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A pilot study on the effects and feasibility of compassion-focused expressive writing in Day Hospice patients

Published online by Cambridge University Press:  17 April 2012

Susan Imrie
Affiliation:
School of Psychology, University of Hertfordshire, Hertfordshire, United Kingdom
Nicholas A. Troop*
Affiliation:
School of Psychology, University of Hertfordshire, Hertfordshire, United Kingdom
*
Address correspondence and reprint requests to: Nicholas Troop, School of Psychology, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB, U.K. E-mail: [email protected]

Abstract

Objective:

Research has found that writing about stress can confer physical and psychological health benefits on participants and that adopting a self-compassionate stance may have additional benefits. This pilot study evaluated a self-compassionate expressive writing intervention in a Day Hospice setting.

Method:

Thirteen patients with life-limiting illnesses wrote on two occasions about recent stressful experiences. Half also received a self-compassion instruction for their writing. Outcome measures were taken at baseline and one week after the second writing session, and text analysis was used to identify changes in the types of words used, reflecting changes in psychological processes.

Results:

Patients given the self-compassion instruction increased in their self-soothing and self-esteem in contrast to patients in the stress-only condition. Happiness broadly increased in both groups although reported levels of stress generally increased in patients given the self-compassion instruction but decreased in patients in the stress-only condition. Those given the self-compassion instruction also increased in their use of causal reasoning words across the two writing sessions compared with those in the stress-only condition.

Significance of Results:

Expressive writing appears to be beneficial in patients at a hospice and was viewed as valuable by participants. The inclusion of a self-compassion instruction may have additional benefits and a discussion of the feasibility of implementing expressive writing sessions in a Day Hospice is offered.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2012

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References

REFERENCES

Beckwith McGuire, K.M., Greenberg, M.A. & Gevirtz, R. (2005). Autonomic effects of expressive writing in individuals with elevated blood pressure. Journal of Health Psychology, 10, 197209.CrossRefGoogle Scholar
Bodor, N.Z. (2002). The Health Effects of Emotional Disclosure for Individuals with Type 1 Diabetes. Doctoral dissertation. Austin, Texas: University of Texas.Google Scholar
Broderick, J.E., Junghaenel, D.U. & Schwartz, J.E. (2005). Written emotional expression produces health benefits in fibromyalgia patients. Psychosomatic Medicine, 67, 326334.CrossRefGoogle ScholarPubMed
Burton, C.M. & King, L.A. (2004). The health benefits of writing about intensely positive experiences. Journal of Research in Personality, 38, 150163.CrossRefGoogle Scholar
Chung, C.K. & Pennebaker, J.W. (2008). Variations in the spacing of expressive writing sessions. British Journal of Health Psychology, 13, 1521.CrossRefGoogle ScholarPubMed
Cohen, S. & Williamson, G. (1988). Perceived stress in a probability sample of the United States. In Spacapan, S. & Oskamp, S. (Eds.), The social psychology of health: Claremont Symposium on applied social psychology (pp. 3167). Newbury Park, CA: Sage.Google Scholar
Danner, D.D., Snowdon, D.A. & Friesen, W.V. (2001). Positive emotions in early life and longevity: Findings from the nun study. Journal of Personality and Social Psychology, 80, 804813.CrossRefGoogle ScholarPubMed
Frattaroli, J. (2006). Experimental disclosure and its moderators: A meta-analysis. Psychological Bulletin, 132, 823865.CrossRefGoogle ScholarPubMed
Gilbert, P. (2005). Compassion and cruelty: A biopsychosocial approach. In Gilbert, P (Ed.) Compassion: Conceptualisations, research and use in psychotherapy (pp. 974). London: Routledge.CrossRefGoogle Scholar
Gilbert, P. (2009). The Compassionate Mind: A New Approach to Life's Challenges. London: Constable.Google Scholar
Gilbert, P., Clarke, M., Hempel, S., et al. (2004). Criticizing and reassuring oneself: An exploration of forms, styles and reasons in female students. British Journal of Clinical Psychology, 43, 3150.CrossRefGoogle ScholarPubMed
Gilbert, P. & Irons, C. (2005). Therapies for shame and self-attacking, using cognitive, behavioural, emotional imagery and compassionate mind training. In Gilbert, P (Ed.) Compassion: Conceptualisations, research and use in psychotherapy (pp. 263325). London: Routledge.CrossRefGoogle Scholar
Gilbert, P., McEwan, K., Mitra, R., et al. (2008). Feeling safe and content: A specific affect regulation system? Relationship to depression, anxiety, stress, and self-criticism. The Journal of Positive Psychology, 3, 110.CrossRefGoogle Scholar
Gilbert, P. & Procter, S. (2006). Compassionate Mind Training for people with high shame and self-criticism: Overview and pilot study of a group therapy approach. Clinical Psychology and Psychotherapy, 13, 353379.CrossRefGoogle Scholar
Joseph, S., Linley, P., Harwood, J., et al. (2004). Rapid assessment of well-being: The Short Depression-Happiness Scale (SDHS). Psychology and Psychotherapy: Theory, Research and Practice, 77, 463478.CrossRefGoogle ScholarPubMed
Kelley, J., Lumley, M. & Leisen, J. (1997). Health effects of emotional disclosure in rheumatoid arthritis patients. Health Psychology, 16, 331340.CrossRefGoogle ScholarPubMed
King, L. (2001). The health benefits of writing about life goals. Personality and Social Psychology Bulletin, 27, 798807.CrossRefGoogle Scholar
Leary, M., Tate, E., Adams, C., et al. (2007). Self-Compassion and reactions to unpleasant self-relevant events: The implications of treating oneself kindly. Journal of Personality and Social Psychology, 92, 887904.CrossRefGoogle ScholarPubMed
Lepore, S. (1997). Expressive writing moderates the relation between intrusive thoughts and depressive symptoms. Journal of Personality and Social Psychology, 73, 10301037.CrossRefGoogle ScholarPubMed
Lester, J. (2005). Life Review with the terminally ill: Narrative therapies. In P Firth, G. Luff & Oliviere, D., (Eds.), Loss, Change and Bereavement in Palliative Care (pp 6679). Maidenhead: Open University Press.Google Scholar
Low, C., Stanton, A. & Danoff-Burg, S. (2006). Expressive disclosure and benefit finding among breast cancer patients: Mechanisms for positive health effects. Health Psychology, 25, 181189.CrossRefGoogle ScholarPubMed
National Council for Hospice and Specialist Palliative Care Services. (1997). Feeling Better: Psychosocial care in specialist palliative care. A discussion paper. Occasional Paper 13, August 1997, London: National Council.Google Scholar
Neff, K. (2003a). Self-Compassion: An alternative conceptualization of a healthy attitude toward oneself. Self and Identity, 2, 85101.CrossRefGoogle Scholar
Neff, K. (2003b). The development and validation of a scale to measure self-compassion. Self and Identity, 2, 223250.CrossRefGoogle Scholar
Neff, K., Kirkpatrick, K. & Rude, S. (2007b). Self-compassion and adaptive psychological functioning. Journal of Research in Personality, 41, 139154.CrossRefGoogle Scholar
Neff, K. & McGehee, P. (2010). Self-compassion and psychological resilience among adolescents and young adults. Self and Identity, 9, 225240.CrossRefGoogle Scholar
Neff, K., Rude, S. & Kirkpatrick, K. (2007a). An examination of self-compassion in relation to positive psychological functioning and personality traits. Journal of Research in Personality, 41, 908916.CrossRefGoogle Scholar
Norman, S., Lumley, M., Dooley, J., et al. (2002). For whom does it work? Moderators of the effects of written emotional disclosure in a randomized trial among women with chronic pelvic pain. Psychosomatic Medicine, 66, 174183.CrossRefGoogle Scholar
Oliviere, D., Hargreaves, R. & Monroe, B. (1998). Good Practices in Palliative Care: A Psychosocial Perspective. Aldershot: Ashgate Publishing Ltd.Google Scholar
Pennebaker, J. & Beall, S. (1986). Confronting a traumatic event: Toward an understanding of inhibition and disease. Journal of Abnormal Psychology, 95, 274281.CrossRefGoogle ScholarPubMed
Pennebaker, J. & Francis, M. (1996). Cognitive, emotional, and language processes in disclosure. Cognition and Emotion, 10, 601626.CrossRefGoogle Scholar
Pennebaker, J., Francis, M. & Booth, R. (2001). Linguistic Inquiry and Word Count (LIWC): LIWC 2001. Mahwah, NJ: Erlbaum.Google Scholar
Pennebaker, J., Mayne, T. & Francis, M. (1997). Linguistic predictors of adaptive bereavement. Journal of Personality and Social Psychology, 72, 863871.CrossRefGoogle ScholarPubMed
Pennebaker, J., Mehl, M. & Niederhoffer, K. (2003). Psychological aspects of natural language use: Our words, our selves. Annual Review of Psychology, 54, 547577.CrossRefGoogle ScholarPubMed
Petrie, K., Booth, R. & Pennebaker, J. (1999). The immunological effects of thought suppression. Journal of Personality and Social Psychology, 75, 12641272.CrossRefGoogle Scholar
Petrie, K., Fontanilla, I., Thomas, M., et al. (2004). Effect of written emotional expression on immune function in patients with human immunodeficiency virus infection: A randomized trial. Psychosomatic Medicine, 66, 272275.CrossRefGoogle ScholarPubMed
Rivkin, I., Gustafson, J., Weingarten, I., et al. (2006). The effects of expressive writing on adjustment to HIV. AIDS and Behavior, 10, 1326.CrossRefGoogle ScholarPubMed
Robins, R., Hendin, H. & Trzesniewski, K. (2001). Measuring global self-esteem: Construct validation of a single-item measure and the Rosenburg Self-Esteem Scale. Personality and Social Psychology Bulletin, 27, 151161.CrossRefGoogle Scholar
Shapiro, S., Astin, J., Bishop, S., et al. 2005). Mindfulness-based stress reduction for health care professionals: Results from a randomized trial. International Journal of Stress Management, 12, 164176.CrossRefGoogle Scholar
Sheldon, F. (1997). Psychosocial Palliative Care: Good Practice in the Care of the Dying and Bereaved. Cheltenham: Stanley Thornes.Google Scholar
Smyth, J. (1998). Written emotional expression: Effect sizes, outcome types, and moderating variables. Journal of Consulting and Clinical Psychology, 66, 174184.CrossRefGoogle ScholarPubMed
Smyth, J. & Pennebaker, J. (2008). Exploring the boundary conditions of expressive writing: In search of the right recipe. British Journal of Health Psychology, 13, 17.CrossRefGoogle ScholarPubMed
Smyth, J., Stone, A., Hurewitz, A., et al. (1999). Effects of writing about stressful experiences on symptom reduction in patients with asthma or rheumatoid arthritis: A randomized trial. The Journal of the American Medical Association, 281, 13041309.CrossRefGoogle ScholarPubMed
Stanton, A., Danoff-Burg, S., Sworowski, L., et al. (2002). Randomized controlled trial of written emotional expression and benefit finding in breast cancer patients. Journal of Clinical Oncology, 20, 41604168.CrossRefGoogle ScholarPubMed
Tausczik, Y. & Pennebaker, J. (2010). The psychological meaning of words: LIWC and computerized text analysis methods. Journal of Language and Social Psychology, 29, 2454.CrossRefGoogle Scholar
Ullrich, P. & Lutgendorf, S. (2002). Journaling about stressful events: Effects of cognitive processing and emotional expression. Annals of Behavioral Medicine, 24, 244250.CrossRefGoogle ScholarPubMed
Weinman, J., Ebrecht, M., Scott, S., et al. (2008). Enhanced wound healing after emotional disclosure intervention. British Journal of Health Psychology, 13, 95102.CrossRefGoogle ScholarPubMed