Is Feeling Shameful Healthy?
Over the past few decades, psychotherapy has looked at the emotional concept of shame. In particular, John Bradshaw, Pia Mellody, Claudia Black, and Pat Carnes have dissected shame, breaking it down into two main categories: healthy shame and toxic shame. In their world, healthy shame describes the feeling of, “I have done something that goes against my core values and beliefs, and I feel bad about that,” while toxic shame describes the feeling of, “I am inherently flawed and defective and therefore unworthy of love and belonging.”
Basically, this is the difference between “I did something bad,” and “I am bad.” When properly defined and understood, these psychiatric terms are quite useful, but, frankly, the people experiencing these feelings are rarely able to distinguish between the two in the heat of the moment, and many have demonstrated an uncanny knack for turning healthy shame into toxic shame in the blink of an eye.
More recently, author and clinical educator Dr. Brené Brown has sharpened the focus on these very different yet easily confused concepts by re-labeling them in ways that feel not only more accurate but much less murky and open to interpretation or confusion. What has heretofore been described as toxic shame is what Brown merely calls shame. And she calls healthy shame what it actually is, which is guilt.
Brown also makes it clear that feeling guilty can absolutely be a healthy thing, as this emotion can and often does lead to positive behavior change: “I feel bad about my behavior, and I’d like to fix the situation and behave differently in the future.” Shame, on the other hand, is incredibly unhealthy, causing lowered self-esteem (feelings of unworthiness) and behaviors that reinforce that self-image: “I am a bad person, and there’s nothing I can do about that, so I might as well continue behaving badly.” In short, guilt is potentially a very healthy feeling, and shame is not.
Guilt: Sharon is shopping for Christmas ornaments. There are two similar ornaments available from the same company—one for $10, and the other, adorned with real crystals, for $60. She surreptitiously swaps them, slipping the more expensive bauble into a $10 ornament box. Then she takes it to the counter and pays $10 for it.
Later, as she’s hanging it on the tree, she feels terrible. She tells her husband what she’s done, and he suggests she return the ornament to the store and make a $50 donation (the price difference) to a local charity. She takes his advice and feels much, much better. Lesson learned.
Shame: Sharon is shopping for Christmas ornaments. There are two similar ornaments available from the same company—one for $10, and the other, adorned with real crystals, for $60. She surreptitiously swaps them, slipping the more expensive bauble into a $10 ornament box. Then she takes it to the counter and pays $10 for it.
Later, as she’s hanging it on the tree, she feels terrible. She realizes that she is an awful human being, and she doesn’t deserve the love and/or respect of her husband and children. Each evening thereafter, she laces her eggnog with copious amounts of brandy and stares at the ornament, viewing it as proof that she is a bad person.
In the examples above, we see that the same basic occurrence can lead to either guilt or shame, and that guilt informs a healthy response (talking to a loved one and making amends), while shame drives an unhealthy response (keeping secrets and drinking heavily).
The Prevalence of Shame in Clinical Practice
Most people enter therapy because they feel depressed, or they’re riddled with anxiety, or they’re constantly angry, or they’re cheating on their spouse, and they can’t seem to stop, or they’re drinking too much, and their life is out of control, or whatever. In other words, people typically walk into a therapist’s office because they have a specific problem, and they want help with it. Usually, a person’s presenting issue is relatively concrete in nature, meaning it fits into a defined and recognizable psychiatric diagnosis (major depression, post-traumatic stress disorder, substance use disorder, etc.)
Part of a therapist’s job is addressing a client’s presenting issue at the moment, but that’s only part, and sometimes just a minor part. Usually, the real work of therapy is deciphering the underlying emotional triggers that lead to the presenting issue, and for most clients (those without profound mental illness or a serious form of psychosis), a primary underlying emotional trigger is very likely to be shame, shame, and more shame. So even though most people arrive in therapy looking for help with depression, anxiety, and the like, long-term healing nearly always requires shame-focused work.
In my practice, I know that shame is an issue as soon as a client starts talking about the “negative tapes” that play in his/her head, or the “committee” that meets between his/her ears and discusses his/her unworthiness at every turn, or the gremlins that live in his/her skull and shout, “Well, you really screwed that one up!” Essentially, these tapes/committees/gremlins are shame in action—the primary way in which a person’s inherent belief that he or she is defective, flawed, bad, not good enough, and therefore not deserving of love and happiness is reinforced over and over again.
Usually, these shame messages are introduced very early in childhood via neglectful and/or abusive and/or inconsistent parents, siblings, teachers, and the like (though pointing this out early on in therapy usually does little to help a suffering adult client). The truly sad part of shame is that shame-based people are, at best, likely to have less rich, less rewarding, and less interpersonally meaningful lives than they’d like. And at worst, they become mired in depression, anxiety, addiction, violence, isolation, dysfunctional relationships, and various other manifestations of deep emotional pain.
Unfortunately, as mentioned above, feeling shame neither encourages nor motivates positive behavior change. In fact, Dr. Brown’s extensive research into the issue has revealed an inverse relationship between shame and the belief that one is capable of changing for the better. Her research also found that shame-based people often behave in ways that reinforce their shame.
In other words, shameful feelings lead not to connection and reaching out for support, but to ill-advised behaviors that bolster feelings of shame. This creates a downward spiral of bad behavior, shame, more bad behavior, more shame, etc. So when people behave in ways that go against their values, feel bad about it, and work to behave differently in the future, shame is not the motivation. Guilt is. So, once again, guilt is potentially a very useful and socially informed emotion, while shame is not.
Sometimes, by the time a person walks into a therapist’s office and asks for help, shame is the driving force in his or her life, manifesting negatively through depression, anxiety, addiction, and numerous other unhealthy feelings and behaviors. For these individuals, regardless of the presenting issue, long-term healing by necessity involves addressing and overcoming shame. In 12-step recovery groups, this work occurs in steps four through nine, while in therapy settings, it usually happens through a specific shame-reduction methodology. At Elements Behavioral Health treatment facilities, where I am Senior Vice President of Clinical Development, we are currently implementing Dr. Brown’s recently developed Daring Way™ shame resilience curriculum, using it in conjunction with 12-step work and other practices when appropriate.
Whatever approach is taken, developing shame resilience is a process of reaching out to supportive others by sharing one’s story and experiencing empathy. Shame thrives in the dark, and it withers in sunlight. Talking about shame with supportive and empathetic others kills it while keeping it a secret helps it grow.
In fact, one of Dr. Brown’s most important research conclusions is that not discussing a shaming event can be more damaging than the actual event. So keeping secrets about shame can actually be more damaging than the shame itself. But when people share about their most difficult experiences—the experiences that leave them feeling defective and unworthy—with caring, supportive, empathetic others, even long after the fact, they feel better. Their stress levels decrease, and their mental and physical health improves. It’s just that simple.
Easier Said Than Done
Unfortunately, opening up about shameful topics and experiences is not an easy thing to do, as shame is something most people try very hard to avoid feeling, owning, acknowledging, or addressing. Simply put, the natural reaction to shame is to hide it. Because of this, shame-based people sometimes isolate and keep secrets, or they worry more about looking good than feeling good, or they become people-pleasers, or they busy themselves with the problems of those around them to such a degree that they never have time to look at themselves.
Other times shame-based people can become aggressive, either verbally or physically (using shame to fight shame), or they simply “numb out” and avoid all feelings via addictive substances and/or behaviors. Most shame-based people actually rely on a combination of these and other unhealthy coping tactics depending on the situation. Unfortunately, the defense mechanisms that shield people from shame also tend to shield them from any meaningful interpersonal connection.
Needless to say, talking about shame can be incredibly scary. For many people, especially those who do not have a supportive atmosphere at home, it is important that “shame sharing” occurs in innately empathetic settings, like therapy sessions (individual and/or group) and 12-step support meetings. The good news is that talking about shame helps to shift this highly toxic emotion into something that can be viewed more neutrally.
Over time, shame-based people are able to progress from “I am bad” to “I did something bad,” or “Something bad happened to me,” or some other less damaging self-belief. When the shift is to a guilt message, such as “I did something bad,” this can serve as a powerful motivation for positive behavior change. Eventually, instead of existing in a downwardly pointing shame spiral, shame-based people can spiral upward toward happiness, improved self-esteem, and healthy intimacy.