Elisabeth Schanche

Trait Self-Compassion Reflects Emotional Flexibility Through an Association with High Vagally Mediated Heart Rate Variability

Converging evidence shows a positive effect of self-compassion on self-reported well-being and mental health. However, few studies have examined the relation between self-compassion and psychophysiological measures. In the present study, we therefore examined the relation between trait self-compassion and vagally mediated heart rate variability (vmHRV) in 53 students (39 female, mean age = 23.63). Trait self-compassion was assessed using the Self-Compassion Scale, and resting vmHRV was measured during a 5-min ECG baseline period. We hypothesized that higher levels of trait self-compassion would predict higher levels of resting vmHRV. Controlling for potential covariates (including age, gender, and BMI), the results confirmed our hypotheses, showing that higher levels of trait self-compassion predicted higher vmHRV. These results were validated with a 24-h measure of vmHRV, acquired from a subsample of the participants (n = 26, 16 female, mean age = 23.85), confirming the positive correlation between high trait self-compassion and higher vmHRV. The relation between trait self-compassion, vmHRV, self-reported trait anxiety (the trait scale of the State-Trait Anxiety Inventory; STAI) and self-reported rumination (the Rumination subscale of the Rumination-Reflection Questionnaire; RRQ-Rum) was also investigated. Higher levels of trait anxiety and rumination were highly correlated with low levels of trait self-compassion. Trait anxiety, but not rumination, correlated marginally significantly with the level of vmHRV. The findings of the present study indicate that trait self-compassion predicts a better ability to physiologically and psychologically adapt emotional responses. Possible implications and limitations of the study are discussed.

The Transdiagnostic Phenomenon of Self-Criticism

Three interventions used to assist highly self-critical patients develop self-compassion are described and illustrated with case material. Theoretical background, assumed mechanism of change, and research evidence for each intervention is presented.

What Brings You Here? Exploring Why Young Adults Seek Help for Social Anxiety

Social anxiety disorder typically manifests in young adulthood, but there is an absence of qualitative research on the actual experiences of young adults suffering with this disorder. The aim of the present study was to investigate the lived experiences of 29 Norwegian university students who were seeking professional help for symptoms of social anxiety. We conducted in-depth interviews prior to a clinical trial. The interviews were transcribed and analyzed using a team-based thematic analysis method based on a hermeneutic-phenomenological epistemology. We identified five themes: (a) from being shy to interpreting anxiety as a mental health problem, (b) experiencing emotions as threatening and uncontrollable, (c) encountering loneliness as relationships fall away, (d) hiding the vulnerable self from others, and (e) deciding to face social fears in the future. We relate our findings to existing theory and research, discuss our process of reflexivity, highlight study limitations, and suggest implications for future research.

Training graduate students as raters in psychotherapy process research

The aim of this study was to conduct a further investigation of the reliability of an innovative new measure for examining processes within psychotherapy sessions, the Achievement of Therapeutic Objectives Scale (ATOS). The ATOS assesses seven common factors in psychotherapy: insight, motivation, activating affects, inhibitory affects, new learning (appropriate expression of feeling), sense of self, and sense of others. Through the use of ATOS, a patient’s degree of ‘assimilation’ or ‘achievement’ of the objectives of psychotherapy can be captured throughout the therapy process. A previous reliability study with graduate students demonstrated poor to fair reliability with 8 hours of training. This study sought to improve reliability by providing 15 hours of training in using the ATOS, in five classes of three hours, and with more focused rating. When all subscales were rated simultaneously, students (N = 32) attained ICCs in the fair to good range of.42–.71. When students were allowed to focus on two subscales at a time (rather than the full scale) during 20 hours of additional practice, ICC values increased to the range of .76–.95. The study suggests that an investment in solid training of clinically inexperienced raters may pay dividends in terms of higher quality ATOS data, and would allow individual rating of tapes.

Both sides of the story: Exploring how improved and less-improved participants experience mindfulness-based stress reduction for social anxiety disorder

Abstract Objective: What works for whom in mindfulness-based group interventions for social anxiety disorder (SAD)? The present article compared the experiences of 14 participants in a clinical study of mindfulness-based stress reduction (MBSR) for young adults with SAD. Methods: A two-staged mixed methods design was used to identify the participants who reported the highest (n = 7) and lowest (n = 7) levels of symptomatic change on outcome measures after treatment, and analyze qualitative in-depth interviews to explore what they experienced as helpful and unhelpful during the MBSR program. The qualitative interviews were analyzed using a thematic analysis methodology. Results: We identified the global theme of (i) Discovering agency to change or not feeling empowered through the MBSR program, and four sub-themes: (ii) Forming an active commitment or feeling ambivalence toward learning mindfulness, (iii) Engaging with others or avoiding contact with the group, (iv) Using the mindfulness exercises to approach or resigning when facing unpleasant experiences, and (v) Using the course to break interpersonal patterns or remaining stuck in everyday life. Conclusions: MBSR may be helpful for young adults with SAD, although it may be important to match clients to their preferred form of treatment.

The Association between Self-Reported Difficulties in Emotion Regulation and Heart Rate Variability: The Salient Role of Not Accepting Negative Emotions

Difficulties in emotion regulation are associated with development and maintenance of psychopathology. Typically, features of emotion regulation are assessed with self-report questionnaires. Heart rate variability (HRV) is an objective measure proposed as an index of emotional regulation capacity. A limited number of studies have shown that self-reported difficulties in emotion regulation are associated with HRV. However, results from prior studies are inconclusive, and an ecological validation of the association has not yet been tested. Therefore, further exploration of the relation between self-report questionnaires and psychophysiological measures of emotional regulation is needed. The present study investigated the contribution of self-reported emotion regulation difficulties on HRV in a student sample. We expected higher scores on emotion regulation difficulties to be associated with lower vagus-mediated HRV (vmHRV). Sixty-three participants filled out the Difficulties in Emotion Regulation Scale and their resting HRV was assessed. In addition, a subsample of participants provided ambulatory 24-h HRV data, in order to ecologically validate the resting data. Correlation analyses indicated that self-reported difficulties in emotion regulation was negatively associated with vmHRV in both resting HRV and 24-h HRV. Specifically, when exploring the contribution of the different facets of emotion dysregulation, the inability to accept negative emotions showed the strongest association with HRV. The results are discussed and need for future research is described.

‘It’s heavy, intense, horrendous and nice’: clients’ experiences in two-chair dialogues

ABSTRACT In this study, we conducted qualitative in-depth interviews to explore how clients experienced working with emotional processing and self-criticism in a two-chair dialogue intervention. Eighteen clients scoring high on self-criticism were interviewed upon completion of a short-term treatment (10–14 sessions) with Emotion-Focused Therapy (EFT), where the two-chair dialogue was used as the main intervention. A hermeneutic-phenomenological approach guided the research process, while a thematic analysis approach was used to analyze the interview transcripts. Our analysis revealed that clients who are asked to engage in the two-chair dialogue intervention often experience an embarrassment or awkwardness before they decide to engage. When engaged in the intervention, most clients found it intense and demanding, but also meaningful. A few clients found the intervention too intense to be of use. Many of those who participated reported that they became more aware of the fact that they were active agents who took part in their self-critical processes. The intensity and somewhat unusual nature of this intervention call for special attention to the working alliance before clients are invited to engage.

Does the two-chair dialogue intervention facilitate processing of emotions more efficiently than basic Rogerian conditions?

ABSTRACT Processing difficult emotions is assumed to be of importance in therapeutic change. In this study, we examine whether a two-chair dialogue in Emotion-focused Therapy (EFT) is associated with a change in emotional processing, measured as changes in emotional arousal and emotional experiencing. In a multiple baseline design, 20 clients in treatment for depression or anxiety first received five, seven or nine weekly sessions of baseline treatment providing Rogerian conditions and affect attunement. In the second phase, two-chair intervention was added for the five consecutive sessions. All sessions were subdivided into 2 min segments which were rated using the Client Emotional Arousal Scale III and the Experiencing Scale. Analyses indicated a significantly higher number of high-arousal segment in the latter phase. Individual clients’ change trajectories were not significantly steeper in the second phase. Experiencing increased throughout both phases of treatment. However, after introducing the two-chair dialogue the Experiencing change trajectory was not significantly steeper than in the baseline phase. Findings suggest that both the two-chair dialogue and the Rogerian conditions with affect attunement focus are effective in facilitating emotional processing. Results are consistent with previous research, suggesting that the two-chair dialogue is an emotionally evocative intervention. Implications and limitations are discussed.