Shame, Resilience and Counter Transference in Psychotherapy (Part I)

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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. It is most simply the emotion of shame.

Shame is different from other emotions. Gershen Kaufman (1992) wrote about shame as “the breaking of the interpersonal bridge” (p.19 ) to describe a rupture in a relationship. It is also described by Nathanson (1992) as “The sudden loss of pleasure and excitement” (p 134-138 Shame and Pride). There is shame when a person feels a break interpersonally between himself and another. 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.

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 noticing it in my clients who have depression or an eating disorder at the hospital. Now in private practice, I notice that shame shows up differently in each person. I am looking for where it is hidden and I am looking for where the person’s resources may be 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, to show that I am not superior, just a little further on the path of healing. I also acknowledge some strengths of the client. I also offer counter-shaming and acknowledgment of the clients strengths and bravery in coming to do therapy.

Because of the Tricky Nature of Shame

This primary emotion of shame needs special attention. The other primary emotions, sadness, anger, can be felt and will eventually pass and shift. Shame, by its special nature, does not shift by going more deeply into it. It just gets even stickier. Shame can bind with other emotions leaving a person stuck in a shame/fear bind or a shame/sadness bind, or often a shame/anger bind. My clients talk of “the gunky feeling that drags me down into the mud.” Some say, “Something’s wrong with me.”  Shore wrote about bypassed shame as the rapid shift from sympathetic arousal to parasympathetic, inhibiting awareness and expression of feeling, being distressed without words, with a disorganizing effect. (Shore, 1994 p 466.) Shame is designed to lower affect in the nervous system. Often people do not realize that the sense of “all of a sudden I just felt stupid” is the nervous system shutting down. Then there a cognitive judgment that shames the person for being stuck once more. This is the feeling shame about feeling shame. We can help a client identify that there is shame there and begin carefully to separate it from other emotions so we can understand it better.

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 mis-attunements 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 or reactivity.

How to Heal Shame

Kaufman (1974) wrote that feeling understood is counter-shaming. “As long as shame remains internalized and autonomous, real change is prevented. New experiences with others, however positive, fail to alter one’s basic sense of self unless the basic developmental sequences also is reversed” (p. 7). These sequences can be reversed through attachment work between therapist and client, the witnessing, connecting and attuning to the client in exquisite detail during the sessions. He also said that within the therapeutic relationship, internalized shame needed to be returned to its developmental origins. (Kaufman, 1992, p. 139)  “Over time, a visceral conclusion is drawn whereby any stirring of emotion (i.e., core affective experience) comes to automatically elicit anxiety or shame . . . which becomes a spur to institute protective strategies” (Fosha, 2000, p. 104). We can use attachment work, drama therapy or expressive arts to explore those core affective experiences in a projective or embodied way that does not threaten this tender balance, but instead supports it toward growth and healing. We can even take the client into the imaginal realm to return shame symbolically to where they were originally shamed, and help them claim their resilience and their dignity.

Counter Transference

When a client goes into a state of shame in the session, it is very easy for the therapist to suddenly begin to feel ‘I’m not a good enough therapist, I can’t help this client.” When the therapist feels their own shame in the session, that is a clue that shame is probably coming up in the client. This is a good place to use tools of mindfulness and grounding themselves to stay out of their own shame dynamic, they teach the client mindfulness and grounding. This is a place to be curious with about what the client may be feeling or experiencing.  Help the client notice something sticky or something heavy or perhaps remembering someone’s voice or a memory of feeling shamed or discounted. Sharing their shame with the therapist can be very healing. It is important that the therapist acknowledge how brave the person is being in sharing something so vulnerable.  As the therapist shows compassion for the client’s shame, the client can learn to have compassion for themselves. Little by little more of the person is recovered and welcomed back.

My husband, Bret Lyon and I have developed Healing Shame workshops for therapists that provide a map for therapists to better understand how to work with shame.