Promoting positive mental health among individuals with eating disorders: Investigating the role of self-compassion

Abstract

There is a call in the eating disorders field to identify factors that not only reduce eating pathology, but that also promote positive mental health and well-being in individuals with eating disorders. Yet, little is known about factors that might accomplish both of these goals. Self-compassion refers to the desire to respond to one’s own distress in a mindful, caring, and understanding manner, coupled with the motivation to prevent and alleviate it. Self-compassion has been found to be associated with reduced eating pathology in people with eating disorders, but no research has examined whether it might also give rise to more positive mental health in this population. However, theoretical and empirical research conducted in diverse non-clinical samples suggests that treating oneself in a self-compassionate manner, both on a given day or in general, can promote markers of positive mental health and well-being. Three longitudinal studies spanning different contexts, durations, and eating disorder populations sought to test the overarching hypotheses that treating oneself with more self-compassion than others or than one’s typical level, such as on a given day or following brief periods of time, would be associated with increased markers of positive mental health (i.e., positive affect, social safeness, and adaptive coping behaviours) in individuals with eating disorders. Study 1 utilized a two-week daily diary design to explore whether daily and trait (i.e., average) levels of self-compassion promoted positive affect and social safeness (i.e., a sense of social connection and belonging) in a community sample of women with typical and atypical anorexia nervosa who were not seeking treatment for their eating disorder. Multilevel modelling revealed that, consistent with hypotheses, higher levels of self-compassion on a given day, than the previous day, and on average over the study period, were associated with greater positive affect and social safeness. In Study 2, a two-week daily diary investigated whether daily and trait levels of self-compassion predicted adaptive coping behaviours in a community sample of women with symptoms of bulimia nervosa. In line with my hypotheses and the findings from Study 1, multilevel modelling revealed that natural upward fluctuations in self-compassion levels from day to day, and trait or average self-compassion levels over the study period, were generally associated with the use of more adaptive coping strategies. Study 3 examined the links between self-compassion and social safeness over a 12-week period in a transdiagnostic sample of individuals receiving inpatient or day hospital treatment for their eating disorder. Multilevel modelling revealed that, as hypothesized, periods of increased self-compassion were associated with a greater subsequent sense of social safeness. Further, consistent with my hypothesis, higher average levels of self-compassion over the course of the 12 weeks of eating disorder treatment were associated with more social safeness. In sum, the current findings largely lend support for my overarching hypothesis: that one’s ability to treat themselves with more self-compassion than is typical for them, including on a given day or over a brief period of time, or than other people, is associated with improved positive mental health. Importantly, the current findings highlight the potential clinical benefits of incorporating self-compassion practices into both eating disorder treatments and the daily lives of individuals with eating disorders. This way of compassionate self-relating, which can be learned, may have a significant, multifaceted impact. Self-compassion interventions have already been shown to help reduce harmful eating behaviors in previous research; however, the current findings suggest that these practices might also enhance markers of positive mental health in eating disorder samples. Therefore, directly targeting self-compassion could provide an effective way to achieve the shared goals of both clinicians and individuals with eating disorders: reducing symptoms of the disorder and enhancing overall quality of life.