Therapy & Counseling for Shame in Sonoma County
Shame: Is There Something Wrong with Me?
Shame is an insidious emotion. Its power never ceases to amaze me—the way it drives so many of the troubles that bring clients into psychotherapy. Shame can be found at the heart of depression, anxiety, addiction, relationship problems, compulsive behaviors, and problems with managing anger. And while shame is so powerful and destructive, it is simultaneously hard to name and usually lies below the radar of conscious awareness.
Gershen Kaufman tells us that shame develops in relationships when who we are is seen repeatedly in a diminished, negative light. Over time, when exposed to enough shaming circumstances, the individual learns to induce shame from within in an often-unconscious pattern of negative self-regard. Clients come into my practice saying things like, “I don’t know what it is, but I have always had the sense that there is something wrong with me.” This tells me we are in the realm of shame. More often, the strategies used to manage shame, and prevent future encounters with it from others, are what bring clients into therapy.
Kaufman provided important insight into the defensive strategies used to respond to, predict, control, or ward off shame from others. These become the unconscious, life-limiting rules clients with shame-based syndromes live by. In particular, he elaborated six patterns:
- Hostility or Bitterness – Actively keeping others away with a generalized hostility, bitterness, or explosive reactivity. Anger insulates against others and the anticipated threat of shame.
- Contempt – Looking down on others as inferior in an effort to avoid feelings of shame or inadequacy from within.
- Striving for Power – Living by the rule of controlling others or achieving social position (e.g., wealth, status, etc.).
- Striving for Perfection – Attempting to erase all perceived faults. Making up for feeling not good enough by trying to be really good (e.g., really nice, really smart, really sexy, having the perfect body, etc.).
- Internal Withdrawal – Withdrawing deep within in order to avoid the world of relationships.
- Blaming – Fault finding in others in order to avoid a sense of fault in oneself.
According to Kaufman, shame requires repair of the interpersonal bridge that has been broken by repeated negative encounters. Psychotherapy provides just such an opportunity for clients. Psychotherapy for shame begins as the client works to become mindful of those strategies employed to manage shame. Once identified, these can be worked with, while the original shaming circumstances are explored and grieved. Shame-based thinking is identified and, through various approaches, including cognitive behavioral, psychodynamic, experiential, and expressive approaches, is modified. Finally, the client works to integrate this new understanding into a compassionate stance toward the self.
I find my work with clients who are struggling with issues of shame to be some of the most meaningful work I do. It is powerful to see clients transform shame and come to appreciate themselves in the process. Sil Machado, Ph.D. is a licensed psychologist who offers psychotherapy, counseling, and neurofeedback in Santa Rosa, CA. He works extensively with individuals struggling with shame-based syndromes, including anxiety disorders, depression, substance abuse, sex addiction, and perfectionism. Dr. Machado takes an integrative approach in which he integrates depth and experiential psychotherapies with evidence-based practices in a manner suited to the unique needs of each client.