickým prístupom zaoberajúcim sa primárne emóciami. Má svoje využitie v párovej (Greenberg, Johnson, 1988) i individuálnej terapii (Greenberg et al., 1993) a je podložená výskumami. Na emócie zameraná terapia bola vytvorená Greenbergom a jeho kolegami v 80. rokoch na základe empirických štúdií procesu zmeny v psychoterapii (Rice, Greenberg, 1984; Greenberg, Johnson, 1988). Prehľadová štúdia načrtáva teoretické východiská tejto terapie, ktorá je u nás relatívne neznámou, a jej špecifiká. Podrobne sa zaoberá markermi a mikromarkermi a úlohám vrámci EFT terapie, šiestim základným empiricky potvrdeným intervenciám na spracovanie emócií v terapeutickom vzťahu, ktoré zároveň slúžia ako ciele terapie v EFT, a navodením procesu zmeny. Štúdia sa zmieňuje aj o konceptualizácii prípadu v EFT terapii. Záverom prináša prehľad doterajších výskumných zistení týkajúcich sa EFT, ktoré zhrňujú výskumy efektu terapie na rozličných vzorkách populácie a v špecifických životných situáciách. EFT sa doteraz ukázalo byť efektívnou terapiou predovšetkým pre liečbu depresie (Greenberg, Watson, 2006) a má sľubné výsledky aj v súvislosti s ďalšími diagnózami.Emotion-focused therapy (acronym EFT) or Process experiential therapy is currently the most famous therapeutic approach dealing primarily with emotions. It is used in couple therapy (Greenberg, Johnson, 1988) as well as in individual therapy (Greenberg et al., 1993) and it is empirically supported treatment. Emotion-focused therapy was developed by Greenberg and his colleagues in the 1980s on the base of empirical research on process of change in psychotherapy (Rice, Greenberg, 1984; Greenberg, Johnson, 1988). Overview study outlines the theoretical background of this therapeutic approach, which is relatively little-known to Slovak and Czech therapists, and its distinctive features. The author explains the markers, micromarkers and tasks in EFT therapy, six fundamental empirically supported interventions for emotion processing in therapeutic relationship, that serve like goals in therapy and process of change. In conclusion, the paper provides an overview of current research findings regarding EFT that summarize research of the therapy effectiveness for different population samples and people in specific situations. EFT has been showed to be effective therapy mainly for depression treatment (Greenberg, Watson, 2006) and it has promising results concerning also other diagnosis. Júlia Halamová, Department of Psychology and Pathopsychology, Faculty of Education, Comenius University in Bratislava, Slovak Republic e-mail: [email protected]

Specifics of psychotherapy with highly self-critical clients

Sebakritickosť je hlavný spoločný faktor na pozadí mnohých psychiatrických diagnóz. Z hľadiska psychoterapie je kľúčová informácia, že prítomnosť sebakritickosti u klienta zásadným spôsobom oslabuje odozvu klienta na liečbu. Práve preto je pre psychoterapeuta dôležité vedieť o sebakritickosti viac a poznať rôzne možnosti ako s ňou pracovať. Predchádzajúci článok „Možnosti intervencie pri práci s vysoko sebakritickým klientom“ poskytuje prehľad rôznych intervencií použiteľných v tejto oblasti. Tento nadväzujúci článok je zameraný na psychoterapeutickú prácu s vysoko sebakritickým klientom. Obsahuje popis ťažkostí pri psychoterapii sebakritických klientov a dôvodov týchto ťažkostí, odlíšenie rôznych druhov vnútorného kritika, základné psychoterapeutické prístupy v práci so sebakritickosťou a všeobecné zásady psychoterapeutickej práce so sebakritikom.Self-criticism is a major conjoint factor in the background of many psychiatric diagnoses. In terms of psychotherapy, it is crucial that client´s self-criticism substantially weakens the client's response to a treatment. That is why it is so important for a psychotherapist to know more about self-criticism and be more familiar with various ways to deal with it. The previous article Possibilities of intervention while working with highly self-critical client"" provides an overview of various possible interventions in this area. This article is focused on psychotherapy with highly self-critical clients. It contains description of difficulties while doing psychotherapy with highly self-critical clients and reasons for these difficulties, typology of inner critics, basic psychotherapeutic approaches dealing with self-criticism and general principles of psychotherapy with the critics. Júlia Halamová, Department of Applied Psychology, Faculty of Social and Economic Sciences, Comenius University in Bratislava, Slovak Republic e-mail: [email protected]