January 13, 2016
Understanding and Treating Chronic Shame
Chronic shame is a powerful and pervasive outcome of relational trauma, but it is usually hidden behind other symptoms of pathology. If chronic shame is ignored, treatment of those symptoms will likely be effective only in the short term. If we can recognize the presence of chronic shame in the symptomstories our patients present, and if we can imagine its particular formation and operation within each patient’s self-system, we will be in position to treat chronic shame directly and effectively. Effective treatment is grounded in understanding that chronic shame is a problem with patients’ right-brain integration of affect, relationship, and self. Treatment requires attuned, nonshaming engagement with our patients, the co-construction of narratives that integrate their sense of emotional/relational (right-brain) self, direct attention paid to their shame whenever possible, including shame-reduction strategies, and our own skillful, self-reflexive handling of the many ways shame becomes enacted within the therapeutic relationship.
Key Learning Points:
- A definition of chronic shame as a relational and right-brain phenomenon
- Assessment markers for chronic shame across symptomologies
- How to make reparative right-brain connections possible with and for chronically shamed clients
- How to recognize and work through shame-disturbances in the therapy relationship
- Strategies for life-time shame reduction
Pat DeYoung MSW, PhD is a psychotherapist and clinical supervisor in private practice in Toronto. A founding faculty member of the Toronto Institute for Relational Psychotherapy, she has written Relational Psychotherapy, A Primer (Routledge, first edition, 2003, second edition, 2015) and Understanding and Treating Chronic Shame: A Relational/Neurobiological Approach (Routledge, 2015).