Effectiveness of Acceptance and Commitment Therapy (ACT) on Self-Shame and Alexithymia in Divorce-Seeking Women

Document Type : Original Article

Authors

• Houriyeh Haghighi ¹
• Hadi Gholammohammadi ²
• Jafar Talebian Sharif ³

¹ M.A. in Family Counselling, Department of Counselling, Hekmat Razavi Institute of Higher Education, Mashhad, Iran.

² Assistant Professor, Department of Psychology and Counselling, Imam Reza International University, Mashhad, Iran

³ Assistant Professor, Department of Counselling, Faculty of Education and Psychology, Ferdowsi University of Mashhad, Mashhad, Iran.

10.22067/tpccp.2025.88147.1651

Abstract

Introduction: The increase in divorce rates in the country and the associated social, cultural, psychological, and individual consequences have doubled the need to address it (Araghi et al., 2020). The consequences of divorce for women and men can be different (Hayati & Soleymani, 2019). Researchers have identified a correlation between divorce-related issues in women and the development of inadequacy feelings, unattractiveness, and self-blame, which can subsequently lead to reduced self-esteem and worthlessness feelings (Donovan & Emmers-Sommer, 2012). Feelings of inadequacy and unattractiveness can lead to the feeling of shame and alexithymia in women (Balderrama-Durbin et al., 2017). Alexithymia is characterized by difficulties in identifying and describing emotions to others, which can lead to ineffective and inflexible emotion regulation (Luminet et al., 2021). Research has identified a correlation between variables associated with a damaged couple relationship including self-shame and alexithymia. For instance, Zarei and Hosseingholi's study (2014) revealed a relationship between shame and low marital commitment. Conversely, Davis et al. (2017) concluded in a study that feelings of self-shame can play a role in reducing sexual satisfaction. A subsequent study by El Frenn et al. (2022) revealed that alexithymia plays a mediating role between couple satisfaction and attachment styles. Momeni et al. (2018) in their study concluded that alexithymia can predict decreased intimacy.
Research findings indicate that women involved in divorce can be helped with different approaches (Abadi et al., 2017). One of these approaches is the acceptance and commitment approach, which is a type of mindfulness-based behavioral therapy that places significant emphasis on psychological flexibility (Najari et al., 2023). Research has demonstrated the efficacy of Acceptance and Commitment Therapy (ACT) in the marital context and among affected women (Candel & Turliuc, 2019). For instance, Abosaidi Moghadam et al. (2020) reported the effectiveness of ACT on the feelings of loneliness and guilt in women seeking divorce. In light of these findings, the present study sought to examine the efficacy of ACT in addressing feelings of shame and alexithymia in women seeking divorce.
Method: In this study, a single-case design with multiple asynchronous baselines was utilized. Subjects entered the baseline phase asynchronously and were randomly assigned to one of two or three-week waiting periods in the baseline phase. They then received eight sessions of ACT (Hayes et al., 2012). The statistical population encompassed all women seeking divorce who had referred to a counseling center in Mashhad. Among the individuals who referred others (N=30), three individuals who met the inclusion criteria were selected using the convenience sampling method. The data collection instruments included the Cook Internalized Shame Scale (Cook, 1993) and the Toronto Alexithymia Scale (Bagby, 1994). The analysis of the data included the use of visual charting, the reliable change index, and the percentage of improvement formula.
Findings: The visual plot revealed that the mean self-shame scores in the baseline phase for the three subjects were (74, 72, and 62.33), and in the treatment phase, they were (33.63, 22.63, and 33.61), respectively. Similarly, the mean alexithymia scores in the baseline phase for the three subjects were (74, 72, and 62.33), and in the treatment phase, they were (33.63, 22.63, and 33.61), respectively. These findings suggest a decrease in the average scores of the target variables. In addition, the value of the index of permanent change after treatment for all three subjects in self-shame (2.33, 3.10, and 3.40, respectively), and alexithymia (3.30, 3.31, and 3.12, respectively), was greater than the Z value. This indicates that ACT was effective in treating self-shame and alexithymia (P<0.05). The results of the percentage of improvement in self-shame for the three subjects were (21.49, 26.18, and 29.39), respectively, and in alexithymia for the three subjects were (30.30, 30.32, and 29.89), respectively. These results indicate that the rate of improvement was significant (P<0.05).
Discussion & Conclusion: The present study sought to ascertain the efficacy of ACT in addressing self-shame and alexithymia in women seeking divorce. The findings indicated that ACT demonstrated a significant impact on self-shame an alexithymia. These findings are consistent with those reported in studies by Sadeghi et al. (2021), Amini & Hasanzadeh (2021), Abosaidi Moghadam et al. (2020), Younesi et al. (2016), and Babakhani (2020). In elucidating the findings concerning shame, it can be posited that ACT facilitates the acceptance of distressing experiences and emotions without the pursuit of control, thereby diminishing their perceived threat (Hayes et al., 2012). Moreover, in elucidating the outcomes concerning alexithymia, it can be posited that the objective of the aforementioned treatment is to facilitate individuals in avoiding evasion of their authentic selves, challenges, and sentiments, and to encourage the articulation, acknowledgment, and encountering of occurrences in their genuine state (Panahi et al., 2018). Confronting and experiencing the challenges associated with alexithymia can lead to a reduction in these symptoms. Individuals with alexithymia tend to evade their emotions, failing to express their feelings, and this treatment aims to facilitate their acceptance of these emotions as integral components of their life journey, rather than avoiding and evading them. Consequently, it is recommended that therapists employ ACT to address the psychological challenges experienced by women on the verge of separation and divorce.

Keywords

• Acceptance and Commitment Therapy
• self-shame
• alexithymia
• divorce

Main Subjects

• Family and Marriage

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