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01-06-2009 | Original Article

Soothing Oneself and Resisting Self-Attacks: The Treatment of Two Intrapersonal Deficits in Depression Vulnerability

Auteurs: Allison C. Kelly, David C. Zuroff, Leah B. Shapira

Gepubliceerd in: Cognitive Therapy and Research | Uitgave 3/2009

Abstract

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.

vorige artikel Metacognitive Therapy in Recurrent and Persistent Depression: A Multiple-Baseline Study of a New Treatment

volgende artikel Impact of a Treatment Rationale on Expectancy and Engagement in Cognitive Behavioral Therapy for Social Anxiety

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Although we were interested in the impact of our interventions on depression, we chose not to have inclusion criteria specific to depression. This is because we were interested in the effects of our treatments on the depressive symptoms of distressed acne sufferers across levels of depression. We therefore focused on ensuring all participants shared significant levels of acne-related distress (as assessed by the SKINDEX-16) and expected that many of these people would also show elevated depression scores, even if not clinically severe.

Participants were asked to visualize an orange and were slowly guided to imagine all of its sensory features—appearance, touch, smell, and taste. We chose an orange as the object of visualization because we felt this was an emotionally neutral object that would not interfere with the subsequent exercises or differentially prepare participants for the particular intervention-specific imagery they would be asked to engage in.

The assessment portion of the slideshow prompted participants to look at themselves in the mirror and to then complete a record form taken from Gilbert and Irons’ (2005) chapter on CMT. Similar to standard cognitive therapy assessments, the form asked individuals to report on variants of automatic thoughts—namely, the thoughts and feelings they have about themselves (internal shame) and the thoughts and feelings they believe others have about them (external shame). They were then asked to rate a series of emotions, taken from PANAS-X, to identify how they felt while reflecting on their acne.

Given that our interventions were self-help nature, there was no therapist present to individualize our intervention exercises to each participant. To overcome this limitation, we tried as much as possible in our instructions to encourage individual adaptations of the exercises, staying within the assigned format, to facilitate their targeting the personal experiences of the participant. For instance, our assessment form asked individuals to report on their own thoughts and feelings, and our intervention asked them to write their own self-letter and self-statements.

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Titel: Soothing Oneself and Resisting Self-Attacks: The Treatment of Two Intrapersonal Deficits in Depression Vulnerability
Auteurs: Allison C. Kelly
David C. Zuroff
Leah B. Shapira
Publicatiedatum: 01-06-2009
Uitgeverij: Springer US
Gepubliceerd in: Cognitive Therapy and Research / Uitgave 3/2009
Print ISSN: 0147-5916
Elektronisch ISSN: 1573-2819
DOI: https://doi.org/10.1007/s10608-008-9202-1

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