ABSTRACT
The field of mental health has needed a comprehensive approach to work with shame in psychotherapy treatment. Psychotherapy involves an uncovering process, and shame promotes covering and hiding. Therefore, shame works against the therapeutic process by inhibiting feelings and all forms of self-expression. Therapists can readily activate shame when attempting to address parts of the self that are dysfunctional and working against relational connection. The author describes the principles of a “shame sensitive” approach to self-protective strategies and a variety of therapeutic challenges in a session. We first identify shame to address it, so this chapter clarifies the neurobiological, non-verbal, and verbal manifestations of shame. She offers specific responses to diminish shame states, and she reworks her language dozens of times to increase its effectiveness.
Many clinicians believe that shame should be approached indirectly, through repetitive experiences of building trust. The author will share her perspective that it's best to directly but sensitively address shame sooner rather than later. Rushing to dispel shame or avoiding it altogether misses opportunities to help a client break free of shame. Shame is an intersubjective phenomenon in therapy. Both therapists and clients can avoid taking risks of self-exposure, holding back observations and feelings vital to therapeutic movement.
