Jenny Sanbrook
Accredited Mental Health Social Worker Certified Gottman Therapist
A theme I have found that is common among many clients is an experience of shame. Whether it be in the context of relationship difficulties, depression and anxiety, childhood trauma or managing the challenges of daily life. However, I find myself at times overlooking shame in therapy sessions, turns out I’m not alone. A 2011 survey of clinicians found that psychoanalysts rarely, if ever, discussed shame with their clients, instead tending to diagnose them with borderline and narcissistic personality disorder (Tangey, J and Dearing, R 2011). As Dr James Gilligan, American Psychiatrist who has spent 25 years working in the American prison system and has studied motivation and causes behind violent behaviour pointed out, “it’s as though we’re so ashamed of shame that we can’t bring ourselves to talk about it” (Hill, 2019). For this reason shame has been branded the sleeper emotion by some eg (Lewis, 1988) – lurking behind depression, obsession, narcissism and paranoia.
What is shame and how is it different to guilt?
Shame is generally defined as a strong negative emotion characterized by perceptions of the global devaluation of oneself (Yohanes and Avon 2021). Dr Brene Brown, Social Worker and public speaker, has spent decades studying shame and vulnerability and has brought the concept into the broader public conversation. She says that her findings and those of other shame researchers define shame as differing to guilt.
“Guilt is adaptive and helpful – it’s holding something we’ve don’t or failed to do, up against our values leading to psychological discomfort. Shame is the intensely painful feeling or experience of believing we are flawed and therefore unworthy of love and belonging – something we’ve experienced, done or failed to do makes us unworthy of connection” (Brown, 2012). Guilt can be absolved – eg, we can apologise if we have wronged someone, but no-one can absolve us of shame. It’s not a feeling that we’ve done something bad it’s that we are bad – thus we can’t be absolved by another person.
In relation to shame and violence/aggression – guilt tends to convince people to avoid crime in the future whereas shame tends to cause people to lash out against unfair emotional pain, social blame.
Shame and Neuroscience (Very briefly..)
Diving into the origins of human emotion – take the work of Estonian Neuroscientist and veterinary specialist, Jaak Panksepp. Panksepp coined the term “Affective Neuroscience” and wrote the text with this title. He is known as the “rat tickler” for his discovery of the high-frequency chirps that he identified as laughter in rats and other insights into the emotional life of mammals. Panksepp championed the idea that emotion was crucial for human change as opposed to relying on cognition and logic which had been a popular view. Pankseppp’s work found there are 7 basic emotions that emerge, not from the cerebral cortex associated with complex thought in humans, but from deep, ancient brain structures, including the amygdala and hypothalamus. These emotions correlate with various pathways, hormones and neurotransmitters in the brain – he has coined the term “emotional command systems” the idea that these circuits take a person’s emotions in a particular direction depending on what a situation requires. We display certain emotions to defend ourselves, get rest or to procreate – Your preferred command system out of the 7 will determine how you respond to certain situations. (See attached link on Panksepp’s work).
Building on this science, other emotion researchers such as Paul Ekman describe 7 primary emotions: Fear, Contempt, Disgust,
Sadness, Anger, Happiness and Surprise. (For an excellent and very readable book on this see: Pauls Ekman’s Emotions Revealed, Understanding Faces and Feelings, 2003). Ekman acknowledges that shame can sit behind sadness and depression, people can also feel ashamed or guilty for having angry feelings. Shame is also associated with disgust of self. Interestingly Ekman and Panksepp don’t distinguish shame, guilt and embarrassment as a separate (or 8th emotion) because “these emotions do not seem to have efficient signals that make them readily distinguishable from one another or from sadness” (Ekman 2013:218)
Instead many Neuroscientists consider shame as an “evolved emotional response”, giving a sense of exclusion and unworthiness. Shame is associated with an early evolutionary response – for example a baby seeking contact from its mother where the mother doesn’t not acknowledge her, can display shame – body slumps, turns away and looks downward (Nathanson, 1987). The function of shame being to prevent us from damaging our social relationships, or to motivate us to repair them.
Shame and Violence
Research around extreme intimate partner violence and coercive controllers has a theme intertwined related to shame, often related to hypermasculinity. Or as Erich Fromm (1973) states “the passion to have absolute and unrestricted control over a human being is the transformation of impotence into omnipotence” . Ultimately a common pattern in these relationships is either a fear of abandonment, or a fear of being exposed as unworthy or defective. The work of James Gilligan (1997) among criminally violent men and antisocial personality disorder has found time and time again that “universal among violent offenders was a sense of deep shame… and that the very purpose of violence is to “banish shame and replace it with pride” (Hill, J 2019: 118). Women in these relationships walk a tightrope as a person consumed by hears ridicule even when none is intended, thus the walking on eggshells phenomenon.
Working with Shame
According to Jess Hill (2019), for most men, shame is built around “don’t be weak”, to be male is to be strong, powerful and in control. For some men, even a small hint of vulnerability is intolerable leading to the desire to expel it at all costs. “The closer a male identifies with the strict gender norms the more likely one is to feel shame for disobeying them” (Hill 2019:116).
For women, “shame is do it all perfectly and don’t let them see you sweat” (Brown, 2012). Women are also faced with various triggers for shame based feeling related to “an ever changing kaleidoscope” of being sexy but not too sexy, smart but not intimidating, assertive but not pushy” (Hill, J 2019). Thus working with shame will require therapists to be aware of these nuances for both genders.
ACT based principles have had positive results in clients with high levels of shame and self stigma, including amongst client with addictions (see Luoma, Khlenberg, Hayes and Fletcher 2011).
There is also much research on the use of a self compassion framework. Research by Paul Gilbert, Kristen Neff, Christoher Germer are some examples of ways shame can be worked with in the room . See attached infographic for summary from the National Institute for the Clinical Application of Behavioural Science.
There is much work to be done on our own understanding of shame, how this response shows up for different people and what can be done to best work with this. In some cases, CBT and Schema approaches will be useful particularly where there are strong Narcissistic traits. Working in the area of violence requires a nuanced and skilled approach in order to avoid victim blaming and also to hold partners responsible. Individual therapy for these clients is often the safest approach and careful assessment for couples work needs to be conducted by someone trained in the area to avoid increasing risk. For other clinical presentations a self compassion approach may be a helpful beginning to unravelling the effects shame has wielded over a person’s life. Either way, greater therapist awareness of bringing this into the room will bring shame out from its slumber.
References
Brown, Brene (2015) Daring Greatly: How the courage to be vulnerable transforms the way we live, love, parent and lead. Brene Brown Publishing, NY
Brene, Brene (2012) Listening to Shame. Ted Talk March 2012
Dearing, R and Tangey J, eds (2011) Shame in Therapy Washington DC American psychological Association.
Fromm, Erich (1973) The Anatomy of Human Destructiveness. Penguin Books
Gilligan, James (1996) Violence Our Deadly Epidemic and Its Causes. Vintage Books USA
Hill, Jess (2019) See What You Made Me Do. McPhersons Printing Group Aus.
Lewis H (1998) The Role of Shame in Symptom Formation in Clynes and Panksepp, J Emotions and Psychopathology. Boston Springer.
Luoma, J Khlenberg, B Hayes S, and Fletcher, L (2012). SLow and steady wins the race: a randomized clinical trial of Acceptance and Commitment therapy targeting shame in substance use disorders. In Journal of Consulting and Clinical Psychology 80(1) 43-53.
Nathanson (1987) The Many Faces of Shame. NY Guilford Press.
National Institute for the Clinical Application of Behavioural Science.
Panksepp, J., and Davis, K. (2018). The Emotional Foundations of Personality: A Neurobiological and Evolutionary Approach. New York: W. W. Norton & Company.
Panksepp, J., and Biven, L. (2012). The Archaeology of Mind: Neuroevolutionary
Origins of Human Emotion. New York: W. W. Norton & Company.
Panksepp, J. (1998). Affective Neuroscience: The Foundations of Human and Animal
Emotions. New York: Oxford University Press.
Tangney, J and Dearing, R (2003). Shame and Guilt – Emotions and Social Behaviour.
Guilford Press 2003.
Yohanes, B and Avon, F. (2021). Shame and Self Esteem: A Meta Analysis In: European Journal of Psychology. May. 17(2): 131-145
