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Updated: May 8, 2018

To acknowledge shameful experiences leads to feeling more shame.

Have you ever felt completely stuck in your work with a client and not been able to put your finger on exactly why? Have you ever felt stuck in your own therapy and wondered why you weren't progressing? I can certainly relate to both of these experiences and would offer that perhaps in the obstacle is shame.

It is incumbent upon clinicians to recognize shame in ourselves and in our clients. Shame that is not addressed is frequently the reason for therapeutic stalemates and even failures (Lewis, 1984). While unaddressed shame can impede the therapeutic process, working directly with shame can deepen the therapeutic process. I created this multi media project with psychotherapists and therapy clients in mind in an effort to demystify and humanize this elusive emotion. My hope is that the information offered about shame will be useful in positively impacting the therapist's relationships with clients, in educating clients, and in deepening therapeutic work.

Shame is a universal emotion. Yet it can be very difficult to actually say the words "I feel ashamed..." to another person, even with a therapist. Why is this?

My intense interest in the topic of shame began during my training as a psychoanalyst. I was able to develop a deep level of trust with clients, yet, I also found there were areas of the work with some clients that remained elusive. I had come to know the depths of my own shameful feelings which allowed me to help clients tolerate their own shame in my presence. But, I wanted to know more about my relationship to shame, about the complexities of shame itself, and how shame impacts the therapeutic relationship.

In my twenty-five years of clinical practice, I have come to understand that shame has unique distinctions from other emotions such as pride, fear, sadness, anger, and joy. Shame reflects feelings of failure, defectiveness, inadequacy, vulnerability, and being unlovable. It creates the fear of being seen by others differently from the way we want to appear, and it can feel intolerable. To acknowledge shameful experiences leads to feeling more shame and, therefore, we possess a strong desire to hide and defend ourselves from shame itself. The word ‘shame’ is derived from the Indo-European root ‘skam’ or ‘skem,’ which means "to hide" and from which we derive the words ‘skin’ and ‘hide.’ Therefore, ‘hide’ has two meanings: we hide to cover ourselves for the sake of shame and we develop a hide for protection from shame (Nathanson, 1987).

Noted authors from many disciplines have made significant contributions to our understanding of shame. Freud made a brief foray into shame before shifting away and emphasizing guilt. Other noted authors include Jean-Paul Sartre, Gerhart Pines, Helen B. Lewis, Andrew Morrison, Benjamin Kilborne, Leon Wurmser, Francis Broucek, Donald Nathanson, Melvin Lansky, June Price Tangney, and Scheff and Retzinger.

Leon Wurmser (1987, p.67-68) comes closest to providing a definition of shame which includes three concepts and most closely captures shame's complexity:

Shame anxiety: “the fear of the anxiety about the danger that we might be looked at with contempt for having dishonored ourselves” “I am afraid that exposure is imminent and hence terrible humiliation”.

Shame affect as a complex reaction pattern: “the affect of contempt directed at the self- by others or by one’s own conscience” and “failing someone else’s expectations or failing the demands of performance by one’s own conscience, standing under the glare of one’s own mind’s eye” “I have been exposed and humiliated, I want to disappear as this being”.

Shame as preventative attitude (reaction formation): “an overall character trait preventing any such disgraceful exposure, an attitude of respect toward others and towards oneself, a stance of reverence...for oneself” “I must always hide and dissemble, in order not to be exposed and disgraced”.

Wurmser states: “in all three forms we can discern an object pole, in front of whom one feels ashamed, and the subject pole, for what one feels ashamed" (1987, p.68).

In my opinion, Wurmser’s 1987 definition needs to be further expanded to include other disciplines because each one offers a unique lens. Shame needs to be viewed from all of these different vantage points in order to be seen in its totality.

Philosophers, psychoanalysts, sociologists, and anthropologists, have, at different points in history, shed light on different aspects of shame. My timeline offers an historical perspective that illustrates how each theorists contributes their own conceptualization. As you will see, psychoanalysts have helped us understand the connection between shame, who we are, and who we hope to be. Researchers have helped us view shame as having an adaptive function, and sociologists have noted our use of language to avoid talking directly about shameful emotions.

Shame, which is about the self and feeling judged by others, and guilt, which is about behavior, are frequently confused, yet, they differ significantly. I offer a comparison which illustrates what we might think and say when we are feeling each one.

Shame can appear in many relationships where we might not think to look. These include: teachers and children, doctors and patients, clinical supervision, professors and college students, and most certainly, therapists and patients. On my page called Shame in Relationships I provide a summary of ideas from authors and experts in each area. The Critical Voice in Your Head illustrates the internalizations of shame from an Object Relations viewpoint. How Shame Feels provides a way of understanding the body's experience of shame.

As clinicians, I feel strongly that we have a responsibility to allow for all emotions, including shame, to enter the consulting room. Yet, if there is a strong desire to hide and defend ourselves from shameful emotions, how can we help this to happen? My interviews and podcast with two noted experts address these questions. You can listen to my interviews with Beth Dobrish, LCSW and Patricia A. DeYoung, PhD.

I invite you to share your thoughts and questions for making this site more useful to clinical work.


Lewis, H.B. (1984). Freud and Modern Psychology: The Social Nature of Humanity. Psychoanalytic Review. 71 (1): 7-26.

Nathanson, Donald L. (1987). “A Timetable for Shame.” In The Many Faces of Shame, ed.Donald L. Nathanson, 1-63. New York: Guilford Press.

Wurmser, Leon. (1987). “Shame: The Veiled Companion of Narcissism.” In The Many Faces of Shame, ed.Donald L. Nathanson, 64-92. New York: Guilford Press.


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