The Role of Self-Compassion in Trauma Recovery: Cross-sectional, Qualitative and Experimental Insights

Interpersonal trauma, such as physical, sexual, and emotional abuse, has a significant impact on self-concept, emotional regulation and relationships. It can lead to Complex Post-Traumatic Stress Disorder (CPTSD), a condition recognised in the International Classification of Diseases-11th Revision (ICD-11) in 2018. CPTSD’s distinctive symptom profile, which includes additional symptoms known as disturbances in self-organisation (DSO) alongside PTSD symptoms, such as negative self-concept (NSC), emotional dysregulation (ED), and relationship difficulties, can often not be fully addressed by existing interventions for trauma-related disorders. Notably, CPTSD symptoms are linked to greater functional impairment than PTSD symptoms alone. It is generally understood that CPTSD usually results from interpersonal trauma and is maintained by high levels of self-criticism. Although self-compassion (SC) shows promise in trauma recovery, its role in CPTSD remains under-investigated. This thesis employs cross-sectional, qualitative, and experimental studies to explore SC as a protective factor and potential target for intervention among individuals with CPTSD symptoms, a history of interpersonal trauma, and high self-criticism. Chapter 1 reviews the literature on trauma, PTSD, and CPTSD, including key theoretical models (Ehlers & Clark, 2000; Lanius et al., 2011). It positions SC as a protective factor, including a detailed discussion of key models of SC (Neff, 2003; Gilbert, 2009), while addressing barriers such as the fear of self-compassion and cultural influences. A new integrative framework is proposed that combines risk, resilience, and intervention pathways. The chapter concludes with an overview of the thesis structure and research questions. Chapter 2 (Cross-Sectional Survey, n=181) investigated SC’s role in CPTSD symptoms by examining its relationship with ED and negative post-traumatic cognitions (PTCs) in trauma survivors (ages 18-77, M=28.8). Using theoretically informed path analysis, the study explored the associations between adverse childhood experiences (ACEs), SC, ED, PTCs, and CPTSD symptoms. Results indicated that higher ACEs, greater ED, and increased PTCs were associated with more severe CPTSD symptoms. Contrary to our hypothesis, SC was not directly linked to ACEs or CPTSD but demonstrated significant indirect effects through ED and PTCs. These findings partially support the theory-based model and align with Ehlers and Clark’s Cognitive model of PTSD (2000), Lanius et al.’s SCAN paradigm (2011), and Gilbert’s Tripartite Model of Emotional Regulation (2009). The findings from Chapter 2 informed Chapter 3 (Qualitative study), which examined the understanding of SC, including its barriers, facilitators, and cultural influences. The study employed semi-structured interviews with 16 ethnically diverse participants (eleven females, five males) with a history of interpersonal trauma. Data were analysed using Reflexive Thematic Analysis (RTA). The findings emphasise the understanding of SC, including the barriers and facilitators in the development and expression of SC, as shaped by both intrapersonal and interpersonal influences, such as social relationships and cultural orientations. These insights should help guide the development of effective, relationally attuned and culturally sensitive SC interventions for conditions like CPTSD. Chapter 4 (Experimental, n = 87) examined indirect methods to enhance SC by testing whether activating social support schemas could temporarily increase state SC in highly self-critical participants (a transdiagnostic risk factor for psychopathology like CPTSD). The study also examined whether such activation could influence soothing positive affect (SPA) and parasympathetic activation (via heart rate variability [HRV]). The findings highlighted the role of support-giving in faster parasympathetic activation as assessed by HRV responses. Additional exploratory analysis found that the positive mood condition was the only condition associated with significant within-group increases in state SC. Trait measures of SC, self-criticism (SCRIT), fear of SC(FSC), positive affect (PA), and negative affect (NA) were collected. These variables were analysed as dispositional predictors of state recovery changes in state SC, state SPA, HRV, and state SCRIT following negative event recall in Chapter 5 using hierarchical stepwise regression. Analyses identified FSC as the only significant predictor of changes in state SC. Chapter 6 presents an overall discussion of the thesis's key findings, explaining how these findings support or contradict existing literature and the proposed theoretical models. It also covers the implications of the thesis, its limitations, strengths, and the overall conclusion. In summary, this thesis broadens the limited literature on SC in trauma recovery and CPTSD by illustrating the protective role of SC in CPTSD symptoms, identifying barriers and facilitators of SC rooted in cultural and relational history, and highlighting the potential benefits of indirect approaches to SC cultivation for those who struggle with SC the most. These findings integrate theory and evidence, advancing understanding of SC’s impact on trauma recovery. Keywords: self-compassion, CPTSD, interpersonal trauma, emotional dysregulation, post-traumatic cognitions, self-criticism.<p></p>

Author dc:creator

• Pranati Misurya (21058721)

• self-compassion
• CPTSD
• Interpersonal Trauma

Statement dc:rights

• All rights reserved
• Open Access after 2027-09-16

Identifier

10779/exe.31843417.v1

OAI identifier oai:identifier

oai:figshare.com:article/31843417