Mindfulness and self-compassion: Applications for suicide and non-suicidal self-injury

Background: Non-suicidal self-injury (NSSI) involves intentionally causing damage to bodily tissue without suicidal intent. Though distinct from suicide, NSSI is a strong predictor of both suicidal ideation and attempts. Although NSSI and suicide are each highly prevalent mental health concerns, few interventions exist to address these phenomena. Mindfulness and compassion are two traits that have been shown to protect against a number of mental health concerns, including suicide and NSSI. Trait mindfulness and self-compassion are each inversely associated with both suicide and NSSI; however, little research has investigated their utility in treating these concerns. Chapter III: Though several studies have examined the effectiveness of mindfulness-based interventions on suicide-related outcomes, it is unclear on a broader level how effective these interventions may be in addressing suicidal ideation. Chapter III of this dissertation presents a meta-analysis of the effectiveness of mindfulness-based interventions on suicide-related outcomes. Results suggest that mindfulness-based interventions may be effective in reducing suicidal ideation, and that treatment effects tend to be stronger in older samples, samples with more female participants, and when participants spend more total hours in treatment.Chapter IV: The results of Chapter III raise the question of whether mindfulness-based interventions may be feasible for and acceptable to individuals who engage in self-injury, given the strong association that exists between suicidal ideation and NSSI. Chapter IV presents the results of a mixed-methods feasibility study of an embodied and embedded mindfulness and compassion-based intervention for individuals who engage in NSSI. Results of this study suggest that the intervention was acceptable to participants, and clinically meaningful reductions in anxiety and depression were observed. These results should be considered in light of the study’s small sample size and the potential impact of the COVID-19 pandemic on those who participated.Chapter V: At present, it is unclear how the pandemic may have impacted those who engage in NSSI. Chapter V outlines an exploratory mixed-methods study of the impact of the COVID-19 pandemic on individuals who engage in NSSI. Quantitative results indicated that loneliness strengthened the association between urges to self-injure and weekly self-injury engagement. Isolation emerged as an important theme in qualitative analyses, as did Changes in Coping, Stressors, and No Change.

Conclusion: Overall, this dissertation examined the feasibility and effectiveness of mindfulness- and compassion-based interventions for suicide and NSSI, as well as the protective role that mindfulness and self-compassion may play with regard to urges to self-injure and self-injury behaviour. The results of this dissertation suggest that mindfulness and self-compassion are potentially promising intervention strategies for suicidal ideation and self-injury