How Exposure to Personal Distress With and Without Self-compassion Affects Distress Tolerance: Results from a Two-Sample Randomized Trial

Self-compassion is a caring way of relating to personal distress that has known soothing physiological effects characterized by feelings of safeness. Individuals low in distress tolerance feel threatened by negative emotions and believe that they are unable to tolerate them. We tested the theory that for this population, experiencing negative emotions with self-compassion, as compared to without self-compassion, would allow individuals to feel safer and more soothed, thereby increasing their distress tolerance, our primary outcome.

We tested this hypothesis in a randomized controlled trial involving Canadian undergraduate students (n = 150) and international community adults (n = 298) with below-average distress tolerance levels. In an online session, participants brought to mind a distressing situation and then completed one of three interventions: writing about their negative emotions (pure exposure); writing about their negative emotions from a compassionate perspective (self-compassionate exposure); writing about a neutral topic (placebo control).

In both samples, self-compassionate exposure yielded higher self-reported post-intervention distress tolerance than pure exposure (d = 0.37–0.55, p < 0.05) but not compared to placebo control (d = 0.10–0.34, p > 0.05). The relative effect of self-compassionate exposure over pure exposure occurred indirectly via greater levels of self-reported soothing affect during the intervention (proportion mediated, 0.53–0.67). Between-condition differences were absent at 1-week follow-up.

Findings suggest that exposure to negative emotions with self-compassion, as compared to without, may be a more effective way to momentarily increase distress tolerance due to its effects on soothing affect.

US Clinical Trials Registry #NCT05284578