We have come to a third chapter about treating chronic shame, and we still have not discussed how to address shame explicitly in therapy. We have talked about creating an emotionally attuned, non-shaming therapeutic relationship with chronically shamed clients. We have discussed helping clients tell stories that integrate emotional and relational selfhood. In both of these ways we hope to bring connectivity to their dysfunctional right-brain neural networks. Awareness of right-brain disconnection and shame shapes our entire conversation—but we are approaching work with shame obliquely, not directly … not yet.
So it goes in therapy. It may take a long time of building trust, working through relational misses and repairs, and co-creating narrative before clients are able to identify and speak about the ugly secret they keep under deep cover, the shame feelings that erupt from time to time when they feel wrong and disgusting to someone. When that someone is us, they’ll be especially reticent about what shame does to them.
When clients finally speak of the pain and destruction that shame wreaks in their lives, they often ask, “Can anything make this better?” I often respond, “Shame needs light and air.” This answer seems to make intuitive sense to them. I’m not the only therapist to find this a useful metaphor. As Shapiro and Powers discuss how group therapy can help resolve participants’ shame, they write: “The most natural response to the experience of shame (i.e., to hide) is the most toxic, whereas the least automatic or natural (i.e., to expose the source of the shame) is the most healing. As the old adage goes, one needs to ‘let the air get at it.’ It is only when shame reaches the light of day that the healing process can begin. The presence of others allows in that light of day.”1
The presence of others helps only if clients know those others won’t further shame or blame them for their suffering. Our clients need to be able to trust that we will understand them from inside their story, not judge or criticize them from the outside. Only then does it become useful for us to speak of light and air for shame.
When we speak this metaphor, we tell our clients we are comfortable being in company with what they feel is loathsome. We communicate implicitly that we are not afraid of shame in general or of our own shame; we can help regulate this. Recommending light and air also signals our belief in a narrative of healing, not of doing, and our commitment to a healing process that takes place naturally when wounds are attended to properly. This settles anxiety too; the last thing chronically shamed clients need is something else to do (that they can’t do) to make themselves feel better.
Of course, by the time a client asks, “Can anything make this better?” shame is already in the open. The first question of this chapter is: How do we bring shame into the light? How can we make safe space in therapy for shame to be identified and spoken?
When we discussed assessing for shame, we noted the clues of shame clients give us, from their posture and manner of speech to their need to control the therapy situation. It is one thing to notice the clues, however, and quite another to let clients know that we can hear their unspoken shame, and to do so in ways that cause no further shame.
Clinicians who write about treating shame disagree about whether using the term “shame” is necessary for treating it effectively.2 I think it’s a matter of sensitivity and timing, and that pushing the word “shame” early is probably a bad idea. That’s because shame, most essentially, is our clients’ experience that their needs to be understood by a connected, caring other cannot and will not be met. They have no idea it could be any different with us. This relational deprivation has become personal pain that is just a given, something to live around. When we speak of shame, we expose something they try not to know or feel, something they believe cannot be helped, and our “help” may cause the very fragmentation of which we speak.
So we don’t expose our clients’ shame; we protect them from fragmentation. We create right-brain connection with them, using affect attunement, empathic curiosity, and our best story-making skills. We create a relationship where emotional understanding becomes possible. But what then? Does relational psychotherapy tell us how we might make it more tolerable for our clients finally to speak their shame and work through it directly?
With its specialty in issues of narcissism, self psychology would seem to be a modality of choice for treating chronic shame. Self psychologists offer support, understanding, and insight to clients who suffer from profound forms of self-fragmentation and depletion. But in its classic form, self psychology may still fall short of what shamed clients need from their therapists. Shamed clients need their therapists to take a stance that involves more than empathic immersion and empathic interpretation.3 They need to feel the person of the therapist within and behind her empathy. After a lifetime of profound disconnection (often with others who seem to be in connection while staying out), they can’t simply trust the authenticity of their therapist’s presence. Chronically shamed clients need interaction and engagement with their therapist so that they can feel her as an embodied, emotional human being.
Self-in-relation therapists and interpersonal/relational psychoanalysts call this contactful quality of therapy “mutuality.” They also call it the essence of a meaningful, useful therapeutic relationship.4 Diana Fosha, a relationalist and proponent of interpersonal neurobiology, suggests that there are two important strands in the parent/child and the client/therapist connection: the attachment strand, providing empathy and affect regulation, and the intersubjective strand, in which “the therapist’s delight in and with the patient is a powerful antidote to his or her shame.”5 This important intersubjective strand of connection is expressed through “mutuality.”
The most powerful therapy for shame is one that provides both attachment connection and intersubjective connection, both attuned affect regulation and the lively contact of mutuality.
Self psychology teaches a powerful practice of empathic attunement and it offers a profound, complex understanding of how affect can be regulated through selfobject experience, both in childhood and in transference. Can self psychology also be practiced with lively engagement and deep interpersonal contact?
The answer is Yes, if we listen to Richard Geist, a self psychologist who brings empathic immersion and mutual contact together in what he calls connectedness. According to Geist, the heart of every self psychological treatment is the client’s need for connectedness. This is more than a need for the therapist to provide “one way” empathic attunement. Connectedness is mutual empathic understanding between the interpenetrating selves of client and therapist, so that each is a strongly felt presence in the other’s life. In connectedness, mutual empathy creates mutual implicit knowing of each other’s being, a powerful, mutually affective bond between two people.6
As he describes our essential need for connectedness, Geist touches on what shamed clients missed in childhood: the dance of mutual emotional engagement between child and parent that creates a lively, whole, and secure self. Shamed clients never had a chance at this sustained connectedness. The absence of mutual connection was where their chronic shame started, and that absence continues. They bring this absence and longing when they bring shame to therapy.
In self psychological therapy according to Geist, we invite these clients not only into our empathic understanding but also into mutual emotional connection with us. When this connectedness is the heart of treatment, the therapy will naturally create mutually experienced selfobject transferences that lead the client toward health.7 I have noted that having selfobject experiences with us is one of the ways our chronically shamed clients get a second chance at the right-brain regulation they missed when they were younger. Merging Geist’s perspective with mine, we can see that this form of affective regulation happens within connectedness. The selfobject transferences of mutual connectedness regulate a self who becomes better able to self-regulate and less fragmented and diminished by shame.
Geist suggests that three kinds of engagement are important for developing connectedness: mutual empathy, nurturing the tendrils of selfobject transferences as they emerge, and interpreting from inside the client’s world.8 The first two belong to the implicit treatment of shame. As we know, mutual empathy is a form of resonance that creates right-brain connectivity. Providing selfobject experience is also an enacted, mostly subliminal response to unmet emotional need that comes our way. But “interpreting from inside the client’s world” gives us, finally, some direction about speaking directly to shame and inviting shame itself to come into the light.
Self psychology has always understood a client’s symptoms and defenses as efforts to maintain his self-cohesion. When a client enters therapy guardedly, a self psychologist understands this resistance as necessary; the client needs to protect his self-organization from being re-traumatized in this new relationship. Even as trust slowly takes on substance in the form of selfobject transference, selfobject failure will cause him to fragment. When this happens, the self psychologist interprets from within the client’s experience of having been misunderstood and let down, believing that repairing the empathic connection will bring the client back into cohesion.
Geist shifts the focus of this picture in a simple but profound way. At the dynamic center of every client’s world, he maintains, is a hidden but powerful drive toward health—health understood not as cohesion but as connectedness. And so interpretation must always be in the service of restoring connectedness. Geist might say that if we take care of connectedness, cohesion will take care of itself. I would say that if we take care of the client’s experience of connectedness, we take care of the client’s experience of shame—the fragmentation caused by disconnectedness.
With his eye for connectedness, Geist adds another dimension to the self psychological understanding of resistance, too. Clients resist trusting the therapy process when they experience it as disconnecting. This kind of resistance happens far more often than we expect because despite our best efforts at empathy, therapy often feels to clients (especially to chronically shamed clients) like a place where they are evaluated and objectified “in treatment.” That’s how they often experience our empathic listening—as shame-inducing disconnection.
Yet, with their unconscious drive for connectedness, our clients also clutch at any chance to make of us something that matches their need. So in spite of their anxious mistrust, they come back. More stories are told; mutual engagement and interpenetrating connections happen; selfobject transferences germinate. Connectedness begins to happen!
And we begin to “interpret.” We begin to reflect back to our clients our tentative understanding of their emotional experience. If we follow Geist’s lead, we will understand that the distress our chronically shamed clients feel is not just about feeling misunderstood or undervalued. It’s more than their struggle to carry on with a self that has far too many missing pieces. It runs deeper than their compulsion to perform, the rigid ways they ward off failure, or the destructive things they do to keep themselves from falling apart. These are all aspects of their distress, but most fundamentally, their pain is about wanting connectedness and having no reliable way to make that happen. This sense of our shamed clients’ core dilemma is what we hold in mind for them. Our interpretive responses implicitly and explicitly build this shared understanding of the connectedness they long for and just “know” they can’t have.
With my client Ellen, for example, whose obsession with perfect performance is all that protects her from falling into utter worthlessness, it’s essential for me to remember that her moments of shining in her mother’s eyes were her best moments of connection. These days it may seem that a need to be special is behind her compulsion to compare herself to others and then to spiral down into abject shame. But really, what’s behind her constant striving is her longing for connectedness. When she shares yet another failure to prove herself worthy with peers and colleagues, I can respond, “I wonder if what you want most of all is connection with them, like you belong with them in a way you can feel.”
If, when I speak, Ellen can feel my compassionate connectedness with her, she may be able to sit still for a moment and feel the truth and pain of her longing for connection. If she touches that truth and cringes away, I may tell her that there’s no shame in needing connectedness; it’s what makes us human, what makes us whole and well. And then the “shame” word would be out—exactly where it belongs, where connectedness should be and never could be.
If Ellen can feel how her need to be special is driven by her heart’s desire for connection, she may become able to grieve her real losses. Failure isn’t the core of her shame; at the core of her shame is an absence—the absence of connectedness. She doesn’t know what it feels like to be known and loved for herself, to “matter” in her being and in her being-with. This absence is what she needs to feel and to grieve. In this grieving process, which integrates split-off emotional pain, she might find some relief from her compulsion to perform. From a more integrated place, she might find herself able to trust connectedness—with others and with me—in ways that aren’t yet possible for her.
For Ellen, it’s also essential that I understand the turbulent times in our relationship as times when our tentative mutual connectedness is failing her and she’s doing whatever she can to get it back. Geist describes such turbulence like this: “Resistance tends to occur when an analyst, though attuned to the patient’s experience, does not allow himself to be included in the patient’s self-structure, molded and shaped according to what the patient metaphorically needs him to be.”9
From this perspective, we can understand even angry demands as a client’s healthy attempt to maintain the particular kind of connectedness she needs. And we can certainly interpret from this perspective. For example, when Ellen tells me that nothing I do helps her, I can say, “I’m wondering whether I’ve done or said something to make you feel disconnected from me right now.” Whatever her answer is and wherever we go with it, this interpretative lead isn’t likely to be felt as evaluative, blaming, or shaming, especially since it rests on my unspoken belief that her desire for connectedness is her movement toward health. Instead, it communicates my understanding that she’s in distress because something has happened between us that prevents her from getting a legitimate, valuable need met.
Yet none of this may reach Ellen when she’s in an active state of shame. Repair may not be possible until I can find a way to continue in a self-disclosing direction, beginning with something like, “I’m thinking about my part in it—when I might have disconnected.” I may share a moment when I was distracted or my defensiveness flared up. Or I might not know what happened for me, and I can ask what she noticed.
Geist strongly recommends this final step: that in moments of repairing connection, we disclose our here-and-now experience of the relationship and our thoughts about how we might have come to disconnect from the relationship momentarily. This is the natural outcome of Geist’s belief that empathy is most therapeutically useful when it expands into mutual connectedness, permeable boundaries, and an interpenetration of selves.10 These moments following rupture are perhaps the most important moments to put a “connectedness” principle into practice, especially when working with chronically shamed clients.
Self psychology has always taught us to understand a client’s experience of empathic failure from inside his world. When there’s a break between us, we say genuinely, “What you feel about what I did makes sense, and I can understand how it hurts you. There’s nothing wrong with you or with your experience.” It seems this should be exactly what it takes to resolve a client’s shame about a rupture. But in such an exchange, we remain invisible behind the function of our understanding. And behind each rupture a client experiences, there’s shame that exists as a client’s unmet, intense need to feel us in a personal way. Chronically shamed clients need for their therapists to take a further step—from, “There’s nothing wrong with you,” to, “I’m feeling the rupture, too, and I’m wondering who I am in it,” or as Geist would put it, “You are a felt presence in my being, as I am in yours.”
Furthermore, when relational rupture is met by, “I wonder what was going on with me when that happened,” chronically shamed clients can no longer assume that when a relationship doesn’t work it’s because there’s something wrong with them. Clearly, “wrong” can be elsewhere, and if it’s with a therapist who thinks about it with calm, connecting curiosity, “wrong” loses its devastating knock-out punch. Over time and with many repetitions, our clients’ general experience of relational rupture can become less of a cliff edge of “something’s terribly wrong” and more of a chance to repair a misunderstanding.
As we repair rupture by honoring our clients’ need for mutual connectedness, there’s opportunity to notice with them how their feelings of shame subside. There’s time to talk with them about what they feared and expected would happen. We can explore what it feels like when their need for connectedness feels wrong, and they feel deeply wrong for having it. We can notice the force that demands punishment for need and vulnerability, and we can call it shame.
When we finally get to these conversations, we’re no longer dealing with a wave of self-disgust that has just obliterated our clients’ sense of coherence and value. Shame is not what’s happening here and now; it’s what happened earlier, or almost happened, or what would have happened had relational events gone as the clients expected. From a here-and-now, non-shamed place of connectedness, clients can look into the shadows, put the name of shame to the dark force lurking there, and call it into the light. What happens next may be unpleasant and take further work, but it won’t be annihilating.
We help clients call their shame into the light because we believe that when they can know and feel what’s hurting them, they can heal. The “light and air” metaphor is especially apt for the concealed emotion of shame, but it holds true for all painful emotions. Disconnecting from anger, grief, or fear isn’t good for our clients’ emotional health either. Being able to integrate a range of difficult emotions into a conscious, balanced, resilient sense of self is a key component of emotional and psychological well-being.
But shame is particularly difficult to own. And so we bring our diplomacy skills to the therapy room. As long as clients can feel the emotion and talk about it in some way, they don’t need to put the label of shame on what they feel. What matters is the essence of the feeling. We can empathize with the pain of longing and not receiving. We can recognize the bleak and utter conviction that “something is just so wrong with me!” We can notice how terribly hard it is for clients to need something from someone. In short, even as we’re honest in our responses to our chronically shamed clients, helping them bring their pained vulnerability into the light, we can also steer clear of the word shame for as long as necessary.
Sometimes there are strong reasons to be extremely careful with the word shame. Some abused and tortured clients have suffered humiliation that is more than a person can bear to describe. Judith Herman quotes Cloitre, Cohen, and Koenen on helping clients deal with such narratives of shame:
In the same way that narratives of fear must be titrated so that the client experiences mastery over fear rather than a reinstatement of it, so too narratives of shame should be titrated so that the client experiences dignity rather than humiliation in the telling.11
Even when humiliation does not appear to be the storyline of a traumatized client’s history, the profound relational violations of physical, emotional, or sexual abuse will have thrown the client, as a child, into extreme and catastrophic states of shame, felt as intense self-disgust and self-hatred. Those states of shame live on, and when they are aroused in adult life, they can feel extreme and catastrophic once again. We don’t want our clients to be re-traumatized by catastrophic shame experiences, and yet we know that completely dissociating their shame will block integration. Since we want to help them integrate their experiences of shame as well as of trauma, we introduce shame delicately and with substitute words that aren’t as strong—for example, feeling silly, dumb, weak, small, worthless, uncomfortable, or embarrassed. In this way feelings of shame can become part of the clients’ stories, material that can be explored again as the feelings become more tolerable and speakable within a deepening therapy relationship.12
With some clients it’s not so clear why shame is a dangerous word. But the danger is signaled by the intensity of what masks or disguises their shame, whether the alternative state is one of judgment, envy, hostility, or grandiosity. If such states come and go, we may still have chances to help our clients speak what they feel about their own needs and vulnerabilities. But if one of those states has become their personality style, we will have to accept that theirs is a story of shame that can’t be told for now. Here diplomacy means not speaking something that can’t be heard and that will only put the therapeutic relationship at risk.
By “diplomacy” I mean what we do to be genuinely present with our clients while making constant small decisions about what will help them the most. With some of our clients it feels right not to insist on too much reality. However, if our diplomacy slips into dishonesty, the therapy relationship will suffer, and we will fail to be helpful. We do our clients harm if we protect them from the reality of shame when they could face and integrate it.
When our clients are able to feel their shame, letting the light and air get at it, we must stay honestly present with them. We have to encourage them to feel this most difficult emotion when what we want to say is: No, you are not ugly or worthless. No, I have never experienced you as selfish or stupid. Of course we would like to convince them that they are worthy, lovable persons. Instead, we must help them push through the language of ugly, stupid, and worthless to the even more painful feelings of deep shame, feelings of not mattering at all to anyone, feelings of needing someone and finding no one, and feelings of disintegration and annihilation.
Within safe connectedness, our chronically shamed clients can touch that reality again. We need to trust that this is their best way, perhaps their only way, out of ugly, stupid, and worthless. When a client sobs, “I … don’t … matter!” we need to reply, with quiet, steady presence, “Yes, that’s how it is for you inside. That’s truly what you feel. It’s just awful. It just hurts.”
There will come a time for us to say, “You matter now!” But first the shame must be experienced for what it is. And in fact there’s no better way to let our shamed clients know that they matter now—to us—than to take their shame seriously enough to feel it with them. We invalidate their need to be fully understood if we try to “make it better” to protect them or to protect ourselves. But we can help them feel that their wounded self matters deeply if they can feel our deep intention to stay a difficult course with them, this process of owning and integrating their lonely, disintegrating experience of shame.
Giving clients some basic information about shame can make it easier for them to bring their shame into the light where they can see it and feel it. It often helps them to hear that shame is probably the most painful emotion human beings can feel, and that not only does it feel excruciating, it’s so disconnecting and isolating that it can go on for a very long time without anyone noticing—except the person who feels the shame.
Hearing that shame is an experience common to humanity helps relieve the loneliness of our shamed clients and ease the shame they feel about feeling shame. Hearing shame defined as an emotion helps normalize it for them. We might add that like other emotions, shame is a response to something that happened, and it needs the same kind of attention that sadness, for example, needs so that it doesn’t become a chronic, draining feeling. We might say, “To get over shame, we have to feel back in connection with people who love us.”
I always welcome a chance to talk with clients about the difference between shame and guilt. When clients tell me that they feel a lot of guilt in their lives, I’ll ask if they feel they’ve done something wrong. If they’re puzzled, I explain where I’m coming from: “I think guilt is about something we’ve done; if we feel bad about who we are, I think that’s shame. With guilt we can say we’re sorry and make amends, but shame is a lot more complicated to fix.” Most clients understand this difference quickly and intuitively. And I have let them know that I’m as comfortable talking about shame as about guilt. I have spoken the unspeakable word, with an invitation to join me in discussing shame whenever they can.
If shame becomes speakable, we can link the emotion of shame to events in our clients’ stories of daily life, noting, for instance, the difference between experiences of shame that are repaired in relationship and those that are not repaired, and the difference between shame that’s a learning experience and shame that’s an annihilating experience. Bit by bit, we can also share with these clients what we believe about the origins of chronic shame. As they tell their stories, they will notice patterns in their personal feelings and their responses to other people. They may wonder how shame just “took over.” That’s when we might make available to our clients some of what we know about the generation of shame in family systems.13
Family systems theory outlines major topics related to shame, but in the spirit of open-minded curiosity and playful co-creation, I don’t teach clients about these topics. Instead, I wait for a moment to ask a “topical” question. To keep things open-ended and to create space where events and emotions can be linked, I usually ask my questions in the form of “What happened when...?”
If my clients are finding it difficult to talk in therapy, I may ask, “What happened when people in your family had conversations?” Some clients answer that question with a laugh: “What conversations!” They don’t remember anything that could be called conversation.
So I might be more specific: “What was it like around the dinner table when you were eight or ten?” Whether we begin there or on a family vacation, a client and I discover a story about communication in his family. I ask some basic questions: Were his family members open about what they felt and wanted? Were they good at listening? I might say that communication can fail in two ways: when people don’t say what they mean and when people don’t listen.
Clients may mention family members who always said what they meant—“and made other people feel like dirt!” I will answer: “I don’t think that counts as being honest. Making somebody be bad because you feel bad is hiding how you feel. Blaming is a tricky, dishonest move, and it causes huge shame in families.”
There are other ways family members avoid saying what they feel. People hide behind silence or behind a lot of pleasant chatter. Maybe nobody wants to talk because nobody will listen. Maybe people are afraid to get hurt. It’s hard to speak up if you think the others will ignore you or attack you. And you can’t listen while you’re preparing your defense or counter-attack.
As my clients and I wonder what was going on in their family to make conversation so dangerous and impossible, they come to see what did get communicated: (1) who I am and what I feel doesn’t matter, and (2) communicating doesn’t work. We can see how these conclusions lead to isolation and despair—the core experience of chronic shame.
When I ask, “What happened when people in your family had emotions?” I’m asking about affect regulation. People who struggle with chronic shame usually report that emotions were either shut down or out of control in their family. Often clamp-downs led to explosions, followed by more silence. Or somebody in the family was always in danger of going “out of control,” and everybody else tried to keep it from happening. In short, when people had emotions, what happened was some kind of emergency or emergency shut-down.
Against this background, I ask clients questions that offer clues about what might have been. I ask whether anybody in their family could say “I feel...” to somebody else. I wonder whether their parents helped them learn to name sad or angry feelings when they were little. Can they remember a time when a parent was there in a calming way, even though he or she couldn’t fix a problem? Were there times when their parents were upset themselves and talked about what they were feeling?
When I ask about “feeling-talk,” I am also asking about how my clients’ families handled emotional vulnerability. I might say: Most families don’t have trouble explaining facts or giving directions to each other. But many families have trouble talking about feelings like sadness, fear, or shame. Sharing so-called “negative emotions” makes people feel vulnerable. It feels like weakness to say, “I feel sad,” or “I feel scared.” Even to say, “I feel angry with you,” (instead of yelling and blaming) is being vulnerable.
I tell my clients that emotions make us feel vulnerable because they come from our core self. In our emotions, we feel alive and real, even when what we feel is painful or disturbing. If we have no help learning to care for our own emotions—if we feel abandoned or annihilated in that vulnerable place—we will feel that there’s something wrong with us in our core being. After a while, just having emotions will make us feel like “there must be something wrong with me.”
As I tell my clients this, I am aware that I am suggesting an alternative story that I believe can become possible between us, a story where emotions can be safely expressed because they can’t be “wrong,” a story of emotional connectedness instead of disconnection.
People who live in a chronic state of shame are very likely to believe, whether they know it or not, that their deepest emotional needs are what make them despicable. At times when those feelings seem not far away from a client, I look for a way to ask, “What happened in your family when you needed something?” As we explore how needs were met in their families, clients may begin to reflect on the meanings they attribute to neediness in general.
I wonder whether it was okay for my clients to ask for what they wanted, and whether their parents would respond in fair, reasonable ways. As clients think about needing, they may become aware of some intangibles: a sense that they’d be wrong to ask for more than was given them, for example, or a sense of emptiness from parents who gave lots of stuff but little time and attention. I might ask, “Was it totally fine to want and need something and hope to get it? Or was it important not to need too much?” And also, “Are people in your family stingy or generous with their understanding and affection?”
People who suffer from chronic shame are likely to carry around a sense of emotional impoverishment, of somehow never getting enough. Some of them spend their adult lives acquiring material goods and satisfactions to make up for what’s missing. Our conversations about needing may help them link unmet emotional needs with other kinds of insatiability they experience. The most important narrative link we make, however, is between emotional need and shame (the shame they may feel about their insatiability, too). How is it that emotional needs turn into chronic shame? Sometimes, when we are deep into the story of having emotional needs, a client asks me that very question.
I’m happy for this chance to “teach” the core story of shame as I understand it: When you’re little and you need to be seen and understood, when you need to matter to someone and it seems you don’t, that hurts. Even the hurt is invisible. That’s how it feels—you feel bad, and nobody cares how you feel. So you decide that these needy feelings are useless and having them makes you stupid. You tell yourself, “What’s wrong with you anyway, to feel this? Get over it!” That’s how shame takes over when emotional needs are ignored or denied. The needs themselves become something wrong with you. And then your hurt feelings about not having your needs met cause you even more shame.
I have never had a client tell me that this answer doesn’t make sense.
Instead of asking, “What happened when somebody in your family made a mistake?” I usually ask, “In your family, what happened when somebody spilled the milk?” I find a way to ask this question when I sense that a client worries a lot about making mistakes with the people in her life, including me.
What I usually hear is, “Somebody got yelled at.” My client and I find that even if she wasn’t the one who got yelled at, the yelling made her anxious. Somebody was made to feel bad; next time it could be her. And the message was clear: mistakes are dangerous. Why are they so dangerous? Because they prove you are careless or stupid. You are always just one mistake away from proving yourself to be a worthless idiot.
“Wow!” I say. “That’s a lot of anxiety to live with all the time!” I go on to wonder what happened in her family when “real mistakes” were made. We may figure out that in her family, there was no sense of proportion about mistakes; all mistakes were just the same kind of bad in the moment when they happened. We may find that there wasn’t even a sense that someone could mean well and by accident make a mistake. And nobody in the family seemed to understand that doing a bad thing was different from being a bad person.
Here’s an opportunity to do another bit of teaching about the difference between shame and guilt. You can make a mistake and still be good person who did a bad thing—or just a “mistaken” thing. You can find a way to say you’re sorry for mistakes and make amends. That’s completely different from being annihilated by “bad self” shame.
My client may realize that she never saw her parents able to be “good people who sometimes made mistakes.” In a family system poisoned by “bad-self” shame, saying “sorry” meant being the bad person in the wrong. So everybody threw blame back and forth, desperate to be the right one who’d been wronged by the other.
Often there’s a spin-off story here about taking responsibility in general. My client may tell me about power being abused in her family. I suggest that responsible power has in it a sense of being in control of oneself, and that it’s personal and respectful. It says, “I am here; I see you; I am accountable for what I do in relationship with you. I respect you as I respect myself.” Implicitly I’m saying to my client, “This is the kind of mutual relationship you and I could have.”
It’s not a big narrative leap from mistakes, shame, and blame to the question, “What happened in your family when there were differences between family members?” In shame-prone families even different opinions lead to conflict, and again people can only be good or bad, right or wrong. Clients say: “In my family it wasn’t okay just to be yourself. People wouldn’t be interested; they’d have judgments or criticism. It was like you’d always fall short of some standard, even if you didn’t know what it was.”
Clients tell stories about two different kinds of families who can’t deal with difference. One kind of family is in constant turmoil over disagreements; fights are loud and emotionally bruising. People shout each other down and stomp out. There’s no “working things out,” there’s just trying to win, and you win by being the angriest. The other kind of family is quiet and tense. People don’t know what other people feel because nobody feels safe enough to say. Nobody talks about the things that matter most to them. Conflict may erupt briefly, but there’s no talking it out to come to some kind of understanding. You can’t even agree to disagree. The fight will go underground, with people giving each other the silent treatment for days … or years.
Neither family’s story has in it a way to accept difference as a normal part of life, something that’s good to talk about. In each story, conflict means that somebody will get hurt and there will be no repair. Nothing gets resolved; even if people “get over it,” resentments smolder. Clients are quick to notice when they are still living this story—they still expect judgment just for being themselves, for example, or they fear conflict because they “know” they’ll just get hurt. They may even come to notice that their fears of conflict shut them down in their therapy relationship.
So far all of these “what happened?” approaches to shame storylines are closely related to the everyday regulation of affect in family relationships. Sometimes I will ask a question that seems to come from a somewhat different place: “How did your family help you learn skills and achieve goals?” or, “What got you noticed or praised in your family?” The skill or goal won’t fall into the category of affective regulation. And yet there will have been potent affect in my clients’ trying to achieve their goals and in how they saw their strivings recognized.
Some clients who struggle with chronic shame as adults remember having been shamed by their parents for failing at school or in sports. But for most of them the shame storyline is more subtle. Some of them remember having to figure things out for themselves and doing them badly without the help they needed. Others take pride in having “made it with no help.” Some remember working hard to meet their parents’ expectations while feeling unclear what their own goals were. Others remember constant praise about being smart and talented no matter what they did—but they could never settle on something to be good at.
These are memories that invite snippets of teaching. I explain that missing out on the experience of being guided by somebody who cares about us can leave us with an empty feeling—even when we reach our goals in life. I note that the unrealized dreams of parents can turn into powerful expectations that take over their kids’ lives. I mention studies that show that praise for being smart or talented doesn’t help kids feel good about themselves; instead, praise can just make them more anxious about living up to the mark the next time.14
I explain how I make sense of this: parents who suffer shame themselves feel afraid of failing as parents. They give lots of praise so that they can feel like the good parents of competent, happy children. But this kind of praise doesn’t help the kids. It doesn’t really see them; it’s about the successful, well-adjusted child their parents need them to be. The kids try to keep up the image but without being really connected to their parents or to themselves, which is where genuine self-esteem comes from.
What these shamed clients needed growing up was close contact with parents who were happy to share skills and knowledge with their kids, and who also saw their kids clearly for who they were. That’s what these clients missed. Praise or “positive feedback” doesn’t help them much now either, unless it comes from someone who can see them as a whole self—a self who can be known, not just praised. In my understanding of their dilemma, I invite them to let me see and know them whole.
Opening up family stories may make more explicit the power of shame in our clients’ lives. But sometimes chronically shamed clients aren’t interested in talking about family history. Then we need to accept that a revised autobiography is not what they need to gain a more coherent, less shame-prone sense of self. For some clients the new relationship with us provides a secure base for developing a new story not about the past, but about who they are now and hope to be tomorrow, and that’s not only good enough, it can be a deeply strengthening process.15
With these clients we can address shame explicitly by paying careful attention to shame that they feel in relation to us, especially when shame feelings enter a therapy session. There are no more transformative moments in therapy than when shame has created profound disconnection between a client and ourselves, and then, with a “moment of meeting” that’s a moment of compassionate mutual understanding, shame dissolves and we can feel our connectedness again.16 This becomes a powerful new story of what’s possible beyond shame.
Whether clients’ shame stories are about the past or the present, change happens because in the interpersonal place where new stories are taking shape, a new kind of implicit knowing about relationship is also coming to be. Here our clients’ memories, thoughts, and feelings matter to someone, and so a self who matters can come to conscious coherence. This experience runs exactly counter to the experience of a self disintegrating in relation to a dysregulating other.
For some shamed clients, their first conscious experience of a right-brain process at work is a troubling awareness of feeling in pieces and at odds with themselves. Until now, they have lived mostly in one part of self with occasional out-of-character breaks for low moments or “cutting loose.” Their troubled parts have been sealed away from their conscious thoughts and emotions. They’ve never before felt their internal disconnectedness. But now they can feel “self” as having disconnected “parts,” and this self-awareness, however incomprehensible and incomplete, is also a self-experience that is larger than any one part. The experience begs for comprehension and completion, and so it may bring them to therapy.
Feeling like a self in parts makes clients aware of their dis-integration. Working with these parts calls forward an integrative part of them who can pay attention to internal disconnections, often related to shame. Paying attention in the presence of an interested, engaged “regulating other,” such as a therapist, helps that integrative self grow beyond shame to new experiences of agency, confidence, and competence.
There are other reasons, too, why working with parts of self is a useful way to bring more light and air to chronic shame. Talking about a part of self who is terribly wounded or bitterly angry is not as risky as saying, “I hurt,” or, “I hate.” With parts language, clients can speak about vulnerability without having to be entirely vulnerable. As one part feels humiliated or worthless, another part has enough distance to see what’s happening. In this way, the pain of shame can be titrated and integrated a bit at a time.
Talking about parts explores clients’ internal worlds, and it also brings the tensions of clients’ family histories to life. Even clients who don’t want to revisit the past are able to visit formative relational dynamics as they animate their inner cast of characters. For example, a Judge may stand in for internalized parental criticism, a Blamer for clients’ early learning about how to manage conflict, a Sneak for how they managed to survive criticism and blame, and a Whiny Baby for the vulnerable sense of self they despise.
The noticing, exploring “main self” part of a client will have relationships with various other parts of self. The parts will also have relationships with one another. Working with the parts often involves exploring how they relate to each other. A Blamer and a Sneak, for example, can be at odds forever in an internal system that’s never had an adult model for taking responsibility for one’s own behavior. In Richard Schwartz’s model, called Internal Family Systems Therapy, parts of self may have many names but they all fall into three groups—exiles, managers, and firefighters—all of whom are defined by their relationships with one another.
Exiles are the hurt parts of self, often child parts, that are sent away—disowned, repressed, or dissociated—because they can’t be tolerated, much less understood. Managers can’t tolerate the exiles’ vulnerabilities and hurt feelings. Whether they are controlling, distancing, or perfectionistic, whether they act as pleasers, worriers, or caretakers, managers live to keep the exiles out, both for the exiles’ safety and the safety of the whole system. They may seem like adults, but in fact managers operate more like parentified children who had to take over adult roles too quickly and with too little support. Firefighters turn up when a system contains badly wounded exiles and, despite the managers’ best efforts, an exile’s feelings are activated and break through. Firefighters douse vulnerable feelings in ways that are less “adult,” using drugs, alcohol, binge eating, self-harm, or outbursts of rage, for example.17
Schwartz believes that if clients can get to know these internal parts, honoring each one’s intentions and working through their impasses, they will come to enjoy a more balanced, harmonious “internal family system” in much the same way that an external family system can reorganize relationships in order to work together and help one another.18
In Bonnie Badenoch’s somewhat different model of “internal community,” parts of self spring from actual experience and resemble real others whom clients have known and internalized. She also recognizes parts she calls watchers and protectors, who help clients negotiate the environment to get nurturance and to avoid injury. And then there are the very important internal parent/child dyads, for example: caring-parent/nurtured-child, unempathic-parent/hurt-child, and abandoning-parent/abandoned-child.19
Badenoch speaks of parts of self in a case example of working directly with shame. At the core of her client’s experience of shame she imagines “a small child relentlessly pursued by an angry and condescending parent, an internalized pair implanted early and unchanged since then.”20 But before approaching such a dyad directly, she says, we must take time and care to be calm, attentive, and consistent, soothing a client’s interpersonal terror, disarming internal protectors, and making a place for trust. In words I have been using, fostering right-brain connection comes first. Then, Badenoch says, we use left-brain access to suggest a new narrative that includes awareness of those parent/child shaming interactions, a narrative that can then be slowly but deeply embraced in emotional/relational (right-brain) ways.
Badenoch describes moving from soothing what hurts the child to understanding what drives the parent “until they both settle,” while constantly attending to here-and-now affect. As a client’s “watcher” is able to feel compassion for his own shamed inner child and eventually for his parent’s inner child as well, previously isolated neural networks become connected. Prefrontal cortex becomes wired into limbic regions; vertical integration happens; self-regulation becomes more possible.21 As parts of self make peace, the brain heals itself; so says contemporary interpersonal neurobiology.
What’s old is new: some of the earliest psychotherapy theory in North America spoke both “parts-of-self” language and what we now could call “right-brain” language. To this day, Gestalt therapists do not offer to diagnose or treat clients; instead, they invite them into bodily, emotional awareness of here-and-now experiences of self with other. Holistic processes of sensing, feeling, and expressing are the “stuff” of Gestalt therapy; the left-brain skills of interpreting, explaining, and conceptualizing just get in the way of change. Change happens not through insight, strategies, or efforts to be different, but rather through radical emotional acceptance of what is. And of course the trademark Gestalt technique for discovering and integrating “what is” is active, emotionally engaged dialogue with and among parts of self.22
If shame is fundamentally the felt experience of self disintegrating in the presence of a dysregulating other, using any of these models of working with parts of self can be profoundly counter-shaming. Each creates a safe, emotionally potent reality where vulnerability and shame can be given symbolic substance and voice—light and air. But perhaps even more important, the identified, personified shame is integrated through a relational process. What once could not be known by another is brought into interpersonal connection.
Now, in the presence of a regulating (therapeutic) other, a nascent regulating self makes contact with disintegrated parts of self in affectively charged moments of meeting. In interaction with and among these parts of self, and with a therapist as guide and model, a client can learn the integrative relational/emotional skills of empathy, compassion, accountability, forgiveness, courage, and respect. All of this expanded sense of self and connection “comes home” not as lessons, but as a series of holistic, embodied, emotional experiences—a lived, right-brain narrative of self in active relationship with self.
Schwartz and Badenoch have both written handbooks on how to work with parts of self, and they teach others how to work within their respective models. There are Gestalt institutes across North America that offer valuable training, too. But we don’t need specialized training in “parts-of-self” work in order to do such work from a relational, psychodynamic perspective. If we understand in our own terms why working with parts of self helps integrate a self disintegrated by shame, we can be flexible and creative with the how. We can also expand our imagination and prime our creativity by listening to what others have to say about how to do parts-of-self work.
From Schwartz we learn that integration comes by way of resolving polarization and fostering communication. So, for example, bringing shame to light often illuminates a needy part of self who is despised by a tough, independent part of self. Listening respectfully to both parts and helping each to find compassion for what drives the other brings better balance and harmony to the whole self system. Schwartz helps us see how important it is that clients feel their agency and leadership as they do this work. Badenoch chooses, instead, to emphasize the client’s attachment relationship with the therapist. Within this attuned emotional holding, parts of self slowly become known, cared for, and integrated. The brain heals itself within a “we-ness” of compassion.
Each of these perspectives gives us good clues about what to try to accomplish when we work with parts. Agency and compassion both matter. Gestalt reminders are also helpful: working with parts of self can instigate organic integration when it’s all about here-and-now, I-and-thou, spontaneous, emotional relationship among parts, and when it’s not about interpreting, explaining, controlling, or prescribing anything.
Working with parts of self can be surprisingly effective—and yet I don’t propose that we make it a required project for our shamed clients. In my practice, I don’t suggest that chronically shamed clients use parts language; the language just turns up. I have something to do with it when I say something like, “So there’s a part of you that’s excited about your party, but another part that’s feeling quite anxious.” This may be “therapy-speak,” but it’s also a fairly common way for people outside of therapy to talk about internal conflict or indecision, similar to: “On the one hand… . On the other hand,” or, “I’m of two minds on the issue.”
Yet when I casually introduce the language of parts, I often find that shamed clients jump at the chance to talk about themselves in this protected yet immediately engaging way.23 As my client Clare did, many of them enjoy the energy of the game. I like to meet their parts and help them speak because I, too, enjoy this edgy, engaging, creative kind of play. And play-spaces are, of course, exactly where right-brain connectivity happens, both within and between minds.
Exploring parts of self can slide in and out of larger ongoing co-created narratives. Narratives that are experienced are especially integrative. When a form of therapy, like Badenoch’s, expands into the arts, parts of self can be brought to life explicitly in psychodrama, dance, sandplay, or visual art. In talk therapy, parts of self emerge as metaphors and images, most often just within the client’s mind, but sometimes speaking out as the client moves between different voices or even different chairs. Some clients identify parts of self that aren’t personified, that feel, for example, like a wall, or a tiny light, or the roots of a tree. It can still be quite useful to ask, “What does the wall know?” or, “What do those tree roots want?”
In short, for certain clients (they will let us know who they are), working with parts of self is a powerful, useful way to give voice to their divided, fragmented self-experience, and thus to let light and air get at their shame. Parts of self can find space to speak the unspeakable about need, longing, and humiliation, and in their speaking and being heard, integration happens. Often a time of working with “parts” comes and goes in therapy, and later clients look back with fond nostalgia on parts they once encountered as “other” but that are now just everyday aspects of the self they know.
Working with parts is not for everyone. Some clients do intense integrative work without the help of metaphors. And then there are other clients who can’t give any voice at all to vulnerability; they can’t face their shame even obliquely. They have no access to parts of self that are hidden away for safety, and in fact, they have no felt sense of their own splitness or fragmentation. Their shame is dissociated—and yet it is generating all kinds of distress. How can therapy help them? That’s the subject of the next chapter.
1. Elizabeth Shapiro and Theodore Powers, “Shame and the Paradox of Group Therapy,” in Shame in the Therapy Hour, eds. Ronda L. Dearing and June Price Tangney (Washington, DC: American Psychological Association, 2011), 124.
2. A wide diversity of opinion on this score is summarized in June Price Tangney and Ronda L. Dearing, “Working with Shame in the Therapy Hour: Summary and Integration,” in Shame in the Therapy Hour, eds. Dearing and Tangney, 384–85.
3. Philip Bromberg describes the limits of a pure self psychological empathic/interpretive stance in “Interpersonal Psychoanalysis and Self Psychology: A Clinical Comparison,” in Standing in the Spaces: Essays on Clinical Process, Trauma, and Dissociation (Hillsdale, NJ: Analytic Press, 1998), 147–62.
4. See, for example, Judith Jordan et al., Women’s Growth in Connnection: Writings from the Stone Center (New York: Guilford, 1991), and Lewis Aron, A Meeting of Minds: Mutuality in Psychoanalysis (Hillsdale, NJ: Analytic Press), 1996.
5. Diana Fosha, “Emotion and Recognition at Work: Energy, Vitality, Pleasure, Truth, Desire, and the Emergent Phenomenology of Transformational Experience,” in The Healing Power of Emotion: Affective Neuroscience, Development and Clinical Practice, eds. Diana Fosha, Daniel Siegel, and Marion Solomon (New York: Norton, 2009), 181.
6. Richard Geist, “Connectedness, Permeable Boundaries, and the Development of the Self: Therapeutic Implications,” International Journal of Psychoanalytic Self Psychology 3 (2008): 130–36.
7. Richard Geist, “The Forward Edge, Connectedness, and the Therapeutic Process,” International Journal of Psychoanalytic Self Psychology 6 (2011): 246.
8. Geist, “The Forward Edge,” 236.
9. Geist, “Connectedness,” 140.
10. Geist, “Connectedness,” 133–36.
11. Marylene Cloitre, Lisa R. Cohen, and Karestan C. Koenen, Treating Survivors of Childhood Sexual Abuse: Psychotherapy for the Interrupted Life (New York: Guilford, 2006), 290, quoted in Judith Herman, “Posttraumatic Stress Disorder as a Shame Disorder,” in Shame in the Therapy Hour, eds. Dearing and Tangney, 270.
12. Herman, “PTSD as a Shame Disorder,” 267–68.
13. For example, James Harper and Margaret Hoopes, Uncovering Shame: An Approach Integrating Individuals and Their Family Systems (New York: Norton, 1990); Stephanie Donald-Pressman and Robert Pressman, The Narcissistic Family: Diagnosis and Treatment (New York: Macmillan, 1994); Merle Fossum and Marilyn Mason, Facing Shame: Families in Recovery (New York: Norton, 1986); John Bradshaw, Healing the Shame that Binds You (Deerfield Beach, FL: Health Communications, 1988); Gershen Kaufman, Shame, the Power of Caring, 3rd edn. (Rochester, VT: Schenkman Books, 1992).
14. Polly Young-Eisendrath, The Self-Esteem Trap: Raising Confident and Compassionate Kids in an Age of Self-Importance (New York: Little, Brown, 2008).
15. See Morton Shane, Estelle Shane, and Mary Gales, Intimate Attachments: Toward a New Self Psychology (New York: Guilford, 1997). They believe that effective transformative therapy can be carried out in various combinations of a client experiencing an old or a new self in relationship with a therapist experienced by the client as an old or a new other. Thus it is quite possible, they say, for a client to experience the therapist as a completely new, non-threatening other, and to be able, then, to have a fundamentally new experience of self in response.
16. The Boston Change Process Study Group defines significant change in psychotherapy as significant change in a client’s “implicit relational knowing,” that is, in his/her unconscious structures for feeling and knowing self-with-other, which I understand as right brain patterns of relational knowing/feeling. Shifts in a person’s implicit relational knowing come by way of the repetition of direct, potent, and novel relational experiences between client and therapist. Opportunities for this kind of experience are “now moments” in therapy, and when their potential is realized, they are, in BCPSG language, “moments of meeting.” Boston Change Process Study Group, “Non-Interpretive Mechanisms in Psychoanalytic Therapy: The ‘Something More’ Than Interpretation,” in Change in Psychotherapy: A Unifying Paradigm (New York: Norton, 2010), 1–29.
17. Richard Schwartz, Internal Family Systems Therapy (New York: Guilford, 1995), 46–53.
18. Schwartz, Internal Family Systems Therapy, 122.
19. Bonnie Badenoch, Being a Brain-Wise Therapist: A Practical Guide to Interpersonal Neurobiology (New York: Norton, 2008), 76–89.
20. Badenoch, Brain-Wise Therapist, 105.
21. Badenoch, Brain-Wise Therapist, 109.
22. Frederick S. Perls, Ralph F. Hefferline, and Paul Goodman, Gestalt Therapy: Excitement and Growth in the Human Personality (New York: Julian, 1951; reprint, Goldsboro, ME: Gestalt Journal Press, 1994).
23. Philip Bromberg, an interpersonal/relational psychoanalyst who invites his patients’ multiple selves to speak with him if they will, comments, “Used judiciously, I have found that an approach which addresses the multiplicity of self is so experience-near to most patients’ subjective reality that only rarely does someone even comment on why I am talking about them in ‘that way.’ It leads to a greater feeling of wholeness (not dis-integration) because each self-state comes to attain a clarity and personal significance that gradually alleviates the patient’s previously held sense of confusion about who he ‘really’ is and how he came, historically, to be this person.” Bromberg, “Standing in the Spaces: The Multiplicity of Self and the Psychoanalytic Relationship,” in Standing in the Spaces, 290.