Shame

What Is Shame?

Signs and Symptoms Associated with Shame

Shame is an emotion of social comparison where an individual fears or anticipates eliciting disgust in others (Gilbert, 1992). Shame is experienced transdiagnostically and has been associated with increased symptom severity and poorer responses to treatment in conditions such as eating disorders (Troop, Allan, Serpell, & Treasure, 2008), PTSD (Dorahy et al., 2015), and depression (Andrews, 1995). Gilbert (1992, 1996) proposes that shame involves two components:

• external shame—thoughts and feelings about how one exists in the minds of others. For example thoughts that others view us having unattractive characteristics and may reject us;
• internal shame—an awareness of how one exists in the minds of others. A focus on the self as flawed, bad, or inadequate (self-criticism).

Psychological Models and Theories of Shame

Paul Gilbert published an evolutionary account of shame which serves as the framework for compassion-focused therapy (CFT). This account argues that human beings have evolved to be regulated through social relationships. Shame means harboring fears that others will dislike or reject them, and experiencing high levels of shame means that individuals disconnect from and are less able to access soothing and regulation from others. Gilbert argues that “Shame is probably one of the most important inner experiences for creating the sense of difference and disconnection from others”(Gilbert, 2017).

Evidence-Based Psychological Approaches for Working with Shame

Compassion-focused therapy (CFT) is regarded as a ‘third wave’ cognitive behavioral therapy. It was developed to help patients struggling with shame and self-criticism. Components of CFT interventions include psychoeducation about our ‘tricky minds,’ and the development of compassionate self-practice. The evidence base for CFT indicates that it is a promising intervention for shame and self-criticism (Leaviss & Uttley, 2015).

Resources for Working with Shame

Psychology Tools resources available for working therapeutically with shame include:

• psychological models of shame and self-criticism
• information handouts for shame and self-criticism
• exercises for shame and self-criticism
• CBT worksheets for shame and self-criticism
• self-help programs for shame and self-criticism

References

• Andrews, B. (1995). Bodily shame as a mediator between abusive experiences and depression. Journal of Abnormal Psychology, 104(2), 277–285.
• Dorahy, M. J., Middleton, W., Seager, L., McGurrin, P., Williams, M., & Chambers, R. (2015). Dissociation, shame, complex PTSD, child maltreatment and intimate relationship self-concept in dissociative disorder, chronic PTSD and mixed psychiatric groups. Journal of Affective Disorders, 172, 195–203.
• Gilbert, P. (1992). Depression: The evolution of powerlessness. New York: Routledge.
• Gilbert, P. (2017). A brief outline of the evolutionary approach for compassion focused therapy. EC Psychology and Psychiatry, 3(6): 218–227.
• Gilbert, P., Allan, S., & Goss, K. (1996). Parental representations, shame, interpersonal problems, and vulnerability to psychopathology. Clinical Psychology & Psychotherapy: An International Journal of Theory and Practice, 3(1), 23-34.
• Leaviss, J., & Uttley, L. (2015). Psychotherapeutic benefits of compassion-focused therapy: An early systematic review. Psychological Medicine, 45(5), 927–945.
• Troop, N. A., Allan, S., Serpell, L., & Treasure, J. L. (2008). Shame in women with a history of eating disorders. European Eating Disorders Review: The Professional Journal of the Eating Disorders Association, 16(6), 480–488.