Shame affect is a complex, multidimensional emotion which has been identified in many children who have been abused or neglected. Situational shame is also experienced by many individuals when they are in shame-producing situations. These include places where they may feel a sense of exposure, ridicule or embarrassment.
Many children who are brought in for therapy have a mixture of depression, anxiety, anger, shame and confusion. How internalized (chronic) shame affect, based on their history of being shamed, impacts on their current feelings of shame as they start treatment, is not clearly understood. Certainly, the severity of internalized shame, as well as the severity of the current shame-producing situation, will play a role in the development of their shame affect. There may be a complex interaction between these types of shame and how children experience it.
Children who grow up with distanced parents, who are often critical and harsh, are prone to develop low self-esteem and shame. Those who internalize shame have chronic feelings of inferiority. They often have memories of failure and ridicule.
Shameful feelings can easily be triggered during daily events. Shame manifests itself in the form of social anxiety, negative self-talk, anger or aggression, or submissive behavior A client who has ongoing memories of rejection and shameful events may develop a distorted view of himself. A child may come to think she is defective and unworthy. This may impact children’s social interactions, academic performance and goal attainment. It seems clear that any child who feels worthless and unwanted will have severe trouble motivating themselves to succeed in school or in social activities.
It is also a natural response for a child to want to hide, or refuse to speak, when they feel shameful. It is a way to seek safety and to temporarily escape. They may also expect a new therapist to treat them the way an abusive caregivers did. In some cases, the child will become verbally aggressive and blame everyone, including the new clinician, for their various problems.
They may ask, “Why can’t you get me into a better home right away? You are not going to be able to help me, no one can. You probably don’t care about me either.” This may be a mixture of shame induced anger and rage. Therapists who observe this reaction often think it is resistance.
Perhaps a more therapeutic approach would focus on why this child is so angry. Angry outbursts may help them temporarily push away shame affect. They are feeling angry toward themselves and others, and unwanted. The child may also be testing the clinician to see if they will reject or accept them. A caring and compassionate therapist — or adult in a child’s life — can provide a strong, corrective emotional experience for this type of child by consistently showing them that they are valuable and special.
Some critical questions need to be addressed. Is the child upset with themselves for any of their past conduct? Do they feel like a failure? Do they have suicidal thoughts?
How can we help children who attend therapy when we know they have shameful feelings as they begin treatment? Therapists can ask them how they feel as they start sessions. Is it easy or hard for them to speak about their family and how they were treated? The clinician can also give them credit for cooperating or attending the sessions, even though they may not want to be there.
Self-blaming and global self-disgust may be present as well. Using a Cognitive Behavioral Therapy (CBT) approach, the therapist can help the child slowly shift their rigid thinking process. This type of child often thinks they are a worthless loser who always gets into trouble. The goal would be to help them recognize that some of their past behaviors were wrong and unacceptable, but they, as a person, are good and valuable. (Psychologist Albert Ellis uses this approach). This, in essence, is helping them feel guilty about their past behavior, rather than shameful about themselves. Guilt is more adaptive in that it can lead to remorse and self-correction.
Of course, many children struggle to make sense of their past experiences. Why were they treated so poorly? It is very confusing and difficult for a young child to comprehend what has occurred to them. They may come to blame themselves and think they deserved to be punished. During therapy this particular issue can be addressed.
The client will need to slowly internalize the concept that they did not do anything that would warrant any form of abuse. This will take time and patience. Once the therapeutic alliance is established the child can speak about their past shameful experiences. Verbalizing their feelings and receiving supportive feedback will help them recover.
Clinicians also need to keep in mind the potential for counter-transference. They can have positive or negative reactions to a child, who could also remind them of someone they know. The therapist may feel frustrated, annoyed, confused or excited when they meet with the child. They may also feel shameful when they feel stuck and unable to help the child make needed changes. They may also change the way they treat the child —perhaps they give extra time to someone they admire, or less time to the client who is irritable and challenging. Clinicians need to monitor their work habits and ask their supervisor for objective feedback.
In sum, shame affect is an important underlying emotion. Therapists may, at times, overlook shame, since it is often hidden by depression, anxiety, and outbursts of anger. Hopefully, with additional training and awareness this important emotional will be identified and treated.
Phil Feldman, Ph.D., LCSW, teaches at Rutgers University, Graduate School of Social Work and has experience working as a psychotherapist and clinical supervisor for 27 years. He is the author of “The Psychotherapy Manual, The Co-occurring Disorders Manual and Shame Affect Theory, Research, and Clinical Treatment.”
Editor’s note: While this column refers specifically to therapists / counselors, understanding the impact that shame can have on young people is relevant to any adult who works with youth.