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Shame is an emotion that often underpins difficulties including low self-esteem, depression, and PTSD. Highly shame-prone individuals sometimes find it difficult to benefit from traditional cognitive behavioral therapies and may benefit from a compassion-focused approach. Read more
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A Guide To Emotions (Psychology Tools For Living Well)

Cognitive behavioral therapy can help your clients to live happier and more fulfilling lives. Psychology Tools for Living Well is a self-help course ...

Audio Collection: Psychology Tools For Developing Self-Compassion

Psychology Tools For Developing Self-Compassion is an audio collection which guides clients through an empirically-supported programme of compassionat ...

Autonomic Nervous System

The autonomic nervous system (ANS) automatically regulates the function of body systems outside of voluntary control. The Autonomic Nervous System han ...

Barriers Abusers Overcome In Order To Abuse

Individuals who have experienced abuse often focus on their own actions (or inactions) and blame themselves for their own abuse. This client informati ...

Before I Blame Myself And Feel Guilty

Guilt is a common post-traumatic reaction and is often the result of cognitive bias. This CBT worksheet explores common cognitive biases that have bee ...

Behavioral Experiment

Behavioral experiments are planned experiential activities to test the validity of a belief. They are one of the most powerful techniques available to ...

Coercive Methods For Enforcing Compliance

Individuals who have experienced abuse often focus on their own actions (or inactions) and blame themselves for their own abuse. This client informati ...

Compassionate Thought Challenging Record

Thought challenging records are commonly used in CBT to help people to evaluate their negative automatic thoughts for accuracy and bias. This Compassi ...


Many people find it hard to label their emotional states or reactions. This information handout provides a list of emotions, categorizing them as basi ...

Emotions Motivate Actions

Many clients find it helpful to recognize the range of actions that are motivated by different emotional states. This worksheet encourages clients to ...


The Externalizing information handout forms part of the cognitive distortions series, designed to help clients and therapists to work more effectively ...

Forgiveness Is

Forgiveness is an effective treatment for anger and relieving hurt. Sadly, many people dismiss forgiveness due to misconceptions regarding its nature. ...

Motivational Systems (Emotional Regulation Systems)

At the heart of Compassion Focused Therapy (CFT) is an evolutionary model of human motivational systems. Developed by Paul Gilbert it is a helpful len ...

Pie Charts (Archived)

NOTE: An improved version of this resource is available here: Responsibility Pie Chart. Older versions of a resource may be archived in the event ...

Responses To Threat: Freeze, Appease, Flight, Fight

Human beings are programmed to respond automatically in a variety of ways to a threat including freezing, escaping, and dissociation. Traumatized indi ...

Responsibility Pie Chart

The Responsibility Pie Chart exercise is designed to guide clients through the process of clarifying and re-evaluating their responsibility for negati ...


The Self-Blame information handout forms part of the cognitive distortions series, designed to help clients and therapists to work more effectively wi ...

Transdiagnostic Processes

A ‘transdiagnostic process’ is the label given to a mechanism which is present across disorders and which is either a risk or maintaining factor f ...

What Is Compassion Focused Therapy (CFT)?

Compassion focused therapy (CFT) was developed to work with issues of shame and self-criticism. The CFT model complements and expands the traditional ...

What Keeps Low Self-Esteem Going?

The “What Keeps It Going?” series is a set of one-page diagrams explaining how common mental health conditions are maintained. Friendly and concis ...

Links to external resources

Psychology Tools makes every effort to check external links and review their content. However, we are not responsible for the quality or content of external links and cannot guarantee that these links will work all of the time.

Guides and workbooks

  • Combating self-criticism
  • Abuse – Information For Adults Physically, Emotionally, Or Sexually Abused As Children (An NHS Self-Help Guide) | Lesley Maunder, Lorna Cameron | 2020

Information Handouts


Self-Help Programmes


  • The importance of soft toys | Donald Winnicott

Recommended Reading

  • Fennell, Melanie JV. “Low self-esteem: a cognitive perspective.” Behavioural and Cognitive Psychotherapy, 25.1 (1997): 1-26.
  • Fennell, M. J. (1998). Cognitive therapy in the treatment of low self-esteem.Advances in Psychiatric Treatment,4(5), 296-304.
  • Fennell, M. J. (2004). Depression, low self-esteem and mindfulness.Behaviour research and therapy,42(9), 1053-1067. Fennell, M. J. (1997). Low self-esteem: a cognitive perspective. Behavioural and Cognitive Psychotherapy, 25(1), 1-26.
  • Gilbert, P. (2000). The relationship of shame, social anxiety and depression: The role of the evaluation of social rank.Clinical Psychology & Psychotherapy: An International Journal of Theory & Practice,7(3), 174-189.
  • Gilbert, P. (2009). Introducing compassion focused therapy. Advances in Psychiatric Treatment, 15, 199-208
  • Veale, D., Gilbert, P. (2014). Body dysmorphic disorder: the functional and evolutionary context in phenomenology and a compassionate mind. Journal of Obsessive-Compulsive and Related Disorders, 3(2), 150-160

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


  • 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 Practice3(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.