Why would I want to be more self‐compassionate? A qualitative study of the pros and cons to cultivating self‐compassion in individuals with anorexia nervosa

Abstract

Objective. Although self-compassion facilitates eating disorder symptom remission, individuals with eating disorders are fearful of developing it and higher fears of selfcompassion are associated with poorer treatment outcomes. In-depth exploration of individuals' pros and cons of behaviour change is generally helpful at resolving ambivalence; however, no research has examined the pros and cons individuals with eating disorders perceive to be associated with developing self-compassion, limiting our understanding of their personal experiences when confronted with self-compassion. Given the research suggesting higher resistance to self-compassion development in individuals with anorexia nervosa (AN), the present study used qualitative methods to gain a deeper understanding of their perceived pros and cons to self-compassion. Methods. Thirty-seven women with typical (64%) and atypical (36%) AN signed up for a study on self-help strategies for daily distress. Upon learning that the intervention would entail cultivating self-compassion, they identified their perceived pros and cons of developing self-compassion by typing them out. Results. Thematic analysis was used to extract themes. Three superordinate cons and four superordinate pros of self-compassion emerged. Perceived cons were as follows: self-compassion leading to personal shortcomings; apprehension and doubt about the efficacy of self-compassion; and emotional challenges associated with developing selfcompassion. Perceived pros were as follows: improved health; personal development (e.g., growth, coping); improved outlook; and enhanced social relationships. Conclusions. These findings reveal the various advantages and disadvantages that women with AN perceive to be associated with developing self-compassion. Results may help clinicians work more sensitively and effectively when trying to cultivate selfcompassion in patients who have AN. Bethany Nightingale has moved since this study was undertaken and is now based at

Using social cognition models to understand why people, such as perfectionists, struggle to respond with self‐compassion

“…perfectionism, prototype willingness model, self-compassion, selfregulation, theory of planned behaviour respond with self-criticism when they experience difficulties (Bayir & Lomas, 2016;Kelly et al, 2021;Tobin & Dunkley, 2021).…”

“…Despite the benefits of self‐compassion, there is emerging evidence that some people have negative views about being self‐compassionate or may even fear being self‐compassionate. For example, prior work suggests that some people believe that cultivating a self‐compassionate stance will lower their personal standards, decrease their motivation to grow as a person, and thus fail to achieve their goals (Kelly et al, 2021 ). Additionally, some people may associate being self‐compassionate with negative traits such as weakness, selfishness, irresponsibility, or self‐indulgence (Bayir & Lomas, 2016 ; Campion & Glover, 2017 ; Kelly et al, 2021 ; Robinson et al, 2016 ; Simpson et al, 2021 ).…”

“…For example, prior work suggests that some people believe that cultivating a self‐compassionate stance will lower their personal standards, decrease their motivation to grow as a person, and thus fail to achieve their goals (Kelly et al, 2021 ). Additionally, some people may associate being self‐compassionate with negative traits such as weakness, selfishness, irresponsibility, or self‐indulgence (Bayir & Lomas, 2016 ; Campion & Glover, 2017 ; Kelly et al, 2021 ; Robinson et al, 2016 ; Simpson et al, 2021 ). Furthermore, some people may believe that being self‐compassionate goes against the expectations of their family or culture (Bayir & Lomas, 2016 ; Campion & Glover, 2017 ; Gilbert, 2019 ), or that they do not deserve to experience self‐compassion (Gilbert et al, 2011 ).…”

“…Furthermore, some people may believe that being self‐compassionate goes against the expectations of their family or culture (Bayir & Lomas, 2016 ; Campion & Glover, 2017 ; Gilbert, 2019 ), or that they do not deserve to experience self‐compassion (Gilbert et al, 2011 ). Finally, there is preliminary evidence that some people lack confidence in their ability to be self‐compassionate, are unfamiliar with the concept of self‐compassion (Campion & Glover, 2017 ; Kelly et al, 2021 ; Pauley & McPherson, 2010 ), or tend (and sometimes even prefer) to respond with self‐criticism when they experience difficulties (Bayir & Lomas, 2016 ; Kelly et al, 2021 ; Tobin & Dunkley, 2021 ).…”

Enriching sociocultural perspectives on the effects of idealized body norms: Integrating shame, positive body image, and self-compassion

“…Recently, a number of qualitative studies have explored the role of self-compassion in clinical eating disorder recovery. For instance, in a sample of 37 women with typical and atypical anorexia nervosa, Kelly et al (2021) investigated participants' beliefs regarding the advantages and disadvantages of developing self-compassion as part of a self-compassion intervention. Perceived advantages included improved physical and mental health; general personal growth and improvement in coping skills; improved view of life and themselves, and healthier relationships.…”