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Effectively Treating Pathological Self-Criticism in Depressed & Dysthymic Clients
Evolutionary thinkers have proposed that depression has an adaptive purpose. For example, social rank theory (Gilbert 2000; Price, 1969, 1972; Price & Sloman, 1987; Sloman, Price, Gilbert, & Gardner, 1994) suggests that the functional value of depression is to inhibit the attainment of resources while signaling to dominant conspecifics that they will not be challenged for resources or for status. In this manner, the depressed organism saves itself from injury. In situations of conflict or defeat, one side will typically adopt an ‘involuntary subordinate strategy’ (ISS), which prevents further conflict and signals to the opponent that the submissive individual is no longer a threat (Allan & Gilbert, 1997; Gardner & Price, 1999; Gilbert, 2000). Most mammalian species are group-living, and submissive behaviour on the part of subordinates allows for the continued stability and cohesion of the group (Gilbert, 1989). A failure of one party to engage in submissive behaviours would result in continuous ‘ritual agonistic behaviour’ (i.e. displays or fighting) that would in turn cause serious injury, death, or the ousting of weaker individuals (Gilbert, 1989).
In contrast to voluntary submissiveness, which serves many purposes and is often healthy, involuntary submissiveness is associated with depression and other forms of psychopathology (Allan & Gilbert, 1997; Gilbert, 2000; Gilbert, Allan, & Trent, 1995). Sloman et al. (1994) have argued that the ISS can account for all of the facets of depression.
By understanding the functions of the ISS we can account for the biological state of depression, the psychological preoccupations (self as inferior, worthless, and powerless), the anxieties (e.g. social and separation), the social behaviour (inhibited, retarded) and the triggers of depression (major losses of allies and friends that reduce self-esteem and confidence, loss of status, and devaluing, rejecting environments, pp. 404–405).
The constructs of social comparison and arrested flight are derived from social rank theory and were hypothesized to be particularly relevant for the personality style of self-criticism, a vulnerability marker for depression. This personality type will be described following a summary of evolutionary constructs.
A model for social anxiety has also been proposed, which asserts that socially anxious individuals operate within a defence system where frequent social comparison and a readiness to submit predominate (Gilbert, 1989; Trower & Gilbert, 1989; Trower, Gilbert, & Sherling, 1990). Social anxiety is primarily geared towards threat and functions to avoid attacks that would result in a loss of status. The distinction with the social rank theory of depression revolves primarily around triggers. Whereas defeat is thought to precede a depressive episode, future threats underlie the dynamics of anxiety.
In humans, it is thought that inescapable life situations lead to entrapment and an arrested flight state (Gilbert & Allan, 1998). Support for this idea comes from the work of Brown, Harris, and Hepworth (1995) who found that entrapment or humiliating experiences, frequently occurring in the context of a loss, predicted the onset of depression better than other categories of severe life events. More specifically, entrapment or humiliating events were three times more likely to predict depressive episodes than loss alone.
Gilbert and Allan (1998) have developed scales to measure the degree of external and internal entrapment. External entrapment can be defined as a motivation to escape from current circumstances while at the same time feeling stuck or trapped. Internal entrapment also involves a motivation to escape and a perception of being trapped but it is in reference to one’s own thoughts or feelings. In support of these constructs, both internal and external entrapment scales have been related to social comparison as well as depression, even when controlling for hopelessness (Gilbert & Allan, 1998).
Dependency and self-criticism
The self-critical personality was the focus of investigation as it was expected to lend itself particularly well to an evolutionary account of depressive vulnerability. This personality configuration involves issues of identity and self-worth. People who are highly self-critical tend to be achievement oriented, competitive, and very hard on themselves (Blatt & Zuroff, 1992). An unforgiving performance standard is coupled with self-loathing and guilt. Not surprisingly, this personality style is statistically highly associated with depressive symptomatology (Blatt & Zuroff, 1992; Nietzel & Harris, 1990).
A large amount of construct validity has been obtained for the two personality styles, as measured by the Depressive Experiences Questionnaire (DEQ; Blatt, D’Afflitti, & Quinlan, 1976). For instance, Zuroff, Moskowitz, Wielgus, Powers, and Franko (1983) found that dependency was associated with guilt over hostility, an external locus of control indicating helplessness, and, for males, lower task leadership and lower masculinity. Self-criticism, on the other hand, was related to moral guilt, low self-esteem, and, in females, to lower social desirability and increased Machiavellinism (willingness to manipulate others). Other research has also supported Blatt’s model, showing that dependency and self-criticism are predictably associated with phenomena ranging from reactivity to particular stressors (Mongrain & Zuroff, 1994; Zuroff & Mongrain, 1987), choice of romantic partners (Zuroff & de Lorimier, 1989), behaviours in close relationships (Mongrain, 1998; Mongrain, Vetesse, Shuster, & Kendal, 1998), and particular childhood experiences (Amitay, Mongrain, & Fazaa, 2004; McCranie & Bass, 1984).
There is preliminary evidence linking self-criticism to social rank theory. For example, Santor and Zuroff (1997) have found self-critical women to be particularly attuned to matters of social status. These women were more likely than non-self-critical women to contest threats to status when outperformed by a friend on a bogus computer task. They were also more likely to withhold praise from their friends if a friend had disagreed with them. This was interpreted as retaliation against threats to status (Santor & Zuroff, 1997). This research therefore suggests that self-critical women are very competitive and sensitive to issues pertaining to status and social ranking. In a subsequent study, Santor, Pringle, and Israeli (2000) assigned 36 couples to a task and gave them bogus feedback that was either favourable or unfavourable.
After unfavourable feedback, self-critical people disagreed with their partners, blamed them more for their joint performance, and made fewer suggestions. Therefore, even in a cooperative situation, self-critics were more sensitive to how their team performance affected their own status.
Santor (2003) has articulated a threat-based model of vulnerability for dependency and self-criticism where each of these personality configurations is associated with different unfulfilled needs. Dependent individuals have unmet attachment needs for emotional closeness, whereas self-critics need admiration and status. When those needs are threatened by external events (such as failure to get promoted), the self-critic will become depressed if behavioural strategies aimed at regulating status are unsuccessful.
- Sturman, Edward D.; Mongrain, Myriam; Self-criticism and major depression: An evolutionary perspective; British Journal of Clinical Psychology; Nov2005, Vol. 44 Issue 4
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