Self-compassion protects against body image concerns in women in the menopausal transition.

Author: Holly Young: A graduate of the MSc in Psychology at the University of Derby, UK.

This is a summary of our empirical paper:

Young, H. & Kotera, Y. (2021). Menopause and body image: The protective effect of self-compassion and mediating role of mental distress. British Journal of Guidance and Counselling. DOI: 10.1080/03069885.2021.2009770.

Self-compassion has been identified as a protective factor against body image concerns, but the relationship has not been explored in women in the menopausal transition, when body image perceptions may be particularly vulnerable. This research, of which the full paper is currently under review, examined the relationships between self-compassion and positive and negative body image in women in the menopausal transition and further explored the role of mental distress in mediating this relationship.

Negative experience of menopause has been found to relate mostly to bodily change and loss rather than menopause per se, which is often seen as largely positive (Hvas, 2006). Physical symptoms reported are many, and as well as hot flushes, night sweats and sleep disturbance, include increased central abdominal fat, loss of muscle tone, changes to skin and body shape and an increase in facial hair (Deeks, 2003; Conboy, Domar & O’Connell, 2001; Woods & Mitchell, 2005). Many women feel that loss of attractiveness is inextricably bound up with their experience of menopause (Rubenstein and Foster, 2013) and it therefore follows that improving women’s body image may lead to a more positive experience overall of the menopausal transition. Yet despite the centrality of body image to women’s experience of menopause, the methods they use to reduce their body image concerns at this stage of life are little researched. Protective factors that adapt and improve influences on poor body image require research in order to find those elements that specifically contribute to a reduced probability of undesirable outcomes and an increased probability of desired ones, that is positive body image and positive experience of this significant milestone.

Self-compassion is particularly interesting as a protective factor because it works at an individual level. It is a way of thinking and understanding which includes three key elements of self-kindness, mindfulness, and common humanity, and which includes an understanding that suffering is a normal part of the human experience (Neff, 2003). In this sense it is an adaptable tool, which can be tailored to many experiences, and one which can be employed at relatively little expense to buffer against negative body image. Experimental research on other populations has found that self-compassion meditation podcasts, self-administered for three weeks, significantly improved body image and reduced body dissatisfaction at little cost (Albertson, Neff & Dill-Shackleford, 2014).

This research, in which women in the menopausal transition self-reported on levels of body appreciation (positive body image), body preoccupation (negative body image), self-compassion and mental distress found that higher levels of self-compassion predicted higher levels of body appreciation, and lower levels of body preoccupation. This suggests self-compassion is a positive influence on body image in women in the menopausal transition and could be utilised for this purpose. Mental distress partially mediated these relationships, reducing the positive effect that self-compassion has, and therefore must also be addressed when considering self-compassion training.

The concepts and strategies offered by self-compassion training need to be both tailored to body image specifically, and offered as part of an individualised approach by healthcare professionals in order to be effective. The point at which psychological symptoms of menopause are discussed with a GP is an opportunity for body image to be talked about. Healthcare professionals are already advised to give information about non-pharmaceutical options such as cognitive behavioural therapy for anxiety and depression during menopause (NICE guidelines, 2015), and the addition of one or two further questions at this point in a consultation could be hugely beneficial in finding solutions for patients who may be struggling with body image concerns, which are in turn affecting their quality of life. Unfortunately, women often report that healthcare practitioners make sweeping judgements about them based on their stage of life, and that symptoms are consequently disregarded, leading to a lack of investigation, lack of treatment and adverse events (Pearce, Thogersen-Ntoumani & Duda, 2014). It is time to enable women to feel comfortable discussing body image concerns in a healthcare setting, confident that they will be listened to, by healthcare providers who are confident that they can offer solutions. Self-compassion training may offer one such solution.

References:

Albertson, E.R., Neff, K.D., & Dill-Shackleford, K.E. (2014). Self-compassion and body dissatisfaction in women: a randomized controlled trial of a brief meditation intervention. Mindfulness, 6 (3). http://dx.doi.org/10.1007/s12671-014-0277-3

Conboy, L., Domar, A., O’Connell, E. (2001). Women at mid-life: Symptoms, attitudes, and choices, an Internet based survey. Maturitas, 38(2): 129–136. https://doi.org/10.1016/S0378-5122(00)00211-5

Deeks, A.A. (2003). Psychological aspects of menopause management. Best practice and research clinical endocrinology and metabolism, 17 (1), 17-31.

Hvas, L. (2006). Menopausal women’s positive experience of growing older. Maturitas, 54, 245-251. doi:10.1016/j.maturitas.2005.11.006

National Institute for Health and Care Excellence. (2015). Menopause: diagnosis and management. NICE guideline (NG23). Retrieved from: https://www.nice.org.uk/guidance/ng23

Neff, K.D. (2003). Development and validation of a scale to measure self-compassion. Self and identity, 2, 223-250. https://doi.org/10.1080/15298860309027

Pearce, G., Thøgersen-Ntoumani, C., & Duda, J. (2014). Body image during the menopausal transition: a systematic scoping review. Health psychology review, 8 (4), 473-489. https://doi: 10.1080/17437199.2013.848408.

Rubenstein, H., & Foster, J.L.H. (2012). ‘I don’t know whether it is to do with age or to do with hormones and whether it is to with a stage in your life’: Making sense of menopause and the body. Journal of health psychology, 0 (0), 1-16. DOI: 10.1177/1359105312454040

Woods, N.F., & Mitchell, E.S. (2005). Symptoms during the perimenopause: prevalence, severity, trajectory, and significance in women’s lives. The American journal of medicine, 118 (12b), 14S-24S. https://www.amjmed.com/article/S0002-9343(05)00885-5/fulltext