The Efficacy of Compassion-Based Psychotherapy on Self-Awareness and Sexual Self-Esteem of Women with Sexual Dysfunction Symptoms
Subject Areas :Siavash Lajevardi 1 , farshid khosropour 2 , hamid Mollayee Zarandi 3
1 - Department of Psychology, Faculty of Humanities and Social Sciences, Islamic Azad University, Zarand Branch, Kerman, Iran.
2 - Department of Psychology, Faculty of Humanities and Social Sciences, Islamic Azad University, Zarand Branch, Kerman, Iran.
3 - Department of Psychology, Faculty of Humanities and Social Sciences, Islamic Azad University, Zarand Branch, Kerman, Iran.
Keywords: Compassion-based psychotherapy, self-awareness, sexual self-esteem, sexual dysfunction, women,
Abstract :
Sexual dysfunction is often accompanied by emotional imbalance, diminished psychological and sexual self-esteem. This study aimed to investigate the effectiveness of compassion-based psychotherapy on self-awareness and sexual self-esteem of women with sexual dysfunction symptoms. A semi- experimental research design with pre-test, post-test, and follow-up measurements was employed. The study population consisted of married women with sexual dysfunction who sought counseling in the family counselling centers in Tehran between January 2023 to April 2023. The research sample included 30 women with sexual dysfunction who were purposefully selected based on inclusion and exclusion criteria and randomly assigned to two groups: experimental(15 participants) and control (15 participants). Data were collected using the Female Sexual Function Index, the short form of the Sexual Self-Esteem Scale, and the Self-Compassion Scale. The experimental group received 12 sessions of 90-minute compassion-based psychotherapy, while the control group did not receive any treatment. Data were analyzed using SPSS 24 software through repeated measures analysis of variance and Bonferroni post- hoc test. The results of repeated measures analysis of variance revealed significant differences between post-test and follow-up measurements of the experimental and control groups in sexual self-esteem and self-awareness scores (p ≤ 0.001). The therapeutic effects were maintained during the 3-month follow- up. Based on the findings, compassion-based psychotherapy was found to be effective in enhancing self- awareness and sexual self-esteem of women with sexual dysfunction symptoms. Therefore, further research is recommended to explore the efficacy of this approach and compare it with other evidence- based treatments in larger samples.
زارعی، سلمان.، فرحبخش، کیومرث.، و اسماعیلی، معصومه (1390). تعیین سهم خود متمایزسازی، اعتماد، شرم و گناه در پیش¬بینی سازگاری زناشویی، دانش و پژوهش در روانشناسی کاربردی، 3 (45)، 51-64.
فرخی سحر و شاره حسین (1393). ویژگی‌های روانسنجی نسخه فارسی فرم کوتاه شاخص عزت نفس جنسی زنان. مجله روانپزشكي و روانشناسي باليني ايران، ۲۰ (۳)، ۲۵۲-۲۶۳.
یزدان¬شناس، ملیحه؛ زارع نیستانک، محمد و دیناری، پریسا (1400). اثربخشی رویکرد درمان متمرکز بر شفقت بر فراهیجان منفی، تحمل آشفتگی و عملکرد جنسی در زنان نابارور. فصلنامه خانواده درمانی کاربردی، 2 (1 پیاپی 5)، 459- 444.
Andersen, B., & Rasmussen, P. H. (2017). Transdiagnostic group therapy for people with self- critic and low self esteem, based on compassion focused therapy principles. Journal of Compassionate Health Care, 4(1), 14. https://doi.org/10.1186/s40639-017-0043-1
Ayling, K., & Ussher, J. M. (2008). “If sex hurts, am I still a woman?” The subjective experience of vulvodynia in hetero-sexual women?. Archives of Sexual Behavior, 37(2), 294–304. https://doi.org/10.1007/s10508-007-9204-1
Barkin, J. L., Serati, M., & Barkin, A. L. (2017). Self-Esteem and Sexual Behavior in Women: How Are They Related?. Journal of women's health (2002), 26(4), 305–306. https://doi.org/10.1089/jwh.2016.6305.
Bell, T., Montague, J., Elander, J., & Gilbert, P. (2020). “A definite feel-it moment”: Embodiment, externalisation and emotion during chair-work in compassion-focused therapy. Counselling and Psychotherapy Research, 20(1), 143–153. https://doi.org/10.1002/capr.12248
Beth, A.V., Julien, B., Anthony, F.B. & Michael, C.A. (2010). Psychopathy, sexual behavior and self-esteem, it's different for girls. Journal personality and individual differences, 48 (7), 833-83.
Branden, N. (1969). The Psychology of Self-Esteem. New York: Bantam.
Broekhof, E., Bos, M., & Rieffe, C. (2021). The Roles of Shame and Guilt in the Development of Aggression in Adolescents With and Without Hearing Loss. Research on child and adolescent psychopathology, 49(7), 891–904. https://doi.org/10.1007/s10802-021-00769-1.
Carpenter, T. P., Tignor, S. M., Tsang, J. A., & Willett, A. (2016). Dispositional self-forgiveness, guilt-and shame-proneness, and the roles of motivational tendencies. Personality and Individual Differences, 98, 53-61.
Cavalera, C., Andreani, P., Baumgartner, O., & Oasi, O. (2022). Do Immature Defense Mechanisms Mediate the Relationship Between Shame, Guilt, and Psychopathological Symptoms?. Frontiers in psychology, 13, 832237. https://doi.org/10.3389/fpsyg.2022.832237.
Dolezal L. (2022). Shame anxiety, stigma and clinical encounters. Journal of evaluation in clinical practice, 28(5), 854–860. https://doi.org/10.1111/jep.13744.
Eisenberg, N. (2000). Emotion, regulation, and moral development. Annual Review of Psychology, 51, 665–697. https://doi.org/10.1146/ annurev.psych.51.1.665.
Fan, Y. C., Hsiao, F. H., & Hsieh, C. C. (2023). The effectiveness of compassion-based interventions among cancer patients: A systematic review and meta-analysis. Palliative & supportive care, 21(3), 534–546. https://doi.org/10.1017/S1478951522001316
Ferguson, T. J., & Eyre, H. L. (2001). Reconciling interpersonal versus appraisal views of guilt: Roles of inductive strategies and projected responsibility in prolonging guilty feelings. Manuscript under review.
Fraser, A. M., Leavitt, C. E., Yorgason, J. B., & Price, A. A. (2023). “Feeling It”: Links between elements of compassion and sexual well-being. Frontiers in Psychology, 13, 1017384.
Gilbert, P. (2014). The origins and nature of compassion focused therapy. British Journal of Clinical Psychology, 53(1), 6–41.
Hooge, I. (2013). Moral emotions and prosaically behavioral: It may be time to change our view of shame and guilt. Psychology of Emotions, 2, 255- 276.
James R. (2011). Correlates of sexual self-esteem in a sample of substance-abusing woman. Journal Psychoactive Drugs, 43(3), 220-8.
Jiménez-Picón, N., Romero-Martín, M., Ponce-Blandón, J. A., Ramirez-Baena, L., Palomo-Lara, J. C., & Gómez-Salgado, J. (2021). The Relationship between Mindfulness and Emotional Intelligence as a Protective Factor for Healthcare Professionals: Systematic Review. International journal of environmental research and public health, 18(10), 5491. https://doi.org/10.3390/ijerph18105491
Jong, C. (2005). Shame and guilt among Asian Americans. Unpublished doctoral dissertation, Department of Psychology, Argosy University, Honolulu, Hawaii.
Kennis, M., Duecker, F., T'Sjoen, G., Sack, A. T., & Dewitte, M. (2022). Sexual Self-Concept Discrepancies Mediate the Relation between Gender Dysphoria Sexual Esteem and Sexual Attitudes in Binary Transgender Individuals. Journal of sex research, 59(4), 524–536. https://doi.org/10.1080/00224499.2021.1951643
Lafortune, D., Girard, M., Bolduc, R., Boislard, M. A., & Godbout, N. (2022). Insecure attachment and sexual satisfaction: A path analysis model integrating sexual mindfulness, sexual anxiety, and sexual self-esteem. Journal of Sex & Marital Therapy, 48(6), 535-551.
Laumann, E. O., Nicolosi, A., Glasser, D. B., Paik, A., Gingell, C., Moreira, E., & Wang, T. (2005). Sexual problems among women and men aged 40-80 y: prevalence and correlates identified in the global study of sexual attitudes and behaviors. International Journal of Impotence Research, 17(1), 39–57. https://doi.org/10.1038/sj.ijir.3901250
Leary M. R. (2015). Emotional responses to interpersonal rejection. Dialogues in clinical neuroscience, 17(4), 435–441. https://doi.org/10.31887/DCNS.2015.17.4/mleary.
Leary M. R. (2015). Emotional responses to interpersonal rejection. Dialogues in clinical neuroscience, 17(4), 435–441. https://doi.org/10.31887/DCNS.2015.17.4/mleary.
Leaviss, L., & Uttley, L. (2015). Psychotherapeutic benefits of compassion-focused therapy: An early systematic review. Psychological Medicine, 45(5), 927–945.
Linde, J., Luoma, J. B., Rück, C., Ramnerö, J., & Lundgren, T. (2023). Acceptance and Compassion-Based Therapy Targeting Shame in Body Dysmorphic Disorder: A Multiple Baseline Study. Behavior modification, 47(3), 693–718. https://doi.org/10.1177/01454455221129989
McLean, L., Steindl, S. R., & Bambling, M. (2018). Compassion-Focused Therapy as an Intervention for Adult Survivors of Sexual Abuse. Journal of child sexual abuse, 27(2), 161–175. https://doi.org/10.1080/10538712.2017.1390718.
McLean, L., Steindl, S.R. & Bambling, M. (2022). Compassion Focused Group Therapy for Adult Female Survivors of Childhood Sexual Abuse: a Preliminary Investigation. Mindfulness 13, 1144–1157 https://doi.org/10.1007/s12671-022-01837-3
Mohammadi, K., Heidari, M., & Faqihzadeh, S. (2008). The validation of female sexual function index (FSFI) in the women: Persian Version. Payesh journal, 7(2), 270-278.
Morales-Sánchez, L., Luque-Ribelles, V., Gil-Olarte, P., Ruiz-González, P., & Guil, R. (2021). Enhancing Self-Esteem and Body Image of Breast Cancer Women through Interventions: A Systematic Review. International journal of environmental research and public health, 18(4), 1640. https://doi.org/10.3390/ijerph18041640
Muris, P., & Meesters, C. (2014). Small or big in the eyes of the other: On the developmental psychopathology of self-conscious emotions as shame, guilt, and pride. Clinical Child and Family Psychology Review, 17(1), 19–40. https://doi.org/10.1007/s10567- 013-0137-z.
Nikolić, M., Hannigan, L. J., Krebs, G., Sterne, A., Gregory, A. M., & Eley, T. C. (2022). Aetiology of shame and its association with adolescent depression and anxiety: results from a prospective twin and sibling study. Journal of child psychology and psychiatry, and allied disciplines, 63(1), 99–108. https://doi.org/10.1111/jcpp.13465.
Park, Y., Impett, E. A., & MacDonald, G. (2021). Singles’ sexual satisfaction is associated with more satisfaction with singlehood and less interest in marriage. Personality and Social Psychology Bulletin, 47(5), 741-752
. Perez, G. R., Stasik-O'Brien, S. M., Laifer, L. M., & Brock, R. L. (2022). Psychological and Physical Intimate Partner Aggression Are Associated with Broad and Specific Internalizing Symptoms during Pregnancy. International journal of environmental research and public health, 19(3), 1662. https://doi.org/10.3390/ijerph19031662
. Porter, A. C., Zelkowitz, R. L., & Cole, D. A. (2018). The unique associations of self-criticism and shame-proneness to symptoms of disordered eating and depression. Eating Behaviors, 29, 64-67.
Ramazani M, Dolatian M, Shams J, Alavi. (2012). The correlation between self-esteem and sexual dysfunction and satisfaction in women. Arak Medical University Journal, 14(59), 57-65. [Persian]
Ritter, K., Vater, A., Rusch, N., Schroder-Abe, M., Schutz, A. Fydrich, T., Lammers, C. and Roepke, S. (2013). Shame in patients with narcissistic personality disorder. Psychiatry Research, 215(2), 429-437
. Rosen, C., Brown, J., Heiman, S., Leiblum, C., Meston, R., Shabsigh, D., et al. (2000). The Female Sexual Function Index (FSFI): A multidimensional self-report instrument for the assessment of female sexual function. Journal of Sex & Marital Therapy, 26(2), 191-208.
Sakaluk, J. K., Kim, J., Campbell, E., Baxter, A., & Impett, E. A. (2020). Self-esteem and sexual health: a multilevel meta-analytic review. Health psychology review, 14(2), 269–293. https://doi.org/10.1080/17437199.2019.1625281.
Salehi, M., Kharaz Tavakol, H., Shabani, M., & Ziaei, T. (2015). The relationship between self-esteem and sexual self-concept in people with physical-motor disabilities. Iranian Red Crescent medical journal, 17(1), e25359. https://doi.org/10.5812/ircmj.25359.
Saunders, F., Vosper, J., Gibson, S., Jamieson, R., Zelin, J., & Barter, J. (2021). Compassion Focused Psychosexual Therapy for Women Who Experience Pain during Sex. OBM Integrative and Complementary Medicine. 7 (2), 2-14. doi:10.21926/obm.icm.2202017.
Silva, G., Lima, S., Reis, B., Macruz, C., Postigo, S. (2020). Prevalence of hypoactive sexual desire disorder among sexually active postmenopausal women with metabolic syndrome at a public hospital clinic in Brazil: A cross-sectional study. Sexual Medicine, 8(3), 545-553. https://doi.org/10.1016/j.esxm.2020.05.008.
Sotomayor, M. (2005). The burden of premature ejaculation: The patient’s perspective. The Journal of Sexual Medicine, 2, 110–114. https://doi.org/10.1111/j.1743-6109.2005.20371.x.
Tangeney, J. P., Wagner, P. E. & Gramazow, R. (1989) The Test of Self-Conscious Affect (TOSCA). George Mason University, Fairfax, VA
Tangney, J. P., & Dearing, R. l. (2002). Shame & guilt. The Guilford Press: New York, London
Tracy, J. L., & Robins, R. W. (2007). The self in self-conscious emotions: A cognitive appraisal approach. In J. L. Tracy, R. W. Robins, & J. P. Tangney (Eds.), The self-conscious emotions: Theory and practice (pp. 3–20). New York, NY: Guilford Press.
Vosper, J., Irons, C., Mackenzie-White, K., Saunders, F., Lewis, R., & Gibson, S. (2021) Introducing compassion focused psychosexual therapy, Sexual and Relationship Therapy, DOI: 10.1080/14681994.2021.1902495.
Zeanah, P. D., & Schwarz, J. C. (2019). Sexual Self-Esteem Inventory and the Sexual Self-Esteem Inventory - Short Form. In R. R. Milhausen, J. J. Sakaluk, T. D. Fisher, C. M. Davis, & W. L. Yarber (Eds.), Handbook of Sexuality-Related Measures (4th edition, pp. 555–558). Routledge. https://doi.org/10.4324/9781315183169 Retrieved from
