In the shadow of all the other emotions is shame. 
Shame is often used interchangeably with, or confused with, guilt. A very simplistic distinction between the two would say that guilt refers to an action by a person, which they subsequently feel bad about, or where moral codes or laws have been transgressed. Shame can occur when that guilt is scaled up to define the person themselves – “I did a bad thing” morphs into “I am bad” which in turn sets up a chain of fear, particularly around potential loss of relationships due to the false perception of being 'bad.' Shame is also associated with bodily sensations, such as blushing. In a previous post, ‘Talking Therapies in the Treatment of Skin Disorders,’ I mentioned how embarrassment, a type of shame, is one of the reactions reflected in our skin pallor and how this is turn reflects underlying physiological processes (neurological, hormonal, circulatory) involved in how we react in specific situations. Studies have shown that the colour red is associated with shame but is also associated with anger and rage. [1] This is not surprising when you consider that the latter are often co existing emotional responses to judgement, humiliation and other shame generating occurrences. Guilt at feeling angry and having a positive attachment relationship to the source, move in quickly to add complexity to the reactions. In so far as there are hues of red, there are also hues of shame and how it is experienced. Examples include transient shame (such as after making a mistake); chronic shame (persistently not feeling good enough); embarrassment; disappointment or defeat (such as that experienced in not getting a promotion or losing a match); humiliation and exclusion. It is not surprising therefore, that shame has a major part to play in anxiety, depression, eating disorders, low self esteem and low level sociopathies. 
To get a glimpse of psychoanalytic thinking around shame, let us recall Sigmund Freud’s description of the mind being made up of the id (containing the instinctual, biological drives that supply the psyche with its basic energy or libido), the ego (that deals with the external world and its demands) and the superego (the internalised parental and cultural standards). Freud held that guilt is a type of anxiety (specifically superego anxiety) and shame is a result of anxiety. As such, it can be internally or externally generated. Internally, it may be a response to a basic biological drive (such as sexual drives and exhibitionism, also called instincts) when that instinct is perceived as a threat, often because of external or social judgement. As an instinct or impulse (expression of the instinct), one of the mechanisms of defence used to protect the ego is reaction-formation , which means behaving in a way that is the opposite of the impulse that has to be repressed, e.g. obsessive cleanliness as a result of a ‘dirty’ thought. 
External causes of shame are derived from our culture and society. We must first learn what types of activity earn the disapproval of others which we then come to fear as they may have painful consequences for us. In a way, it is a measuring stick which enables us to measure the effect of our behaviour on others. In turn, society benefits by directing the energy of the biological drive into the tasks necessary for its preservation. Similarly, guilt protects civilization by diverting aggressive impulses that may otherwise destroy it. In addition to internal and external sources of shame, there are also believed to be phylogenetic sources, transmitted down the generations since the dawn of humanity. [2,3,4] There is a ‘healthy’ aspect to shame if it teaches us humility, allows us laugh at ourselves, or teaches us about boundaries. 
That shame has an importance equivalent to guilt was supported by psychoanalysts Erik Erickson and Franz Alexander. Erikson claimed that “Shame is an emotion insufficiently studied because in our civilisation it is so early and easily absorbed by guilt.” He distilled down his own belief of shame to be “essentially rage turned against the self.” [5] Piers and Singer’s well-known text Shame and Guilt, delves further into the structure of shame from a psychoanalytic point of view, if the reader wants to learn more from this stance. [6] 
For the therapist, the task is often working out which anxiety form is at play or whether one in masking another. They are all shades of red after all. Time is needed to work this out as well as having sensitivity to the intensity of the shame experienced and how it shows up for the client. Coupled to this, our culture promotes comparing and competing which increases shame tension and thus increases compensatory activity. In time, we start to see how a client has been using shame as a defence and like all defences, how it functioned to protect their ego but is now not serving them well. For example, when developmental and emotional needs such as affection, affirmation, autonomy emotional expression, protection, boundaries, acceptance, being heard and so on, were not met in childhood, or when a client has continuously been dismissed, rejected or judged, they unconsciously shut down or split off those parts of themselves or adapt ways of having those needs met, often at a cost to other parts of themselves. Feeling unloveable, unworthy or not good enough leads to the employment of coping strategies like people pleasing, perfectionism, procrastination and giving platform to internalised critical voices (super ego) as ways of adapting to get needs met. Self hate and self ridicule prevail. The process of self shaming becomes so embedded, it can be very hard to start the process of reparation, as it requires practicing self compassion and being curious about emotions and relationships to others. This can feel threatening and a client can feel vulnerable and resistant even though they want to change things. The therapist maintains a benign, kind, parental presence, providing a space where the client’s emotional experience can be expressed and repaired. Showing them that the injured child is still a part of them and that they are now in a position to help that child can often help. 
Get in touch here if you would like some help dealing with feelings of anxiety, anger, guilt or shame. 
1. Crozier, W.R. (2006). Shame, Guilt and Anger. In: Blushing and the Social Emotions. Palgrave Macmillan, London. 
2. Freud, S. (1926) Inhibitions, Symptoms and Anxiety. Standard Edition 20. London. Hogarth Press 
3. Freud, S. Three Theories on Sexuality. Standard Edition 7. London. Hogarth Press 
4. Hazard, P. A. (1969). Freud's Teaching on Shame. Laval théologique et philosophique, 25(2), 234–267. 
5. Erikson, E.H (1950) Childhood and Society. New York, Norton & Co. pp. 223 
6. Piers, G. and Singer, M.B. (1953, reprinted 2015) Shame and Guilt: A Psychoanalytic and a Cultural Study.  
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