ABSTRACT
It is common for clinicians to encounter difficulties in the effectiveness of traditional cognitive therapy when working with clients who experience profound shame and shame flashbacks in the aftermath of trauma. Therapists report patients who struggle to access and believe a more balanced and helpful perspective on their traumatic experience in a way that is meaningful to them and thus helps them feel differently about the experience. For example, patients may report that they understand or can see that they are not to blame for their trauma. Yet they still feel to blame, in that they suffer from affect, such as shame, which is congruent with the cognitions of self-blame. Therapists often report that the use of the Socratic method and guided discovery to facilitate a shift in perspective on self-blame can lead to ‘dead ends’ as patients report such things as that they are bad because they were born that way or they have always felt that way, or that they are different from everyone else.
