PsychologyandPsychotherapyTheoryResearchandPractice20112011TheBrit - PDF document

PsychologyandPsychotherapy:Theory,ResearchandPractice(2011)2011TheBritishPsychologicalSociety British www.wileyonlinelibrary.comFearsofcompassionandhappinessinrelationtoalexithymia,mindfulness,andself-criticismP.Gilbert,K.McEwan,L.Gibbons,S.Chotai,J.DuarteandM.MatosMentalHealthResearchUnit,KingswayHospital,Derby,UKCognitive-BehaviouralResearchCentre,UniversityofCoimbra,PortugalBackground.Thereisincreasingresearchtosuggestthatfearsof,andresistancesto,afÞliativeandpositiveemotionsarelinkedtoself-criticismandarangeofpsychopatholo-gies.Itisunclearhowthesefearsandresistancesarelinkedtoeachotherandhowtheseinturnarelinkedtopsychologicalprocesses,suchasabilitiestobemindfulandrecognizeanddescribeemotions.Objectives.Thisresearchexplorestherelationshipbetweenfearsofcompassionandhappinessingeneral,withcapacitiesforemotionalprocessing(alexithymia),capacitiesformindfulness,andempathicabilities.Toadvancethisresearch,anewscalewasdevelopedtomeasuregeneralfearsofpositivefeelingsÐtheFearofHappinessScale.Theresultsshowedthatfearsofcompassionforself,fromothersandinparticularfearofhappiness,werehighlylinkedtodifferentaspectsofalexithymia,mindfulness,empathy,self-criticismanddepression,anxietyandstress.EspeciallynoteworthywastheveryhighcorrelationbetweenfearofhappinessanddepressionWhilethedevelopmentofpositiveemotions,especiallythoselinkedtoafÞliationandconnectednessareincreasinglyseenasimportanttherapeutictargets,littleresearchhasfocusedontheblocksandfearstopositiveemotions.Thisstudyusednewlydevelopedfearsofpositiveaffectscales(e.g.,compassionandhappiness)toexploretheseaspectsandfoundtheyweresigniÞcantlylinkedtopsychopathologyvariablesself-criticismanddifÞcultiessuchasalexithymia.Manyformsofpsychopathologyarelinkedtopatternsofaccentuatednegativeaffectandreducedpositiveaffect(Watson,Clarketal.,1995a,b).However,overthelast10years,clinicianshavearguedthatmanytherapieshavefocusedratherexclusivelyontheregulationofnegativeemotions,particularlyfearandanger,butratherlessonthedevelopmentandaccentuationofpositiveemotions,suchashappinessandpersonalstrengths.Thisisparticularlytrueinamovementcalledpositivepsychology(e.g.,Carr, CorrespondenceshouldbeaddressedtoProfessorPaulGilbert,MentalHealthResearchUnit,KingswayHospital,DerbyDE223LZ,UK(e-mail:p.gilbert@derby.ac.uk). P.Gilbertetal.2004;Seligman,2011).Thisimportantshiftoffocuswithinclinicalpsychologyraisesanumberofkeyissues.First,althoughpositiveemotionscantonedownthreat-basednegativeemotions(Frederickson,2001;Fredrickson,Tugade,Waugh,&Larkin,2003),reducingnegativeemotionsdoesnotautomaticallyincreasepositiveones(Gilbert,1989).AsDillionandPizzagalli(2010)notedinarecentreviewofpositiveemotionsa

ndpsychopathology,problemsintheactivation,experience,andregulationofpositiveemotionsaretransdiagnosticproblems,whichhavebeenpoorlystudied.Secondistheproblemthatpositiveemotionstendtobeseenalongasingledimensionalbutinfacttherearedifferenttypesofpositiveemotionswithdifferentevolvedformsandfunctionsanddifferentneurophysiologicalmediators(Carter,1998;Depue&Morrone-Strupinsky,2005;Porges,2007).OnetypeofpositiveemotionisactivatingandÔexcitingÕinsomecontexts(e.g.,seekingoutandsecuringresources;passinganexam,goingoutonadate,securinganewjob)butothersareassociatedwithfeelingsofcontentmentandquiescence,calmingandsoothing,associatedwithasenseofpeacefulwell-beingandasenseofsafenesswhichisalsolinkedtoafÞliation(Depue&Morrone-Strupinsky,2005;Panksepp,1998).AthirdimportantissueisthatinclinicalpopulationsÔpositiveemotionsÕsuchassafeness,joy,andhappinessarenotnecessarilyexperiencedaspleasurablebutareratherfrightening.Onereasonbeingthatpreviousexperiencesoftheseemotionsmayhavebeenassociatedwithadverseoutcomes,forexample,thepersonwhosaysÔhappinessneverlastsÐwhenIfeelhappyIamalwayswaitingforsomethingbadtohappenÕ.Itthereforefollowsthatresearchintopositiveemotionsneedstodistinguishbetweendifferenttypesofpositiveaffectregulationsystemsandalsothedegreetowhichindividualsblockoutdifferenttypesofpositiveaffectbecauseoffearsandaversiveemotionalmemories(Gilbert,2010).Inanefforttoseeifthesetwotypesofpositiveaffectscouldbedistinguishedusingself-reportmeasures,Gilbertetal.(2008)developedaself-reportquestionnaireÐtheTypesofPositiveAffectScale.Interestingly,ratherthantherebeingtwofactors,factoranalysisrevealedthreefactors,whichwelabelledas:(e.g.,ÔenergeticÕ,ÔlivelyÕ,(e.g.,ÔrelaxedÕ,ÔcalmÕ,ÔpeacefulÕ),and(e.g.,ÔsafeÕ,ÔsecureÕ,ÔwarmÕ).Importantly,itwasthefactorthatwasthebestpredictorofloweranxietyanddepressioninastudentandbipolarpopulation(Gilbertetal.,2008).TheemotionsofÔsafeÕÔsecureÕ,andÔwarmÕareespeciallylinkedtosocialexperiencesandfeelingsociallysafeandconnected.Forexample,Gilbertetal.(2008)foundthatthesequalitiesweresigniÞcantlyassociatedwithsecureattachmentexperiencesandnegativelyassociatedwithanxiousattachment.PositiveemotionscreatedwithinpurelysocialcontextshavelongbeenassociatedwithafÞliation,kindness,andwarmthandseenasemotionaltexturesforcompassion(Gilbert,2005).TobecompassionaterelatestothespeciÞcmotivationstobecaring,sensitivetodistress,tolerantofdistress,andempathic(Gilbert,2005,2009).Beingarecipientofcompassionfromselforotherscanhelpregulatedistress,andcopingwithnegativeemotions(Cozolino,2007;Mikulincer&Shaver,2007).Forexample,childrenwhoareregularlysoothedandcaredfordevelopinnersoothingcapacities,whichregulatetheirthreatsystem(C

ozolino,2007).Incontrast,childrenwhoareinsecureand/orsubjecttoabusemaynotexperiencemuchearlysoothingandthereforedonotlaydowntheappropriateneuralpathwaysneeded.Thismeansthatsoothingmentalrepresentationsoftheselfandothersarenotaccessible(Mikulincer&Shaver,2007).ThesafenessthatpeoplecanexperiencethroughafÞliativeandattachmentrela-tionshipshasbeenlinkedtothedevelopmentofcompetenciessuchasempathyand Fearsofcompassionandhappinessmentalizing,whichinturnarenegativelylinkedtovariousformsofpsychopathology(Fonagy&Luyton,2009;Fonagy&Target,2006).Theexperienceofasecurebasecreatesasenseofsafenessfromwhichthecognitivecapacitiesforself-reßection,emotionalawareness,andtolerancedevelop.LiottiandGilbert(2011)notethatfeelingsafecannotonlycreateconditionsofcontentedpeacefulnessbutalsodevelopcuriosityandmoreenergizedexplorativebehavioursÐincludinginterestinexploringoneÕsownfeelingsandthoseofothers.Asinanyexplorativeventure,theabilitytoreturntoasafeplaceoffersconÞdenceinthatjourney.Hence,intheabsenceofsupportandcaring,childrenmaystruggletoregulatethreatprocessingandmayhavedifÞcultieswiththematurationofimportantcognitivecompetenciesforaffectprocessingandregulation.Theseincludeabilitiestomentalize,tolerateemotions,bemindfulinthepresenceofemotions,anddescribeandreßectontheiremotions.LiottiandGilbert(2011)suggestthatmentalizingandempathizingcouldbeviewedasformsofexplorativebehaviour,facilitatedinthecontextofsafenessbutcompromisedincontextsofthreat.DifÞcultiesinprocessingemotionsWhetherpeoplearetryingtoregulatenegativeemotionsorexperiencemorepositiveemotions,havinginsightandunderstandingofthenature,source,andmaintenanceofemotionsisimportant.Researchsuggeststhatsomeindividualsstrugglewithcompe-tenciesthatfacilitatetheunderstandinganduseofemotions(Frawley&Smith,2001;Taylor,Bagby,&Parker,1997).OneapproachtoexploringdescribingthesedifÞcultiesiswiththeconceptofÔalexithymiaÕ,whichwaslabelledbyPeterSifneos(1973)todescribedifÞcultiesinunderstanding,processingandverballydescribingemotions.ItnowreferstoasetofinterconnecteddifÞculties:ofidentifyinganddistinguishingbetweenfeelingsandthebodilysensationsofemotionalarousal;difÞcultydescribingfeelings(especiallytootherpeople);andastimulus-boundexternallyorientedcognitivestylewithconstrictedimaginalprocesses,asevidencedbyapaucityoffantasies(Bagby,Parker,&Taylor,1994).Hence,peoplewithalexithymiatypicallythinkthecausesoftheirfeelingsareexternalratherthaninternal(e.g.,theirpersonalinterpretations).Theabilitytounderstandemotions,incontrasttofeelingthemtobeincomprehensibleoroverwhelmingandtobeavoided,iscentraltoanumberofrecentmodelsofpsychopathology(Chawla&OstaÞn,2007;Greenberg&Safran,1987;Hayes,Follette,&

Linehan,2004;Leahy,2002;seeKring&Sloan,2010forreviews).Importantly,oneofthekeyprocessesthatenablesexplorationofemotionsistheopennessandvalidationofothers,particularlyattachmentobjectsearlyinlife.Theserelationshipssetanexplorativecontextforemotions(Fonagy&Luyton,2009).Intheabsenceof(early)positiveattachmentandafÞliativerelationships,emotionsmaybecomemoredangerousanddifÞculttoexplore,thinkaboutorreßecton,evenbecomingasourceforavoidanceandasourceofalexithymia(Fonagy&Luyton,2009;Fonagy&Target,2006;Liotti&Gilbert,2011;Mikulincer&Shaver,2007).Mindfulnessisaformofmeditationthathasbeenlinkedtoemotionalprocessingetal.,2004).Thewordmeditationactuallymeansfamiliarization,andfocusofmeditativepracticesistobecomemoreaware,familiar,andreßectiveoftheprocessesandcontentsofoneÕsmind(Kabat-Zinn,2005).Mindfulnessmeditationandtheconceptofmindfulnessitselfcanbecontrastedwithalexithymiatotheextentthatmindfulnessencouragesopencuriosityandattentivenesstoinnerexperiencesandbecomingfamiliarwiththearisingthoughtsorfeelingsinthebody.Theabilitytoobserveinnerprocesseswithoutbeingoverwhelmed,avoidant,suppressant,oractingonthemisacorefeature P.Gilbertetal.ofmindfulness.CommonlyaccepteddeÞnitionsofmindfulnesssuggestthatitistheabilitytobeattentiveandholdawarenesswithoutjudgementoravoidanceinthepresentmoment(Brown&Ryan,2003;Brown,Ryan,&Creswell,2007;Kabat-Zinn,2005;Lykins&Baer,2009).Mindfulnesshasalsobeendescribedasamultifacetedconstructthatcanbecomparedandcontrastedwithcompetencies(orlackof)suchasmetacognition,emotionalintelligenceandalexithymia(Baer,Smith,Hopkins,Krietemeyer,&Toney,2006;Bishopetal.,2004).LykinsandBaer(2009)foundtrendsformindfulnesstobenegativelylinkedtoalexithymia,difÞcultiesinemotionalregulationandfearofemotions.Alsolinkedtothesepsychologicalconstructsareabilitiesforempathy.Empathydescribestheabilitytounderstandthementalstatesofothersandtosharetheirfeelings(Davis,1980;Singer,2006).ProblemsinprocessingpositiveemotionsItisimportanthoweverthatcapacitiesformindfulnessshouldnotbetakenoutoftheirsocialcontext.IndeedasHofmann,Grossman,andHinton(2011)haverecentlypointedoutinareviewoflovingkindnessandcompassionmeditationpracticesaspsychologicalinterventions,mindfulnessisnotacolddetachedprocessbutoneinfusedwithcompassion,afÞliation,andkindness.Inaddition,capacitiesformentalizingandabilitiestoreßectononeÕsownorotherpeopleÕsemotionsandmotivesaresigniÞcantlylinkedtoafÞliativeemotionssuchasfeelingsofsocialsafeness(Liotti&Gilbert,2011).ItfollowsthereforethatfearsofafÞliativeemotionscouldbeexpectedtointerferewithsuchmindfulnessexperiencesandalsothedevelopmentofmentalizingcompetencies,whichprotectagainstalexithymia.Anumberofresearchershaves

uggestedthatpositiveemotionsingeneralhelppeoplebroadentheirperspectives,buildtheirresources,andcopewithadversities,withnumerousimpactsoncognitiveandsocialprocesses(Ashby,Isen,&Turken,1999;Fredickson,2001;Fredricksonetal.,2003).FurtherÔfacilitatinghappinessÕasapathtomentalwell-being(Carr,2004;Layard,2005;Seligman,2010)hasbecomeakeyareaoffocusforpsychologicalchange.However,whathappensifpeoplearenotjustfearfulofnegativeemotionsbutarealsofearfulofpositiveemotions?Consideringtheevidencesurroundingdifferenttypesofpositiveemotion,itisimportanttoseparateoutfearsofcompassionateandafÞliativeemotionsfromthoseofexcitementthatcomesfromachievementsand/orgeneralhappiness.ToconsidertheafÞliative-basedemotionsÞrst,ourresearchgrouphasbeguntoexplorethefearsofcompassionwithmeasuresoffearsofbeingcompassionatetoothers,beingarecipientofcompassionfromothersandbeingself-compassionate(Gilbert,McEwan,Matos,&Rivis,2011;Gilbert,McEwan,Chotai,&Gibbons,2011).Earlydatasuggeststhatfearsofcompassion(especiallycompassionfromothersandbeingself-compassionate)areassociatedwithself-criticism,depression,anxietyandstressinstudentandpatientsamples(Gilbert,McEwan,Chotai,etal.,2011;Gilbert,McEwan,Matos,etal.,2011).Inregardtopositiveemotionsingeneral,ArietiandBemporad(1980)raisedtheissuethatsomedepressedpatientshavewhattheycallÔatabooonpleasureÕandcanbefearfuloffeelinghappy.Typicallythesedepressedpeoplehavebeenbroughtupinverypuritanicalfamilieswherepositiveemotionwasfrownedupon.Positiveemotionscanbeassociatedwithnegativeoutcomesparticularlyinchildrenwhohavebeenpunishedattimeswhentheyhavebeenenjoyingthemselves(Gilbert,2007).Forexample,onepatientwhosemotherwasagoraphobicrecalledoftengettingexcitedaboutgoingoutto FearsofcompassionandhappinessthebeachortowatchaÞlmonlyforhermothertobreakdownatthelastmomentinapanicattack,triggeringargumentswithherfather,andcreatingaÔhorribleatmosphereÕ.Shefeltitwasbetternottolookforwardtothings.Clearlythepotentialforaversiveclassicalconditioningofpositiveemotionsstoredinemotionalmemorycouldplayaroleinsuchexperiences.Whilstthereismuchclinicalevidencetosuggestthatfearsofhappinessmaybeakeycharacteristicofpsychopathology,therehasbeennoformalinvestigationofthis.Hence,oneoftheaimsofthisresearchistodevelopameasureoffearofhappinessingeneralandexplorethisinrelationtoempathiccapabilities,self-criticism,anddepression.Self-criticismanddepressionSelf-criticismisofcoursetheoppositeofself-compassionandactivatesdifferentneurophysiologicalsystems(Longeetal.,2010).Itisthereforeimportanttoconsiderhowthefearsofcompassionandfearofhappinessmaybelinkedtoself-criticismandpsychopathology.Self-criticismisoneofthemostpervasivefeaturesofpsychopatholog

y(Gilbert&Irons,2005;Zuroff,Santor,&Mongrain,2005).Researchsuggeststhatself-criticsstrugglewithself-compassionandmayÞnditthreatening.Forexample,Rockliff,Gilbert,McEwan,Lightman,andGlover(2008)foundthatcompassionateimageryincreasedheart-ratevariabilityandreducedcortisolinlowself-criticsbutnotinhighself-critics.Highself-criticsshowedadecreaseinheart-ratevariabilitythatisindicativeofathreatresponse.Arecentfunctionalmagneticresonanceimaging(fMRI)studyfoundthatself-criticismwasassociatedwithamygdalaactivation(anareaassociatedwithprocessingemotionallysalientandinparticular,negativestimuli)ininstancesofself-reassurance.ThisagainindicatesdifÞcultiesforsomepeoplewhentryingtobecompassionate(Longeetal.,2010).Whenpeoplearehighlyself-criticalitbecomesdifÞculttoengageinexplorativebehaviours,particularlypositiveones(Gilbert,2010).Self-criticismmaybeaninternalprocessthatclosesdownabilitiestobeopenandexploreoneÕsfeelingsbecauseonedoesnotfeelsafewiththemandmayfeelashamedofThisstudyseekstofurtherdevelopresearchintofearofpositiveemotionsbydevelopingaFearofHappinessScalebasedonclinicalobservations.ThisscalewillthenbeusedwithourthreeestablishedFearsofCompassionScalestoexplore(1)thelinkbetweenfearofhappinessandcompassiononemotionalprocessingcompetenciesasmeasuredbyalexithymia,mindfulness,andempathy;(2)thelinkbetweenfearofhappinessandcompassionwithdifferenttypesofpositiveaffecttraits;(3)thelinkbetweenthesevariablesandself-criticismandpsychopathology.WehypothesizethatfearofcompassionwillbelinkedtodeÞcitsinaffectprocessingasmeasuredbyalexithymia,mindfulness,andempathy.ParticipantsStudentsfromtheUniversityofDerbyparticipatedinthestudy(185).Participantswere153womenand32menwithanagerangeof18Ð57years( P.Gilbertetal.Allparticipantscompletedself-reportscalesmeasuringfearsofcompassionandpositiveemotions,abilitiesforemotionprocessing,mindfulnessandempathy,positiveaffect,self-criticism,andpsychopathology.MeasuresFearsofCompassionScalesTherearethreescalesmeasuringfearsofcompassion(Gilbert,McEwan,Matos,etal.2011):(1)fearsoffeelingorexpressingcompassionforothers(10items,e.g.,ÔBeingtoocompassionatemakespeoplesoftandeasytotakeadvantageofÕ),(2)fearsofreceivingfromothers(13items,e.g.,ÔItrytokeepmydistancefromothersevenifIknowtheyarekindÕ),and(3)fearsofcompassionforself(15items,e.g.,ÔIworrythatifIstarttodevelopcompassionformyselfIwillbecomedependentonitÕ).RespondentsrateonaLikertscalehowmuchtheyagreewitheachstatement(0ÔDonÕtagreeatallÕtoÔCompletelyagreeÕ).Inastudentsample,theCronbachÕsalphaswere.72forfearsofexpressingcompassionforothers,.80forfearsofreceivingcompassionfromothers,and.83forfearsingivingcompassiontoself(Gilbert,McEwan,Matos,etal.,2011)

.TorontoAlexithymiaScaleTheTorontoAlexithymiaScale(TAS-20)(Bagby,Parker,&Taylor,1994)measuresthreefactorsofalexithymia:(1)difÞcultyidentifyingfeelingsÐassessingtheabilitytoidentifyfeelingsandtodistinguishthemfromthesomaticsensationsthataccompanyemotionalarousal(e.g.,ÔIamoftenconfusedaboutwhatemotionIamfeelingÕ.(2)describingfeelingsÐassessingtheabilitytodescribefeelingstootherpeople(e.g.,ÔIamabletodescribemyfeelingseasilyÕ.(3)ExternallyorientedthinkingÐmeasuringthetendencyofindividualstofocustheirattentionexternally(e.g.,ÔIprefertoanalyzeproblemsratherthanjustdescribethemÕ.Eachofthe20itemsareratedonaÞve-pointLikertscalerangingfrom1(ÔStronglydisagreeÕ)to5(ÔStronglyagreeÕ).TheauthorshavereportedCronbachÕsalphasof.80forfactor1;.76forfactor2;.71forfactor3;and.86forthetotalscale(Parker,Taylor,&Bagby,2003).FiveFacetsofMindfulnessQuestionnaireThis39-itemscale(Baeretal.,2006)measuresÞveaspectsofmindfulness:innerexperience(e.g.,ÔIpayattentiontosensations,suchasthewindinmyhairorsunonmyfaceÕ),experience(e.g.,ÔIcaneasilyputmybeliefs,opinionsandexpectationsintowordsÕ),actingwith(e.g.,ÔIÞnditdifÞculttostayfocusedonwhatÕshappeninginthepresentÕ),ofexperience(e.g.,ÔImakejudgmentsaboutwhethermythoughtsaregoodorbadÕ),andtoinnerexperience(e.g.,ÔIperceivemyfeelingsandemotionswithouthavingtoreacttothemÕ).ItemsareratedonaÞve-pointLikertscalerangingfrom1(ÔNevertrueÕ)to5(ÔAlwaystrueÕ).TheFiveFacetsofMindfulnessQuestionnaire(FFMQ)hasbeenfoundtohaveadequatetogoodreliability,withalphacoefÞcientsrangingfrom.75to.91forthesubscales(Baeretal.,2006).DavisInterpersonalReactivityIndexThis28-itemscaleconsistsoffoursubscales,eachmeasuringaseparateaspectofempathy(Davis,1980).Thesubscalemeasuresattemptstoadopttheperspectivesofothersandseethingsfromtheirpointofview(e.g.,ÒWhenIÕmupset Fearsofcompassionandhappinessatsomeone,IusuallytrytoÔputmyselfinhisshoesÕforawhileÓ).ThemeasuresthetendencytoidentifywithcharactersinÞlms,novels,plays,andotherÞctionalsituations(e.g.,ÔIdaydreamandfantasize,withsomeregularity,aboutthingsthatmighthappentomeÕ).Theempathicconcernsubscalemeasuresfeelingsofwarmth,compassion,andconcernforothers(e.g.,ÔIoftenhavetender,concernedfeelingsforpeoplelessfortunatethanmeÕ),whilethepersonaldistresssubscalemeasuresthepersonalfeelingsofanxietyanddiscomfortthatresultfromobservinganotherÕsdistress(e.g.,ÔIsometimesfeelhelplesswhenIaminthemiddleofaveryemotionalsituationÕ).ItemsareratedonaÞve-pointLikertscalerangingfrom0(ÔDoesnotdescribemeatallÕ)to4(ÔDescribesmeverywellÕ).ItisrecommendedbyDavis(1980)thatasumtocreateanindexofhighorlowempathyisnotpossibleasallfoursubscalesarenotallpositivelycorrelated.TheauthorreportedCronbachÕsalphasrangingfr

om.70to.78forthesubscales(Davis,1980).TypesofPositiveAffectScaleThisisashortened12-itemversionoftheoriginal18-itemscaledevelopedbyGilbertetal.(2008)andmeasuresthedegreetowhichpeopleexperiencedifferenttypesofpositiveemotions.RespondentsareaskedtorateonaÞve-pointLikertscalehowcharacteristiceachofthe12ÔfeelingÕwordsisforthem(0ÔNotcharacteristicofmeÕto4characteristicofmeÕ).Factoranalysisrevealedthreefactors,whichwelabelled:(e.g.,ÔenergeticÕ,ÔlivelyÕ,ÔactiveÕ),(e.g.,ÔrelaxedÕ,ÔcalmÕ,ÔpeacefulÕ),and(e.g.,ÔsafeÕ,ÔsecureÕ,ÔwarmÕ).CronbachÕsalphasforthisscalewere.83forand.73foretal.,2008).FormsofSelf-CriticismandSelf-ReassuranceScaleGilbert,Clarke,Hempel,Miles,andIrons(2004)developedtheFormsofSelf-CriticismandSelf-ReassuranceScale(FSCRS)fromclinicalworkconcerningself-criticismandtheabilitytoself-reassure.Thescaleismadeupofthreefactors:InadequateSelf(asenseoffeelinginternallyputdownandinadequatefollowingfailure),HatedSelf(asenseofself-dislikeandaggressive/persecutorydesirestohurttheselffollowingfailure),andReassuredSelf(asenseofencouragementandconcernforselfwhenthingsgowrong).Thescalebeginswithaprobestatement,ÔWhenthingsgowrongformeÕandparticipantsrateeachofthe22statementsonaÞve-pointscale(0ÔNotatalllikemeÕto4ÔExtremelylikemeÕ).ExamplesofitemsincludeÔIthinkIdeservemyself-criticismÕ(InadequateSelf),ÔIhaveasenseofdisgustwithmyselfÕ(HatedSelfandÔIÞnditeasytolikemyselfÕ(ReassuredSelf).TheCronbachÕsalphasintheoriginalstudywereabove.86foreachsubscale.Depression,Anxiety,andStressScaleThis21-itemshortenedversionoftheDepression,Anxiety,andStressScale(DASS-42)consistsofthreesubscalesmeasuring(e.g.,ÔIfeltdown-heartedandblueÕ),(e.g.,ÔIwasawareofdrynessinmymouthÕ),and(e.g.,ÔIfounditdifÞculttorelaxÕ)(Lovibond&Lovibond,1995).Participantsareaskedtoratehowmucheachstatementappliedtothemoverthepastweek,onafour-pointLikertscalefrom0(ÔDoesnotapplytomeatallÕ)to3(ÔAppliedtomeverymuch,ormostofthetimeÕ).The P.Gilbertetal.DASS-21subscaleshaveCronbachÕsalphasof.94fordepression,.87foranxiety,and.91forstress(Antony,Bieling,Cox,Enns,&Swinson,1998).FearofHappinessScaleThisnewlydevelopedscalecontains10items(laterreducedtonineitems),whichexplorepeopleÕsperceptionsandanxietiesaroundfeelinghappyandpositivefeelingsingeneral.ItemsareratedonaÞve-pointLikertscalerangingfrom0(ÔNotatalllikemeÕ)to4(ÔExtremelylikemeÕ).ItemsweregeneratedfromstatementsmadeduringtherapysessionswithauthorPG(e.g.,ÔIworrythatifIfeelgoodsomethingbadcouldhappenÕ)andwereratedforfacevaliditybytheresearchteam.ThisscaleyieldedagoodCronbachÕsalphaof.90.DataanalysisAnalysiswasconductedusingSPSSversion18forPCs.Thedatawerecheckedfornormalityofdistributionandoutliersusingscatterplots,whichrev

ealednooutliers.Theskewnessvaluesrangedfrom0.01to1.44andkurtosisvaluesrangedfrom0.00to1.44.Hatedselfwastheonlyvariabletoshowanyskewness(1.44).Theseßooreffectsarenotsurprisinggiventhatthiswasanon-clinicalpopulation.ThenewFearofHappinessScalewasfactoranalysedbeforeinclusioninfurtheranalysis.Inaddition,factoranalysiswasconductedforthe12-itemshortformoftheTypesofPositiveAffectScalebecausethisisourÞrststudyusingtheshortenedscale.Toaddressourprimaryresearchobjective,fearsofcompassionandhappinesswerecorrelatedwiththestudyvariables(seeTable3).ToreplicatepreviousÞndings,depressionwasalsocorrelatedwiththesestudyvariables.Asasecondaryanalysis,alexithymiaandmindfulnesswereexploredinrelationtotypesofpositiveaffect.FactorstructureofthenewFearofHappinessScaleWeconductedanexploratoryfactoranalysis(MaximumLikelihoodextractionwithpromaxrotation)ontheFearofHappinessScale.Theinitialsolutionproducedtwofactors.However,asthesecondfactorhadmultiplecrossloadingswiththeÞrst,wethereforeforcedthesolutionintoonefactor.Item3ÔIfeelrelaxedwhenIÕmenjoyingmyselfÕhadapoorloadingof.36,andwasthereforedeletedfromthescaleandfromfurtheranalysis.Withoutthisitem,theone-factorsolutionhadaneigenvalueof5.15,explaining57.20%ofthetotalvariance.Factorloadingsrangedfrom.81foritem10(ÔIamfrightenedtoletmyselfbecometoohappyÕ)to.58foritem7(ÔIfyoufeelgoodyouletyourguarddownÕ).TheitemsandfactorloadingsareshowninTable1.FactorStructureoftheTypesofPositiveAffectScaleÑShortformAnexploratoryfactoranalysis(MaximumLikelihood)revealedtwofactors:activatedpositiveaffect,butthepreviouslydistinctsafeandrelaxedpositiveaffectfactorshadcollapsedintoonefactor.TheinitialfactorsolutiondidsupportthepreviouslyfoundthreefactorsidentiÞedbyGilbertetal.(2008),buttheÞnalsolutiononlysupported FearsofcompassionandhappinessTable1.FactorloadingsfortheFearofHappinessScale Factor1 Iamfrightenedtoletmyselfbecometoohappy.81IÞnditdifÞculttotrustpositivefeelings.81Goodfeelingsneverlast.80IfeelIdonÕtdeservetobehappy.78Feelinggoodmakesmeuncomfortable.76IdonÕtletmyselfgettooexcitedaboutpositivethingsorachievements.76WhenyouarehappyyoucanneverbesurethatsomethingisnotgoingtohityououtoftheblueIworrythatifIfeelgoodsomethingbadcouldhappen.74Ifyoufeelgoodyouletyourguarddown.58 twofactorswitheigenvalues1.GiventhattheGilbertetal.(2008)studyrevealedstrongcorrelationsbetweensafepositiveaffectandpsychopathologyvariables,butlesssoactivatedorrelaxedpositiveaffect,wechoosetomaintainthisthree-factorstructurebutwewouldsuggestotherresearchersusethelongeroriginalversionofourscale.DescriptiveanalysisThemeans,standarddeviations,andCronbachÕsalphasofthevariablesstudiedareshowninTable2.Theinternalconsistencyofthescalesw

asgenerallygood.AseriesoftestsrevealedsigniÞcantdifferencesbetweenmales(32)andfemales153)onseveralmeasures.Malesscoredhigherthanfemalesonfearofcompassionfromothersotherst(39.24)=2.25,p=.030]andexternallyorientedthinking[.012].Incontrast,femalesscoredhigherthanmalesontheDavisInterpersonalRe-activityIndexÐfantasy[empathicconcernconcernt(180)=Š4.33,p.001],perspectivetakingakingt(180)=Š3.17,p=.002],andpersonaldistressdistresst(180)=Š2.73,p=.007].However,theseresultsmustbecarefullyinterpreted,asthemalesampleinthisstudyisconsiderablysmaller(CorrelationanalysisPearsonÕscorrelationcoefÞcients(twotailed)forfearsofcompassionforothersothers,forself,andfearofhappinessarepresentedinTable3.Fearsofcompassion,fearofhappiness,andalexithymiavariablesFearsofcompassion(forothers,fromothers,andforself)andfearofhappinesswerepositivelycorrelatedwithalexithymia.Thisrelationshipwasnotsopronouncedforfearofcompassionforotherswithalexithymia.Fearofcompassionfromothers,forself,andfearofhappinessalsosharednegativecorrelationswiththedescribing,awarenessofmindfulness.Thiswasparticularlystrongforfearsofpositivefeelingsand.ThissuggeststhatabilitiestodescribeandbeawareofoneÕsfeelingsandbeingnon-judgmentalarelinkedtofearsofcompassionandhappiness.Inaddition,thereweresmallcorrelationsbetweenfearofcompassionforothersandthesesame P.Gilbertetal.Table2.Means,standarddeviations,andCronbachÕsalphasforself-reportmeasures MeanStd.deviationCronbachÕsalpha FearofcompassionForothers19.707.34.85Fromothers15.269.61.91Forself14.6411.74.94TAStotal46.5411.87.83DifÞcultydescribingfeelings12.094.28.70DifÞcultyidentifyingfeelings15.116.12.84Externallyorientedthinking19.334.60.55FiveFacetMindfulnessScaleObserve22.506.21.80Describe26.215.78.81Awareness23.865.97.84Non-judge28.217.38.90Non-react19.384.67.74DavisInterpersonalReactivityIndexFantasy15.825.16.69Empathicconcern19.234.20.67Perspectivetaking16.894.63.71Personaldistress11.885.10.77Fearofhappiness11.638.31.90TypesofpositiveaffectSafe11.102.99.81Relaxed9.543.35.87Active10.833.28.84Inadequateself18.238.04.89Hatedself3.584.54.86Reassuredself20.105.57.82DASSDepression5.655.13.87Anxiety5.435.05.85Stress8.215.64.88 Note.TAS,TorontoAlexithymiaScale;FSCRS,FormsofSelfCriticising/AttackingandSelfReassuringScale;DASS,Depression,Anxiety,andStressScale.Fearsofcompassionandfearofhappinesshadsmallnegativecorrelationswithempathicconcern.Thereweresmallpositivecorrelationsbetweenfearsofcompassionforothersforself)andfearofhappinesswithpersonaldistress.Inaddition,therewasasmallnegativecorrelationbetweenfearofcompassionforothersperspectivetaking.Hence,empathicabilitieswerelinkedtofearsofcompassionandFearsofcompassion,fearofhappin

ess,andpositiveaffectFearofcompassionfromothersforselfwasnegativelycorrelatedwiththedimensionofpositiveaffect,butnotwiththedimensions(except FearsofcompassionandhappinessTable3.PearsonÕscorrelationmatrix(twotailed)ofstudyvariables FearofFearofFearofFearcompassioncompassioncompassionofDASSDASSDASSforothersfromothersforselfhappinessdepressionanxietystress TAStotal.27DifÞcultydescribingfeelingsDifÞcultyidentifyingfeelingsExternallyorientedFiveFacetMindfulnessScaleObserve.10.13.05.15AwarenessNon-react.00.02.02DavisInterpersonalReactivityIndexFantasy.02.02.03.03.10.15Empathicconcern.08.00PerspectivetakingPersonaldistress.18.14.16TypesofpositiveaffectSafeRelaxedActiveInadequateself.27Hatedself.32ReassuredselfDASSDepression.24Anxiety.23Stress.18 Note.TAS,TorontoAlexithymiaScale;FSCRS,FormsofSelfCriticising/AttackingandSelfReassuringScale;DASS,Depression,Anxiety,andStressScale.asmallnegativecorrelationbetweenfearofcompassionforself).Fearofhappinessshowednegativecorrelationswithallthreetypesofpositiveaffect,butfeelingsofsafenessinparticular.Fearsofcompassion,fearofhappiness,andself-criticismBoththefearsofcompassionandfearofhappinesshadmoderatetohighpos-itivecorrelationswithself-criticism(inadequateselfhatedself)andmod-eratenegativecorrelationswithreassuredself.Fearofcompassionforothersshowedsmallercorrelationswithself-criticismandnosigniÞcantcorrelationwithself- P.Gilbertetal.Table4.PearsonÕscorrelationmatrix(twotailed)ofstudyvariables SafeRelaxedActive TAStotalDifÞcultydescribingfeelingsDifÞcultyidentifyingfeelingsExternallyorientedthinking.01.03FiveFacetMindfulnessScaleObserve.00.04.03Describe.38Awareness.30Non-judge.38Non-react.22 Fearsofcompassion,fearofhappiness,andpsychopathologyFearsofcompassionwerepositivelycorrelatedwithdepression,anxiety,andstress.Thelinkbetweenfearofcompassionforothersandpsychopathologywasnotasstrongincomparisontofearofcompassionfromothersforself.AnewandpotentiallyveryimportantÞndingforthisstudywastheespeciallyhighpositivecorrelationbetweenfearofhappinessanddepression(Alexithymia,mindfulnessandpositiveaffectAscanbeseeninTable4,difÞcultiesdescribingandidentifyingfeelingsaresigniÞcantlylinkedtofeelingsofsafenessmoresothantotheothertypesofpositiveaffects.Externallyorientatedthinkingisminimallylinkedtosafenessbutnotatalltotheothertypesofpositiveaffect.TheseÞndingsaremirroredformindfulnesswheretheabilitytoexperiencesafenessislinkedtomindfulqualities.RegressionanalysisItisinterestingtospeculateaboutwhetherthedifferentfearsofcompassionandhappinessarelinkedtodifÞcultiesinbeingabletoreßect,describe,andprocessemotions.ThisisespeciallyinterestingbecauseafÞliativepositiveemotionprobablyoffersthesecur

ebase,whichenablespeopletoexperienceandexploretheiremotions.IndividualswiththefearofcompassionmaythereforehavedifÞcultiesinexperiencingthatdegreeofsafeness,whichinhibitstheircapacityfordevelopingunderstandingandreßectionontheemotions.Hence,aregressionanalysiswasconductedtoexploretherelationshipofdifferentfearsofcompassiontoalexithymia.AlexithymiaThealexithymiatotalwasenteredasthedependentvariableandthethreefearsofcompassionandfearofhappinesswereenteredasindependentvariables.Theregressionequationaccountedfor36%ofthevariance[(4,178).001].Thelargestcontributortothevariancewasfearofcompassionfromothersfollowedcloselybyfearofhappiness(.002),withfearofcompassion-approachingsigniÞcance( FearsofcompassionandhappinessThereisincreasinginterestintherelationshipbetweenpeopleÕsabilitiestoexperienceandtoleratepositiveemotions,andvulnerabilitiestopsychopathologies(Arieti&Bemporard,1980;Dillion&Pizzagalli,2010;Gilbert,2007,2010;Gilbert,McEwan,etal.,2011;Gilbert,McEwan,Matos,etal.,2011).Thisstudyextendsthisresearchinanumberofways.First,wedevelopedanewscaletomeasurefearsofÔgeneralÕpositivefeelingsÐcalledtheFearofHappinessScale.Second,weexploredfearsofcompassionandhappinessinrelationtoalexithymictraits,mindfulness,andThepsychometricpropertiesofthenewFearofHappinessScalearegoodwithaCronbachÕsalphaof.90.Weforcedaone-factorsolutiononthisscalebecauseofhighcrossfactorloadings.However,therewasanindicationthatitmightbepossibletoclassifyfearsofhappinessintomoresubtledimensions.Forexample,ourscalehintedatafearoffeelinghappyÔbecausesomethingbadcouldhappenÕandthismightdifferfromfeelingoneÔdoesnotdeservetobehappyÕ.Wesuggestthiscouldbeafruitfulavenueforfutureresearch.ThecorrelationanalysisrevealedthatfearsofcompassionfromothersforselfarelinkedtodifÞcultieswithmindfulnessandalexithymia,difÞcultiesinfeelingsafeandbeingself-reassuring,andelevatedself-criticism.Itisnotablethatforallcorrelations,thefearofhavingcompassionforothersislesscorrelatedwiththestudyvariables.AssuggestedbyGilbert,McEwan,Matos,etal.(2011),acceptingcompassionfromothersandfortheselfmightoperatethroughdifferentprocessesthanhavingcompassionforTheÞndingthatfearsofcompassionwereassociatedwithself-criticismsupportstheÞndingsofpreviousstudies(Gilbert,McEwan,Chotai,etal.,2011;Gilbert,McEwan,etal.,2011;Longeetal.,2010;Rockliffetal.,2008;Rockliffetal.,2011)andclinicalexperiencethatself-criticalpeopleactuallyhaveafearofbeingkindtothemselves(Gilbert&Procter,2006).Inaddition,fearsofcompassionwerestronglylinkedtodepression,anxietyandstress.Thisisinlinewithpreviousstudies(Gilbert,McEwan,Matos,etal.,2011)andon-goingstudies(Gilbert,McEwan,Chotai,etal.,2011).PauleyandMcPherson(2010)foundth

atdepressedpatientsfeltthatincreasinglevelsofcompassionwouldbehelpfultothembutverydifÞculttodoandhardtoexperience.Thiswaspartlylinkedtodepressionandfeelingsofnotdeservingcompassion.TheÞndingthatalexithymiaisassociatedwithdepressionisconsistentwithotherstudies(e.g.,Hintikka,Honkalampi,Lehtonen,&Viinamaki,2001;Honkalampi,Hintikka,Laukkanen,Lehtonen,&Viinamaki,2001).Inaddition,alexithymiawasassociatedwithself-criticism.Whilstweareunabletospeculateaboutcausallinks,itispossiblethatpeoplewhobecomeself-criticalquicklymaynotallowthemselvestimeorspacetostandbackandreßect,andmaybeanxiousaboutwhattheywouldfeeliftheydidreßect.Itisalsounknownhowhelpingpeopletoreduceself-criticismmightimpactonalexithymictraits.ItispossiblethatanimmediatereactiontodifÞcultexperiencescanbeÞlledwithfrustration,self-criticism,andhostility.Thiscanbetargetedthroughmindfulnesstrainingastimeandspacetoslowdownandreßectonexperiencesisapertinentfeatureofmindfulness.Tofurtherexploretherelationshipsofthefearsofcompassionandhappinesswithalexithymia,weconductedamultipleregression.Thisrevealedindependenteffectsoffearofcompassionfromothersandfearofhappiness.FearofcompassionforselfwasapproachingsigniÞcance.Therefore,ifoneisfearfulofreceivingcompassionandkindness,thismaybelinkedtopoorabilitiestoexploreand P.Gilbertetal.reßectonfeelingsandbemindful.Thisinturn,maycurtailtheabilitytobecuriousandreßectiveofoneÕsownandotherpeopleÕsmentalstates.Indeed,thisstudyexploredtheeffectsofdifferenttypesofpositiveemotionswithalexithymia,mindfulness,anddepression.Consistentwiththeideathatitistheexperienceofsafenessandcontentmentthatiskeytodevelopingemotioncompetencies,wefounditwasthesafenesssubscalethatbestpredictedalexithymia,mindfulness,anddepression.Theredoesseemtobeanintimaterelationshipbetweencertaintypesofpositiveemotionandtheseinternal,cognitive,andattentivereßectivecompetencies.AnotherkeyÞndingofthisstudyisthehighcorrelationbetweenfearofhappinessanddepression.Indeed,weweresurprisedbythesizeofthecorrelationatthisindicatesthatcliniciansprobablyneedtoexplorefearsofhappinessindetailandintermsofenhancingwell-being.WeshouldnotassumethatÔchallengingnegativethoughtsÕorincreasingpositivebehavioursnecessarilyareexperiencedpositively.AsArietiandBemporad(1980)notedsomedepressedpeoplereallydostrugglewithallowingthemselvestoexperiencepositiveemotionsingeneralandcanhaveaÔtabooonpleasureÕ.Ifpeopleareavoidingpositiveemotionsbecausetheyarefrightenedofthem,thismayindicateachronictendencytowardstoned-downpositiveaffectandthereforeanhedonia.Wementionthisbecausefearofpositivefeelingsisdifferentfromanhedonia.Fearsofcompassionandhappinesswerehighlyassociatedwithpsychopathologies,whereasty

pesofpositiveaffecthadsmall-moderatecorrelationswithpsychopathology.Thismaysuggestthatitisnotsimplyalackofpositiveaffect(oranhedonia),whichisassociatedwithpsychopathologyvariables,butanactualofpositiveemotions.AnhedoniaisusuallyregardedasalossofpositivefeelingsinpeoplewhowishtheycouldÔfeelhappyÕ,whereasthefearofpositivefeelingsinvolvesavoidingthesefeelingsdespitehavingtheabilitytoexperiencethem(e.g.,becauseofthefearsomethingbadwillhappen).However,ifoneisavoidingfeelinghappythenthismightbeexperiencedasaformofanhedonia.White,Laithwaite,andGilbert(inpress)havesuggestedthatanhedoniainpsychosiscouldbelinkedtotheactivationofdefeatstates,sincesuchstatesareknowntotone-downpositiveaffect(Gilbert,2006).Itisunknownhowafearofbeinghappymightoperateindefeatstates.Alimitationtothisstudyisthepredominatelyfemalestudentsample(83%),whichmaynotberepresentativeofotherpopulations.Itwillbeusefultoreplicatethisstudyinaclinicalpopulationsothatimplicationsfortherapycanbeaddressed.Inaddition,althoughwehavefocusedonthefearofpositiveemotionsinthisstudy,wenotethatsomeitemsinthisscalemaytapanelementoffearofdisappointment(i.e.,thatifoneallowsoneselftoexperiencepositiveemotionsthiswillultimatelyresultindisappointmentwhenpositiveemotionsarenotforthcomingorßeeting).Futurestudiesshouldalsoexplorethefearofnegativeemotions(e.g.,grief,anxiety,andanger)andanydifferencesbetweenthetwo.Forthemomentthough,itwouldseemthatstudiesinpsychopathology(especiallydepression)andhappinesscouldbeadvancedbyexploringthefearofpositivefeelings.TheÞndingsthatfearsofcompassionareassociatedwithalexithymictraitshavetherapeuticimplications,especiallyforthetherapeuticrelationship.Forexample,ifonecanreducethefearofcompassion,andindividualscanfeelsafeandvalidatedbyothers(thetherapist)thenalexithymiamaybereduced,andmentalizationincreased,animportantfocusinpsychotherapy(Fonagy&Luyton,2009). FearsofcompassionandhappinessAcknowledgementsThisworkwasundertakenbytheMentalHealthResearchUnitwhoreceivedaproportionofitsfundingfromtheDepartmentofHealth.TheviewsexpressedinthispublicationarethoseoftheauthorsandnotnecessarilythoseoftheDepartmentofHealth.ReferencesAntony,M.M.,Bieling,P.J.,Cox,B.J.,Enns,M.W.,&Swinson,R.E.(1998).Psychometricpropertiesofthe42-itemand21-itemversionsofthedepressionanxietystressscalesinclinicalgroupsandacommunitysample.PsychologicalAssessment,176Ð181.Arieti,S.,&Bemporad,J.(1980).Severeandmilddepression:ThepsychotherapeuticapproachLondon:Tavistock.Ashby,F.G.,Isen,A.M.,&Turken,A.U.(1999).Aneuropsychologicaltheoryofpositiveaffectanditsinßuenceoncognition.PsychologicalReview,529Ð550.Baer,R.A.,Smith,G.T.,Hopkins,J.,Krietemeyer,J.,&Toney,L.(2006).Usingselfreportassess

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