Education, Faculty of
Educational and Counselling Psychology, and Special Education (ECPS), Department of
DSpace
UBCV
Fender, Alayna
Master of Arts - MA
University of British Columbia
Sexual shame is a salient experience for sexual and gender minority (SGM) women. While mindfulness is known as having protective effects against shame, little is known about why mindfulness sometimes has adverse impacts. As individual differences are known to influence outcomes related to mindfulness, the purpose of the present study was to test the hypothesis that self-critical or self-compassionate appraisals of internal experiences will influence whether mindfulness is helpful or harmful for sexual shame among SGM women; such that self-criticism will weaken the protective association between mindfulness and sexual shame while self-kindness will strengthen the association. Participants (N = 384) were SGM women (75.8% cisgender; 68.2% white) recruited through Prolific (an online tool designed for research participant selection) who completed a web-based survey with measures assessing trait mindful awareness, self-kindness, self-criticism, and sexual shame. The self-kindness and the self-criticism moderation models supported our hypotheses. Specifically, among SGM women low in self-kindness or high in self-criticism, greater mindful awareness was associated with higher sexual shame, whereas the reverse was true for those high in self-kindness or low in self-criticism. These findings challenge universal mindfulness recommendations, as trait self-kindness and self-criticism appear to influence whether mindful awareness links with increased or decreased sexual shame. Results highlight the importance of assessing for self-criticism and self-kindness before mindfulness-based interventions are indicated for SGM women experiencing sexual shame.
WHEN MINDFULNESS BACKFIRES: SELF-CRITICISM AND SELF-KINDNESS MODERATE THE MINDFUL AWARENESSâSEXUAL SHAME LINK AMONG SEXUAL AND GENDER MINORITY WOMEN by Alayna Fender B.A., The University of Winnipeg, 2015 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS in THE FACULTY OF GRADUATE AND POSTDOCTORAL STUDIES (Counselling Psychology) THE UNIVERSITY OF BRITISH COLUMBIA (Vancouver) October 2025 © Alayna Fender, 2025 iiThe following individuals certify that they have read, and recommend to the Faculty of Graduate and Postdoctoral Studies for acceptance, the thesis entitled: When mindfulness backfires: Self-criticism and self-kindness moderate the mindful awarenessâsexual shame link among sexual & gender minority women submitted by Alayna Fender in partial fulfilment of the requirements for the degree of Master of Arts in Counselling Psychology Examining Committee: Dr Daniel Cox, Professor, Counselling Psychology, UBC Supervisor Dr Chan Jeong Park, Assistant Professor, Counselling Psychology, UBC Supervisory Committee Member Dr Nicole Johnson, Associate Professor, Counselling Psychology, UBC Supervisory Committee Member iiiAbstract Sexual shame is a salient experience for sexual and gender minority (SGM) women. While mindfulness is known as having protective effects against shame, little is known about why mindfulness sometimes has adverse impacts. As individual differences are known to influence outcomes related to mindfulness, the purpose of the present study was to test the hypothesis that self-critical or self-compassionate appraisals of internal experiences will influence whether mindfulness is helpful or harmful for sexual shame among SGM women; such that self-criticism will weaken the protective association between mindfulness and sexual shame while self-kindness will strengthen the association. Participants (N = 384) were SGM women (75.8% cisgender; 68.2% white) recruited through Prolific (an online tool designed for research participant selection) who completed a web-based survey with measures assessing trait mindful awareness, self-kindness, self-criticism, and sexual shame. The self-kindness and the self-criticism moderation models supported our hypotheses. Specifically, among SGM women low in self-kindness or high in self-criticism, greater mindful awareness was associated with higher sexual shame, whereas the reverse was true for those high in self-kindness or low in self-criticism. These findings challenge universal mindfulness recommendations, as trait self-kindness and self-criticism appear to influence whether mindful awareness links with increased or decreased sexual shame. Results highlight the importance of assessing for self-criticism and self-kindness before mindfulness-based interventions are indicated for SGM women experiencing sexual shame. ivLay Summary While mindfulness has been linked to improvements on various mental health outcomes, including shame, some people report experiencing adverse impacts. The purpose of this research was to investigate how individual differences in self-kindness and self-criticism can impact the association between mindful awareness and sexual shame in sexual and gender minority (SGM) women. The findings indicated that mindful awareness was associated with increased sexual shame in those who were high in self-criticism and decreased sexual shame in those who were self-kind. These results are important for clinicians and the public. When working to reduce sexual shame in SGM women, assessing for levels of self-criticism and self-kindness before utilizing mindfulness is imperative to reducing the risk of increasing shame in this population. vPreface This thesis is original, unpublished, independent work by the author, Alayna Fender, and supervised by Dr. Daniel W. Cox. The use of Generative AI in this thesis was limited to the use of ChatGPT 5 for checking sentences and paragraphs for correctness and clarity. The research was approved by the University of British Columbiaâs Behavioural Research Ethics Board [certificate #H25-00935-A001]. viTable of Contents Abstract ......................................................................................................................................... iii Lay Summary ............................................................................................................................... iv Preface ............................................................................................................................................ v Table of Contents ......................................................................................................................... vi List of Tables .............................................................................................................................. viii List of Figures ............................................................................................................................... ix Acknowledgements ....................................................................................................................... x Dedication ..................................................................................................................................... xi Chapter 1: Introduction ............................................................................................................... 1 Sexual and Gender Minority Community and Sexual Shame ..................................................... 1 The Complexity of the Mindfulness-Shame Link ......................................................................... 2 Present Research ........................................................................................................................ 4 Chapter 2: Method ........................................................................................................................ 6 Inclusion and Exclusion .............................................................................................................. 6 Participants ................................................................................................................................. 6 Procedures .................................................................................................................................. 6 Measures ..................................................................................................................................... 7 Demographic Questionnaire ................................................................................................... 7 Sexual Shame .......................................................................................................................... 8 Mindful Awareness ................................................................................................................. 8 Self-Kindness and Self-Criticism ........................................................................................... 9 Statistical Analyses ................................................................................................................... 10 Chapter 3: Results ....................................................................................................................... 11 Preliminary Analyses ................................................................................................................ 11 Moderation Analyses ................................................................................................................ 11 Hypothesis 1: Self-Kindness as a Moderator ........................................................................ 11 Hypothesis 2: Self-Criticism as a Moderator ........................................................................ 12 Chapter 4: Discussion ................................................................................................................. 14 Practical Implications ............................................................................................................... 17 Limitations and Future Directions............................................................................................ 18 viiChapter 5: Conclusion ................................................................................................................ 19 Tables and Figures ...................................................................................................................... 20 References .................................................................................................................................... 26 viiiList of Tables Table 1: Sociodemographic Characteristics of Participantsâ¦â¦â¦â¦â¦â¦â¦â¦â¦â¦..â¦â¦â¦â¦20 Table 2: Bivariate Correlations and Descriptive Statistics for Primary Variablesâ¦â¦â¦â¦.â¦...22 Table 3: Unstandardized Coefficients for Self-Kindness Moderating the Association between Mindful Observation and Sexual Shameâ¦â¦â¦â¦â¦â¦â¦â¦â¦â¦â¦..â¦â¦â¦â¦â¦â¦...23 Table 4: Unstandardized Coefficients for Self-Criticism Moderating the Association between Mindful Awareness and Sexual Shameâ¦â¦â¦â¦â¦â¦â¦â¦â¦â¦â¦â¦..â¦â¦.................23 ixList of Figures Figure 1: Interaction Between Mindful Awareness and Self-Kindness on Sexual Shameâ¦â¦â¦24 Figure 2: Interaction Between Mindful Awareness and Self-Criticism on Sexual Shameâ¦â¦â¦25 xAcknowledgements Thank you to Dr. Daniel Cox, my thesis supervisor. This thesis would not have existed without your continuous support, guidance, and contribution. Your dedication to excellence and commitment to your students was an inspiration and buoy throughout this project. I would also like to thank my committee members, Dr. Nic Johnson and Dr. CJ Park, for your insights and expertise. You challenged and cheered, and I appreciated your feedback immensely. Most of all, I thank my wife and family. I am so grateful for your consistent care, love, encouragement, and unending belief in me. I would not have made it to the end of this degree without you, and think about how unbelievably lucky I am to have you all in my corner, each and every day. xiDedication To Dr. Michael McIntyre for giving me a shot 1Chapter 1: Introduction Shame is a known concern for people in the sexual and gender minority (SGM) community (Pachankis et al., 2024), as they face minority stressors such as chronic stigma, discrimination, and an expectation of rejection (Meyer, 2013). Although mindfulness is widely cited as linked to improvements in mental health difficultiesâincluding shame (Goffnett et al., 2020; González-Martín et al., 2023; Westerman et al., 2020)âfor some mindfulness has no effect or even exacerbates difficulties (Britton et al., 2021; Farias et al., 2020; Goldberg et al., 2022; Wong et al., 2018). While intentionally placing awareness on the self is central to the practice of mindfulness (Baer et al., 2006), some have noted the importance of decreasing self-focused attention in those who are highly self-critical (Dunn & Luchner, 2022; Krebs et al., 2024; Robertson & Strodl, 2020). Additionally, considering self-criticism's robust association with shame (Castilho et al., 2017), it may be that self-criticism impacts whether mindfulness is helpful or harmful. Following previous research demonstrating that the connection between mindfulness and reduced shame may be explained by the presence of self-compassion (Sedighimornani et al., 2019; Stynes et al., 2022; Woods & Proeve, 2014), we propose that it is self-kindness specifically that potentiates the benefits of mindful awareness on sexual shame, while self-criticism hinders them. Sexual and Gender Minority Community and Sexual Shame Shame is the experience of intense negative self-evaluation where people believe themselves to be fundamentally flawed, inferior, or bad, and unworthy of belonging (Brown, 2012). Consistent with minority stress theory (Meyer, 2013), evidence showing that SGM people experience higher levels of shame than their heterosexual peers is unsurprising (Pachankis et al., 2024) considering that shame can arise from internalized stigma, prejudice, and rejection around 2sexuality (Brown & Trevethan, 2010; Greene & Britton, 2012; Johnson & Yarhouse, 2013). Further, there is compelling evidence that shame explains a substantial portion of the association between sexual minority orientations and adverse mental health outcomes such as depression, anxiety, and suicidality (Brown & Trevethan, 2010; Pachankis et al., 2024; Seabra et al., 2024). Considering chronic exposure to stigmatization may lead to the internalization of that stigma as shame (Johnson & Yarhouse, 2013), the disproportionate sexual stigmatization faced by women and SGM people (Farvid, 2021; Meyer, 2013) may lead to the internalization of that stigma as sexual shame. Sexual shame is shame about sexual thoughts, desires, behaviours, or identities (Litam & Speciale, 2021), and has been identified as a key contributing factor in womenâs sexual dysfunction, poor sexual satisfaction, and psychological distress (Graziani & Chivers, 2024; Litam & Speciale, 2021; Marcinechová & Záhorcová, 2020; Pulverman & Meston, 2020). Additionally, sexual shame has been linked to internalized homophobia, emotional dysregulation, and sexual compulsivity in SGM people (Cienfuegos-Szalay et al., 2022). Thus, further understanding sexual shame at the intersection of these identitiesâamong SGM womenâis important for understanding and improving sexual and psychological wellbeing in this population. The Complexity of the Mindfulness-Shame Link Mindfulness, bringing awareness to present-moment internal and external experiences (Baer, 2003), has a growing body of evidence linking this awareness to enhanced emotional regulation and reduced psychological distress, including to reduced shame (Goffnett et al., 2020; González-Martín et al., 2023; Leyland et al., 2019; Westerman et al., 2020). Despite the substantial evidence that mindfulness is connected with desired psychological outcomes (see Huong, 2023, for a comprehensive review), for some, practicing mindfulness has been associated 3with adverse effects such as increased anxiety, traumatic re-experiencing, lasting dysregulated arousal states, and even increased shame (Britton et al., 2021; Farias et al., 2020; Goldberg et al., 2022; Malouf et al., 2017). However, it is unclear which mechanisms may be interacting with mindfulness to produce these adverse outcomes. Several studies have documented individual difference factors as influencing mindfulnessâ link with distress, anxiety, self-confidence, and overall well-being (de Vibe et al., 2015; Gan et al., 2024; NyklíÄek & Irrmischer, 2017). This research provides evidence that certain traits may influence the associations between self-focused awareness and psychological outcomes (Mor & Winquist, 2002). Self-criticismâa way of responding to oneâs perceived flaws and inadequacies with persecution and hostility (Gilbert & Procter, 2006)âis a relevant trait in this context as self-criticism has been strongly (r = .66) linked to shame (Castilho et al., 2017), and has been found to be elevated among SGM people (Nappa et al., 2022). However, the impact of individual differences in self-criticism on the association between mindfulness and sexual shame remains unclear. Previous research has found self-compassionâa construct defined by an attitude of self-kindness, a recognition of shared human experiences, and a mindful awareness of the present moment (Neff, 2003a)âto be associated with decreased levels of shame (Gilbert & Procter, 2006; Sedighimornani et al., 2019; Woods & Proeve, 2014). Considering mindfulness-based interventions have been shown to be most effective in targeting shame when there is a focus on self-compassion (see Stynes et al., 2022, for a systematic review), and self-compassion appears to facilitate the celebrated link between mindfulness and shame (Sedighimornani et al., 2019), it follows that the desired association between mindfulness and sexual shame may be contingent on the presence of self-kindness or the absence of self-criticism. 4Present Research Shame is a prevalent experience among SGM people (Pachankis et al., 2024) and sexual shame has been identified as a key contributing factor for adverse psychological outcomes in this community (Brown & Trevethan, 2010; Cienfuegos-Szalay et al., 2022; Pachankis et al., 2024; Seabra et al., 2024). As the sexualities of women and SGM people are disproportionately stigmatized (Farvid, 2021; Meyer, 2013), it follows that sexual shame is particularly relevant for exploration at the intersection of these identities. Based on the existing research indicating that individual differences influence the outcomes associated with mindfulness (de Vibe et al., 2015; Gan et al., 2024; NyklíÄek & Irrmischer, 2017), and the evidence associating self-compassion and self-criticism with shame (Castilho et al., 2017; Gilbert & Procter, 2006; Sedighimornani et al., 2019; Woods & Proeve, 2014), we hypothesize that how internal experiences are appraisedâcompassionately or criticallyâinfluences the association between mindfulness and peopleâs perception of their sexuality as shameful. Presently, we examined self-kindness and self-criticismârather than general self-compassionâas these components most directly measure how people appraise themselves and their internal experiences. We analysed mindful awarenessârather than general mindfulnessâas this component most directly measures the observation of the self. We expect that self-kindness will strengthen the positive association between mindful awareness and sexual shame, while self-criticism will weaken this association. Our specific hypotheses are: H1: The negative association between mindful awareness and sexual shame will be stronger for SGM women with higher levels of self-kindness. 5H2: The negative association between mindful awareness and sexual shame will be weaker for SGM women with higher levels of self-criticism. 6Chapter 2: Method Inclusion and Exclusion Participants were included if they identified as an adult (18 or older) sexual or gender minority woman, resided in the USA or Canada, and were fluent in English. Participants were excluded if they failed multiple attention checks. Of the 419 surveys collected, 35 (8.4%) were excluded â 32 for not meeting the SGM or woman inclusion, two for outliers/influential points, and one for missing more than one attention check (see Procedures section). Participants The studyâs sample was comprised of 384 self-identified SGM adult women. 291 participants (75.8%) identified as cisgender, followed by nonbinary/genderqueer (n = 37; 9.6%), trans/nonbinary (n = 29; 7.6%), and transgender (n = 27; 7.0%) identities. The majority of our sample identified as bisexual or pansexual (n = 252; 65.6%), with 20.8% (n = 80) identifying as lesbian or gay, 6.0% (n = 23) as queer, 5.7% (n = 22) as asexual, and 0.3% (n = 1) as Two-Spirit. Over two-thirds (n = 262; 68.2%) of participants identified as White, followed by 25.3% (n = 97) of participants identifying as Black and 7.8% (n = 30) as Hispanic or Latino/Latina/Latinx. Participants could select multiple race/ethnicity options. The majority of participants were single (n = 131; 34.1%), followed by those in a relationship (n = 102; 26.6%) or married (n = 109; 28.4%). Similar to race/ethnicity, participants could select multiple relationship statuses. Sociodemographic details can be found in Table 1. Procedures Participant recruitment was done using Prolific â a well-known online crowdsourcing tool designed for research participant recruitment (Palan & Schitter, 2018). Initial participant selection was done within Prolific using pre-screened demographic data to identify participants 7who were fluent in English, lived in the USA or Canada, and identified as SGM women. Participants then completed a web-based survey, including four attention checks (e.g. âPlease respond to this question by selecting âSometimes trueâ to show that you are paying attention.â) and questions to further ensure participants met study inclusion criteria (e.g., were SGM women; see Demographic Questionnaire section). Prior to accessing the survey, participants read a consent form; if they consented, they were invited to complete the questionnaires. Participants were compensated an average of $20.04 CAD per hour to align with the current minimum wage in British Columbia. They were provided with information on mental health resources should they find participating in the study distressing. Study procedures were approved by the UBC Behavioural Research Ethics Board, and all data were collected in June of 2025. An a priori power analysis was conducted using G*Power version 3.1 (Faul et al., 2007). With a significance criterion of α = .05 and power = .80, the desired sample size was N = 395 for moderation analysis. The obtained sample size of N = 384 was slightly less than the desired sample size but deemed adequate for testing the studyâs hypotheses. Measures Demographic Questionnaire Participants were asked to identify their age, race/ethnicity, household income, relationship status, gender identity, and sexual orientation. To measure gender identity, we used the Gender/Sex 3x3 (Beischel et al., 2023). This measure includes the free-text question, âWhat is your gender? (e.g., woman, agender, etc.)â And questions about participantsâ transgender or cisgender identity, and about their binary or nonbinary identity. Gender was recoded into the following categories: âTransgender womenâ 8(women who identified as transgender binary), âCisgender womenâ (women who identified as cisgender binary), âTrans/nonbinary womenâ (women who identified as transgender nonbinary), and âNonbinary/genderqueer womenâ (women who identified as none of the above or otherwise self-disclosed). To measure sexual orientation, we used a single question (Bates et al., 2022), âWhich of the following best represents how you think of yourself? Lesbian or gay; Straight, that is, not gay or lesbian; Bisexual; Two-Spirit; I use a different term [free-text]; Donât know; Prefer not to answerâ. We added âAsexual, pansexual, and queerâ as potential selectable identities to include more of the 2SLGBTQIA+ community. Participants were identified as belonging to the SGM community if they endorsed bisexual or pansexual, lesbian or gay, asexual, queer, or identified as another option other than straight or heterosexual. Sexual Shame Levels of sexual shame were assessed using the sexual shame subscale of the Sexual Shame and Pride Scale (SSPS; Rendina et al., 2019). The sexual shame subscale consists of eight self-report items (e.g. âI often feel embarrassed by the sexual activities that I likeâ). Each item is rated from 1 (not at all like me) to 6 (exactly like me). We used the total sexual shame score, calculated by computing the sum of item responses. Higher scores indicated higher levels of sexual shame. Convergent and divergent validity for the sexual shame subscale have been supported via correlations with scores on measures of related constructs (e.g., depression and internalized homonegativity) and it has shown adequate test-retest reliability over nine and 12 months (r = .60; Rendina et al., 2019). In the present study, the sexual shame subscale showed a high level of internal consistency (Cronbach's a = .91). Mindful Awareness 9Trait mindful awareness was measured using the observe facet of the Five Facet Mindfulness Questionnaire (FFMQ; Baer et al., 2006). The FFMQ is a 39-item self-report measure that contains five subscales. Since we were interested in mindful awareness specifically, we used the subscale most closely related to present-moment focus: Observing. The observe subscale measures a personâs levels of paying attention to sensations and emotions using eight items, such as âWhen Iâm walking, I deliberately notice the sensations of my body movingâ and âI pay attention to how my emotions affect my thoughts and behavior.â Each item is rated on a 5-point scale from 1 (never or very rarely true) to 5 (very often or always true), with a higher score indicating higher levels of awareness. We used the summed total of these item responses to determine mindful awareness. Convergent and divergent validity have been supported via correlations with scores on measures of related constructs such as life satisfaction and depression (Christopher et al., 2012). Construct validity has been supported by demonstrating that experienced mindfulness meditators scored higher on the measure than non-meditators (Baer et al., 2008). In the present study, the observe subscale showed a high level of internal consistency (Cronbach's a = 0.80). Self-Kindness and Self-Criticism To measure self-kindness, we used the self-kindness subscale of the Self-Compassion Scale (SCS; Neff, 2003b). To measure self-criticism, we used the self-judgement subscale, as its items reflect self-critical attitudes. The SCS is a 26-item self-report questionnaire designed to measure six positive and negative facets of self-compassion: self-kindness versus self-judgement, common humanity versus isolation, and mindfulness versus overidentification. The self-kindness subscale measures the way people respond to themselves when facing difficulty, using items such as âIâm kind to myself when Iâm experiencing sufferingâ and âIâm tolerant of 10my own flaws and inadequacies.â The self-judgement subscale measures how critical a person is of themselves, using items like, âIâm disapproving and judgemental about my own flaws and inadequacies.â Each item is rated on a 5-point scale from 1 (almost never) to 5 (almost always), with higher scores indicating greater levels of the respective subscales. Convergent and discriminant validity was confirmed via correlations with scores on measures of related constructs such as self-criticism, emotional intelligence, anxiety, depression, perfectionism and life satisfaction. Construct validity has been demonstrated through Buddhist practitioners scoring significantly higher on the measure than non-Buddhist practitioners. In the present study, the self-kindness subscale showed a high level of internal consistency (Cronbach's a = 0.91), as did the self-judgement subscale (Cronbachâs a = .89). Statistical Analyses To examine the moderating effects of self-kindness and self-criticism on the association between mindful awareness and sexual shame, moderation analyses were performed. Each independent variable was mean-centered. We tested two moderation models, both with mindful awareness as the independent variable and sexual shame as the dependent variable. In the first model we analyzed the moderating effects of self-kindness and in the second we analyzed the moderating effects of self-criticism. Significant moderation effects were further explored using a simple slopes test where the conditional effects of mindful awareness on sexual shame were plotted at three levels of the moderators â one standard deviation above the mean, at the mean, and one standard deviation below the mean. Moderation analyses were conducted using Hayesâ PROCESS v5.0, Model 1 in IBM SPSS Statistics 30. 11Chapter 3: Results Preliminary Analyses Descriptive statistics and bivariate correlations are presented in Table 2. Sexual shame demonstrated significant associations with our proposed moderators; SGM women higher in self-kindness reported significantly less sexual shame (r = -.33, p < .001), while those higher in self-criticism experienced significantly more sexual shame (r = .36, p < .001). Data appeared normally distributed based on their skewness and kurtosis statistics, confirmed through visual inspection of histograms. No basic regression assumptions were found to be violated. Moderation Analyses Hypothesis 1: Self-Kindness as a Moderator First, we examined our hypothesis that self-kindness would moderate the association between mindful awareness and sexual shame (see Table 3). The overall model was significant, explaining 14% of the variance in sexual shame, F(3, 380) = 20.01, p < .001, R2 = .14. Our hypothesis was supported as the interaction between mindful awareness and self-kindness was significant, explaining an additional 2.7% of the variance, ÎR2 = 0.027, F(1, 380) = 12.04, p < .001. To better understand the size and direction of the moderating effect of self-kindness, we probed the interaction through a simple slopes analysis (see Figure 1). This analysis revealed that for SGM women with low levels of self-kindness (-1 SD), higher mindful awareness scores were associated with significantly higher levels of sexual shame (b = .27, SE = .09, p = .002), at moderate levels of self-kindness (mean) the relationship was non-significant (b = .04, SE = .07, p = .566), while for women with high levels of self-kindness (+1 SD), mindful awareness was associated with lower levels of sexual shame (b = -.19, SE = .11, p = .084). 12To better understand the thresholds at which mindful awareness shifted from being related to decreases or increases in sexual shame, we employed a Johnson-Neyman analysis. Results showed that mindful awareness was related to significantly increased sexual shame for nearly a third of the sample (31.3%): those whose self-kindness scores were below 2.56 (0.41 points below the mean score of 2.97). Simultaneously, mindful awareness was significantly related to a decrease in sexual shame for 10.4% of the sample: those whose self-kindness scores were above 4.20 (1.23 points above the mean). Hypothesis 2: Self-Criticism as a Moderator Our second hypothesis, that self-criticism moderated the relation between mindful awareness and sexual shame, was also supported (see Table 4). The overall model was significant, explaining 15% of the variance in sexual shame, R² = .15, F(3, 380) = 22.49, p < .001. Additionally, as hypothesized, the interaction between mindful awareness and self-criticism was significant, explaining an additional 2.3% of the variance, ÎR2 = 0.023, F(1, 380) = 10.09, p = .002. The better understand the size and direction of the moderating effect of self-criticism, we probed the interaction through a simple slopes analysis (see Figure 2). This revealed that for SGM women with low levels of self-criticism (-1 SD), higher mindful awareness scores were associated with significantly lower levels of sexual shame (b = -.22, SE = .10, p = .028), at moderate levels of self-criticism (mean) the association was non-significant (b = .03, SE = .07, p = .668), while for women with high levels of self-criticism (+1 SD), mindful awareness was associated with significantly higher levels of sexual shame (b = .20, SE = .09, p = .031). To better understand the thresholds at which mindful awareness shifted from being related to decreases or increases in sexual shame, we ran a Johnson-Neyman analysis. Results 13showed that mindful awareness was related to significantly increased sexual shame for a fifth of the sample (20.6%): those with self-criticism scores above 4.27 (0.84 points above the mean of 3.43). Simultaneously, mindful awareness was significantly related to a decrease in sexual shame for 17.4% of the sample: those whose self-criticism scores were below 2.60 (0.83 points below the mean). 14Chapter 4: Discussion While research has linked mindfulness with lower levels of shame (Goffnett et al., 2020), in some, mindfulness has been found to be unhelpful or even hurtful. However, little is known about the individual differences that may be responsible for the adverse outcomes reported by some (Britton et al., 2021; Farias et al., 2020; Goldberg et al., 2022; Malouf et al., 2017; Wong et al., 2018). Considering that decreasing self-focused attention in those who are highly self-critical is the current recommendation (Dunn & Luchner, 2022; Krebs et al., 2024; Robertson & Strodl, 2020), it follows that self-criticism may impact mindful awarenessâ link to the improvement or worsening of shame, as turning attention toward the self is a key component of mindful awareness (Baer, 2006). In the present study, we explored the associations between mindful awareness, self-kindness, self-criticism, and sexual shame among SGM women, as women and those in the SGM community are particularly vulnerable to both shame and self-criticism (Else-Quest et al, 2012; Nappa et al., 2022; Neff, 2003b; Panchankis et al., 2024). We found that self-kindness moderated the association between mindful awareness and sexual shame. Specifically, among SGM women with high levels of self-kindness, greater mindful awareness was related to less sexual shame. This is consistent with evidence that self-compassion facilitates the link between mindfulness and positive mental health outcomes (Sedighimornani et al., 2019; Stynes et al., 2022; Woods & Proeve, 2014). Perhaps our most notable finding was that for women who were highly critical of themselves, mindful awareness was associated with higher levels of sexual shame. These results indicate that the benefits of mindful awareness for sexual shame are not ubiquitous but depend on the psychological context in which they occur. Thus, mindful awareness may amplify whatever self-relational mindset is present, for better or worse. When people relate to themselves 15with kindness, mindful awareness may facilitate what Gilbert and Procter (2006) term compassionate attention: observing experiences with empathy and warmth rather than judgement. Conversely, when a self-critical mindset is present, the self-focused attention of mindful awareness may amplify these self-judgements, increasing the feelings of deficiency and worthlessness central to the experience of shame (Brown, 2012). These findings challenge universal implementation of mindfulness for reducing shame (Goffnett et al., 2020) and support the use of caution when applying mindful awareness in highly self-critical people. The known association between self-criticism and rumination (Flett et al., 2021; OâConnor & Noyce, 2008) may help us further understand the observed increase in sexual shame related to mindful awareness in those who were highly self-critical. It may be that heightened mindful awareness strengthens the relation between self-criticism and rumination as self-critical thoughts are noticed, paid attention to, and subsequently ruminated on. In a self-critical context, mindful awareness may shift from present-moment, non-judgemental observation (Baer, 2003), to a ruminative awareness of self-judgement, thereby intensifying shame. Thus, in addition to observing their self-judgemental thoughts around sex and sexuality, SGM women high in self-criticism and mindful awareness may linger on these judgements in a way that allows rumination to flourish, increasing sexual shame rather than alleviating it. Our finding that 20% of the SGM women in the study reported self-criticism levels high enough for mindful awareness to become harmful extends our understanding of the psychological impact of elevated self-criticism in this population (Nappa et al., 2022). This heightened self-criticism, and association between mindful awareness and increased sexual shame, can be understood through minority stress theory (Meyer, 2013), as sexual minority identities face continuous stigma, discrimination, and rejection, and the internalization of these 16stressors increases self-criticism and shame (Brown & Trevethan, 2010; Smith et al., 2020). Thus, mindful awareness may increase attention toward a sexuality already steeped in self-judgement and shame (Greene & Britton, 2012; Johnson & Yarhouse, 2013). Self-critical SGM women might observe societally stigmatized aspects of their sexuality and experience an intensifying of sexual shame by concluding: âThese aspects of my sexuality are wrong/bad/dirty, and I need to rid myself of them.â Alternatively, SGM women who relate to themselves with kindness might observe their sexuality and offer care in response to any internalized homophobic beliefs that arise, thereby soothing potential sexual shame. Both our self-kindness and self-criticism models revealed a consistent pattern: high self-kindness and low self-criticism linked mindful awareness to decreased sexual shame, while low self-kindness and high self-criticism linked mindful awareness to increased sexual shame. Although we analyzed self-kindness and self-criticism independently to examine their unique contributions, our findings are consistent with Neffâs (2003a) conceptualization of self-kindness and self-judgement as operating like two sides of the same coin. It appears that these components work similarly rather than as unique mechanisms (Phillips, 2019), with high criticism showing a nearly identical influence on the relation between mindful awareness and sexual shame as low kindness, and low criticism and high kindness showing the inverse pattern. Another interesting result was that moderate levels of either construct resulted in a neutral zone where mindful awareness was not significantly related to sexual shame in one direction or the other. Taken together, these results indicate the presence of what Bachard et al. (2024) termed a coextensive opposite: a self-relational continuum shared between self-kindness and self-criticism, where each trait functions as the inverse of the other while sharing a single scale. Where people fall along 17this self-relational spectrum influences whether mindful awareness facilitates healing, has no impact, or amplifies shame. Practical Implications While mindfulness has been associated with improvements in a variety of mental health difficulties (González-Martín et al., 2023), our study indicates that for SGM women with elevated self-criticism or low self-kindness, mindful awareness can be linked to increased sexual shame. For practitioners working with sexual shame, consideration around clientsâ contact with their internal experiences (their level of mindful awareness), and their way of relating to themselves and their sexuality (whether with kindness or criticism) will be important for determining appropriate treatment. Our finding that participants high in mindful awareness and self-criticism reported elevated levels of sexual shame may appear to position trait mindful awareness as a vulnerability. However, we can also look at mindful awareness as an opportunity, as we additionally established that those participants high in mindful awareness experienced beneficial influence from self-kindness, resulting in decreased sexual shame. Therefore, increasing levels of self-kindness in this population may mitigate the potential risks of mindful awareness by directing its internal magnifying qualities with intention. Although we examined trait-level mindful awareness, they may have implications for mindfulness practices with self-critical SGM clients. In particular, before encouraging clients to mindfully engage with their shame-related experiences, it may be important to build a foundation of self-kindness, and reduce self-criticism. Explicitly integrating self-kindness into mindfulness practices is indicated. There are several well-established and empirically supported practices in this domain, such as compassion-focused therapy (CFT; Gilbert, 2010) and the Mindful Self-Compassion program (MSC; Neff & Germer, 2013). Both of these therapeutic resources aim to 18facilitate self-compassion and mitigate self-criticism while including a focus on shame. The clinical aim is to facilitate a fundamental shift toward compassion in clientsâ ways of relating to themselves, and thereby their experiences of shame. Limitations and Future Directions There are several limitations worth considering. First, the cross-sectional design limits our ability to establish causal associations. Longitudinal research is required to test whether changes in self-compassion or self-criticism predict changes in sexual shame. Additionally, future research is needed to establish whether the implementation of compassion-based practices results in changes in self-kindness and self-criticism, and if subsequent changes in sexual shame follow. Another limitation is that our study did not evaluate participantsâ sexual trauma history, which may act as a confounding variable, increasing sexual shame while impacting levels of self-criticism, self-kindness, and mindful awareness. Future studies including non-SGM participants should be undertaken to establish if the reported influence of self-kindness and self-criticism are the same in non-SGM populations. 19Chapter 5: Conclusion The aim of the present study was to assess whether individual differences in self-kindness and self-criticism impacted the association between mindful awareness and sexual shame in SGM women. Our results indicated that in combination mindful awareness and self-criticism were a risk factor for increased sexual shame, while the combination of mindful awareness and self-kindness were protective. Thus, the same mindful awareness that allows self-kind SGM women to turn toward their sexuality without shame intensifies the sexual shame of self-critical women as they pay attention to a sexuality saturated with internalized stigma. Mindful awareness provides the present-moment attention necessary to observe a societally shamed sexuality, but it is self-kindness that offers the emotional safety required to heal shame experiences rather than amplify them through self-criticism. Too often mindfulness is presented as a cure-all without adequate attention paid to the individual factors that may influence its impact. Our hope is that these findings add to the literature in a way that arms clinicians with the knowledge they need to provide safe and appropriate care to their SGM clients. 20Tables and Figures Table 1 Sociodemographic Characteristics of Participants Sociodemographic characteristic n (%) Gender identity Cisgender 291 (75.8) Transgender 27 (7.0) Nonbinary/genderqueer 37 (9.6) Trans/nonbinary 29 (7.6) Sexual orientation Lesbian/gay 80 (20.8) Straight a 6 (1.6) Bisexual/pansexual 252 (65.6) Queer 23 (6.0) Asexual 22 (5.7) Two-Spirit 1 (0.3) Age b 18-34 230 (61.7) 35-54 122 (32.7) 55+ 21 (5.6) Race/ethnicity c White 262 (68.2) Black 97 (25.3) Latine 30 (7.8) East Asian 13 (3.4) South Asian 7 (1.8) Southeast Asian 9 (2.3) Indigenous 8 (2.1) 21Sociodemographic characteristic n (%) Annual household income Less than $25,000 54 (14.1) $25,000-$74,999 154 (41.2) $75,000-$149,999 128 (32.5) $150,000+ 47 (12.2) Relationship status c Single 131 (34.1) In a relationship 102 (26.6) Living with partner(s) 72 (18.8) Married 109 (28.4) Divorced/separated 24 (6.3) Widowed 2 (0.5) a Straight-identifying women were included if they identified as a gender minority. b Missing age data for 11 participants. c Participants could select more than one; thus, total may exceed 100%. 22Table 2 Bivariate Correlations and Descriptive Statistics for Primary Variables Variable M SD Possible range Actual range 1 2 3 4 1. Sexual shame 1.97 0.91 1â5 0.88â5.00 â 2. Self-kindness 2.97 0.94 1â5 1.00â5.00 -.33** â 3. Self-criticism 3.43 0.98 1â5 1.00â5.00 .36** -.76** â 4. Mindful awareness 3.56 0.62 1â5 1.50â5.00 -.03 .27** -.10* â *p < .05. **p < .001. 23Table 3 Unstandardized Coefficients for Self-Kindness Moderating the Association between Mindful Awareness and Sexual Shame Variable b SE Mindful awareness 0.05 .07 Self-kindness -0.33*** .05 Mindful awareness Ã Self-kindness -0.23*** .07 R2 .14*** *** p < .001 Table 4 Unstandardized Coefficients for Self-Criticism Moderating the Association between Mindful Awareness and Sexual Shame Variable b SE Mindful awareness -0.01 .07 Self-criticism 0.32*** .04 Mindful awareness Ã Self-criticism 0.21** .06 R2 .15*** ** p < .01, *** p < .001 24Figure 1 Interaction Between Mindful Awareness and Self-Kindness on Sexual Shame Mindful Awareness Note. Simple slopes of the association between sexual shame and mindful awareness for those with high (+1 SD), mean, and low (-1 SD) self-kindness. 1.251.51.7522.252.52.75Low HighSexual Shame High Self-Kindness Mean Self-Kindness Low Self-Kindness 25Figure 2 Interaction Between Mindful Awareness and Self-Criticism on Sexual Shame Mindful Awareness Note. Simple slopes of the association between sexual shame and mindful awareness for those with high (+1 SD), mean, and low (-1 SD) self-criticism. 1.251.51.7522.252.52.75Low HighSexual Shame High Self-Criticism Mean Self-Criticism Low Self-Criticism 26References Baer, R. A. (2003). Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology: Science and Practice, 10(2), 125â143. https://doi.org/10.1093/clipsy/bpg015 Baer, R. A., Smith, G. T., Hopkins, J., Krietemeyer, J., & Toney, L. (2006). Using self-report assessment methods to explore facets of mindfulness. 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Thesis/Dissertation
eng
Counselling Psychology
Vancouver : University of British Columbia Library
Attribution-NonCommercial-NoDerivatives 4.0 International
Graduate
Cox, Daniel W.
When mindfulness backfires : self-criticism and self-kindness moderate the mindful awareness-sexual shame link among sexual and gender minority women
Text