Department of Clinical Psychology, University of Bergen.
Norwegian University of Science and Technology, Trondheim.
Psychotherapy (Chic). 2011 Sep;48(3):293-303. doi: 10.1037/a0022012.
In the short-term dynamic psychotherapy model termed "Affect Phobia Treatment," it is assumed that increase in patients' defense recognition, decrease in inhibitory affects (e.g., anxiety, shame, guilt), and increase in the experience of activating affects (e.g., sadness, anger, closeness) are related to enhanced self-compassion across therapeutic approaches. The present study aimed to test this assumption on the basis of data from a randomized controlled trial, which compared a 40-session short-term dynamic psychotherapy (N = 25) with 40-session cognitive treatment (N = 25) for outpatients with Cluster C personality disorders. Patients' defense recognition, inhibitory affects, activating affects, and self-compassion were rated with the Achievement of Therapeutic Objectives Scale (McCullough et al., 2003b) in Sessions 6 and 36. Results showed that increase in self-compassion from early to late in therapy significantly predicted pre- to post-decrease in psychiatric symptoms, interpersonal problems, and personality pathology. Decrease in levels of inhibitory affects and increase in levels of activating affects during therapy were significantly associated with higher self-compassion toward the end of treatment. Increased levels of defense recognition did not predict higher self-compassion when changes in inhibitory and activating affects were statistically controlled for. There were no significant interaction effects with type of treatment. These findings support self-compassion as an important goal of psychotherapy and indicate that increase in the experience of activating affects and decrease in inhibitory affects seem to be worthwhile therapeutic targets when working to enhance self-compassion in patients with Cluster C personality disorders.
在被称为“情感恐惧症治疗”的短期动态心理治疗模式中，人们假设患者防御识别能力的提高、抑制性情感（如焦虑、羞耻、内疚）的减少以及激活性情感（如悲伤、愤怒、亲近感）的体验增加与增强自我同情有关，而这种增强是通过各种治疗方法实现的。本研究旨在基于一项随机对照试验的数据来检验这一假设，该试验比较了为期 40 节的短期动态心理治疗（N=25）与为期 40 节的认知治疗（N=25）对伴有 C 类人格障碍的门诊患者的治疗效果。在第 6 节和第 36 节中，患者的防御识别、抑制性情感、激活性情感和自我同情分别通过治疗目标实现量表（McCullough 等人，2003b）进行评估。结果表明，治疗早期至晚期自我同情的增加显著预测了治疗前至治疗后精神病症状、人际关系问题和人格病理学的减少。治疗过程中抑制性情感的减少和激活性情感的增加与治疗结束时自我同情程度的提高显著相关。当统计控制抑制性和激活性情感的变化时，防御识别水平的提高并不能预测更高的自我同情。与治疗类型无显著交互作用。这些发现支持自我同情是心理治疗的一个重要目标，并表明在努力增强 C 类人格障碍患者的自我同情时，增加激活性情感的体验和减少抑制性情感似乎是有价值的治疗目标。
