ABSTRACT
For three decades the author has been asking clients what brings them to psychotherapy, and not one of them has said, 'I need help with my chronic shame'. The author believes that most symptoms of so-called mental illness, from depression and anxiety disorders to personality and dissociative disorders, have something to do with childhood relational trauma. Not everyone who suffers from chronic shame can rise above it with outstanding performances of a competent self. Shame takes hold in different ways, depending on a child's disposition and on the many possible forms of mismatch between a child's need for connection and a caregiver's ability to respond. Some chronically shamed clients do not live out a split existence. Rather, they struggle daily just to survive constant feelings of isolation, despair, and worthlessness. Beneath their current lives of alienation and emotional pain lie histories of physical, sexual and emotional abuse at the hands of caregivers they should have been able to trust.
