| Summary: | A stroke is a sudden, life-changing event, which can have emotional, cognitive and physical consequences. Adjustment following a stroke is a complex and multidimensional process, and encompasses factors that contribute to negative and positive adjustment. Emotional difficulties, such as anxiety and depression, are common after a stroke. However, some individuals experience more positive adjustment through developing an acceptance of stroke-related changes and through perceiving benefits as a consequence of a stroke. Proposed models of adjustment to stroke or other chronic illness suggest that such a critical event disrupts individuals' emotional equilibrium, their assumptions about the world, and beliefs about themselves. The process of adjustment involves restoring this equilibrium and resolving discrepancies between one's pre-injury self and the current self. Personal background factors, social context, and stroke-specific factors are all thought to influence how individuals adjust following a stroke. Self-compassion has been shown to influence how people cope with chronic illnesses and to be beneficial across a range of mental health difficulties. Some individuals are fearful of the affiliative experience of compassion, however. This study investigated the relationships between self-compassion, fears of compassion and indicators of negative (i.e. anxiety, depression, helplessness) and positive (i.e. acceptance, perceived benefits) psychological adjustment following a stroke. Sixty-nine adults were recruited from the community using an online cross-sectional survey. Correlational analyses found that self-compassion was positively associated with indicators of healthy adjustment and negatively associated with indicators of poorer adjustment. Inverse relationships were found with self-judgement and the adjustment variables. Fears of receiving compassion, either from others or from the self, were negatively associated with healthy adjustment, and positively associated with indicators of poorer adjustment. Being less self-judgemental emerged as most protective against anxiety and stroke-related helplessness. A lower self-judgemental attitude combined with being less fearful of receiving compassion from others was most protective against depression after stroke. Being more self-compassionate emerged as most important in enabling acceptance of one's circumstances. The compassion variables were more weakly related to perceiving benefits after a stroke than to experiencing acceptance. These findings may be relevant for tailoring psychological interventions to help individuals adjust psychologically after a stroke. Interventions to reduce self-judgemental thinking could be beneficial in protecting against depression, anxiety, and helplessness. Interventions to foster self-compassion might influence healthy adjustment by enabling acceptance. Therapists considering such interventions should explore individuals' tolerance of affiliative emotions and possible blocks to compassion.
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