(12PressRelease.com) In much psychoanalytic literature shame has been mostly considered a defense against exhibitionism/grandiosity. My clinical research however, leads me to understand shame as primarily an affective experience from which defenses develop. Even when shame in fact serves as defense, the affective experiential nature of shame begs to be understood and acknowledged. Shame is a genuine human affliction that requires treatment, and which may be frequently overlooked in part because it inevitably reverberates with shame experiences in the therapist. In other words, because most therapists have not experienced their own shame analysis, they collude with the patient to keep these feelings unrecognized and unexamined. Shame then, is ever-present in the therapeutic encounter; and unless it is adequately understood and intentionally considered, transferential interpretations frequently seem to the client/patient to be criticisms or irrelevant.
Shame presents in various ways, often very subtle because it may be mostly unconscious. Seldom will a patient speak explicitly of shame, but may speak of feeling worthless, invisible, pathetic, ridiculous, foolish, or of simply feeling poorly about themselves. It is helpful to learn the language of shame. It is also beneficial to become familiar with defenses of shame including anger, addiction, denial, withdrawal, perfectionism, and arrogance. It is almost always present in patients with impulse control issues.
For patients with primarily narcissistic phenomena, shame will be more pervasive and will be in the foreground of all aspects of narcissistic vulnerability. Defenses for these patients will be more active and primitive, often representing manifestations of projective identification.
Shame makes us feel small. Shame is almost an intolerable human experience and so we very quickly and automatically develop 'defenses' like anger to avoid feeling the shame. Anger makes us feel big. It is impossible to be angry and feel small at the same time. The significance of helping individuals become aware of their underlying 'shame' has become evident to many experts in the field of anger management. State-of-the-art anger management programs include a complete 'shame' psycho-educational component. Dr Pfeiffer is Director of Growth Central, an Anger Management Specialist Certification training organization http://growthcentral.com, and Distinguished Diplomat of the National Anger Management Association (NAMA) http://namass.org
