Working with shame in the therapy process. (Part 6)

What does a therapist do when a client presents with strong feelings of shame. One knows what to do when a client is angry. They feel the anger, they express the anger and when ready they drop the anger. When a client feels sad the therapist acknowledges the feeling, the client expresses the sadness with some kind of crying usually, one listens to the client, empathises with them and is compassionate. Then the sadness is dealt with.

However shame is different. Unlike sadness and anger, shame tears at the very sense of who we are in a way that other feelings do not. With shame one experiences a sense of painful self diminution. Their sense of worth, importance and sense of who they are as a person is painfully reduced. With shame there is a sense of ‘I am bad’. What does a therapist do with this?

When people feel shame there is a strong desire to withdraw or change the topic. The person wants to go into hiding in some way. This seems to be the natural Free Child reaction to shame. The problem with this, is it does not deal with it, in the therapeutic sense.


Now that's embarrassing!


In essence it is an avoidant, ‘Lets try and forget about it’, approach. This works with small ‘traumas’ but with big ones it does not work. They need to be brought out into the open, experienced and then one can ‘get over it’. The Free Child reaction with shame is to hide and avoid. With most other feelings the Free Child reaction is a therapeutic one that will bring resolution of the painful event like expressing sad feelings when one’s cat dies. With shame the natural Free Child reaction will not bring resolution or closure to the event. Thus shame is somewhat unique in this way.

I will cite how I have developed my approach to shame over the years.
The first step is to clarify the shame, the guilt and the internally directed anger. As I have shown before these can be articulated by three separate transactional diagrams:







These three transactions can coexist in various combinations at the one time and often do. The therapist needs to assist the client to untangle them. Sometimes when a client initially reports a feeling of shame one finds there is not a shame reaction but it maybe a guilt reaction or internal anger reaction.

One indicator that shame is present the client’s unwillingness to bring it up and discuss it. If there is a true shame reaction the client may be quite unwilling to mention it which is a problem in itself because the therapist may not hear about it for some time. Obviously if the therapist does not know about it then it cannot be dealt with. Examples of this can be self harm or bulimia. The shame that is felt about these activities may result in the client not mentioning it for some time.

However when the client does raise the shaming event the therapist knows this is a positive move indeed. It means the client now experiences the therapeutic relationship in such a way that she is prepared to raise such a sensitive and intimate issue. The therapist is now being trusted in way that he has not been before.



When this happens the therapist untangles the three possible reactions of inward anger, guilt and shame. The therapist then deals with the inward anger and guilt in the usual therapeutic ways. Whilst doing this the stage is being set for the shame to be dealt with.

The client is then asked to do something that is unnatural for them to do. With shame the Free Child wants to hide and withdraw but the therapist asks the client to come out into public (with the therapist) and talk about the shame and the shaming event.

This to my mind, is the first step to resolving the shame. As simple and unsophisticated as it is. The shame is simply brought out into the relational with the therapist and the therapist responds in an empathetic fashion. Once the shaming event has been disclosed the therapist can bring it out into the open at the appropriate time. This requires some caution such that one does not reshame the client in the therapy setting.

From what I have seen once the event and shame have been discussed a number of times it seems to loose its potency. The catharsis obtained from speaking about it with the therapist seems to reduce the need to hide it. Subsequently it can be raised much more easily by either party when need be.



Thus the initial therapy process is to come out of hiding, speak about the event and the feelings with another trusted person. If that person responds favourably the shame and embarrassment diminish over time.

However this is not the end of the story. Whilst it may be easier to discuss it with the therapist, the underlying damage that resulted from the shaming event still remains. With guilt one has the sensation of ‘I am bad because I did x’. With shame it is simply, ‘I am bad’.

This is treated with the usual various redecisions, awareness of the shame, acceptance of shame as a natural thing, hypnotic suggestions when the client is significantly regressed, working through the negative and positive transference reactions, forgiveness of self and so forth. This takes time depending on the depth of ‘badness’ the client experiences. However this process is significantly helped if the shaming event looses it impact in the ways I have described above such that the event can be more easily spoken about. The need to hide with the shame fades and diminishes.

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The expression of shame & blushing (Part 5)

Thanks to all those people who kindly sent me bits and pieces on shame when I requested any information on the physiology of shame. That information still remains quite elusive. That is, what physical bodily changes occur when a person experiences shame or embarrassment. I have for the moment given up on my pursuit of that information and will seek to produce a statement about what happens to the person when they feel shame.

I am referring to here and now shame rather than neurotic shame at this juncture. We all go through life and sooner or later circumstances arise where we will feel shame which is appropriate to the events. For most this is probably not a common occurrence and as I mentioned before the experience of embarrassment is probably much more common for most. People who were shamed as children will feel shame in response to a wider variety of events in adulthood because they have been ‘programmed’ to have that reaction.



What happens when a person feels shame or embarrassment?

Common body expression and attitudes when one experiences shame include a bowing of the head, an attempt to hide the face possibly with the hands, a blushing of the face and possible sweating, body bent over on itself and possibly a closing of the eyes. It is like the person is endeavouring to make self as small and as invisible as possible and as a result there will be a strong drive to remove self from any company and seek to isolate self for a while.

The other interesting feature of shame and embarrassment is blushing. In this instance there is a reddening of the face, neck and possibly the upper chest. This is seen to be a reaction of the sympathetic nervous system that causes the blood vessels in the face to dilate. The cheeks tend to have more capillaries and blood vessels than other parts of the body and the vessels also tend to be wider in diameter and closer to the surface. The increased blood flow results in a colour change in that area from light pink to dark red. As it is involuntary it is something that cannot be controlled which may cause even further disquiet.

It is believed that everyone has the physical capacity to blush. The whiter the skin the more observable it is. In dark skinned people it is almost impossible to notice but they do blush the same as lighter skinned people. Women tend to blush more than men. It is reported to occur in kindergarten aged child but some report that a child as young as two years old can blush. Adolescence is the stage at which it is most prevalent due to it being a period of high self consciousness. As one grows older it tends to decrease as people start to become less self conscious (in normal circumstances) and the stimulation of the blood vessels decreases with age.



From a human communication point of view blushing is an interesting phenomena. Blushing is body language like any other kind of body language and people can use it to communicate. What does it communicate to the observer of the body language? Perhaps one could draw the blushing transaction as such:


Blushing transaction

1. The blusher receives some kind of information from the other person or from the environment in some way. A woman at a party has a wardrobe malfunction in front of a group of others and exposes her breast. She does not realise until someone brings it to her attention. A wife may mention to others in front of him how her husband now has to wear a ‘nappy’ since his bladder operation.

2. In response to the incoming information the person blushes with a reddening of the cheeks. This communicates back to the observer that the blusher thinks he has broken some moral boundary or sense of personal dignity as defined by the Child ego state and he is currently feeling very bad and uncomfortable about it. They will also know he is highly motivated to end the precipitating event either by withdrawal or changing the subject and so on.

This response will be a Free Child transaction if the shame or embarrassment is an appropriate reaction to the incoming information. If the shame is not an appropriate response that would be seen as an Adapted Child reaction and form the basis of neurotic shame. The two examples cited in number 1 above could be seen to be examples where it is appropriate to feel shame.


Unfortunately many teachers have learnt that shame is a good way to control children. Whilst parents may be careful not to shame a child at home it can be happening in the classroom.

A good example of the AC (neurotic) response can be found with some social phobics. A person with such a phobia can have self defeating internal talk. When in conversation they may start thinking that the observer can see they are blushing and thus how much of an idiot they look or how embarrassing they are. They may or may not be actually blushing but the person feels they are. This makes them more uncomfortable and thus the blushing increases or is felt to increase more so.

Note the lack of Parent ego state involvement in the transactions which is typical of the difference between shame and guilt. Like guilt, shame has the capacity to curb human behaviour most notably the Free Child. Whereas guilt comes from a Parent ego state introject shame is a Child ego state driven process and hence tends to be more potent and destructive. Shame feels very unpleasant to the person and thus they will be highly motivated to change their behaviour. Shame is experienced as being more in the core of the person as compared to guilt.

Do people blush alone, is an interesting question. People certainly can feel shame whilst being alone. The woman cited above who had the wardrobe malfunction can recall that event the next day whilst alone in her home and feel shame about it. However would her feelings of shame result in blushing? She is aware she is not being observed by anyone in that instance. I am unsure of the answer to this question. I would tend to think that she would not blush or certainly any blushing that did occur would be less intense. However I have no data on which to base this conclusion.


Making children perform on stage can easily produce a shame reaction. Parents need to take care when the child is required to make some kind of public performance.


Does anyone out there have personal experience with being alone and blushing or not blushing?

Whilst my parents were by no means perfect they never did shame me as a child. Thus I have few incidents where I can recall when I felt shame as a child or an adult. There are a couple and if I recall them I do not think that I demonstrate any blushing.

This leads us to the next stage in the process of our discovery of the various components of shame. Many a client will recount incidents where they felt shame in the past. If a client experiences shame in front of the therapist what does the therapist do? Watch this space.

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Shaming in child development (Part 3)

As one endeavours to increase their understanding of what shame is one needs to isolate what can be shaming practices by adults on children. There are certain critical times and events that occur in a child’s life where shaming by the parents can be particularly influential. I am reminded of an example with a client a few weeks ago.

A mother whom I had seen on and off for about a year raised a concern she had about her daughter who was five years old at the time. She reported that when checking on her daughter asleep at night she observed that her daughter often had her hand down her pants touching her genitals.

She wanted to know if I thought it was psychologically OK for her daughter to be touching her genitals in a masturbatory way. I suspected the real question she was building up to was, do I think this is a sign that she has been sexually abused?


Dissociation

The reason why I suspected this is because Australia is a pedophobic society. There is almost a hysteria around pedophillia in Australia. Male school teachers are a slowly dying breed as a result. I was also recently amused by the report of a health official who publicly announced that perhaps we could reduce childhood obesity in Australia by getting more children to walk to school. Initially there was much “oohhing and aahhing” about such a proposal. What a good idea it was and why hadn’t we thought of it before. A few days later there were those saying it was too dangerous as the pedophiles may get our children as they walked to school. People suggested counter proposals of having meeting points where children could walk in groups to school or having special wardens to walk with the children. The upshot of it was that it got too complicated and guess what - children still don’t walk to school.

Somebody forgot to mention that the likelihood of a complete stranger sexually attacking a child is about 2%. The vast, vast majority of sexual assaults on children are by someone in the family, known to the family or in some position of trust with the child. But that does not seem to matter as Australia has convinced itself that there is a pedophile hiding in every bush waiting to jump out and abscond with our children.



I informed my client of this Australian cultural pedophobia and also that almost all children touch their genitals and masturbate at times. And thus we arrive at the point at hand. This is a critical point in the development of shame problems in a child’s psychological development. As a result of their own beliefs and taboos about masturbation a parent could quite easily use shame as a means of attempting to stop the child from doing such a thing. Shaming around sexual matters is particularly powerful. Thus one would be suggesting to parents that they do not engage in such shaming practices as it can seriously impact on a child's sense of shame and effect their self esteem. This is also particularly relevant in young teenagers as well.

In situations like this I sometimes provide a little information about the misunderstandings of childhood masturbation to concerned parents. When Freud originally proposed the idea of childhood masturbation it was met with much horror and aghast. How could such a thing be true many asked!!



Well children grow up and have other feelings like sadness, anger, fear just like adults do so why can’t they have sexual feelings as well. Of course they do. However there is another common misunderstanding because adults will assume that a child’s comprehension and perception of masturbation is the same as an adults. It is however different in significant ways.

As a child grows it discovers its body. It learns that if it has a itch on its backside and scratches it that feels good. If it has a booga up its nose and pries it out with a finger that also feels good. It also learns that if it touches its genitals that feels good. In a child’s mind touching its genitals and scratching its backside are the same kind of thing. In an adults mind they are very different because the child does not yet understand all the connotations that go along with masturbation as compared to scratching its backside. So a child’s comprehension of masturbation is very different to the adult.

Secondly, the vast majority of people report their first orgasm occurred after puberty. The vast majority of children who masturbate do not do so with the goal of orgasm. Obviously very few children even understand what an orgasm is. They simply touch their genitals because it feels good. Another significant difference between adult masturbation and what has been unwisely called childhood masturbation.


Its every where you know!


When communicating with children about sexual matters parents must be vigilant to avoid any shaming. The other critical point with children and shaming is in their toilet training. Watch this space.

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Shame - edit #4 (Part 1)

This post will develop over a couple of days

When one reads the literature on shame one finds a bit of confusion as to what shame is and is not. Or perhaps it is better to say that people have differing views on it. One commonly finds three things mentioned in relation to shame.

Internalised anger
Guilt &
Shame

These three things are often mentioned as relating to or being part of shame. My own view is that each of these constitute three separate psychological processes. They are three separate entities. However they can and often do occur contemporaneously.



This would explain why some people may see guilt as being part of the shame experience or internal anger as defined as being shame on occasion. They can occur at the same time and often do. If one can define the three separate psychological processes this would clarify the nature of shame and its associated processes.

There are two ways in which internal anger can occur as shown in the diagram



People can express anger at themselves from their Child ego state. When this occurs people will do negative internal self talk such as I am stupid, I was a geek talking to that girl and so on....

Anger can also be expressed from the Critical Parent ego state to the Child of the person. In this case the internal self talk does not start with a “I” statement but with a “You” statement when an internal ‘telling off’ occurs. Examples may be “You were such a jerk talking to that boy”, “You can’t even get a simple report right”, You stupid f**k” and so forth.

Guilt occurs when the person has a sense of breaking an internal rule which they have for them self. If a husband thinks the woman next door is hot and foxy but he has a rule inside his Parent ego state which says, “Thou shalt not covet thy neighbours wife” then he can end up feeling guilt for having such thoughts and feelings.



Or a person may steal money from a brother and later feel guilt about it because he has the rule in his Parent that you don’t steal from your brother. People can feel guilty the next day after a night of drinking too much. Alcohol decommissions the Parent ego state and thus people behave in such ways that they usually wouldn’t. The next day after the alcohol has worn off they feel guilty because the Parent ego state becomes active again.



Finally we have shame which is a natural feeling reaction to a particular environmental stimuli. Often, but by no means always, it is associated with sex, nudity or intimate bodily processes such as urinating or defecating. A prime example is the enuretic child who wets his bed at night. When the child wakes up and realises he has wet the bed it is very easy for him to feel shame about that and he can go to extensive lengths to try and hide it. Indeed parents need to be very careful not engender a sense of shame in a child when he wets the bed. It needs to be dealt with very carefully so as to avoid this. Thus we have the shame transaction.



As you can see this differs from the guilt transaction in that there is no Parent to Child transaction before for emotion is experienced. This is consistent with Freud’s presentations on shame which is probably best summed up by Lynd(1958) who notes that guilt is usually more related to transgressions of clear moral codes and rules. No better example of this is found in religious texts which define what behaviours, thoughts and feelings are regarded as sinful. These are incorporated into the Parent ego state by the young child and when transgressed the individual most often will expoerience guilt.

With shame the rules are much less codified and clear. Transgressions of them are more by tactlessness, errors in taste or bad luck. As a result the Parent ego state is much less involved in the process. Again the example of the enuretic child demonstrates this. Wetting the bed does not break a Parent ego state rule and generally would not be regarded as sinful. Instead it result from bad luck or factors outside the child’s control.

Lynd, H.M. (1958) On Shame and the Search for Identity. London: Routledge & Kegan Paul.


This indicates that there are three separate psychological processes - inward anger, guilt and shame. They can occur on their own or they can occur together. However if we see them as separate processes then the situation as to what shame is and is not can be kept more clear.


The separateness of these three psychological processes can be understood experientially as well. In therapy I may ask the client the following questions:

Recall a time when you felt guilty.
What happened and describe the feeling? Use a few words to describe what the experience of guilt feels like for you?

Recall a time when you felt shame.
What happened and describe the feeling? Use a few words to describe what the experience of shame feels like for you?

Recall a time when you felt angry at yourself.
What happened and describe the feeling? Use a few words to describe what the experience of self directed anger feels like for you?

Most people find this quite easy to do and report that the experience of shame and guilt are different which supports the contention that they involve discrete psychological operations.

If any one here wants to do this exercise I would be interested to hear your answers.




Shame and embarrassment

Under normal circumstances shame is not an emotion that is experienced all that often. The feelings chart shows there are various groups of feelings.



I have purposely used the word “Family” because they are like that. There is a commonality amongst the feelings but they are also all different. Just like members in a family, they all have a basic commonality and they are also all different.

It is proposed that shame and embarrassment are like this. Embarrassment is a minor version of the full shame reaction and thus embarrassment is a much more common feeling for people to experience. It is safe to say that most people could relatively easily recite situations where they have felt embarrassed. Under normal circumstances there would be far less events to recall where the person felt shame.

They both come from the same emotion but vary in their impact. Whilst embarrassment is an unpleasant emotion to experience it does not have the devastating effect that shame can have. Charles Rycroft notes that shame is the cinderella of the destructive emotions. The experience of shame tears at the core of who we are. It effects us at a deep level and the understanding of who we are.



With guilt people can have the experience of,

“I am bad for doing that thing”

whereas with shame the person is more likely to end up with the feeling of,

“I am bad”
Whilst the shame will be connected to a certain event occurring the resultant comprehension of it is more about me as a person rather than about something I have done. Shame has far more destructive power than most other emotions.

As stated above under normal circumstances shame is infrequently experienced. It tends to only be experienced in relation to quite unusual circumstances, where as embarrassment is more frequently experienced in reaction to a wider range of events. There is however an exception to this.


Will he feel embarrassed about ending up like this? Lots of people are watching!


Parents quickly learn that emotions are a effective way to get children to conform.

They can use guilt.

“Mummy will feel sad and hurt if you don’t eat up all your food”.

They can use fear by threatening abandonment.

“Unless you have your bath now mummy will get a policeman to come and take you away”.

These emotions cause pain in the child and thus the child will tend to behave in order to avoid the painful experience. The same applies for shame which can be a very unpleasant emotion to experience. Thus parents can say things like,

“You should be ashamed of yourself for.....”

It works in getting a child to behave in a certain way but it is also particularly destructive in the ways described above. I would strongly advise parents not to employ this kind of child rearing practice.


This will get people to conform, but at what long term psychological cost?

If you are working with a client who reports this kind of parenting in their childhood then you know the person may be damaged psychologically at quite a deep level. Also they will tend to report the experience of shame in the present more than average. They will tend to react to events with shame whereas others would tend to only experience embarrassment. This of course just amplifies the problem.

Rycroft, C.
1971. Reich. Fontana: Great Britain

The discussion about using shame as a parenting technique provides insight into the difference between neurotic shame and Here and Now (H&N) or reality based shame.



This figure shows the two different types of shame are functions of two different parts of the personality. Reality based shame is a function of the Free Child aspect of the personality and the Adapted Child ego state is where neurotic shame would result from.

This proposal rests on the assumption that shame can be a normal and natural human emotion. An assumption that gets plenty of support. Firstly Freud (1942) notes that shame is “,,, organically predetermined...”(p.46). Then English (1994) discusses the topic in some depth. As she notes it would be impossible to instil shame in a child who did not already have the organic receptors for it. The ability to feel shame can be seen to have some evolutionary advantages as well.

English reports that Charles Darwin suggested that shame had certain evolutionary advantages. Shame is often around nudity and sexual matters and that covering up the genitals afforded more protection of them which also increased the likelihood of the propagation of the species. The expression of shame often involves blushing and a desire to hide which corresponds to the feeling of being dangerously exposed.


Why only cover up those parts of the body?



English, F. (1994) ‘Shame and Social Control Revisited.’ Transactional Analysis Journal. 24, 2, 109 - 120.

Freud, S. (1942) Three Contributions to the Theory of Sex. London: Imago.



As a result humans are so constructed that should a particular set of circumstances arise they will naturally feel shame. To make the assessment of reality based shame versus neurotic shame one needs to judge the appropriateness of the circumstances that have lead to the shame reaction.

Sometimes this is clear but at other times it is harder to assess. As said before shame is often, but by no means always, associated with nudity, sex or intimate physical and psychological factors. Below are some instances where many would feel shame as an appropriate H&N reaction.

The child who wets its bed or soils itself.
A woman discovers her ex-partner has placed intimate nude photographs of her on the internet for all to see.
A man is publicly exposed as an adulterer in his church group.
A man publicly jokes about his wife’s vaginismus.
A woman pokes fun at her husband about his baldness which she knows he is very sensitive about.



If a person reports feeling shame in such situations these could be diagnosed as Free Child shame reactions.

Some times the circumstances are less clear.
A teenager gets an F for his maths test.
A lecturer trips on steps as he walks up onto the stage to give a lecture.
Is it appropriate to feel shame in these examples, is harder to judge.

Many people with a social phobia report shame and embarrassment that is neurotic in nature. They feel as they walk into a social gathering that everybody is looking at them, they look awkward and odd such that they experience shame. Or as they talk they think they are blushing and saying stupid things and feel shame as a result.

These are likely to be Adapted Child ego state responses of shame. One reason why these occur can be due to the parenting styles as described above. If the parents have used shame as a method of punishment and said things like, “You should be ashamed of your self for...” the person is primed to have shame reactions as an adult. As a result they will have reactions of shame when most others would not.



This leaves us at the next juncture of what does one do when they feel shame? Thus the distinction between neurotic and reality based shame assumes some importance.


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