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A thematic analysis of compassion-focused imagery for people with personality disorder: inhibitors, facilitators and clinical recommendations

Naismith, I; Kerr, S; Mwale, A; Feigenbaum, J; (2019) A thematic analysis of compassion-focused imagery for people with personality disorder: inhibitors, facilitators and clinical recommendations. Clinical Psychologist , 23 (3) pp. 213-224. 10.1111/cp.12180. Green open access

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Abstract

Background: Compassion‐focused therapy (CFT) is increasingly being offered for a range of conditions, including personality disorders (PDs). A key process in CFT is to identify inhibitors to developing compassion and helping clients to overcome these. This study explores inhibitors and facilitators for clients with PD trialling compassion‐focused imagery (CFI) over 1 week. / Methods: Fifty‐three participants with a diagnosis of at least one PD engaged in CFI for the first time, before and after a negative mood‐manipulation. Semi‐structured group interviews and written open‐response questions were used to collect data on experiences of CFI, immediately following CFI and after 1 week of daily practice. Participants were invited to practice CFI daily for 1 week then complete further open‐response questions online. Data were analysed using thematic analysis. / Results: CFI generated both positive and negative experiences for clients. Six superordinate themes were identified regarding inhibitors of CFI: weak imagery ability, fear of compassion (with multiple subthemes), lack of compassionate experiences, and psychological symptoms. Most inhibitors remained following 1 week of practice. Several facilitators of CFI were identified. / Conclusions: Clients with PD diagnoses face numerous inhibitors to CFI that occur transdiagnostically. Others may be more specific to this population, such as fear of compassion focused on a dangerous “other.” Some inhibitors are not overcome with practice alone, including weak imagery. Failure to assess for and address inhibitors prior to introducing CFI in this population risks causing harm to clients.

Type: Article
Title: A thematic analysis of compassion-focused imagery for people with personality disorder: inhibitors, facilitators and clinical recommendations
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/cp.12180
Publisher version: https://doi.org/10.1111/cp.12180
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: borderline personality disorder, compassion, compassion‐focused therapy, mental imagery, personality disorders
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
URI: https://discovery.ucl.ac.uk/id/eprint/10077451
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