Shame in the therapy room

by Johnny Moran

I had no other Name, to take the Blame
I owned all Pain, I lived their Shame

(Moran, 2017)

The Oxford dictionary defines shame as feelings of humiliation or distress caused by the consciousness of wrong or foolish behaviour (Pearsall, 2002). In the therapy room shame often presents as something much more complex, sustaining and damaging. A more relevant adapted definition for self-shaming would be where our core self becomes like a wronged fool, where our shame is then often managed by turning it back on oneself.

Shame, when it is directed inward, can become all-consuming, as if a toxic acid has burnt a hole through the very soul of the individual and removed their connection to their humanness. This is the chasm within which self-shame can come into being and thrive. Self-shame has many of the same characteristics as addiction; self-compassion is absent or disconnected while low self-esteem is dominant. With self-shame come the rituals and co-dependency of self- shaming. Self-shaming is powerful and soul-destroying, delivering the ultimate unconscious self-coping strategy. By self-attacking self, we become our own victim and perpetrator. Our use of self-abuse supports low self-esteem, creates and maintains our shame, while also serving the function of holding the feelings we need to deny or avoid in check. How self-shame is navigated, explored and processed can be a significant determination of therapeutic progress and outcome. My belief here is that the therapeutic relationship must get to the place where the deeper underlying emotions can be revealed, tolerated and explored. I have an early memory of struggling with a deeply self-shamed client who could not see any merit in any of his obvious achievements from past to present, particularly his ability to survive and show up. The more I tried to help the client to rationalise with any degree of reasonableness towards self, the more I can see now that I unintentionally became his accomplice and inadvertently maintained his self-shame structure. Just as an addiction has its roots in an adapted, dysfunctional means of coping, the powerful addiction to self-shame is not given up lightly and won’t be infiltrated without accessing the various root, denied emotions that gave birth to it.

Shame regularly presents itself in the therapy room, and that just includes the pile the therapist brings in or is left holding. Client self-shame can take a central role in maintaining problematic attachment, object relations, ego states, character structures and belief system deficits. Similar to other therapy processes involving addiction, the therapist could find himself out- manoeuvred, entrapped, overwhelmed, or even surrendered to the manipulative behaviour of the self-shaming addict, to the point where the therapist fulfils a role of co-dependant enabler.

For our client in the therapy room, their sense of ME can be experienced by them as the one absolute consistent ingredient in shaME and blaME. Shame moves the goalposts from a client’s perception that they did something wrong to a core painful belief that they are something wrong. Self-shame represents the premier league of toxic shame and can arise for victims of sexual and physical abuse, from various traumas including emotional neglect.

Psychotherapy indicates that you cannot change what you have denied, you cannot change what you are not aware of, or what you have lost true memory, connection or recollection of. Disassociation plays a central role in shame, in its disconnection from truth and from self. The truth was, or became, unbearable and so defences formed a structure to disconnect from memory and impact. Arising ego defences that are created are not who the shame victim truly is, but most definitely who the therapist will be challenged by. Such adapted defences serve as a construct representing coping mechanisms and it is for the therapist to tolerate, guide, hold, support, resource and educate the client through their journey towards insight and healing.

Self-shame represents a helpless victim in denial. The truth is unbearable. Shame is supported on an ongoing basis and expanded through subsequent behaviour, and the reactions that such behaviour generates, allowing shame to marinate and thrive. The original shaming event travels well disguised and disassociated.

The adapted shame-motivated patterns repeat to deny and bury the truth and bring credibility to the lies. Is it any surprise that shamed people can act shamelessly? Their behaviour originates from their shaming experience, with their subsequent conduct and manifest response serving to keep their core shame alive, real, relevant and topped-up.

The client’s adaption to create the ultimate, perpetual shaming protection of self-shaming ensures that there is no space for them to be further shamed by any other, and in so doing they have regained control.

Guilt says to the client ‘I made a mistake’, while self-shame maintains ‘I am the mistake’. Shame allows the innocent to take the blame for something they did not do. Self-shame offers the only solution to ensure survival, providing a one-way street to travel onward away from annihilation. And so it becomes the single route to survival, the only possibility other than to fragment and shatter. Shame facilitates the innocent victim to carry blame that does not belong to them.

It follows that when an event is experienced where recompense or justice is not an option and where we experienced no protection, accessible safety or support, we feel ourselves helpless and powerless. We become young and defenceless under attack, be it physical, emotional or both, without any ability to fight back or seek any redress. We then cope by taking on the blame for the injustice, neglect, abuse, suffered as a flaw in the Self. We take full responsibility and blame for what was done to us. We know no better, see no other choice – we own the badness, we are the badness.

Repeatedly reflecting the complexity of self-shame victims, client shame presentations often record a victim of abuse who can relate to a loving and caring abuser yet see themselves as bad and disgusting. Such an adaptive coping construct can serve to maintain the idealised parents, family, and support the child in its core desire to be loveable, protecting the family unit. From such enmeshments and confusion develops a protected self-amnesia born out of the core shaming experience.

The concept of taking on blame to understand, to cope, to survive, to find a path to carry on is commonly found in psychological post-trauma survival such as in rape, sexual and physical abuse, and in emotional neglect. Shame facilitates, enables and justifies the punishment. It maintains the negativity towards self to enable the victims to constantly criticise themselves, and to turn and maintain denied anger inwards. Without such self-shame, we would not allow this, it could not be justified, it would not be tolerable. Shame facilitates our sense of shame to associate and connect with not being worthy, and with being helpless. This gives the necessary justification to continue beating oneself up with negative self-talk and negative beliefs, manifesting ultimately in the hamster wheel of misery.

Why is self-shame so popular? Perhaps there is an upside or benefit also denied, worth exploring by the therapist. Clients can fight hard not to let go of their shame. Shame can enable the victim to regain control and move from helpless victim to perpetrator. And so, the threatened psyche faced with impending isolation and destruction of a hapless self, finds a way of survival. In becoming both the victim and the perpetrator, the dysfunctional self-construct believes it will be in a stronger position, it will have regained control where it was previously powerless and helpless. In effect, ‘I am protected, nobody or nothing can hurt or shame me more than I can do to myself, I am back in control’. The common and consistent plot is then played on by the wounding again and again and again of self by self. Maintaining shame repeatedly denies any possibility for growth in self-esteem.

The sorrow which has no vent in tears may make other organs weep.

(Maudsley, 1872, as cited in Corvo, 2014, p.247)

At the heart of shame is disconnect between mind and body – as the mind has taken on dysfunctional coping strategies, so it is no longer integrated and in sequence with the body. The body still holds, records, remembers. Bodily sensations which tell the truth are suppressed, disconnected, no longer trusted. Unbearable memories are filed away with the emotional truth experienced to whatever memory networks can be accessed; survival needs come first.

Self-shame is complex, tricky, slippery, consuming and toxic to the soul. To combat it requires a mind-and-body approach tailored to each individual. Resourcing of mind and body includes building coping skills, safety resources and self-protection strategies. That said, establishing the individual’s emotional tolerance and developing a trusting relationship can take time. How long, you ask? The simple answer is as long as it takes.

Timing and resourcing are essential to avoid re-traumatisation and breakdown, leading to withdrawal in therapy before the real work of necessary emotional processing can begin. As with comedy, timing is everything, and of course following the individual client’s pace as a priority is essential. The therapeutic relationship provides support and scaffolding for the work. Being met in a congruent, non-judgemental way, while essential, will however rarely in itself be sufficient. Working with embedded shame to facilitate processing, to arrive at and experience new client insight and understandings, requires something more.

The corrective emotional experiences that therapy can deliver may prove to be intolerable for victims of embedded self-shame, within the therapy space. Even achieving a strong trusting therapeutic relationship, investing in building, resourcing, ongoing phase-appropriate psycho- education may often not be sufficient to avoid a therapy rupture, leading to failure. Accessing bodily sensations and developing the body as an empowering resource may prove intolerable and overwhelming. It follows that those cut-off from, or lacking trust in, body sensations will be very resistant to go there.

Common to shame presentations is lack of self-esteem, sense of helplessness and no connection to empowerment. The client may have some cognitive understanding concerning their experiences, but balanced tolerable access to their full range of impacted emotions is not possible.

Any sense of self-compassion can find itself necessarily absent and disconnected, unable to get a look-in. Psychoeducation can be helpful but you may realise that it too is impotent to finding deeper connection and cannot rise beyond cognitive understandings. Self-punishment, directly and indirectly, is always supported by a lack of self-compassion.

It follows that a lack of self-compassion supports low self-esteem and, critically, justifies anger directed and looped back against oneself. Internalised and unconscious anger related to the injustice suffered represents the fuel that powers the engines of shame. Such a rigid presentation with no sense of hope or empowerment, lacking purpose, overcome with negativity yet engulfed in relentless shaming, also requires significant personal investment and energy to be maintained.

Denied anger is the smoking gun equipped with silencer that drives the shame. It follows that you won’t necessarily be good or kind to someone you don’t like. You won’t listen to someone you don’t trust. Self-compassion provides a possible antidote to diffuse anger directed at self and so any trace of self-compassion must be denied. And yet shame presentations can show no obvious anger, with any traces of anger deeply internalised and denied. It follows also the therapy that pokes the anger will possibly be met in further apathy and withdrawal and likely failure.

The challenge of therapy is to bring the self-directed anger gracefully out in the open. This provides the opportunity for compassion to come in and creates the space for something new by reprocessing what was frozen. As much as memory and trauma is disassociated, therapeutic progress requires denied anger to be revealed and processed. This is facilitated by accessing newly connected self-compassion and empathy, which serves to neutralise anger and enable change possibilities. The process requires a tolerable conversation and exploration of the possible benefits of existing self-shame structure, alongside the consequences. Such new space facilitates access for grief and loss to be processed, as anger becomes tempered and self-compassion evolves.

This represents the ultimate challenge for the client and for the facilitating therapist. This therapy process can be supported by encouraging the client to access outside environmental supports and by the therapist having the support of a supervisor to call on to help manage and understand his own and his clients’ transferences.

References:

Corvo, R. (2014). Traumatised and non-traumatised states of personality: A clinical understanding using Bion’s approach. London: Karnac.

Moran, J. (2017). Shame. Unpublished.

Pearsall, J. (Ed). (2002). Concise Oxford English dictionary. Oxford: Oxford University Press.