The worst loneliness is to not be comfortable with yourself.
Mark Twain
ALL OF US are born exploding with primitive, selfish, and uncivilized instincts—a part of our psyche Freud called the id. We expect to be the center of attention and have our parents’ complete and undivided attention. Because caretakers work hard to provide for our every physical and emotional need during the first year of life, this fantasy is, at first, largely fulfilled. However, as children begin to explore their environments, they are exposed to a dangerous world. We are taught shame to keep us safe, but it is a visceral reminder of how dependent we are. As a result, we react to an emotional threat as though our physical survival depends on it.
This freeze response is coded within the autonomic nervous system as a rapid transition from sympathetic arousal to parasympathetic inhibition. When the freeze response is triggered, children are snapped from a mode of curiosity and exploration to one of fear, rigidity, and withdrawal. As a result, the child stops, looks downward, hangs his head, and rounds his shoulders. The consequences of this primitive form of social control become central in both intimate relationships and how we behave in groups. If you were going to design a mechanism of social control that would keep alphas in line behind betas, you couldn’t do better than core shame. Those with core shame try to be perfect soldiers and only feel confident when they are following someone else’s orders.
Bad Dog!
The disappearance of a sense of responsibility is the most far-reaching consequence of submission to authority.
Stanley Milgram
If you scold your dog for soiling the rug or chewing up the sofa, he will hunch over and roll over on his back, or pull his tail between his legs and slink away. Similar postures occur in reaction to exclusion, judgment, and submission in virtually all social animals. It essentially says “You’re the boss.”
Most children aren’t overly damaged by this social conditioning; after all, we have to absorb plenty of corrections during life. Although we all want to be kings and queens of the world, our parents want respectful, hard-working, and well-behaved children. Problems in psychological and intellectual development can occur, however, when a child is met with prolonged scolding, criticism, and rejection. This can occur due to harsh parenting, oversensitive children, and a variety of other factors that can thwart the development of healthy self-esteem. The overuse of shame as a disciplinary tool also predisposes children to longterm difficulties with emotional regulation. Chronically shaming parents have children who spend much of their time anxious, afraid, and at risk for depression and anxiety.
An important aspect of avoiding instilling core shame is to rescue children from withdrawn and dysregulated states by reattuning with them as soon as possible after a rupture of connection. It is thought that repeated and rapid returns from shame states to reconnection and attunement results in rebalancing of autonomic functioning while contributing to the gradual development of self-regulation and self-esteem.
The problem is that what began as an ancient strategy to protect our young has been conserved as the unconscious infrastructure of the later-evolving psychological processes of attachment, social status, and self-identity. The feeling of being lovable or unlovable becomes the foundation of our intimate relationships, what we think of ourselves, and how we function in groups. Those of us with core shame spend our lives with the distinct feeling that we are at risk of attack, abandonment, and even death.
The Origin of Core Shame
I don’t take compliments very easily.
James Taylor
Because core shame is formed during a developmental period characterized by egocentric information processing, the loss of a parent through imprisonment, divorce, or even death is taken personally. During childhood, our parents don’t leave a marriage or die from an illness; they abandon us because we weren’t lovable enough for them to stay. Children can’t comprehend the notion of quality time, leading them to interpret the amount of time spent together as love. If you spend most of your time away from them, they will experience it as rejection. It doesn’t matter how good your excuse is or that other adults would understand; humans have been shaped to be next to and connect with their caretakers.
It appears that experiences of emotional misattunement with parents trigger the same parasympathetic reflex as being scolded and abandoned. Thus, the emotional unavailability of the parent is experienced as a rejection and interpreted as, “I’m not important, valuable, or lovable enough to be secure in my membership in the family”—which feels life threatening when your survival depends upon your family’s protection. These experiences may occur in early attachment relationships when an excited expectation of connection in a child is met with inattention, indifference, or anger from a parent or caretaker. These experiences of emotional misattunement trigger the same rapid shift from sympathetic to parasympathetic control as dominance-submission displays do in other social mammals.
These ruptures of attunement and emotional connection happen between the best of parents and the healthiest of children. However, a child with a sensitive or anxious temperament may suffer greatly in the face of what appear to be normal, everyday parenting interactions. Differences in temperament and personality between parent and child can also contribute to the development of core shame because they can result in consistent misattunement.
Appropriate Versus Core Shame
Live in such a way that you would not be ashamed to sell your parrot to the town gossip.
Will Rogers
Let’s clearly distinguish core shame from the appropriate kind of shame that upholds the morals and values of the group. Appropriate shame emerges slowly during childhood along with an understanding of others’ expectations, an ability to judge our behaviors according to these expectations, and the control necessary to inhibit antisocial impulses. Appropriate shame supports the development of conscience, deepens our empathetic abilities, and allows us to have mutually supportive relationships.
In contrast, core shame develops in the earliest months of childhood as a reflection of how we experience our value as an individual and as a member of our family. The result of core shame is that the self is experienced as fundamentally defective, worthless, and unlovable. While being guided by appropriate shame builds positive identity, core shame results in the antithesis of self-esteem. If appropriate shame is consciously expressed as being ashamed of something you have done, core shame is a deep emotional experience of being ashamed of who and what you are. With core shame, a central part of your experience is the sense that you have lost face with no chance of redemption.
Common Consequences of Core Shame
Psychological
Depression, low self-esteem
Inappropriate self-blame
Anger, hostility, envy, and blaming others
Interpersonal
Conflict avoidance, reflective apologizing
Superficial overconfidence with reduced interpersonal problem solving
Intermittent rage
Decreased immunological functioning
Increased levels of cortisol and adrenaline
Decreased neuroplasticity
School and Work Performance
Maladaptive perfectionism
Reduced pride in response to success
Fear of negative evaluation and intense shame in the face of failure
Clients with core shame report similar themes from their childhoods. They tend to have authoritarian and critical parents or feel like they were less favored than their siblings. They are more likely to have experienced abuse, neglect, or abandonment from one or both parents or to have had parents who relied on them for emotional and practical support. Many children who have inadequate parents take on the role of being the parents’ emotional caretaker from an early age.
Despite the competence of these children and their adult demeanor, the absence of adequate parenting is interpreted by their young brains as an absence of their own value. The belief is, “If I were worthy of love, my parents would have given me what I needed.” At the heart of core shame is an inner certainty of being a defective person combined with the fear of this truth becoming public knowledge. Even though someone with core shame has done nothing wrong, there is also a deep sense that nothing can be done to make up for it, for the “crime” of not being loved by their parents is seldom part of their awareness.
When children with core shame are old enough to go to school, they enter the classroom anxious and fearful, anticipating academic failure and social exclusion. Because every social and educational opportunity also provides the possibility of failure, children with core shame often struggle to participate in class, interact with peers, and feel like a part of the group. Core shame is stored in implicit memory as something we never remember learning but never forget—a central aspect of the unthought known. One of the key reasons why therapy works is that we are able to uncover and name core shame and develop strategies to manage it.
Self-Esteem Versus Core Shame
Self-esteem isn’t everything; it’s just that there’s nothing else without it.
Gloria Steinem
By the time we achieve consistent self-awareness between 5 and 10 years of age, positive self-esteem or core shame have already been programmed as social and emotional givens. It is similar in many ways to booting up your computer and being presented with a desktop that has been organized by a Microsoft or Apple operating system. You accept it as the parameters of your computing universe, unaware of the thousands of lines of programming language required to generate your reality. In other words, basic self-esteem and core shame are programmed so early in life that they are deeply known, but seldom thought about or directly articulated.
As children graduate into increasingly complex peer groups, core shame comes to shape their social world. As you might imagine, both victims and perpetrators of bullying are more likely to struggle with core shame. It becomes especially prominent during adolescence due to the heightened emphasis on being cool, acceptance into new groups, and dating. Core shame distorts social cognition and creates the experience of rejection in neutral and even positive situations. Consistent misperception of neutral interactions as rejecting creates a vicious cycle that aversively impacts victims’ popularity, social status, and ability to form relationships. Their lives become marked by chronic anxiety, depression, and exhaustion from their losing struggle to achieve acceptance.
Because not knowing something can be intolerable, individuals with core shame have difficulty patiently working toward solutions. They will want quick resolutions for problems and will readily accept labels and simplistic answers from religious leaders and pop psychologists to escape the anxiety of uncertainty. Tools for regulating fear and stress will be necessary for positive change with these clients. As one of my clients put it, “I can be where I am, and I can be where I’m going, but I can’t tolerate the uncertainty of being in between.”
Core Shame in Psychotherapy
A friend is somebody who adores you even though they know the things you’re most ashamed of.
Jodie Foster
Core shame has a number of key symptoms that therapists need to keep an eye on. Unyielding perfectionism, a lack of self-care, and choosing partners that are either abusive or nonsupportive are the most common. You also see expressions of shame in an inability to tolerate being alone or in individuals who attempt suicide after a breakup. For people with core shame, relatively minor abandonment is experienced as life threatening because it triggers implicit memories of early abandonment experiences. For some, any feedback suggesting that they are less than perfect triggers panic, making them unable to take risks, explore new ideas, or accept guidance.
When we are ashamed, our brains, like our bodies, shut down. Many who struggle with disabling shame have their cognitive and intellectual capacities negated by their negative emotions. In other words, it’s hard to think rationally or to see reality clearly when your brain is telling your mind that you are in danger of abandonment and death. One of my clients described it this way: “My shame makes it impossible for me to be loved because I’m certain I’m not lovable. Therefore, if someone does love me, I can’t possibly respect them because their judgment is so poor.”
Establishing a positive and honest connection with clients with core shame is necessary to stimulate their brains to change. But as you can imagine, they are going to make you work very hard to earn their trust. Often, they will turn the tables on you and ask you to share your problems with them. Taking care of others is often a successful strategy to hide our own neediness from ourselves and others. Because shame leads to anger and resentment, considerable blame and hostility may be directed at you. Your dedication and availability can be experienced as a threat or attack. Clients sometimes become bullies, acting out their shame by victimizing you.
Children with parents who have problems with addictions or the law or both may have their core shame reinforced by the conscious shame of their family members. Often, children are more deeply connected to parents who mistreat them, so don’t assume that abused and abandoned children don’t blame themselves for what has been done to them. A kind and attentive therapist may be attacked by neglected clients because being cared for activates their sadness about the parents they never had. Clients may also direct the anger they have toward their parents at a safer target—you. Until you resolve this transference, no good deed you perform will go unpunished.
Clients with core shame can become compulsive apologizers in an attempt to avoid conflict and the anger of others, which always feels deserved. Praise bounces off them, but anything that can be interpreted as criticism will be taken hard, triggering a fight-or-flight reaction. They will overreact to interpretations because they suggest imperfection and trigger shame. Although quite intelligent, clients will avoid trying anything new unless they feel certain of success. While serving to avoid failure, it also prevents them from being open to new material, taking on challenges, and learning how to regulate their feelings of insecurity on the way to mastery. This is a reason why successful therapy correlates with a decrease in avoidance behaviors. In other words, facing our fears is a central mechanism of building new networks to inhibit fear.
Ruptures of attunement are inevitable, but a rapid return to a state of attunement supports affect regulation and contributes to the gradual development of self-regulation. It is thought that repeated and rapid returns from shame states to reconnection and attunement results in rebalancing of autonomic functioning while contributing to the gradual development of self-regulation. These repeated repairs are stored as visceral, sensory, motor, and emotional memories at all levels of the central nervous system, making the internalization of positive parenting a full-body experience. At its heart, core shame is a full-body experience of being disconnected, shunned, and expelled from social connectedness, stimulating the same brain regions activated by pain and fear. This is why Tylenol reduces the emotional impact of social rejection.
Because the level of stress associated with core shame is so high, the negative effects on brain biochemistry inhibit neuroplasticity and learning, making benefiting from therapy extremely difficult. For this reason, the transference associated with core shame is a central component of the therapy. Spanning the chasm between you and your client is the work necessary to approach and treat issues of core shame.
Therapists are just as vulnerable to core shame as clients. Clients with core shame are exceptionally good at detecting and exploiting the weaknesses and insecurities of others, especially if they fear your evaluation. Your unexplored shame, fears, and vulnerabilities may be seen and exploited by those with core shame—a good offense is a great defense. A therapist’s emotional maturity and self-knowledge can make all the difference in her success. Try to discover, explore, and begin to heal some of your own brokenness before you sit across from your first client.
I’ll Be Watching You
When a woman is talking to you, listen to what she says with her eyes.
Victor Hugo
The most important information in the world comes to us from the faces of others. Eye gaze, pupil dilation, blushing, and facial expression link us to the hearts and minds of other people. In fact, a basic preference for and recognition of faces with direct eye contact is seen during the early days of life. Later, eye gaze comes to serve as a means of social control. How many of us remember getting “the face” from a parent that made us shake in our boots? Researchers have found that while most people don’t wash their hands after using a public restroom, a pair of eyes painted on the bathroom mirror will significantly increase this prosocial behavior.
The direction of eye gaze plays an especially powerful role in social communication. When we see others gazing at a person or object, looking up, or staring at something behind us, we shift our attention to share their focus. When we see a fearful or surprised look on the faces of others, we quickly reorient in the direction of their gaze to find out what they are reacting to. Increased arousal in response to eye gaze is demonstrated as early as three months of age, a process that is delayed or thwarted in people with autism spectrum disorder.
Being the object of someone else’s gaze is a somewhat different story. This is one reason why eye contact can be so difficult in therapy. As the gaze of another shifts from the environment to us, our brain becomes aroused, autonomic activity increases, and the networks of the social brain go on high alert. The detection and analysis of the direct eye gaze of another is very rapid because of the significance eye contact has for physical safety and reproductive success. You can actually feel this shift as you experience yourself going on alert as someone’s gaze, especially someone who looks particularly threatening or attractive, locks in on you. If people maintain eye contact for more than a few seconds, they are likely to either fight or have sex.
While direct eye gaze has the power to activate the arousal needed for a fight-flight response or a romantic approach, an averted gaze can signify rejection, ostracism, or the silent treatment. Being gazed at in an adoring way makes the gazer appear more attractive to us—most people like being adored. On the other hand, a diverted gaze from another can activate feelings of low self-esteem, decreased relational value, and the impulse to act aggressively against those who look away from us.
While our brains have been wired to orient to and gather social information via eye gaze, the language of the eyes is also influenced by early social interactions and cultural values organized in the prefrontal cortex. If we look too intently at another, it can be experienced as an insult or a sign of aggression. We monitor the gaze of our listeners to see if they are paying attention and are likely to become offended if they look away too often. In many other cultures, gaze aversion is a sign of respect to higher-ranking people and something that is expected between the sexes. Eye contact is also used to establish social dominance. Kids engage in staring contests to see who has more nerve. On the other hand, maintaining direct eye contact with a potential romantic interest can be interpreted as a sign that an approach will be accepted.
Reactions to direct eye contact can be very telling about your client’s internal state. Fear or avoidance of eye contact are often symptoms of social anxiety, borderline personality disorder, and core shame. Because direct eye contact has so much meaning, looking at your clients can be experienced as anything from reassuring to threatening. How your gaze will be interpreted will be determined by an interaction between your behavior and your client’s experience of you.
It has always been a mystery to me how men can feel themselves honored by the humiliation of their fellow beings.
Mahatma Gandhi
There is no sweeter music to a therapist’s ears than to meet a new client who desires to make radical changes by any means necessary. Jillian was such a client. Intelligent, psychologically sophisticated, but she was wracked with an array of physical illnesses that earned her the diagnosis of conversion disorder. She entered therapy certain that her physical suffering was a result of her childhood challenges. At 60, Jillian could see a clear trajectory from her relationship with her parents to her lifetime of emotional inhibition and ardent desire to remain invisible at all costs. Despite these challenges, she had managed to build a successful marriage, raise two healthy children, and engage in meaningful work helping victims of domestic violence.
Definition: Conversion Disorder
When emotions are repressed and not expressed, they set up a reverberating loop within the body that disrupts homeostatic and immunological functioning. This sets us up for what Freud called conversion disorders—a conversion of psychological and emotional pain into physical symptoms. Adding the up, left, and out model is an extension of Freud’s theory with the addition of a more contemporary understanding of the underlying neurobiology. What sometimes works well with conversion is experiments in emotional expression, visibility, and assertiveness.
Both of her parents were emotionally unavailable and preoccupied with their own struggles related to self-esteem, attachment, and sexuality. Jillian’s childhood was a collage of inappropriate sexualization, pathological religiosity, and keeping secrets from family and friends. She and her siblings were largely alone in coping with the chaos, confusion, and anxiety caused by their two deeply narcissistic parents. Although the story is not unusual, her need to be invisible and her core shame have a unique twist due to her parents’ involvement with nudism.
At the dawn of Jillian’s adolescence, her parents decided to spend each Sunday at a nudist camp. Despite her initial protests, Jillian was forced to endure long days in a wooded park being stared at by adult men. “There were no other teenagers at the camp. Other people stopped going when their kids reached adolescence, but not my parents—for us, that’s when it all began.” Jillian felt as if she and her sisters were being “pimped out” as a way for her parents to attract attention and make friends.
When I asked her why she went at all, she said that her mother insisted she go because there was nothing wrong with it. At the same time, she was also told never to tell anyone or her father would lose his job. Jillian’s rapid submission to these wishes had been shaped by her mother’s dominant and controlling nature, and she felt that rebellion was out of the question. She had been taught to follow orders and kept the secret of the Sundays at the nudist camp well into adulthood.
Jillian remembers men gathering around her family’s beach chairs to stare at her and her sisters and the shame and embarrassment she felt each week. As protection against the entire experience, Jillian would bury herself in a book and try to ignore the eyes she could feel on her body. One of the aftereffects of these nude Sundays was a lifelong fear of being seen or of drawing attention to herself, especially as a sexual being. She spent her life wearing the least attractive clothes she could find, shunned makeup, and downplayed anything that identified her as a woman. She looked as if she paid no attention to her clothes while in reality, her appearance was very intentional.
Her core shame and desperate need to be invisible drove her to avoid developing a career, and then to bury herself again in taking care of her children and husband. By the time I met Jillian, she had almost completely suppressed her anger, fear, and rage, and had converted them into autoimmune diseases and other physical problems. She knew that she had to learn to get these emotions out but also realized that a lifetime of hiding in fear would not change overnight.
I began my work with Jillian by doing my best to understand her core shame, fear of being seen, and the real-life struggles of staying alive. I told her that, despite her enthusiasm to forge ahead, we would need to take small steps and that she was to always stay in control of our work. This therapeutic stance is especially important with clients who have been controlled by others who have hurt them in the past.
Beginning with a focus on her medical struggles, I explained a working model that I call up, left, and out. Up, left, and out is based on the idea that our emotions are activated and stored in our bodies and need to be connected to conscious awareness by being transmitted up to the right cortical hemisphere (the apex of bodily processing), and integrated with left cortical processing in order to put words to feelings and then articulate them to ourselves and others.
While Jillian was no longer in communication with her father, her mother was compelled to keep in touch to retain her sense of control over Jillian. Jillian had coped with this by avoiding her calls as opposed to establishing a clear boundary. The first experiment was for Jillian to clearly tell her mother that she no longer wanted to communicate with her in order to establish an intentional boundary and Jillian’s power.
Another way her mother influenced her life was by giving a constant stream of holiday crockery, which Jillian and her husband hated but nonetheless saved in their cupboards and closets. So the second experiment was “the breaking of the crockery,” which we turned into a ritualistic destruction of her mother’s influence in her life. Jillian texted me a series of pictures that depicted the piling up of shards on the garage floor. Many clients have found this exercise not only productive but also satisfying and fun.
A third experiment in visibility was to encourage Jillian to write about her work with victims of domestic violence and to organize the materials she used in her groups for possible publication. A fourth involved changing her wardrobe and appearance in the direction of being visible and even attractive to others. While all of these individual exercises may appear to be small, together they represent a gradual and manageable process to come out of the shadows and into the light.
Each of these experiments can be taken slowly, analyzed, and reconfigured for the next challenge. This allows our clients to slowly build the descending cortical circuitry necessary to inhibit amygdala activation in the face of visibility, assertiveness, and personal power. Good-enough parents help their children to accomplish this earlier in life through emotional attunement while sharing and articulating experiences. But as I’ve witnessed over and over again, it’s never too late to learn these lessons.