East Tennessee State University Digital Commons @ East Tennessee State University Electronic Theses and Dissertations Student Works 8-2015 Self-Compassion and Self-Forgiveness as Mediated by Rumination, Shame-Proneness, and Experiential Avoidance: Implications for Mental and Physical Health Elizabeth Conway Williams East Tennessee State University Follow this and additional works at: https://dc.etsu.edu/etd Part of the Clinical Psychology Commons Recommended Citation Williams, Elizabeth Conway, "Self-Compassion and Self-Forgiveness as Mediated by Rumination, Shame-Proneness, and Experiential Avoidance: Implications for Mental and Physical Health" (2015). Electronic Theses and Dissertations. Paper 2562. https://dc.etsu.edu/ etd/2562 This Dissertation - Open Access is brought to you for free and open access by the Student Works at Digital Commons @ East Tennessee State University. It has been accepted for inclusion in Electronic Theses and Dissertations by an authorized administrator of Digital Commons @ East Tennessee State University. For more information, please contact [email protected]. Self-Compassion and Self-Forgiveness as Mediated by Rumination, Shame-Proneness, and Experiential Avoidance: Implications for Mental and Physical Health ___________________________________ A dissertation presented to the faculty of the Department of Psychology East Tennessee State University In partial fulfillment of the requirements for the degree Doctor of Philosophy in Psychology with a Concentration in Clinical Psychology _____________________ by Elizabeth Conway Williams August, 2015 _____________________ Jon R. Webb, Chair William T. Dalton, III Stacey L. Williams Ginette C. Blackhart Jameson K. Hirsch Keywords: self-compassion, self-forgiveness, shame, rumination, experiential avoidance ABSTRACT Self-Compassion and Self-Forgiveness as Mediated by Rumination, Shame-Proneness, and Experiential Avoidance: Implications for Mental and Physical Health by Elizabeth Conway Williams Self-compassion and self-forgiveness appear to have much in common, as both relate to one’s self-regard during challenging circumstances; however, their empirical relationship is largely yet to be explored. The present study examines theoretical and empirical areas of overlap and proposes a theory of their relationship, including its possible impact on health. Self-compassion and self-forgiveness were proposed to have a direct relationship that may be mediated by reduction in rumination, shame, and experiential avoidance. These factors together were also hypothesized to have a positive impact on health functioning. The current study tested these models in a sample of undergraduate students (n = 199). In parallel mediation analysis, self- compassion and self-forgiveness were related to one another and this association was partially mediated by shame, only. As such, neither rumination nor experiential avoidance were included in subsequent analyses. In serial mediation analyses, self-compassion, shame, and self- forgiveness were found to affect health outcomes in various ways. For psychological distress, the association of self-compassion was partially mediated by shame and self-forgiveness, in an indistinguishable fashion. For mental health status, self-compassion was found to have a significant direct effect, only. For both somatic symptoms (full mediation) and physical health status (indirect only effect), the association of self-compassion operated through self-forgiveness both alone and linked with shame. As these two emerging areas in the psychological literature continue to mature, researchers should prioritize both integration between and nuances within 2 these constructs in order to develop a more complete understanding of self-compassion, self- forgiveness, and their implications for health. 3 DEDICATION AND ACKNOWLEDGEMENTS I dedicate my dissertation to each of my grandparents: Randy and Mary Lynn Conway, and Harry and Norene Trantham. Thank you for always believing in me, for being my biggest cheerleaders, for being exemplar models of how to live a life. I am here today because of each of you. I love you dearly and carry each of your legacies in my heart, always. I am also eternally grateful to my parents. You taught me how to strive for my goals, live a values-based life, and practice love daily. I love you so much and would not be who I am today without you. They say it takes a village to raise a child, and it certainly takes a village to complete a Ph.D., especially with a child in tow. Thank you to our village, to my siblings, extended family, and friends, for the vast and varied support I have received on this journey, and to all those who helped take care of Clint along the way. Thank you to those who have contributed to my professional development. Dr. Webb, you have been a faithful, supportive, and conscientious mentor for the last five years. Thank you for all you have taught me and for all you have done to transform me from an anxious first year to a confident and competent Ph.D. candidate. I am also grateful to my supervisors, especially Dr. Dalton, who taught me so much both in research and clinical practice, and Dr. Whitehead and Dr. Holland, who have had lasting effects on my development as a therapist and person. Finally, this milestone belongs to my boys. Kyle Williams, I am so grateful for your unselfishness, for your love and loyalty, for your unfaltering support. Thank you for the hours, months, and years you commuted without complaint in order for me to realize my childhood dream. You are my rock and I can scarcely believe all we have built together. And, my sweet son Clinton, thank you for your present-moment awareness, for your daily reminders 4 to have exuberance and awe for the ordinary, and for teaching me the meaning of unconditional love. You inspire me more than you will ever realize. 5 TABLE OF CONTENTS Page ABSTRACT.....................................................................................................................................2 DEDICATION AND ACKNOWLEDGEMENTS..........................................................................4 LIST OF TABLES.........................................................................................................................10 LIST OF FIGURES ......................................................................................................................11 Chapter 1. INTRODUCTION.....................................................................................................................12 Self-Compassion................................................................................................................13 Self-Compassion and Health Outcomes............................................................................14 Self-Forgiveness................................................................................................................15 Models of Self-Forgiveness...............................................................................................16 Self-Forgiveness and Health Outcomes.............................................................................19 Problems with the Self-Forgiveness Construct..................................................................21 Self-Compassion and Self-Forgiveness.............................................................................24 Evidence for the Self-Compassion/Self-Forgiveness Relationship...................................26 Theoretical Distinctions Between Self-Compassion and Self-Forgiveness.......................29 The Nature of the Relationship Between Self-Compassion and Self-Forgiveness............29 Rumination. ...........................................................................................................30 Shame-Proneness...................................................................................................33 Acceptance, Experiential Avoidance, and Psychological Flexibility....................38 Self-compassion and Acceptance.............................................................40 Self-forgiveness and Acceptance..............................................................42 6 Present Study: Purpose and Hypotheses............................................................................45 2. METHOD..................................................................................................................................48 Participants........................................................................................................................48 Measures............................................................................................................................50 Demographic Information......................................................................................50 Self-Compassion....................................................................................................50 Trait Self-Forgiveness............................................................................................51 Rumination.............................................................................................................51 Shame-Proneness...................................................................................................52 Experiential Avoidance..........................................................................................52 Physical Health (Somatic Symptoms)...................................................................53 Mental Health (Psychological Distress).................................................................53