PsychologyandPsychotherapy:Theory,ResearchandPractice(2011),84,239 - PDF document

239 PsychologyandPsychotherapy:Theory,ResearchandPractice(2011),84,239–255 C  2010TheBritishPsychologicalSociety The British Psychological Society www.wileyonlinelibrary.com Fearsofcompassion:Developmentofthree self-reportmeasures PaulGilbert 1  1 ,MarcelaMatos 2 andAmandaRivis 3 1 MentalHealthResearchUnit,KingswayHospital,Derby,UK 2 Cognitive-BehaviouralResearchCentre,UniversityofCoimbra,Portugal 3 InstituteofWork,HealthandOrganisations,UniversityofNottingham,UK Objectives. Thereisincreasingevidencethathelpingpeopledevelopcompassionfor themselvesandothershaspowerfulimpactsonnegativeaffectandpromotespositive affect.However,clinicalobservationssuggestthatsomeindividuals,particularlythose highinself-criticism,canndself-compassionandreceivingcompassiondifcultandcan befearfulofit.Thisstudythereforedevelopedmeasuresoffearof:compassion forothers , compassion fromothers ,andcompassion forself .Wealsoexploredtherelationshipof thesefearswithestablishedcompassionforselfandcompassionforothersmeasures, self-criticism,attachmentstyles,anddepression,anxiety,andstress. Method. Students( N = 222)andtherapists( N = 53)completedmeasuresoffears ofcompassion,self-compassion,compassionforothers,self-criticism,adultattachment, andpsychopathology. Results. Fearofcompassion forself waslinkedtofearofcompassion fromothers , andbothwereassociatedwithself-coldness,self-criticism,insecureattachment,and depression,anxiety,andstress.Inamultipleregression,self-criticismwastheonly signicantpredictorofdepression. Conclusion. Thisstudysuggeststheimportanceofexploringhowandwhysome peoplemayactivelyresistengagingincompassionateexperiencesorbehavioursandbe fearfulofafliativeemotionsingeneral.Thishasimportantimplicationsfortherapeutic interventionsandthetherapeuticrelationshipbecauseafliativeemotionsaremajor regulatorsofthreat-basedemotions. Thelast10yearshasseenagrowthofresearchintothenatureandfunctionsof compassion(Davidson&Harrington,2002;Gilbert,2005,2009,2010a,b;Goetz,Keltner, &Simon-Thomas,2010).CompassioncanbedeÞnedinmanyways.Forexample,the DalaiLama(1995)deÞnescompassionasÔanopennesstothesufferingofotherswitha commitmenttorelieveitÕ.Compassionisalsolinkedtofeelingsofkindness,gentleness,  CorrespondenceshouldbeaddressedtoProfessorPaulGilbert,MentalHealthResearchUnit,KingswayHospital,Derby DE223LZ,UK(e-mail:p.gilbert@derby.ac.uk). DOI:10.1348/147608310X526511 240 PaulGilbertetal. andwarmth(Fehr,Sprecher,&Underwood,2009).Researchhasbeguntoexplorethe attributesofcompassionsuchasamotivationtocare,acapacityforsympathy,anability totolerateunpleasantemotions,thecapacityforempathicunderstanding,andnon- judgingorcondemning(Gilbert,2005,2009,2010a).Intermsoftheßowanddirection ofcompassion,wecanhavecompassionatefeelings for others,experiencecompassion fromothers ,andcanhaveempathyandcompassion forourselves (self-compassion), especiallyintimesofdifÞculty(Gilbert,2009,2010a;Neff,2003a,b). Thereisincreasingevidencethathelpingpeopledevelopcompassionforthemselves andforothershaspowerfulimpactsonnegativeaffectandpromotespositiveaffect(Lutz, Greischar,Rawlings,Ricard,&Davidson,2004).Lutz,Brefczynski-Lewis,Johnstone, andDavidson(2008)foundthatregularmeditationpracticeofcompassionforothers hasanimpactonresponsestostressandthefrontalcortex.Compassion-practised individualsalsoshowedincreasedsensitivitytodetectandrespondtodistressinothers. Fredrickson,Cohn,Coffey,Pek,andFinkel(2008)gavesix60-minuteweeklygroup sessions(withhomepractice)withaCD-basedloving-kindnessmeditation(compassion directedtoself,thenothers,thenstrangers).Thistrainingincreasedpositiveemotions, mindfulness,feelingsofpurposeinlifeandsocialsupport,anddecreasedillness symptoms.Pace etal. (2008)foundthatcompassion-focusedmeditationsreduced stress-linkedimmuneandbehaviouralresponses.Astudywithanon-clinicalsample foundthatabriefloving-kindnessmeditationincreasedpeopleÕsfeelingsofsocial connectednesstowardsstrangers(Hutcherson,Seppala,&Gross,2008).Inother words,compassion-focusedmeditationsdecreasenegativeaffectsandstressresponses, increasepositiveaffectsandincreasefeelingsofafÞliationandkindnesstowards others. Neff(2003a,b),apioneerinstudiesofself-compassion(www.self-compassion.org), hasshownthatself-compassioncanbedistinguishedfromself-esteemandpredictssome aspectsofwell-beingbetterthanself-esteem(Neff&Vonk,2009).Self-compassionaids incopingwithfailure,suchasacademicfailure(Neely,Schallert,Mohammed,Roberts, &Chen,2009;Neff,Hsieh,&Dejitterat,2005).Compassionateletterwritingtooneself hasalsobeenshowntoimprovecopingwithlife-eventsandreducesdepression(Leary, Tate,Adams,Allen,&Hancock,2007). Thereisincreasingevidencethatcompassionisapowerfulantidotetoavarietyof mentalhealthdifÞcultiesincludingdepressionandanxiety.Shapiroandhercolleagues (Jain etal. ,2007;Shapiro,Astin,Bishop,&Cordova,2005;Shapiro,Brown,&Biegel, 2007)foundthat,inthecontextofmindfulnesstraining,loving-kindnessandcompassion- focusingmeditationsreduceddepression.Developing self -compassionandcompassion forothershasrecentlybeenthefocusoftherapeuticinterventions(Gilbert,2000,2007, 2009,2010a,b).GilbertandProcter(2006)demonstratedthatCompassion-Focused Therapy(CFT)reducedshame,self-criticism,depression,anxiety,andstressinachronic dayhospitalpopulation.MayhewandGilbert(2008)foundthatinasmallpilotstudyof threevoicehearers,compassiontrainingsigniÞcantlybeneÞtedtwo,withathirdÞnding ithelpfulbutlimitedbecausehefelthedidnotdeservecompassion(possiblydueto undisclosedshame-linkedfantasies).Inastudyofgroup-basedCFTfor19clientsina highsecuritypsychiatricsetting,Laithwaite etal. (2009)foundÔ...alargemagnitude ofchangeforlevelsofdepressionandself-esteem...Amoderatemagnitudeofchange wasfoundforthesocialcomparisonscaleandgeneralpsychopathology,withasmall magnitudeofchangeforshame...Thesechangesweremaintainedat6-weekfollow-upÕ (p.521). Fearsofcompassion 241 Fearofpositiveemotions AlthoughdevelopingcompassionappearstohavesigniÞcantpositiveeffectsonmental well-being,workingwithCFThasilluminatedmajordifÞcultiesinsomepeopleÕsabilities andmotivationstodevelopcompassion.Forsomepeople,compassiongivesriseto avoidanceorevenfearreactions(Gilbert,2010a).Thefearofpositiveemotionshas beennotedintheliteraturebefore.Forexample,ArietiandBemporad(1980)identiÞed asubgroupofdepressedpeoplewhohadaÔtabooonpleasureÕandwerefearfulof positiveemotions.SomebelievedthatÔifyouÕrehappytodaysomethingbadwillhappen tomorrowÕ.AclientofPGrecalledtimeswhenshewashappyasachildbutthenher motherwouldbecomeunpredictablyangryorcritical.SoshelearnedthatÔyoushould neverbehappybecausethatisthetimeyouareoffyourguardandbadthingscan happenÕ.Anotherpatientnotedthatitwasattimeswhenshefelthappythatfrightening thoughtscameintohermindÐsuchthatsomethingcouldhappentoherchildrenor husbandthatwouldendherhappiness.However,shenotedthatwhenshewasmore depressedandmiserablethesedistressingthoughtsdidnotintrude.Shewassurprised todiscoverhowfearfulofbeinghappysheactuallywasandwaslaterabletolink thiswithearlylife-eventsofloss.Hence,positiveemotionscanbeconditionedto,and associatedwith,aversiveoutcomes.SinceafÞliativeemotionsarepositiveemotions thatareassociatedwithinterpersonalcloseness,thenonecananticipatethataversive backgrounds,particularlythoseassociatedwithabuseandneglect,mightleadtofears ofafÞliativeemotions(Gilbert,2010a). BasedontheworkofBowlby(1969,1973,1980),Gilbert(2005,2010a)suggested thatcapacitiesforcompassionwererootedin,anddevelopedby,theattachmentsystem (seealsoGillath,Shaver,&Mikulincer,2005).However,theattachmentsystemcan operatelikeabook,closingdownduetoabuseorneglectbutthatthecompassionof thetherapistorsomeCFTexercisescanreactivatetheattachmentmotivationalsystem. Whenitisopeneditopensattheplacethatitwasclosed.Hence,iftheattachmentsystem becomesclosedbecauseofemotionalconßicts,neglect,orabuse,reactivatingthesystem willreactivatetheseemotionalmemories.There-emergenceofthesedifÞcultiesand feelingscanunderpinfearsofcompassionandbemajorblockstorecovery,especially forpeoplewithhighshameandself-criticism.Theimportanceofunderstandinghowthe attachmentsystemisregulated,howitunderpinspsychopathologyandcanbeafocus withinpsychotherapy,hasbeencentraltoanumberoftherapies(e.g.,Holmes,2001; Wallin,2007). Fearofcompassionfromothers AfÞliativeemotionsaregenerallyregardedaspositiveemotionsbutonesthathave speciÞcqualitiesofsoothing,calmingandareaccompaniedbyfeelingsofwell-being. TheseafÞliativeemotionsarelinkedtospeciÞcneurophysiologicalsystemsespecially endorphinandoxytocin,thataredifferentfromÔdriveandexcitementÕsystems(Depue &Morrone-Strupinsky,2005).Affectionandcarearefundamentaltoattachmentbe- haviours,thecreationofasafeplaceandpositivefeelingsabouttheselfandothers (Bowlby,1969,1973;Mikulincer&Shaver,2007). However,forreasonsnotedabovesomepeopleÞndcertaintypesofafÞliative emotionsmorethreateningthanpleasant.Thisisclearlyproblematicgiventhat,from anevolutionarypointofview,afÞliativeemotionsaremajorregulatorsoffeelingsof threatandsocialisolation(Depue&Morrone-Strupinsky,2005;Gilbert,2000,2007, 2009,2010a;Mikulincer&Shaver,2007).Thefearofcompassionatefeelingshas 242 PaulGilbertetal. beenexploredbyresearchintocompassionactivationusingimagery.Rockliff,Gilbert, McEwan,Lightman,andGlover(2008)measuredheart-ratevariabilitywhenindividuals wereaskedtoimagineaÔcompassionatebeingÕexpressingcompassiontothem.They foundthatlowandhighself-criticsrespondedverydifferentlytothiscompassion imagery,withhighself-criticsrespondingwithareductioninheart-ratevariability (anindictorofincreasedthreat)andlowself-criticsshowedanincreaseinheart-rate variability. Clinicalworkhasalsoindicatedthatthefeelingsofwarmthassociatedwith compassionfromothers(andintryingtobecomeself-compassionate)canactivategrief feelingsofwantingbutnotreceivingaffectionandcarefromsigniÞcantothers,withan increasedawarenessofinnerlonelinessandayearningforcloseandaccepting/valuing relationships(Bowlby,1980;Gilbert,2010a).Ifthefeelingsofgrief,triggeredbythe experienceofkindnessandcompassionfromothers(andself-compassion),arevery unfamiliar,oraschildrenpeoplelearnttodissociateorblockthemoff,thentheycanbe overwhelmingandmayeventriggerdissociationagain. Individualsfromsecurebackgroundshowever,havebeenshowntoperceiveothers assourcesofsoothing,security,andsupportandaremorelikelytoengageinsupport seekingwhendistressed,beopentocompassionfromothers,andfeelhelpedbyit. Thisisincontrasttoindividualsfrominsecurebackgroundswhoareuncertainofthe availabilityandsupportofothersandarepronetoeitherclinganxiouslytoattachment Þgureswithoutfeelingsoothedoravoidandwithdrawfromothers(Collins,1996;Collins &Read,1990;Kobak,Cole,Ferenz-Gillies,Fleming,&Gamble,1993;Meyer,Olivier,& Roth,2005;Mikulincer&Florian,1995). Fearofcompassionforothers Feelingandactingcompassionatelytoothershasbeenlinkedtoarangeofpsychological processesthathaveemergedfromtheliteratureonhelping.TiceandBaumeister(1985) foundthatpersonalidentity,notablyhighmasculineidentity,especiallywhenlinkedto lossofpoiseinhelping,inhibitedhelping.Graziano,Habashi,Sheese,andTobin(2007) foundthathelpingandcompassion(prosocialmotivation)arelinkedtopersonality, empathy,andsituationalcontexts.ReedandAquino(2003)foundthatcompassionate valueswerelinkedtoadesiredmoralself-identity.Evidencefromtheattachment literaturesuggeststhatavoidantindividualsviewsupportseekingasaweaknessand mayperceiveothersindistresswithcontempt(Collins&Read,1994;Feeney&Collins, 2001;Mikulincer,Shaver,Gillath,&Nitzberg,2005).Anxiouslyattachedindividualscan beoverlyconcernedwithbeingcompassionateandhelpfulinordertobelikedand thuscanactsubmissively,whilstavoidantindividualsareuncomfortablewithdistress emotionsanddistancethemselvesfromothersindistress.Someindividualsbecome personallydistressedbyothersÕdistressandbecomeavoidant(Collins&Read,1994; Feeney&Collins,2001;Mikulincer etal. ,2005).Incontrast,attachmentsecurityis associatedwithincreasedcapacitiesforengaginginempathic,compassionate,and caringbehaviourstowardsothers(Gillath etal. ,2005;Mikulincer&Shaver,2007). Secureindividualsaremoresensitivetotheemotionalstatesandneedsofthemselves andothersandareabletoempathizeandprovidecarewithoutbeingoverwhelmedby theirdistressandthatofothers. Mostspiritualtraditionsimploreustobemorecompassionatetoeachotherwiththe recognitionthatoftenwearenot.Compassionateactionsmaybesuppressedifpeople perceivetherecipientofcompassiontohavecommittedamoralinjustice(Batson, Fearsofcompassion 243 Klein,Highberger,&Shaw,1995),andcompassioncanbeinhibitedbycertaintypes ofself-interest(Gerhardt,2010).Evolutionarytheoristshavearguedthataltruismand compassionareexpensiveresourcestodispenseandthereforesubjecttoevolutionary pressures.Thus,wearemorelikelytobecompassionateandhelpfultokin,thosewe likeandseeaspotentialreciprocatorsofhelpfulness,thantonon-kinandthosewe donotknoworlike(Burnstein,Crandall,&Kitayama,1994).Individualsmotivated bysocialdominance,especiallyfortheirgrouptobesuperiortoothergroupscan endorseverynon-compassionatevaluestooutgroups(Pratto,Sidanius,Stallworth,& Malle,1994).Whenoperatingwithincorporations,individualsareatriskofsigniÞcantly increasingexploitativeanduncaringbehaviourstowardsothers(Bakan,2005).Failures incompassionhavealsobeenattributedtoobediencetoauthority,followinggroup norms,Þttingin,andcarryingoutorders(Kelman&Hamilton,1989).So,self-interest canblockcompassionandtherecanbeafearthatcompassionmaybedetrimentalto self-interest. Fearofbeingcompassionatecanalsoarisefromconfusionsofcompassionwith submissiveness,e.g.,thatbeingkindandforgivingisshowingweaknessandsubmissive- ness.Instudiesofretributiveversusrestorativejustice,peoplecanfearthatcompassion maybelettingpeopleoffthehook,orpeoplewilltakeadvantage(McLaughlin,Huges, Fergusson,&Westmarland,2003).Todate,thoughtherehasbeennospeciÞcstudyof thefearof being compassionatetoothers. Compassioncanalsobereducedduetoemotionalstate.Forexample,research hasshownthattraumatizedindividuals,andthisincludesthosewhoarevicariously traumatized,canexperienceÔcompassionfatigueÕ,associatedwithdetachmentfrom empathicandsympatheticemotionsforthesufferingofothers(Figley,2002;Rothschild, 2006).Vitaliano,Zhang,andScanlan(2003)foundthatcaringandeffortstobe compassionatecouldhavedetrimentaleffectsonhealthifcaringwasseenasobligatory andiftheperceiveddemandsexceededresources. Fearofself-compassion Asnotedabove,self-compassionhasbeenshowntohaveavarietyofhealthbeneÞts. However,therecanalsobeasigniÞcantfearofbeingself-compassionate.Gilbertand Procter(2006)foundthatinagroupofchronicmentalhealthpatients,theirÞrst movementtowardsself-compassionwasoftenmetwithdoubt,fear,andresistance. Thesewerelinkedtofeelingsofwhethercompassionwasdeserved,oraweakness, unfamiliaritywithcompassion,unresolvedgriefofwantingloveandkindnessbutoften feelinglonelyandrejected,andsimplyÔneverconsideringthevalueofself-compassionÕ. BasedontheseÞndingsPauleyandMcPherson(2010)lookedatthemeaningandvalue ofself-compassioninadepressedgroup.Theyfoundthatwhilstparticipantsviewedself- compassionaspotentiallyveryhelpfultothemtheyalsosawitasbeingverydifÞcultto develop.TheyfeltthisdifÞcultywasinpartduetotheimpactoftheirillness.Pauleyand McPherson(2010)notethatÔaninterestingrelatedÞndingwasthatmanyparticipants reportedthatitwasnotjustthattheyfounditdifÞculttobeself-compassionate,but alsothattheyexperiencedtheexactoppositeofself-compassionwhendepressedor anxiousÕ(p.140). Thefearofself-compassioncanbemarked,especiallyifpeoplecomefromlow affectionorabusivebackgrounds(Bowlby,1980;Gilbert,2007;Mikulincer&Shaver, 2007).Highself-criticsinparticularcanstrugglewithdevelopingself-compassion (Gilbert&Procter,2006;Mayhew&Gilbert,2008;Rockliff etal. ,2008).Inafunctional 244 PaulGilbertetal. magneticresonanceimaging(fMRI)study,Longe etal. (2010)foundthatbeingself- criticalorself-reassuringtoset-backeventsactivateddifferentbrainareas.Peoplehighin self-criticismhadmoredifÞcultyinbeingself-reassuringandshowedathreatresponse duringeffortstobeself-reassuring. However,despitethevariousfearsofcompassion,developingtherapeutictechniques toengagewithandhelppeopleresolvetheirfearsofandresistancetocompassioncan haveimportanttherapeuticeffects(Gilbert&Procter,2006;Laithwaite etal. ,2009)Ðnot leastbecausetheafÞliativesystemisamajoraffectregulationsystem(Depue&Morrone- Strupinsky,2005).Todate,however,ourunderstandingofthefearofandresistance toafÞliativeemotionsandcompassionisderivedfromattachmenttheory(Mikulincer &Shaver,2007)andclinicalobservations(Gilbert,2010a,b).Toadvanceresearchand understandingintothenatureoffearofafÞliativeemotionsandcompassionrequires measuresoftheseprocesses. Aims Theaimofthisstudywastodevelopmeasuresoffearofcompassioninthreedomains: FearsanddifÞcultiesinfeelingcompassion fromothers,forothers ,and forself .We exploredthesethreefearsofcompassioninrelationtoestablishedself-compassion andothercompassionscales,self-criticismandself-reassurance,attachmentstyles, anddepression,anxietyandstress.Wewereparticularlyinterestedinexploringthe relationshipbetweenfearsofcompassionanddepression. Methods Participants StudentsfromtheUniversitiesofDerbyandNottinghamparticipatedinthestudy( N = 222;Psychology N = 125,Criminology N = 97).Weconductedanindependent t testto seewhetherthesesamplescouldbetreatedasone.TherewerenosigniÞcantdifferences betweenthestudentsfromDerbyandNottinghamandstudentsfromPsychologyand Criminologycourses.Participantswere168womenand54men,agerangedfrom18to 59years( M = 22.70; SD = 7.07).Inaddition,wecollecteddatafrom59therapists(49 women,10men)attendingathree-dayCFTworkshop.Therapistsagerangedfrom26 to61years( M = 39.52; SD = 10.99).Allparticipantscompletedaseriesofself-report scalesmeasuringfearsofcompassion,compassionforselfandothers,self-criticism,adult attachment,andpsychopathology. Measures FearsofCompassionScales Wedevelopedthreescalesforthisstudy,measuringfearofcompassion forself (compassionwehaveforourselveswhenwemakemistakesorthingsgowrongin ourlives),fearofcompassion fromothers (thecompassionthatweexperiencefrom othersandßowingintotheself),andfearofcompassion forothers (thecompassionwe feelforothers,relatedtooursensitivitytootherpeopleÕsthoughtsandfeelings). Wegeneratedaseriesofitemsbasedonvariousfearsofcompassionforeachof thesescales.ManyoftheseitemswerederivedfromPGsdiscussionswithpatients,ideas generatedinthepsychotherapyliterature(e.g.,Arieti&Bemporad,1980)andinthe attachmentliterature(Bowlby,1969,1973,1980). Fearsofcompassion 245 Wegenerated20itemsforeachdomainandthenaskedtheresearchteam(six people)toranktheitemsaccordingtofacevalidityandselectedtheitemswhichwere ratedtobethemostvalid.Thoseitemsforwhichtherewasgeneralagreementthat theyhadlowfacevalidityorweredifÞculttounderstandwererejected.Thesubscales consistedof:fearofcompassion forSelf comprised17items(e.g.,ÔIworrythatifIstart todevelopcompassionformyselfIwillbecomedependentonitÕ);fearofcompassion fromOthers comprised15items(e.g.,ÔItrytokeepmydistancefromothersevenifI knowtheyarekindÕ);fearofcompassion forOthers comprised13items(e.g.,ÔBeing toocompassionatemakespeoplesoftandeasytotakeadvantageofÕ).Theitemswere ratedonaÞve-pointLikertscale(0 = DonÕtagreeatall,4 = Completelyagree).Thefull scalesaregivenintables1Ð3.TheCronbachÕsalphasforthesescalesarereportedin Table5. Self-CompassionScale This26-itemscaleassesseslevelsofself-compassion(Neff,2003a,b).Therearethree factorsof positive self-compassion: Self-kindness ,C ommonhumanity and Mindfulness , andthreefactorsthatfocusona lack ofself-compassion:S elf-judgment , Isolation ,and Over-identiÞcation .Weobtainedtwototalsforthisscale: Self-compassion (sumofthe threepositivefactors)and Self-coldness (sumofthethreenegativefactors).Participants indicatehowoftentheyengageinthesewaysofself-relatingonaLikertscale1Ð5.The scalehasgoodreliability(CronbachÕsalphasrangingfrom.75to.81).Inthisstudy,we chosetostudythenegativeandpositiveitemsofthisscaleseparatelyandnotasasingle factorscale.Thisisbecausepositivefeelings(ofcompassion)andnegativefeelings(of lossandthreat)aretypicallyseenastwoindependentdimensionsofaffect(Watson etal. ,1995),andfMRIdatasuggestthattheyaretappingdifferentphysiologicalsystems andprobablyshouldnotbeseenasaunitaryconcept(Longe etal. ,2010). CompassionateLoveScale This21-itemscalemeasurescompassionateloveforothers(Sprecher&Fehr,2005). Therearethreeversionsofthisscale:oneassessescompassionatelovetowardsclose others,oneassessescompassionateloveforaspeciÞcother,andthethirdmeasures compassionatelovetostrangers.Inthecurrentstudy,weusedtheversionofthescale whichmeasurescompassionforstrangers.Thiswastoavoidcompassionforothers beingassociatedwithattachmentissues.Respondentsareaskedtoratehowtrueeach compassionatestatementisonaseven-pointLikertscalerangingfrom1(notatalltrue ofme)to7(verytrueofme).ThisscalehasbeenfoundtohaveagoodCronbachÕsalpha valueof.95(Sprecher&Fehr,2005). FormsofSelf-Criticism/Self-ReassuringScale This22-itemscaleassessesparticipantsÕthoughtsandfeelingsaboutthemselvesduringa perceivedfailure.Twosubscalesmeasureformsofself-criticizing( Inadequateself and Hatedself )andonesubscalemeasurestendenciestobereassuringtotheself( Reassured self ).ParticipantsrespondonaLikertscale(0 = Notatalllikeme,4 = Extremelylike me).ThescalehasgoodreliabilitywithCronbachÕsalphasof.90forInadequateself,.86 forHatedself,and.86forReassuredself(Gilbert,Clarke,Hempel,Miles,&Irons,2004). 246 PaulGilbertetal. AdultAttachmentScale This18-itemscalemeasuresthreeattachmentdimensions.C lose measureseaseofgetting closetoothers. Depend measuresabilitiestodependonothers,and Anxious measures degreeofworryaboutabandonment.RespondentsareaskedtorateonaLikertscale 1Ð5howcharacteristiceachstatementisofthem.TheCronbachÕsalphaswere.75for Depend,.72forAnxietyand.69forClose(Collins&Read,1990). Depression,Anxiety,andStressScale This21-itemshortenedversionoftheDepression,Anxiety,andStressScale(DASS-42) consistsofthreesubscalesmeasuring Depression , Anxiety ,and Stress .Participantsare askedtoratehowmucheachstatementappliedtothemoverthepastweek,onaLikert scale0Ð3.TheDASS-21subscaleshaveCronbachÕsalphasof.94forDepression,.87for Anxiety,and.91forStress(Antony,Bieling,Cox,Enns,&Swinson,1998;Lovibond& Lovibond,1995). Results Dataanalysis AnalyseswereconductedusingSPSSversion18.Thedatawerecheckedfornormality ofdistributionandoutliersusingboxplots.Inthestudentpopulation,skewnessvalues rangedfrom Š 0.00to1.09andkurtosisvaluesrangedfrom Š 0.01to Š 0.71.Weremoved thedatafromsixofthetherapistsastheywereextremeoutliers.Inthetherapist, populationskewnessvaluesrangedfrom Š 0.06to1.64andkurtosisvaluesrangedfrom Š 0.04to2.87.ThevariablesÔDepressionÕandÔAnxietyÕwaspositivelyskewedand kurtotic;theseßooreffectsarepossiblyduetothefactthatatherapistpopulationis likelytobelessanxiousthanayounger,studentpopulation. Thethreenewlydevelopedfearofcompassionscalesweresubjectedtoseparate exploratoryfactoranalyses.Variableswerethensubjectedtodescriptiveanalyses, PearsonÕscorrelationsandstandardregressionanalysis. Factoranalysis Theexploratoryfactoranalysesusedmaximum-likelihoodextractionandoblique(Pro- max)rotation.Eachofthethreescalesrevealedsingle-factorsolutionswitheigenvalues greaterthanone.Tables1Ð3givetheitemsandfactorloadingsfromthestructure matrices.Someitemshadsmallfactorloadingsandwerethusremovedfromthescales andfromfurtheranalyses.Theremainingitemswerethenrenumbered(seeTables1Ð3) andarethebasisforallsubsequentanalysis. Descriptives Anindependentmeasures t testwiththerapistsandstudentsshowedthattherewere manysigniÞcantdifferencesbetweenvariablesforthesetwogroups.Thereforethe studentandtherapistsampleswereanalysedseparately(seeTable4).Table4also displaysthemeansandstandarddeviationsforeachgroup.Correlationsforstudentsand therapistsarepresentedinTable5(studentdataarepresentedinthelowerleftofthe matrixandtherapistdataarepresentedinthetoprightofthematrixinitalics).The CronbachÕsalphasforthethreecompassionscalesaregood(seeTable5). Fearsofcompassion 247 Table1. Fearofexpressingcompassionforothers Weexploredgenderdifferencesinstudents(54men,168women)witha t test [ t (72.56) = 2.33, p = .023]andfoundthatmen( M = 19.37, SD = 12.07)hadsigniÞcantly highermeanscoresonfearofcompassion forself thanwomen( M = 15.09, SD = 9.59).TherewerenosigniÞcantgenderdifferencesfortheothervariablesstudied,or differencesingenderwithinthetherapists. Table2. Fearofrespondingtotheexpressionofcompassionfromothers 248 PaulGilbertetal. Table3. Fearofexpressingkindnessandcompassiontowardsyourself Correlationanalyses ThecorrelationmatrixisgiveninTable5withtherapistdatainthetopright-hand quadrantandthestudentdatapresentedinthebottomleft-handquadrant.WeÞrst exploredthecorrelationsbetweenthenewfearofcompassionscales.Fearofcompassion forself washighlycorrelatedwithfearofcompassion fromothers inbothstudents Table4. Means,standarddeviations,and t test p valuesforstudents( N = 222)and therapists ( N = 53) Fearsofcompassion 249 Table5. CorrelationsandCronbach’salphasforstudents( N = 222;bottomleft)and therapists ( N = 53;topright) 250 PaulGilbertetal. andtherapists.Fearofcompassion forself alsoshowedasmallcorrelationwithfearof compassion forothers instudentsbutnottherapists.Fearofcompassion fromothers and forself showedamoderatecorrelationwithfearofcompassion forothers instudents. So,itappearsthatfearofcompassion forself andcompassion fromothers mayreßect adifÞcultyinexperiencingafÞliativeemotions ingeneral Ðfrombothinternaland externalsources. Selfandothercompassion Asnotedabove,inthisstudy,wechosetoanalysethepositiveandnegativefactorsof theNeff(2003a,b)Self-CompassionScale(SCS),separately.Inthestudentsample,the positiveself-compassionsubfactorhassmallsigniÞcantnegativecorrelationswiththe threefearofcompassionscales.Thenegativeself-compassionsubfactor(self-coldness) hasaslightlyhigherpositivecorrelationwiththefearofcompassionscales.Thetherapist populationmirrorsthisinregardtofearofcompassion forself and fromothers but not forothers .Thestrongestassociationsarewiththenegativeself-coldnessitemsfor bothpopulations.InregardtoSprecherandFehrÕs(2005)CompassionateLovefor Others(CLO)Scale,onlyfearofcompassion forothers inthestudentsampleshoweda signiÞcantnegativecorrelation. Self-criticism Fearofcompassion forself andtoalesserextentfearofcompassion fromothers were positivelyassociatedwithfeelinginadequateandself-hatred,andnegativelyassociated withself-reassuranceinbothofoursamples.Fearofcompassion forothers hadasmall correlationwithfeelinginadequate,onlyinstudents.TheseÞndingsmirrortheÞndings withtheself-coldnesssubscalefromtheNeff(2003a,b)SCSindicatingthatself-criticism issigniÞcantlylinkedtofearofcompassion forself andreceivingcompassion from others .ThisconÞrmsclinicalimpressions,thatself-criticalpeopleactuallyhaveafearof beingkindandafÞliativetothemselves. Attachment Instudents,thethreeattachmentstyleswerelinkedtofearofcompassion forself , from others ,and forothers .Inthetherapistgroup,thefearofself-compassionandcompassion fromotherswereveryhighlycorrelatedwithanxiousattachmentstyle.Thisindicates thatanxiousattachmentisnotjustafearofabandonment,butcanbeanactual fear of afÞliation.Thisisstronglyindicatedintheattachmentliterature(Mikulincer&Shaver, 2007). Depression,anxiety,andstress Fearofcompassion,especiallyfearofcompassion forself and fromothers ,arelinked todepression,anxiety,andstress,instudentsonly.Intherapists,fearofcompassion for self iscorrelatedwithdepression,andfearofcompassion fromothers iscorrelatedwith depressionandstress. Fearsofcompassion 251 Multipleregression Inamultipleregressionanalysis(studentsonly),whenenteringfearofcompassion for self and fromothers ,self-compassion(Neff,2003a,b)andself-criticism(Inadequateand Hatedself-summed)aspredictorsofdepression,thesevariablesaccountedfor38%ofthe variance[ F (4,197) = 29.90, p = .000].Self-criticismemergedasthebestglobalpredictor (  = 0.54, p = .000).Thisisbecauseself-criticismissostronglylinkedtodepression. Discussion Clinicalobservations(Arieti&Bemporad,1980)suggestthatsomepeoplehaveafear ofpositiveemotions.Thisstudyexploredfearrelatedtoaparticulartypeofpositive emotionlinkedtoafÞliation.Clinical(Gilbert,2000,2007,2009,2010a,b;Pauley& McPherson,2010),attachment(Bowlby,1969,1973),andphysiologicalevidence(Longe etal. ,2010;Rockliff etal. ,2008)suggestthatsomeindividualsÞndreceivingafÞliative andcompassionateemotionsfromselforothersdifÞcultorevenunpleasant/threatening. TostudythedifferentdimensionsoffearofcompassionandafÞliativeemotions,we designedthreeself-reportscalesmeasuringfearsofcompassion: forself , fromothers , and forothers . Wefoundthatforbothstudentsandtherapistsfearofcompassion forself washighly andsigniÞcantlylinkedtofearofcompassion fromothers ,suggestingageneraldifÞculty indealingwithselforothergeneratedafÞliativeemotions.Fearsofcompassion for self and fromothers werealsolinkedtoself-coldness,self-criticism,anddepression.If individualshaveafearofaparticularpositiveemotion,thenclearlythiscouldbetargeted intherapyÐnodifferentinprincipletodesensitizingandfacilitatingexposuretoany avoidedorfearedemotion.However,afearofcompassionmighthaveverydifferent implicationsfortheformationandmaintenanceofthetherapeuticrelationshipthan (say)afearofanxiety. Wewereinterestedinthefactthatinstudentsafearofcompassion forself and compassion fromothers werealsosigniÞcantlylinkedtofearofcompassion forothers . Inaddition,inthispopulation,fearofbeingcompassionatetootherswassigniÞcantly associatedwithinsecureattachmentstyles.ThisÞtswiththeattachmentliterature suggestingthatinsecureattachmentisrelatedtoproblemswithempathicengagement andabilitiestoeffectivelycareforothers(Mikulincer etal. ,2005).Itisinterestingtonote thatfearofbeingcompassionatetootherswas(inourstudents)signiÞcantlyassociated withself-coldnessandfeelinginadequate. Whenweexploredtherelationshipbetweenvariablesusingamultipleregression (instudents),wefoundthatthevariableself-criticismwassopowerfulthatnoother variablesweresigniÞcantpredictorsofdepression.Indeed,asseenfromthecorrelations inbothstudentsandtherapists,self-criticism(bothInadequateselfandHatedself)was veryhighlylinkedtothefearsofcompassion.ThisÞndingÞtswithotherstudies(e.g., Longe etal. ,2010;Rockliff etal. ,2008)andunderlinesthefactthatself-criticismis notjustaboutnegativeattitudestooneselfbutitalsocontainswithinitafear-based orientationtoafÞliation(Gilbert,2010a).GiventhatafÞliationissuchanimportant emotionalregulatorofthreat(e.g.,Depue&Morrone-Strupinsky,2005),thisÞndinghas importanttherapeuticimplications. Ingeneral,forfearofcompassion forself , fromothers ,and forothers ,ourtherapist grouphassimilarcorrelationstothestudentsample.Inregardtodifferencesbetween therapistsandstudentsonallstudyvariables,thesemayberelatedtotheirage,training,or 252 PaulGilbertetal. basicpersonalitycharacteristics.Itisinterestingthatthisgroupoftherapistsisgenerally loweronfearofcompassion. TheseÞndingssuggestthatitisnotjusttheabsenceofcompassionthatisimportant butalso thefearofcompassion .Thismeansthatpeoplemayactivelyresistengaging incompassionateexperiencesorbehaviours.Therapeutically,thisactiveresistanceto compassionmaybegeneratedbyvariousfears,thatwouldneedtobeaddressedwithin thetherapeuticcontext.Moreworryingperhapsisthepossibilitythatwithincreasingly competitivesocietiesthereisincreasingfearofcompassion(Gerhardt,2010;Gilbert, 2009). OurresearchhasidentiÞedapotentiallyimportantareaforfutureresearchand therapydevelopment.If,inworkingwithanypsychologicaltherapy,patientsarenot abletoexperiencefeelingsofreassurance,compassion,andkindness,thenitispossible thattherapywillbeoflimitedimpact.Thisisbecauseforover120millionyearsthe mammalianbrainhasbeenevolvingimportantemotionregulationsystemsthatare linkedintoafÞliativeinteractions(Depue&Morrone-Strupinsky,2005).Theinabilityto experiencethebeneÞtsofcompassionandafÞliationimpliesmajordifÞcultiesininternal affectregulation(Gilbert,2010a).Althoughsometherapiesfocusontheimportanceof workingwiththedifÞcultieswithintheattachmentsystem(Holmes,2001;Wallin,2007), therapymaybefurtheradvancedbyimprovingwaysofaccessingandfacilitatingthe developmentofdifferentformsofinterpersonalsafenessandcompassionandaddressing thefearsofcompassion(Gilbert,2010a,b). 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