Effectiveness of Experiential-Dynamic Emotion Regulation (EDER) and Mindful Self Compassionate (MSC) Eclectic Therapy in people with Introjective Depression

Document Type : Research Paper

Authors

1 Ph.D student, Clinical Psychology, Faculty of Educational Sciences and Psychology, University of Shiraz

2 Ph.D, Psychology, Faculty of Educational Sciences and Psychology, University of Shiraz. Email: crahimi2016@hotmail.com (Corresponding Author)

3 Ph.D, Psychology, Faculty of Educational Sciences and Psychology, University of Shiraz

Abstract

The aim of this study was to investigate the effectiveness of experiential-dynamic emotion regulation and mindful self-compassionate Eclectic Therapy in reducing core shame, increasing self-compassion and reducing depression severity in patients with introjective depression.  This was a single subject study with pretest-posttest design with a 45-day follow-up. The study participants included individuals diagnosed with depression in 2019 at Shiraz University Counseling and Psychotherapy Clinic. The individuals scored above 20 in Beck’s Depression Inventory II and finally, 3 individuals were selected as sample group with purposive sampling method given the inclusion and exclusion criteria. Internalized Shame Scale (ISS), Self-Compassion Scale (SCS) and BDI-2 were used for each individual in the pretest-posttest phase, and finally integrative therapy for 8 sessions of 45 minutes was administered. Data were analyzed using charting and effect size method. The effect size changes in treatment interventions were larger than 0.5. Hence, Experiential-Dynamic Emotion Regulation and Mindful Self-Compassionate Eclectic Therapycan be used as a novel intervention to reduce the severity of introjective depression

Keywords


منابع
 
خسروی، صدالله، صادقی، مجید، و یابنده، محمد رضا (1392). کفایت روان‌سنجی مقیاس شفقت خود، روش‌ها و مدل‌های روانشناختی، 3(13): 59-47.
رجبی، غلامرضا و عباسی، قدرت اله. (1390). بررسی رابطه خودانتقادی، اضطراب اجتماعی و ترس از شکست با شرم درونی در دانشجویان، دو فصلنامه پژوهش های روانشناسی بالینی و مشاوره، 1(2)، 1-12.
شریفی، ونداد؛ اسعدی، سید محمد؛ محمدی، محمد رضا؛ امینی، همایون؛ کاویانی، حسین؛ سمنانی، یوسف؛ شعبانی، امیر؛ شهریور، زهرا؛ داوری آشتیانب، رزیتا؛ حکیم شوشتری، میترا؛ صدیق، ارشیا؛ جلالی رودسری، محسن. (1383).  پایایی و قابلیت اجرای نسخه فارسی مصاحبه ساختاریافته تشخیصی برای DSM5، تازه های علوم شناختی، 6 (1)، 10-22.
صادقیان، اعظم؛ بیگدلی، ایمان الله و علیزاده زارعی، مهدی. (1396). اثربخشی تمرینات یکپارچگی حسی حرکتی بر بهبود علائم کودکان اختلال طیف اتیسم. مجله مطالعات ناتوانی، 7: 8-1.
فتا، لادن، بیرشک، بهروز، عاطف وحید، کاظم، و دابسون، استفان (1384). ساختارهای معناگذاری/ طرح‌واره‌ها، حالت‌های هیجانی و پردازش شناختی اطلاعات هیجانی: مقایسه دو چارچوب مفهومی. اندیشه و رفتار، 3 (1) ، 312 – 326.
فرست، مایکل بی، ؛ ویلیامز، جانت بی. و؛ کارگ، رونداس  و اسپیتزر، رابرت ال  (1396). مصاحبه ساختاریافته بالینی برای ارزیابی اختلال های DSM5. ترجمه پروانه محمد خانی و محمد ابراهیم زاده موسوی. تهران: انتشارات دانشگاه علوم بهزیستی و توانبخشی.
 
Abbass, A., Town, J., & Driessen, E. (2011). The efficacy of short-term psychodynamic psychotherapy for depressive disorders with comorbid personality disorder. Psychiatry: Interpersonal & Biological Processes, 74(1), 58-7
 
Abraham, H. C., Abraham, K., & Freud, E. L. (1965). A psycho-analytic dialogue: The letters of Sigmund Freud and
Karl Abraham, 1907-1926. London: Hogarth Press and the Institute of Psycho-Analysis.
Ajilchi, B., Nejati, V., Town, J. M., Wilson, R., & Abbass, A. (2016). Effects of intensive short-term dynamic psychotherapy on depressive symptoms and executive functioning in major depression. The Journal of nervous and mental disease, 204(7), 500-505.
Ajilchi, B., Kisely, S., Nejati, V., & Frederickson, J. (2020). Effects of intensive short-term dynamic psychotherapy on social cognition in major depression. Journal of Mental Health, 29(1), 40-44.
 
Bibring, E. (1953). The mechanics of depression, in Affective Disorders: Psychoanalytic Contributions to Their Study. Edited by Greenacre P. New York, International Universities Press.
Blatt, S. J. (2008). Polarities of experience: relatedness and self-definition in personality development, psychopathology, and the therapeutic process. Washington, DC: American Psychological Association Press.
Blatt, S. J., & Luyten, P. (2009). A structural–developmental psychodynamic approach to psychopathology: Two polarities of experience across the life span. Development and Psychopathology21(3), 793-814.
Blatt, S. J., D'Afflitti, J. P., & Quinlan, D. M. (1976). Experiences of depression in normal young adults. Journal of Abnormal psychology85(4), 383.
Blatt, S. J., & Shahar, G. (2004). Psychoanalysis—With whom, for what, and how? Comparisons with psychotherapy. Journal of the American Psychoanalytic Association52(2), 393-447.
Boone, L., Soenens, B., & Luyten, P. (2014). When or why does perfectionism translate into eating disorder pathology? A longitudinal examination of the moderating and mediating role of body dissatisfaction. Journal of Abnormal Psychology123(2), 412.
Braehler, C., Gumley, A., Harper, J., Wallace, S., Norrie, J., & Gilbert, P. (2013). Exploring change processes in compassion focused therapy in psychosis: Results of a feasibility randomized controlled trial. British Journal of Clinical Psychology, 52(2), 199–214.
Braehler, C., & Neff, K. (2020). Self-compassion in PTSD. In Emotion in Posttraumatic Stress Disorder (pp. 567-596). Academic Press.
 
Bowlby, J. (1977). The Making and Breaking of Affectional Bonds: II. Some Principles of Psychotherapy: The Fiftieth Maudsley Lecture (expanded version). The British Journal of Psychiatry130(5), 421-431.
 
Busch, F. N., Rudden, M., & Shapiro, T. (2016). Psychodynamic Treatment of Depression. American Psychiatric Pub.
Cȃndea, D. M., & Szentágotai-Tătar, A. (2018). The impact of self-compassion on shame-proneness in social anxiety. Mindfulness, 9(6), 1816-1824.
 
Cook, D. R. (1993). The internalized shame scale manual. Menomonie, WI: Channel Press.
Coughlin della Selva, P. (1996). Intensive short-term dynamic psychotherapy. Theory and practice. New York: John Wiley & Sons.
Coyne, J. C. (1986), Toward an interactional description of depression. In: Essential Papers on Depression, ed. J.C. Coyne. New York: New York University Press.
Cozolino, L. (2015). Why therapy works. New York: Norton and Company.
Davanloo, H. (2000). Intensive Short Term Dynamic Psychotherapy, Selected paper of Habib davanloo. England: John Wily and Son.
Dearing, R. L., & Tangney, J. P. E. (2011). Shame in the therapy hour. American Psychological Association.
Driessen, E., Cuijpers, P., de Maat, S. C., Abbass, A. A., de Jonghe, F., & Dekker, J. J. (2011). The efficacy of short-term psychodynamic psychotherapy for depression: a meta-analysis. Clinical psychology review, 30(1), 25-36.
Driessen, E., Hegelmaier, L. M., Abbass, A. A., Barber, J. P., Dekker, J. J., Van, H. L., ... & Cuijpers, P. (2015). The efficacy of short-term psychodynamic psychotherapy for depression: A meta-analysis update. Clinical psychology review, 42, 1-15.
 
DeFife, J. A., Peart, J., Bradley, B., Ressler, K., Drill, R., & Westen, D. (2013). Validity of prototype diagnosis for mood and anxiety disorders. JAMA Psychiatry, 70(2), 140-148.
Fonagy, P., Gergely, G., Jurist, E. L., & Target, M. (2002). Affect regulation, mentalization, and the development of the self.
Frederickson, J. (2013). Co-creating change: Effective dynamic therapy techniques. Kansas City: leaves press.
Frederickson, J. J., Messina, I., & Grecucci, A. (2018). Dysregulated anxiety and dysregulating defenses: Toward an emotion regulation informed dynamic psychotherapy. Frontiers in psychology, 9.
Freud, S. (1917). Mourning and melancholia. Standard edition, 14, 243-258.
Germer, C., & Neff, K. (2019). Teaching the mindful self-compassion program: A guide for professionals. Guilford Publications.
Gilbert, P., Baldwin, M. W., Irons, C., Baccus, J. R., & Palmer, M. (2006). Self-criticism and self-warmth: An imagery study exploring their relation to depression. Journal of Cognitive Psychotherapy20(2), 183-200.
Gilbert, P., Clarke, M., Hempel, S., Miles, J. N., & Irons, C. (2004). Criticizing and reassuring oneself: An exploration of forms, styles and reasons in female students. British Journal of Clinical Psychology43(1), 31-50.
Gilbert, P., McEwan, K., Catarino, F., Baiao, R., & Palmeira, L. (2014). Fears of happiness and compassion in relationship with depression, alexithymia, and attachment security in a depressed sample. British Journal of Clinical Psychology, 53(2), 228–244.
Heim, C., Newport, D. J., Mletzko, T., Miller, A. H., & Nemeroff, C. B. (2008). The link between childhood trauma and depression: insights from HPA axis studies in humans. Psychoneuroendocrinology33(6), 693-710.
Jiang, Y., You, J., Zheng, X., & Lin, M.-P. (2017). The qualities of attachment with significant others and self-compassion protect adolescents from non-suicidal self-injury. School Psychology Quarterly, 32(2), 143.
Kamimura, A., Nourian, M. M., Assasnik, N., & Franchek-Roa, K. (2016). Depression and intimate partner violence among college students in Iran. Asian Journal of Psychiatry23, 51-55.
Kimbrel, N. A., Meyer, E. C., DeBeer, B. B., Gulliver, S. B., & Morissette, S. B. (2016). A 12-Month prospective study of the effects of PTSD-depression comorbidity on suicidal behavior in Iraq/Afghanistan-era veterans. Psychiatry Research243, 97-99.
Lee, D.A. (2005). The perfect nurturer: A model to develop a compassionate mind within the context of cognitive therapy. In P. Gilbert (Ed.), Compassion: Conceptualizations, research and use in psychotherapy (pp.326–351). London: Brunner-Routledge.
Leighton, T.D. (2003). Faces of compassion: Classic Bodhisattva archetypes and their modern expression. Boston: Wisdom.
Luyten, P., & Blatt, S. J. (2011). Psychodynamic approaches to depression: whither shall we go? Psychiatry74(1), 1-3.
Luyten, P., Mayes, L. C., Blatt, S. J., Target, M., & Fonagy, P. (2015). Theoretical and empirical foundations of contemporary psychodynamic approaches. Handbook of Contemporary Psychodyamic Approaches to Psychopathology, 3-26.
Matos, M., Duarte, J., & Pinto-Gouveia, J. (2017). The origins of fears of compassion: Shame and lack of safeness memories, fears of compassion and psychopathology. The Journal of Psychology, 151(8), 804–819.
Mikulincer, M., Shaver, P. R., & Pereg, D. (2003). Attachment theory and affect regulation: The dynamics, development, and cognitive consequences of attachment-related strategies. Motivation and Emotion, 27(2), 77–102.
Mikulincer, M., & Shaver, P. R. (2017). Adult attachment and compassion: Normative and individual difference components. In E. M. Seppälä, E. Simon-Thomas, S. L. Brown, M. C. Worline, C. D. Cameron, & J. R. Doty (Eds.), The Oxford handbook of compassion science (pp. 79–90). New York: Oxford University Press.پ
Morrison, A. P. (2014). Shame: The underside of narcissism. United Kingdom: Routledge.
Neff, K. D. (2003). The development and validation of a scale to measure self-compassion. Self and identity2(3), 223-250.
Neff, K; Germer, Ch. (2018). The mindful self-compassion workbook New York: the goilford press.
Neborsky, R. J., & ten Have-de Labije, J. (2012). Mastering intensive short-term dynamic psychotherapy: roadmap to the unconscious. London: Karnac Books.
Pauley, G., & McPherson, S. (2010). The experience and meaning of compassion and self‐compassion for individuals with depression or anxiety. Psychology and Psychotherapy: Theory, Research and Practice83(2), 129-143.
Rapaport, D. (1967), should Edward Bibring's theory of depression be restored? In: The Collected Papers of David Rapapon, ed. M. Gill. New York: Basic Books.
Roisman, G. I., Padron, E., Sroufe, L. A., & Egeland, B. (2002). Earned–secure attachment status in retrospect and Prospect. Child Development, 73(4), 1204–1219.
Pauley, G., & McPherson, S. (2010). The experience and meaning of compassion and self‐compassion for individuals with depression or anxiety. Psychology and Psychotherapy: Theory, Research and Practice83(2), 129-143.
 
Rudden, M., Busch, F. N., Milrod, B., Singer, M., Aronson, A., Roiphe, J., & Shapiro, T. (2003). Panic disorder and depression: A psychodynamic exploration of comorbidity. The International Journal of Psychoanalysis84(4), 997-1015.
Sedighimornani, N., Rimes, K. A., & Verplanken, B. (2019). Exploring the relationships between mindfulness, self-compassion, and shame. Sage Open, 9(3), 2158244019866294.
 
Soenens, B., Vansteenkiste, M., & Luyten, P. (2010). Toward a domain‐specific approach to the study of parental psychological control: Distinguishing between dependency‐oriented and achievement‐oriented psychological control. Journal of Personality78(1), 217-256.
Swanson, J. W., Holzer III, C. E., Ganju, V. K., & Jono, R. T. (1990). Violence and psychiatric disorder in the community: evidence from the Epidemiologic Catchment Area surveys. Psychiatric Services41(7), 761-770.
Werbart, A., & Levander, S. (2006). Two sets of private theories in analysands and their analysts: Utopian versus attainable cures. Psychoanalytic Psychology23(1), 108.
Werbart, A., Aldèn, S., & Diedrichs, A. (2017). Changes in the anaclitic-introjective personality configurations following psychoanalytic psychotherapy with young adults. Research in Psychotherapy: Psychopathology, Process and Outcome, 28, 397-410.
Westen, D., DeFife, J. A., Bradley, B., & Hilsenroth, M. J. (2010). Prototype personality diagnosis in clinical practice: A viable alternative for DSM–5 and ICD–11. Professional Psychology: Research and Practice41(6), 482.