Attachment and compassion-threat: Influence of a secure attachment-prime

The relationships among factors affecting compassion fatigue, compassion satisfaction, and burnout in Japanese nurses: A cross-sectional study

AIM

This study aimed to investigate the relationships among factors affecting compassion fatigue/secondary traumatic stress, burnout, and compassion satisfaction in Japanese nurses, focusing on self-compassion, fears of compassion, and attachment styles.

METHODS

This cross-sectional observational study enrolled 400 clinical nurses (aged ≥20 years) in Japan, registered with an online survey company, from June 6 to June 26, 2021. The subjects completed a web-based questionnaire that assessed compassion fatigue/secondary traumatic stress, burnout, compassion satisfaction, self-compassion, fears of compassion for self, anxiety, and avoidance. Additionally, descriptive statistics, correlation analysis, multiple regression analysis and path analysis were performed to examine the relationships among the influencing factors.

RESULTS

Compassion fatigue/secondary traumatic stress was influenced by anxiety and fears of compassion for self (R2 = .31). Burnout was affected by compassion fatigue/secondary traumatic stress, compassion satisfaction, self-compassion, anxiety, and avoidance (R2 = .63). Compassion satisfaction was impacted by self-compassion, anxiety, and fears of compassion for self (R2 = .31). Additionally, self-compassion (R2 = .28) and fears of compassion for self (R2 = .55) were influenced by anxiety and avoidance.

CONCLUSIONS

Compassion fatigue/secondary traumatic stress leads to burnout, whereas compassion satisfaction moderates burnout. Furthermore, there were associations among the factors leading to compassion fatigue/secondary traumatic stress and burnout and compassion satisfaction. Therefore, an approach that enhances self-compassion and promotes the development of a stable attachment style could mitigate compassion fatigue/secondary traumatic stress and fears of compassion for self while moderately maintaining and improving compassion satisfaction.

Attachment and propensity for reporting compassionate opportunities and behavior in everyday life

Introduction

Researchers have identified links between anxious and avoidant attachments and difficulties with self-compassion, giving others compassion, and receiving compassion. However, while compassion requires both awareness of opportunities for compassion and compassionate action, little is known about attachment-related differences in reporting compassionate opportunities. Further, most research relies on retrospective-reports that may not accurately assess compassionate behaviors in everyday life.

Method

Consequently, we collected 2,757 experience sampling survey responses from 125 participants (95 women, 27 men, 3 non-binary, M age = 18.74, SD age = 1.66) to investigate whether attachment anxiety, avoidance, or their interaction were associated with differences in propensity for reporting compassionate opportunities, actions, and emotional responses to opportunities in everyday life across self-compassion, giving compassion, and receiving compassion.

Results

Anxiety was associated with greater likelihood of reporting all types of compassionate opportunities and less positive responses to opportunities to receive compassion. Avoidance was associated with less likelihood of reporting opportunities to give and receive compassion and less positive responses to opportunities to give compassion. Those high in anxiety but simultaneously low in avoidance reported fewer self-compassionate actions, but we identified no further differences in compassionate action.

Discussion

This study highlights the potential role of awareness of compassionate opportunities in attachment-related differences in compassion.

The Role of Implicit Memory in the Development and Recovery from Trauma-Related Disorders

Post-traumatic Stress Disorder is a chronic condition that occurs following a traumatic experience. Information processing models of PTSD focus on integrating situationally triggered sensory-emotional memories with consciously accessible autobiographical memories. Review of the nature of implicit memory supports the view that sensory-emotional memories are implicit in nature. Dissociation was also found to be associated with the development and severity of PTSD, as well as deficits in autobiographical memory. Moreover, disorganized attachment (DA) was associated with greater degrees of dissociation and PTSD, and like the defining neural activation in PTSD, was found to be associated with basal ganglia activity. In addition, subcortical neuroception of safety promotes a neurophysiological substrate supportive of social engagement and inhibition of fear-based responses. Furthermore, activation of representations of co-created imagined scenes of safety and secure attachment are associated with increases in this neurophysiological substrate. Repeated priming of secure attachment imagery was associated with modification of internal working models of DA along with reductions in dissociation and recovery from complex PTSD. In conclusion, it is posited that adequate recovery from extensive trauma experiences requires more than conscious elaboration of traumatic autobiographical memories and that the application of implicit nonconscious memory modification strategies will facilitate more optimal recovery.

Impact of a 12-Week Group-Based Compassion Focused Therapy Intervention on Heart Rate Variability

Heart rate variability (HRV) is considered an index of self-regulatory capacity, and trait compassion predicts healthy HRV and self-regulation. Compassion focused psychotherapy interventions have been shown to increase levels of compassion in the general population but no studies to date have examined if these interventions also increase HRV in a distressed clinical sample. The present study examined whether a 12-week compassion focused therapy intervention administered in group format would improve resting HRV and impact HRV reactivity during self-critical writing and self-compassion writing tasks administered before and after the intervention. A total of 31 participants in a university counseling center completed the intervention and HRV assessments. Resting HRV did not significantly change over the course of the intervention in the overall sample. Only those who showed a reliable increase in self-compassion also had a significant increase in resting HRV post-intervention. Additionally, the self-critical writing task was associated with a significant decrease in HRV, with HRV staying low during self-compassionate writing and then significantly increasing during recovery. Reliable change in self-compassion predicted increased HRV reactivity to self-critical and self-compassion writing tasks following the intervention, indicating greater engagement with the task. Findings support the idea that increased self-compassion increases HRV reactivity and potentially strengthens ability to engage with difficult emotions in psychotherapy.