The effectiveness of self-compassion and self-esteem writing tasks in reducing body image concerns

Highlights

• Participants read a negative body image scenario to induce body image concerns.

• Self-compassion (SC), self-esteem (SE), and control writing tasks were compared.

• State body appreciation, body satisfaction, and appearance anxiety were assessed.

• SC writing resulted in greater body appreciation than SE and control writing.

• SC and SE writing resulted in higher body satisfaction than control writing.

Abstract

This study investigated whether single-session self-compassion and self-esteem writing tasks ameliorate the body image concerns evoked by a negative body image induction. Ninety-six female university students aged 17–25 years (M_age = 19.45, SD = 1.84) were randomly assigned to one of three writing treatment groups: self-compassion, self-esteem, or control. After reading a negative body image scenario, participants completed scales measuring state body appreciation, body satisfaction, and appearance anxiety. They then undertook the assigned writing task, and completed the three measures again, both immediately post-treatment and at 2-week follow-up. The self-compassion writing group showed higher post-treatment body appreciation than the self-esteem and control groups, and higher body appreciation than the control group at follow-up. At post-treatment and follow-up, self-compassion and self-esteem writing showed higher body satisfaction than the control. The groups did not differ on appearance anxiety. Writing-based interventions, especially those that enhance self-compassion, may help alleviate certain body image concerns.

Introduction

Within industrialised Western societies, the thin physique has become such a prevalent and pervasive ideal beauty standard that the term “normative discontent” (Rodin, Silberstein, & Striegel-Moore, 1985) was coined to describe the negative affect women experience when they feel they have not achieved this ideal. Body image concerns appear to be common among female undergraduates as they negotiate the challenges of new social demands in a competitive environment (Lowery et al., 2005). Research shows that 87% of female undergraduates within normal BMI range desire to weigh less (Neighbors & Sobal, 2007), and that almost all female undergraduates speak negatively about the size and shape of their bodies, with about 30% doing so frequently (Salk & Engeln-Maddox, 2011).

In contemporary society, young women are frequently exposed to live, vicarious, and virtual images that might represent threats to their body image (Cash, 2002, Tiggemann, 2001). These appearance-related threats have the potential to evoke body image concerns including increases in negative body image and/or decreases in positive body image. One aspect of negative body image that may be evoked during an appearance-related threat is a reduction in one’s state body satisfaction, or a momentary decrease in the evaluative/affective attitude toward one’s body or parts thereof (Cash, Fleming, Alindogan, Steadman, & Whitehead, 2002). Another aspect that may be exacerbated is state appearance anxiety, defined as a state of uneasiness or apprehension about one’s body parts falling short of culturally-defined beauty standards (Reed, Thompson, Branick, & Sacco, 1991).

Positive body image is not simply low levels of negative body image. It is a multifaceted construct that is flexible, holistic, and protective, and moves beyond simple appearance evaluation and satisfaction to include respecting, honouring, loving, and accepting the body, including its unique characteristics that differ from societal appearance ideals (Tylka & Wood-Barcalow, 2015; Wood-Barcalow, Tylka, & Augustus-Horvath, 2010). However, qualitative research suggests that in the short-term, positive body image may not always protect against body image-related threats (Wood-Barcalow et al., 2010). One facet of positive body image that may decrease during an appearance-related threat is state body appreciation (Halliwell, 2015), defined as momentary acceptance of, respect for, and gratitude toward one’s body (Homan, 2016, Tylka and Wood-Barcalow, 2015).

Body image concerns are known risk factors for disordered eating behaviours, clinical eating disorders, and mood disorders (Peat & Muehlenkamp, 2011; Stice, Marri, & Durant, 2011). Given the seriousness of these outcomes for young women, strategies aimed at ameliorating body image concerns are needed. This study set out to examine the effects of two such strategies, both of which involved writing exercises intended to reduce negative body image and enhance positive body image following a negative body image induction. Both writing tasks targeted beliefs/attitudes regarding the self, on the basis of evidence showing that body image and self-concept are closely, and likely reciprocally, related, especially in young females (Harter, 1999, Wichstrøm and Von Soest, 2016).

The first of the two strategies aims to promote the adoption of a self-compassionate perspective. Research suggests that self-compassion is related to many aspects of psychological well-being (Neff & Vonk, 2009) via its negative associations with anxiety and depression (Johnson & O’Brien, 2013; Neff, Kirkpatrick, & Rude, 2007) and its positive associations with happiness and optimism (Neff et al., 2007, Smeets et al., 2014). Neff (2003) defines self-compassion as a way of relating to oneself, entailing three interacting components: (a) self-kindness, which refers to a caring perspective towards oneself through unconditional self-acceptance in an attempt to overcome harsh self-criticism; (b) common humanity, which refers to an acceptance of personal flaws or difficult life circumstances as part of a shared human condition; and (c) mindfulness, which offers awareness and acceptance of a negative experience in a balanced manner that helps prevent rumination.

The acceptance and kindness towards one’s imperfections that are inherent within a self-compassionate perspective highlight the role that this perspective can play in addressing the challenges posed by appearance-related threats (see Albertson, Neff, & Dill-Shackleford, 2015; Toole & Craighead, 2016; Wasylkiw, MacKinnon, & MacLellan, 2012). Previous correlational studies have shown that self-compassion and body satisfaction covary in female undergraduates (Kelly & Stephen, 2016), and that university female athletes who are high in self-compassion report fewer instances of distress associated with the perception of how others evaluate one’s physique (Koç & Ermiş, 2016). Experimental studies have examined the effects of self-compassion meditation on body dissatisfaction in adult women (Albertson et al., 2015) and body image distress in female undergraduates (Toole & Craighead, 2016). Albertson et al. (2015) found that, compared to a wait-list control group, a group trained in self-compassion meditation showed reduced body dissatisfaction and increased body appreciation, and these effects were maintained at a 3-month follow-up. Toole and Craighead (2016) also found self-compassion intervention participants to show higher body appreciation than wait-list controls, although they observed no significant differences in body dissatisfaction (possibly due to low statistical power).

Authors of both studies indicated that engagement in self-compassion meditation was effortful for many participants, suggesting that alternative means of inducing a self-compassionate mindset are needed. Evidence shows that writing tasks are also efficacious at producing positive psychological effects (e.g., Leary, Tate, Adams, Allen, & Hancock, 2007; Shapira & Mongrain, 2010) including positive body image (Alleva, Martijn, Van Breukelen, Jansen, & Karos, 2015). Therefore, the current study assessed the efficacy of a writing-based task aimed at inducing a self-compassionate perspective as a means of dealing with challenges faced after exposure to appearance-related threats.

The second strategy currently under investigation sought to promote participants’ self-esteem or overall evaluation of self-worth (Harter, 2000). Although the direction of any causal associations between self-esteem and body image has yet to be established (Wichstrøm & Von Soest, 2016), the existence of a robust link between these variables has provided the basis for the development of self-esteem based interventions for the prevention of body image concerns (O’Dea, 2004). For example, in O’Dea’s (1995) Everybody’s Different program, students focus on developing their sense of self-worth by embracing multiple aspects of the self to help decrease the importance of appearance. The program showed significant improvements in body image for female students.

Self-esteem enhancement interventions, however, have shown mixed findings. Some studies show improvements in body dissatisfaction, dietary restraint, and shape and weight attitudes (McVey et al., 2003; Norwood, Murray, Nolan, & Bowker, 2011; O’Dea & Abraham, 2000), while others show no differences between intervention and control groups on such body image variables (Ghaderi, Mårtensson, & Schwan, 2005; McCabe, Ricciardelli, Salmon, 2006; McVey & Davis, 2002). Indeed, researchers have argued that self-esteem based on physical appearance—where it requires constant validation or favourable comparison with others—may be continually threatened (Harter, 2000, Lowery et al., 2005, Neff, 2011). In particular, individuals with appearance contingent self-esteem may ruminate on negative body image incidents, thus becoming more vulnerable to negative body image (Neff, 2011). The mixed findings suggest that continued consideration of self-esteem interventions is warranted, with a particularly important goal being to ensure that its effects are assessed independently of self-compassion.

Self-esteem based programs usually incorporate self-acceptance themed activities—a core component of self-compassion—and this makes it difficult to establish whether successful outcomes are due to self-esteem alone. For example, Leary et al. (2007, in Study 2) compared self-esteem and self-compassion as strategies in imagined stressful scenarios, and found that self-compassion uniquely predicted behavioural calmness in all three scenarios, whereas self-esteem did not predict calmness in any of the scenarios. Although previous research showed that self-compassion and self-esteem were moderately correlated (Neff, 2003), Leary et al. (2007) suggested that self-compassion reflected not only positive self-evaluations, but also a kinder and more balanced approach to difficult situations. Leary et al. (2007) also noted that, had they only measured self-esteem, they would have attributed the effects to self-esteem, unaware that self-compassion may have been the underlying factor at play.

A follow-up study (Study 5) by Leary et al. (2007) compared the effects of writing tasks aimed at inducing state self-compassion or state self-esteem on recall of personal painful events. Wording of the prompts used in the writing tasks was based on (a) the three facets that comprise self-compassion, and (b) the tactics people use when protecting their self-esteem, such as self-affirmations and defensiveness. Results indicated that self-compassion, but not self-esteem, was uniquely related to lower negative affect.

Past research has documented the therapeutic benefits of planned writing exercises (Alleva et al., 2015, Leary et al., 2007), yet no prior study has investigated, or sought to compare, the impact on body image concerns of writing exercises aimed at promoting self-compassion and self-esteem. The current study makes important contributions in these respects. Central to the design of this study was the notion that exposure to image-related threats may evoke body image concerns (i.e., reduced state body appreciation and state body satisfaction, and heightened state appearance anxiety), which subsequently need to be ameliorated. Following Leary et al.’s (2007) methodology, the study thus exposed participants to an imagined distressing body image scenario and tested the impact of self-compassion and self-esteem writing tasks on measures of state positive and negative body image. We expected that a writing task that induced self-compassion would be more efficacious, both immediately and at two-week follow-up, in reducing body image concerns than would one aimed at self-esteem enhancement, and that both these treatments would be more efficacious than a control writing task. Thus, we hypothesised that at post-treatment and 2-week follow-up: (H1) Self-compassion writing would produce (a) higher state body appreciation, (b) higher state body satisfaction, and (c) lower state appearance anxiety than self-esteem and control writing; and (H2) Self-esteem writing would produce (a) higher state body appreciation, (b) higher state body satisfaction, and (c) lower state appearance anxiety than control writing.