By Sheila Rubin LMFT, RDT, BCT
This is an excerpt from my chapter in the book "The Use of the Creative Therapies in treating Depression" edited by Stephanie Brooke and Charles Meyers and published by Charles C. Thomas Publisher.
My client came in. Instead of her usual smile and carefree toss of her hair, this day there was sadness to her and slowness to her movements. “I was leading my yoga class and I had all these new students. Everyone was so excited; their friends told them how good my class is. When I started to teach, all of a sudden I could not get my words out. I must be the worst yoga teacher in the world! I could hardly wait for the class to be over. I felt like such a phony! I don’t want to teach anymore!”
A couple was having a hard time raising a blended family. Every time the husband “gets into it” with his partner’s son, he went into a blinding rage. His wife said it is her husband’s fault that her son is having trouble adjusting to the new family structure. I asked him what happens, and he replied, “The boy just gets under my skin.” When I explored further, he remembered being bullied in high school. He had trouble remembering that he is the adult now; reacting automatically, he yelled at the boy without meaning to.
A 8-year-old client has not seen her father in many months. She has no words when I asked her how she is doing. Then, slowly, with one hand she pointed to her heart. With the other hand, she pointed to a tear from her sad eyes. We built a bond in silence working with symbols.
Identifying Shame And Resilience
I am always looking for resilience. And, I am looking for where resilience is blocked. I am looking for something that is almost invisible – something as subtle as the way light shines through a raindrop or does not. Something that is very familiar to me because of my own family history. This blockage is something that may be overlooked if we are not looking for it. It is most simply and most profoundly the emotion of shame. The feeling of shame is different from other emotions. Gershen Kaufman (1992) wrote about shame as “the breaking of the interpersonal bridge” (p.19 )when there is a rupture in a relationship. It is also described by Nathanson (1992) as“The sudden loss of pleasure and excitement” (p 134-138).
There is shame when a person feels a break interpersonally. And there is further, profound shame when a person feels a break inside himself or herself. It is the feeling of shame that somehow clients leave out of sessions unless the therapist knows to look for it and brings it up. And it is this very mysterious feeling that can keep people stuck in depression for so long, and not finish their therapy. I believe that shame is not fully addressed in therapy. Unhealed shame can keep a person in a depressive state for years, or keep them living only partly the life they could be living.
Shame is at the core of the inner critic, perfectionism, depression, and low self-esteem. Shame has been at the core of my work since first discovering it in my clients who have depression or an eating disorder when I worked at the hospital. Now I work with clients and couples in private practice. I recognize shame in some frequency of putting the self down, staying out of conflicts or getting into conflicts, or having an almost mysterious reaction to certain events that seem to keep bringing up the shame that the person has carried. Shame is different in each person, so therefore it is helpful to have tools for the therapist to help the client create a map of where the shame wounds are hidden, of where they are healed, and where the resources are to heal it.
From the first session, I am building my attachment with the client. Aware of the power differential of the therapy situation, I may share some personal weakness or vulnerability to show that I am not superior, just a little further on the path of healing. I also acknowledge some strengths of the client as we begin to work together to further level the field. I also offer counter-shaming and acknowledgment of the clients bravery in coming to do therapy.
Purpose of Shame
Shame is a primary emotion and has a developmental purpose; parents use it in child rearing to show what is acceptable and what is not in each family. Shame is there to help a person understand how to better to fit in society, a job, a family, or community. Unfortunately, many people remain stuck in toxic shame because early attachment repairs, like apologies and explanations, did not heal the pain of shame when first occurring. Often large or small misattunements between parent and child can lead to shame, remaining hidden, toxic, and unhealed. When there has been actual abuse, children received the message deeply that they do not matter and are worthless. This can lead many to live within a state of all pervasive shame, constricting their life and keeping them under a blanket of depression.
Daniel Hughes wrote about shame in his book Attachment-Focused Family Therapy, “Pervasive shame functions to hide the self from anticipated negative evaluations of others” (Hughes, 2007, p. 177). He went on to say that, Shame “represents the greatest barrier to developing a coherent autobiographical narrative. Events that are full of shame do not become subjective experiences fit for inclusion into one’s story of one’s self” (Hughes, 2007, pp. 177-178). He explained further “Whereas fear tends to activate attachment behaviors within a child, shame tends to deactivate attachment behavior” (Hughes, 2007, p. 178. When the child has fear, they seek the parent. When the child has shame, the child hides from the parent.
Hughes (2007) also explained that sometimes when a child becomes angry, the child is moving through shame to rage. With rage, children are reactivating and bolstering their self, which was previously impaired by being in a state of shame. When there has been discipline, the child needs to reconnect with the parent to repair the relationship. Otherwise, shame remains in the core of the child. The child might think that it is she who is flawed, and not what she did.
Many adult clients that I work with have developed depression due to this continual misattunement and misunderstanding from discipline or reactions from parents so many years ago. Nathanson explained in his book Shame and Pride (1992) that there are four reactions to shame: attack self, attack other, withdraw, and deny. I find that many clients who follow a “withdraw” reaction of shame often find themselves pulling in, licking their wounds. This withdrawal can lead to isolation, mistrust, and loss of faith and hope. This path of depression is deep and familiar for many of my clients. The choice of “attack self” can lead to an insatiable inner critic that is exhausted from running as fast as it can toward perfection. “If I can just do all the things on this list, maybe I can be ok.” Deep inside is a belief that “There is something wrong with me.” Other beliefs include “I’m bad” or “I’m toxic.” “Denial” is the avoidance of the feeling of shame by denying that anything is wrong. And, “attack other” is where shame can turn into blame, passed as the hot potato from one family member to another. Rage is often an attachment protest.