Shame - a feeling that is allowed to be there (but doesn't have to be)

Dealing with shame in therapy

Shame as a silent companion

Shame is a feeling that everyone knows, but that hardly anyone talks about openly. Especially in the context of psychotherapy, shame is often revealed in between the lines: When people hesitate to seek help, when certain topics are ignored or symptoms are played down.

Perhaps you recognise yourself in this:

Doubts about being ‘good enough’
Fear of rejection or negative judgement
The feeling of not fulfilling expectations or social norms
An inhibition to share certain thoughts or experiences that you consider ‘not normal - even in therapy

Many people feel this way. Because shame is a completely normal feeling that affects us all in different ways.

Potential outcomes of shame in the therapy process

It happens time and again that clients report intense shame regarding with their symptoms during the course of therapy. There is still a social stigma of mental health disorders and psychotherapy and many people believe they have to deal with their problems without professional support. This may not only lead to prolonged hesitation before confiding in relatives or friends, but can also contribute to a delay of the first contact with therapy - for fear of being thought weak or revealing ‘strange’ thoughts.

So: Shame can delay help-seeking or lead to the omission of important information, the trivialisation of complaints or the glossing over of certain experiences. This usually happens out of a deep need to protect oneself - but it has the potential to make the diagnostic and therapeutic process more difficult. Shame can thus become an obstacle if it is not recognised, acknowledged and understood.

Why shame is important

Shame is not a ‘disorder’, but a completely normal emotion. Just like joy, anger or sadness, it is helpful and important for healthy development.

Shame is a social emotion. It arises when we experience ourselves as wrong, inappropriate, or inadequate in the eyes of others (or in our own inner mirror). In the context of our social relationships, shame has an important function: it acts as a protective mechanism for social bonding. It helps us to conform to rules and social norms and to show consideration for others.

Shame comes with the desire for integrity, belonging, connection and respect, but also the fear of rejection and social exclusion. Shame is therefore closely linked to a person's self-image and in the long term shame can have profound impact on their self-esteem.

From the perspective of systemic therapy, shame can be indicative of an injured attachment motive or (hidden) loyalties to a social system such as the family system. In some families or communities, shame can even become an integral part of communication or relationship patterns and be passed down through generations, e.g. through taboos (‘We don't talk about things like that!’). In such contexts, shame becomes part of the relationship system - often unspoken, but no less effective as a result.

How shame manifests itself

Shame is a complex feeling that can manifest on different levels:

Physical: trembling, sweating, blushing, lowered gaze, quiet voice, freezing up
Emotional: feelings of embarrassment, inferiority and guilt
Cognitive: Increased self-observation, intense self-criticism
Social: Withdrawal or attack, avoidance of certain conversations or contacts

The intensity ranges from mild embarrassment to a strong and painful desire for ‘the earth to open up and swallow you whole’. It is important to note that experiencing shame always depends on the context. Family, cultural or social norms shape what we are ashamed of and whether we can feel like we can talk about it.

How those affected can deal with their shame

If you feel shame, it shows that your relationships are important to you. You pay attention to the effect your behaviour has on others. Instead of suppressing or ignoring this feeling, it can be helpful to accept it as an indicator: What is important to me? What do I want to protect myself from? What can be seen here?

And be aware that psychotherapists are well familiar with these feelings. What may seem ‘crazy’ or ‘wrong’ to you is often a well-known expression of inner conflicts.

Give yourself time: not everything has to be said immediately. Trust develops gradually ansd over time. When you feel ready, you can name your shame: ‘I find it difficult to talk about it, but...’. You can also prepare yourself and write down thoughts or topics that are important to you. This can help you to address them more easily during the conversation.

What psychotherapists can do

When we encounter shame in our practice, it is our responsibility to treat it with respect, empathy and curiosity. Together with our clients, we can develop a deeper understanding of the system in which the feeling of shame makes sense, what it was important for in the past and what function it still fulfils today. This makes it possible to deal with shame constructively.

Helpful steps can include:

Normalising: Many thoughts, feelings or symptoms that cause anxiety are more common than people realise
Promoting understanding: A better understanding of symptoms and emotional processes can provide relief
Reframing: recognising and acknowledging shame as an expression of the desire for belonging and a sense of responsibility
Exploring inner parts: Shame can be understood as a part of yourself that draws attention to something important. What does it want to protect you from?
Strengthening self-compassion and empathy: A more compassionate attitude towards oneself can offer relief

Conclusion

Shame is a normal feeling. It shows us that something is important to us: our relationships, our self-image, our place in the community.

Chronic and intense shame can be part of psychological disorders - for example in the case of depression, anxiety and obsessive-compulsive disorders, eating disorders, trauma disorders or self-harming behaviour. In this case, it is worth taking a closer look together.

Shame does not have to disappear. It can be there. But it can also be heard, understood and reframed in order to change.

Perhaps you have recognised yourself in some of the above. If so, I would like to encourage you that you don't have to be alone with this. In my practice in Frankfurt or in an initial online consultation, we can explore what your shame is trying to tell you and how a new, friendlier view of yourself is possible.