ACT With Compassion

Every month, we scour the scientific literature for interesting studies that have practical implications for therapists working with shame, self-criticism, or compassion. Below are a few of our favorites for this month:

Oxytocin a promising adjunct to treatment for some people, but not ready for prime-time yet

This study is the first published meta-analysis of placebo-controlled effects of intranasal oxytocin administration on psychiatric symptoms. The fact that all selected studies are placebo controlled, means that the results are very unlikely to be due to placebo effect. The authors’ search resulted in the inclusion of 16 studies examining a range of symptoms including depression, anxiety, psychosis, autism, and general psychopathology. Intranasal oxytocin administration had beneficial effects across all diagnoses, with moderately strong effect size.

Take away: This study suggests that oxytocin may be beneficial for a variety of presenting problems, but the mechanism is unknown. In addition, data suggests that oxytocin administration may not be beneficial for people with certain types of attachment and childhood experiences. More work is needed before we are ready to give oxytocin to our clients.

Read more: 
Hofmann, S. G., Fang, A., & Brager, D. N. (2015). Effect of intranasal oxytocin administration on psychiatric symptoms: A meta-analysis of placebo-controlled studies. Psychiatry Research.

An interesting study that might give you some ideas for how to work with your own shame as a therapist

In this study, the authors examined shame and embarrassment experiences among psychotherapists. Events eliciting these self-conscious emotions were categorized into themes such as making mistakes, being late for an appointment, falling asleep in session, misspeaking, using the wrong name for the client, and bodily functions. The authors also categorized responses to shame and embarrassment into themes such as apologizing, using humor, avoiding, and processing with the client.

Take away: This research is a good reminder that it is normal and expected for therapists to sometimes feel shame. Many of these experiences present opportunities for modelling how to more effectively move through shame.

Read more:
Klinger, R. S., Ladany, N., & Kulp, L. E. (2012). It’s Too Late to Apologize Therapist Embarrassment and Shame. The Counseling Psychologist, 40(4), 554-574.

Guilt, but not Shame, Motivates Readiness to Change Drinking Habits

The authors used an expressive writing paradigm in this study to examine college students’ reported readiness to change and intention to drink. Participants were instructed to write either about a positive drinking experience, a negative drinking experience, or a neutral non-drinking experience. The authors found that writing about negative drinking experiences increased both shame and guilt relative to the other conditions. They also found that, as predicted, drinking-related guilt mediated the relationship between the writing intervention and readiness to change, which predicted intention to change drinking behaviors. Shame had no effect on readiness to change.

Take away: There is some debate in the literature about whether or not eliciting shame is an effective strategy for motivating change in substance use. Although too much weight should not be given to a null finding, this study indicates that reparative guilt, but not shame, motivates behavior change.

Read more:
Rodriguez, L. M., Young, C. M., Neighbors, C., Campbell, M. T., & Lu, Q. (2015). Evaluating Guilt and Shame in an Expressive Writing Alcohol Intervention. Alcohol.