One thing that can frequently increase the suffering of many patients with PTSD is shame.
Even worse, shame can limit a patient’s treatment – even if they objectively know that there’s nothing to be ashamed of.
But is there a way to trade self-judgment for self-compassion? And would that reduce a client’s symptoms?
Asle Hoffart, PhD, adjunct professor of psychology at the University of Oslo, wanted to study how self-compassion impacted symptoms of PTSD.
Hoffart measured self-compassion with his six-part Self-Compassion Scale. First, he designated three components that made up self compassion: self-kindness (being kind to oneself even during hard circumstances), common humanity (the ability to recognize experiences as universal to the human condition), and mindfulness (the practice of observing and balancing painful emotions rather than being consumed by them).
His other three components were made up of behaviors that would not contribute to improving self-compassion: Being self-judgmental, isolating personal experiences, and over-identifying with unpleasant emotions.
Now, these behaviors were not mutually exclusive to Hoffart’s self-compassion scales (a patient with high levels of self-judgment does not always have low levels of self-kindness, for example). However, these behaviors had been previously found to suggest higher levels of PTSD symptoms.
So what might happen if we could both increase self-compassion and decrease negative behaviors?
Hoffart and his colleagues randomly assigned 65 patients from a PTSD treatment program to either a traditional imaginal exposure treatment (IE) or an imagery re-scripting treatment (IR).
The IE group went through sessions of reliving their traumatic experiences. The IR group, on top of reliving their experiences, was asked to identify and show compassion to their traumatized self.
The subjects were evaluated over ten weeks of treatment. Researchers monitored their levels of self-compassion and their levels of negative behaviors (self-judgment, isolation and over-identification) as well as the frequency and severity of their PTSD symptoms, such as dissociative episodes and reactivity to traumatic triggers. These levels were based on weekly reporting of the Hoffart’s Self-Compassion Scale Self Report and the PTSD Symptom Scale Self-Report.
The results could change the way we treat PTSD.
Researchers found that increases in self-compassion, notably self-kindness and mindfulness, were associated with decreases in PTSD symptoms. In subjects who had raised self-compassion levels over time, PTSD levels were found to go down.
What’s more, subjects with high levels of negative behaviors began the study with high occurrences of PTSD symptoms. As the behaviors decreased, the subjects reported fewer symptoms.
Now, there are a few limitations here. Even though all the subjects met specific criteria for PTSD, their traumatic experiences ranged from assault to accidents to war trauma. Also, some of the subjects already had diagnosed personality disorders and so their symptoms could have stemmed from either those illnesses or the PTSD.
Still, the study suggests that treatments that teach our traumatized clients self-compassion could be useful in our work. Mindfulness and other self-compassion practices might ease the feeling of shame that PTSD can cause.
Now I’d like to hear from you. Have you had a patient whose symptoms and suffering lessened after their shame was treated? Please share your experience in the comments below.
Great post.
I have CPTSD, there were many things which contribute(d) to my recovery but one of the biggest things that helped me was learning self-compassion. A way into this for me was utilising my outward compassion for others as a ‘way in’. I had a very skilled psychologist, and benefited from compassion focussed approaches; his expression of, and modeling of, his compassion for me in times of emotional distress and during intense feelings of shame was paramount.
I am now a Lived Experience Practitioner (@chimetothrive) with research interests in trauma, peer support and recovery working with people who are struggling with their mental health, and a compassion-focussed approach is fundamental in the work i do with individuals and in training others.
This was really a fascinating matter, I am very lucky to have the ability to come to your blog and I will bookmark this page so that I might come back one other time.
Hello I love you and feel honored to of heard your eloquent and raw story.. so brave! I suffered amazing shame from 2 on after my parents left me in a hospital ward alone after I had been run over by a car. I’ve never worked through this trauma but am studying up on how to now. Anyways, you’re beautiful and I hope you continue to shine the way you do ❤️
Awesome!
Great article, thank you Ruth
I speak as a 45 year old adult adoptee. As a premie baby put into permanent ward of government care for my first 10 weeks because my mother was simply not married I can tell you that I stewed in shame from my very beginnings. I had no name until I was adopted. Having been the eldest of the adoptive parents I felt a lot of pressure to be good and help them be a good family, help their marriage… Be a good example to my sister that was adopted and was native and had fetal alcohol. Then later to my two bio siblings they had… I tried my best to be “good” and never be left again. After absorbing some more shaming from adoptive mom after dad left the family. There was a lot of emotional neglect and abuse from her, alienation of him from all us kids. He made another family of 6 natural children. Things were increasingly dysfunctional using my shame that I had failed my adoptive mother – I felt beholden to her I absorbed shame even though I really had done nothing wrong. Understanding shame and having self kindness and validation has been key to my healing. Starting with the shame of being a “bastard” which is really society shame that was accepted.( unfortuneately) I deserved to stay with my first mom and wish we had been supported instead of shamed. She to this day has kept me a secret and it is too terrifying to relive the feelings after me finally finding her. And I have broken free from my adoptive mom, siblings from that marriage and somewhat reunited with my adoptive dad. We are all suffering ptsd though and self compassion and kindness and affirmations really do make the difference.
Thanks for being so brave to share and create awareness around another dimension of shame. I’m sorry you had to go through what you did and that your birth mother was also made to feel shame. I could not imagine having any of my babies forced away from me. You’re so aware and hopefully this will lead you to creating a full and authentically happy and peaceful life for yourself. I hope you’re also receiving support for your ptsd.
Shame is definetly the precurser to not wanting help. Support after the session is also a precurser of not wanting to get help. What is the answer . Love and compassion . How do we drum it up when life seems un bareable. Hand on the forehead and think of the stress of it all till you get the breath back . Its a good start on the stress of it all . Ma
I always update both the Shame and Compassion circuits before I start reviewing traumatic experiences. Focusing on “Self-pity’ is the fastest way to clear misinformation from the Compassion (for self and others) circuit. Compassion for others can also be updated, if needed, but is a problem less often. It’s a simple process and doesn’t require skill building. Emotions are innate. Feeling sorry for ourselves is necessary to acknowledge when we were harmed through no fault of our own. Research has shown that infants even have a sense of what’s fair and what’s not. Jaak Panksepp hasn’t identified shame and compassion circuits in his research with rats, but they certainly seem to be important in humans.
Dear Dr. Hoffart,
Adult children from alcoholic and dysfunctional families are considered to suffer from PTSD. In ACa we’re taught through the 12 steps about taking care of ourselves ( self-love, compassion, expressing our feelings, meditation – mindfulness) and to free ourselves from shame and blame. Many ACA’s find self acceptance and relief from their symptoms through working the 12 steps. So it’s no surprise that PTSD sufferers from trauma, accident and war would see decreased symptoms just as ACAs do. I trust there are support groups for these PTSD sufferers as many ACAs have found relief from their symptoms in support groups.
Sincerely,
Joe Knell
Recovering
Adult Child of a Dysfunctional Family
Me again. There is 30 years of study from the psychological field about the effects that alchohilism and dysfunction affect children and that 12 step support groups help these adult children. It’s worth looking into.
Where can we find Hoffart’s self compassion scale ? could you make it available on line.
? thanks
What about tutoring those dealing with sexual traumas with
vital information about VICTIM SELECTION and
SELF DEFENSE skills. That would teach how NOT to set
yourself up for recapitulation and turn the fickle finger of
SHAME toward SOCIETY.
In a society which victimizes the victim, while simultaneously SAYING they care so much, the
SHAME tends to lessen very little. I’ve just finished *The Slave Across the Street*, by Theresa Flores.
It stares out from the page that she did not and does not get support from MOST people—(only from the victims of sexual abuse)—but not from the General Public who blames a mere child for being dragged into a do-loop of denigration.
Her parents did not *see* it. Her teachers saw it and did nothing to assist, fearing for their own lives and jobs. School police turned away. Her little brother who saw quite a bit had little capability to help her out. She did all to save their lives and reputations, while they stepped away in fear. This SHAME does not belong to Theresa Flores. It belongs to her SOCIETY.
I recently had an interesting experience working with a client and shame. She made her first appointment to deal with a significant abuse event perpetrated by her spouse. As is our focus with the Holographic Memory Resolution I use with clients, we work from a client and body centered approach. Once I began the HMR, I was surprised that the abuse issue she had mentioned earlier didn’t come up until the third session. The first 2 sessions she dealt only with her shame of her childhood. This client reminded me that shame issues can block our healing. I’m thankful I used the HMR approach and didn’t try to deal with the abuse until she was ready.
Resolving PSTD can be a lifelong challenge. Eg. My memory of my tonsillectomy aged 4 is re-traumatised by hearing about FGM, which must be far more traumatic assault by which girls are violated. This is more than 60 years after my operation. Even now I’m only just beginning to learn to find uneasy balance and try soothing my infant self, by remembering the other, the eternal, the infinite that I am and that is me/I, who intuitively knew all this in infancy. Now still recovering that perfect humanity of the very young child.. .which incidentally I believe all humans retain and can recover if they want to. Yes here ‘mindfulness’ is a good tool. This ‘tool’ used as a skill to ‘savour the flavour’ of the present moment, or of an experience, preferably a positive one. This analogy of a gourmet at a degustation of fine foods is quite helpful to me. It can be translated to many other aspects of life and put into relevant context.
Shame is usually rather high among Christians. I developed an “anti-shame” program that helped them to be kind for their bodies, while facing ugly feelings in the body (especially caused by sexual abuse). I use showering while listening to worship music, parfum use, clothing and how one experiences one´s body while laying naked in bed. It has in this cultural environment done a lot to tackle shame
This study is rather interesting. It only included people who were adult or very near adulthood when the traumatic event happened. In other words, they could recall the memory of the event fairly well. So those who had any childhood trauma were not tested. The method relies on being able to recall the event(s) and talk about the event(s). If people think that the child forgets the event, obviously they are very wrong (van der Kolk, “The Body Keeps the Score”). Growing up just helps the child block the conscious memory and prevent conscious recall, but not unconscious memory and recall. Some people may be so traumatized that they cannot even talk about the event, which makes this method rather useless for them, at early stages of treatment. Most of the technique used involves imagery, which can be triggered by body memory stored in the brainstem, so it will trigger strong emotional connections to the parts of the event stored there.
The patient will feel many symptoms related to the event, e.g. cold chills, sudden heat, pain, burning and itching sensations and may even hear a sound (hallucination) which was heard during the event, too. All of those somatic symptoms need to be related to the emotion the person feels at the same time. Sometimes the person cannot identify the emotion, so Muscle reflex/response testing (MRT) can tell the patient what the emotion was.
I found that asking questions that involve the following, in this order, helps most people recall even very early memories: when, who, where, what, & how. I was able to recall events early in my learning how to use MRT when I asked questions like when did this happen? who was there?, where did it happen (where was I)?, what happened (describe the scene, and let the neocortex analyze and suggest the scenario), how it happened (who was doing what at the time)? Because MRT demands “yes/no” questions, you have to suggest an answer at each level. Soon you learn that the brainstem actually prompts you with the questions to ask, by sending signals from these body memory cells to the temporal lobe to activate words associated with these signals. The concept appears in your mind first, then the words for that concept come afterward. The concepts stored in the brainstem are clearly very uncomplicated, e.g. “home,” “toy,” “hard,” etc. With practice, your neocortex pays more close attention to the brainstem (mindfulness) and its signals, and both parts of the brain learn to integrate basic signals with the analyzing power of the neocortex.
When they say that children cannot tell the difference between fantasy and reality, they are correct but not necessarily in their reasoning. I think that children depend more upon the brainstem for early analysis, and only learn how to rely upon their neocortex for that analysis later. Telling them that they are lying when they claim something told them to do something (e.g. following an inner “urge”) is just not correct. They are not lying at all, they are just telling us what their own brainstems are telling the neocortex.
very helpful information. thank you
The article is freely available here
My own story is that shame was a hidden major imprisoning factor in my life fed by generational, cultural sources, as well as PTSD. The love of God in Christ Jesus applied to my real and my toxic shame has and is bringing me to a greater love/like of who I am. Being present in the moment, aware of who God is and my own emotions and thoughts, has been part of my healing also. Many of the Psalms really are wonderful examples of shame, mindfulness (meditating) and healing from PTSD
I spent a year focusing on shame in my studies–brain, body, mind–all the ways shame strangles the good. Janina Fisher’s work helped me so much. She reconfigured shame as a strategy chosen by a helpless child that protects that child from further aggression. A child who stands up for herself is much more likely to be beaten than a child who cowers in a corner. When I began finding heroes in these former children who smartly chose shame as protection, my patients who felt so belittled began to reconsider lifelong shame as something that helped them stay alive. They recognized how smart they had been in taking on that feeling–and, since it had been a choice, they could now choose to turn shame in for a more useful strategy that would fit where they are now. Amazingly, stomach aches disappeared, people stood taller (Pat Ogden, thank you), the life force returned and the dance began. Today, some of these clients are complaining because they now have the same problems as the rest of us. It gives us all a good laugh.
Excellent reminder…thank you.
I am a survivor of childhood trauma. It’s a long story. I know that I am higher functioning today than ever before in my life. Two counselors changed my life, one in my twenties, the next starting at age 55. I’m on permanent disability after a lifetime struggle with trying to be “successful” in a world that can be cruel and retraumatizing when you don’t have the necessary internal skills to be solid. After 16 long numbing years on psychiatric medications where the numbing effects increased my inability to be present and effective in situational stressors, I was introduced briefly to DBT as a crisis worker at a county. Later when my life continued to fall apart, I sought services at a local center for mindfulness. The MFT challenged me on not being present. I did not know what she was talking about at first. Slowly my memory came back that I did not even buy the diagnosis given to me 16 years previously, following me around like a beaten puppy dog. Unfortunately, the psychiatrists, psychologist, licensed practicioner did not review my diagnosis, ever. I got additional ones and more medications. 16 years on klonopin, 5 on depokate, 11 on neurontin, 16 on antidepressants, and even a wrong diagnosis of mitral valve prolapse via 35 years on a beta blocker. The rapid heart rate was from the hyper vigilance of trauma. I was able to learn insight meditation as I safely titrated myself off of one medication at a time. I continued in mindful psychotherapy almost 5 years, qigong, meditation, massage, journaling, writing poetry, flower practice, energy healing, and the kitchen sink if nedded. My last step is EMDR. I’ll write you later with my results!! Mindfulness works because I was able to step back and see my thoughts as not being who I was. No longer totally emerged with the inner critics from my childhood. Slowly building a core muscle and learning to be me. No longer doomed to obey cruel inner voices. I woke up. I continue to wake and and learn to take care me. No dependency on medications and slowly becoming a functional human being. Thank you for reading my story. Nsmaste~
thank you for sharing with such openness , you are a great spokesperson for self compassion .
Thank you for sharing your story. You have showed great courage and resilience in your persistence, awareness and growing self-compassion. I have much to learn in my own journey.
There is a lot of research going into how a low GI diet similar to a diabetic diet has been able to help about 90% of clients with PTSD. Other technices such as CBT, Narrative Therapy, Art Therapy and the like are also helpful.
Along with these helpful things it is because PTSD has its basis in painful memories, as a helping community I believe we have been touching the surface and dealing more with the effects rather than the cause and it seems that as long as the effects are minimised then we believe that the cause will not have its effect again.
What seems to occur is that whilst under some treatment the painful memories of the past are still there; however, the treatment is giving pleasant experiences on top of these and treatment itself becomes a good memory which is then sought out again and again due to the increase in dopamine levels in these treatments; so, the client returns to be treated again like a drug addict to their drugs for another fix.
What was intended for the client to be useful for themselves to instigate and practice themselves does not “cut it” for them by themselves.
Personally I believe there needs to be a paradymn shift in treating those with PTSD on the psychological level that involves both mental memories and body/muscle memories from the past and not in the present. This approach I have not heard of as being attempted apart from Exposure Therapy which is also a guided present experience.
Seeing the dietary approach has had very good impact, this to me should be included in and with a different approach to PTSD treatment on the psychological and the body level surrounding past memories.
I’m being trained in Somatic Experiencing- look it up. It addresses body memory.
My scenario is directly connected to shame ..my son has not been in education since An episode of post traumatic stress when he was 10 relating to divorce and abandonment .Years of family and individual therapy CBT ensued but he struggled to engage with CBT ..he is now nearly 21 no friends and no education and won’t have any support medication or therapy ..two weeks ago his little dog was brutally killed while on a walk with him ..his only friend .i apologise for using this forum to try and ask for any advice or experience of such an extreme case.Many thanks
Will he watch video clips on a computor?
It could be a first step.
There is considerable relief and …. to be gained in watching others release trauma in a healthy natural way. (One can watch the same video over and over) Iit also moves one from I’m the only one.
treaustralia has a selection of individuals
bercelifoundation.org has a lot of groups
Most importantly it brings one into self empowered engagement.
Hi,
I have found recently that two of my clients who have PTSD symptoms really worry about and resent being seen as part of common humanity and want to be seen as special and apart. Can anyone shed any light on this? With thanks in advance.
All my best,
Julia
I can speak for myself about this issue has affected me. For years, every time I’d read about trauma, it seemed like people were trying to tell me how I felt, what I thought was wrong, and that somehow knew better than me what I ought to be doing, thinking feeling.
When I tried to express this, it came out as if I was somehow special, which then made me feel worse too, because it looked like I was being inflated, and perhaps I was.
For me, the really hard thing I’ve had to disengage with is our ‘stories’ about trauma about PTSD. Even with the best will in the world, all the modalities come out as a new ‘story’ about how we are/ I am. And actually, I’m not those things. So for me healing only came from disengaging from therapy, therapist’s talk, theories etc so I could find ‘me’. It definitely seemed as if I was wanting to be special. When in fact, I was trying to find ‘me’.
I understand that feeling of wanting to be special. In my case it’s probably more about wanting to be seen, heard and not dismissed. I love your reference “trying to find me”… I believe that a good therapist accompanies and guides clients in a self-empowering journey of discovering their authentic self. Of weeding through and integrating the obstacles that posed an obstacle to this progress in the past. Personally, I’ve tried to “find me” on my own and it’s lead to complete disasters. Another example of the how different we all are. I hope you have good support networks around you.
Self-Compassion/Loving-Kindness practices continue to bring me increasing inner healing. Tim Desmond has a new book out on Self-Compassion is clinical practice. I highly recommend it!
I know of several accredited folks who do EFT Emotional Freedom Technique + Tapping with Prisoners, with local Military and Rape victims. It’s easy to do, affordable, medication free and Really Works when nothing else does. It’s the golden key to healing and we should do it first not last.
I used it to cure my painful Achilles injury that had continued for 2+ years. A friend who was a certified EFT practitioner came over and we “tapped”. I took a class in EFT Tapping. And whenever I felt a bit of pain I would stop walking and tap. ( My morning workout has been walking in the woods w/ my dogs for over 20+ years.)
check out Nick Ortner on line, he has a book out too– he helped the families who’s children were murdered in the Conn. School massacre. EFT is an amazing healing practice! Athletes have been using it for years…
I haven’t tried it yet, but I’ve been working all around this for many years. To me, this is the missing piece for an unlimited number of emotional and mental traps people are caught in. Thank you so very much for sharing this vital information. I’ll let you know more when I’ve had a chance to try it.
I’m a 48 year old woman who grew up poor in an abusive family in the mountains of Idaho. There was a woman in my little town who had retired from the New York Ballet. She knew how to dance, and she taught me how to dance by giving me free dance classes throughout my childhood.
My parents never came to see me dance and never complimented me on dancing; instead, they called me a “prima dona” and told me “to get over myself”. I grew up loving my passion for movement but feeling ashamed of it as well. I was so good at it. I found a way to college and studied it along with the social sciences. I started making beautiful choreography as a young woman, but when people complimented me, I felt “ashamed”. Good friends would tell me “to love myself”. I thought they were promoting conceit, and I refused to engage in such “nonsense”.
All this confusion, abuse, self-hatred ans shame built up over time. I began having uncontrollable epileptic seizures at 34. I felt “ashamed” of my seizures and my dysfunctional body/mind. The abuse of doctors and the medical industry didn’t promote self-compassion. With lots of fear mongering, they promoted more shame. I was sick. I was a failure. I was ashamed.
Overtime, I walked away from western medicine and began to listen and learn from my illness. It actually was kind to me, teaching me deep lessons about life. Unlike my parents, it was always there saying take a walk, don’t eat that donut, no more caffeine. My mother didn’t even come to visit me when I was in a coma for four days. Then one day while meditating, I experienced a deep revelation – self-love wasn’t about “conceit”. It was about “compassion”. It was about recognizing our common humanity with everyone. I realized that I could love myself and not compromised my values. My seizures decreased substantially, and I embraced life again. Check out my book, “SEIZED – Searching for Health In The United States”.
Thank you Ruth for sharing these gems of wisdom and helping the therapists intent on healing their patients suffering from trama heal.
Sincerely,
Andre Duchesneau
Being no stranger to shame myself, I spontaneously developed a body-centered practice for myself and clients while having an EMDR therapy session for something I felt shame around. Here is the article. It is called Healing Shame Through Mindfulness.
If you’d like to share it, all I ask is that my writer credit, copyright notice and link to my website be included. Please feel free to try it with your clients. My clients have found it very healing, as have I. I hope it is of benefit.
bethspatterson.com/healing-shame-through-mindfulness-and-visualization/
Beth S. Patterson, MA, LPC
bethpatt@mac.com
bethspatterson.com
I would be interested in any way to introduce self-compassion and to reduce shame in children.
Thank you.
Yes,I love both Kristin Neff and Tara Brach. Their contributions are monumental. Also the work of Diane Poole Heller.
Kristin kneed has done wonderful work in this area. So has Tara Beach. I believe this approach is essential for all patients. Therapy and overcoming shame is very difficult. Self compassion and kindness are essential practices
“Treatment…in a traditional Imaginal exposure program”…we know must contain more than re-exposure,to actually constitute treatment rather than re-traumatizing. Could you provide a link to the study? I thank you.
Terrific approach. Shame is such an intense and secretive affect, and so poorly understood by most of us, that it generates belief systems based on inferiority or guilt that interfere with compassion. Using this technique to make the image of self an object of compassion can neutralize the shame. I love it.
Brock Hansen, Author of Shame and Anger: The Criticism Connection
Great insights Ruth. Hoffart is very accurate with these 6 areas and knowing them will help many professionals and clients in the treatment of PTSD, and in overcoming any barriers and stigma to making meaningful progress, and healing.
I think it is important to recognize the work of Kristin Neff here. She is the person who designated the three components of self-compassion . . . self-kindness, mindfulness and common humanity.
Yes, the Self-Compassion Scale is Kristin Neff’s, not Hoffart’s. He utilized it in this research study.
Using the Affect-Script Psychology of Dr. Silvan S. Tomkins (www.tomkins.org) I always work with the affect of shame-humiliation which is inherently a result of the interruption of the pleasurable affects of interest-excitement or enjoyment-joy. Most traumatic experiences have that in common but result in magnified shame when the victim’s reaction to fear-terror is the freeze response rather than fight-flight. Using EMDR as a treatment modality, I know that shame is being desensitized when the client begins to spontaneously report messages of self compassion and understanding that they were not at fault or deserving of blame for what happened to them. The body begins to be less rigid and becomes more relaxed. The treatment is successful!
I absolutely agree that.shame induces further trauma. Self compassion, self soothing, self regulation, revising disorganisedv, avoidant, ambivalent attachment styles, mindfulness, and unconditional caring from a therapist, life partner, family member or friend can heal pretty much any and every traumatic story. Compassion and love banish shame. Accountability, integrity, and determination replace shaming, blaming,withdrawal, isolation, guilt, and fear. This has been and is my path to wholeness and freedom as well as the path I travel with clients who choose emotional freedom and empowerment.
For people suffering from shame about their body size, Health At Every Size (HAES) reduces shame
and increases healthy behaviors, regardless of weight. One very good HAES program is
The Body Positive.
Thank you for your work Ruth. My wife works for the VA as a LCSW. She is a first line case worker with returning vets and the many contributing factors of homelessness. I will be forwarding this article to her as I have a few of your others. I have experience both personally and professionally with various populations applying the concepts of mindfulness and believe professor Hoffart is right on target in his 6 areas of study.
Thank you.
Hi, Dr. Buczynski. I like the idea of teaching personality characteristics to off-set shame, guilt and resentment. I have used the practice of teaching to adjust personality to improve performance and it is very effective.
Teaching the client to regularly practice yogic breath to stabilize the ANS followed with IRest Yoga Nidra (guided meditation). Mindfulness and CBT weekly session for approximately three months creates self compassion and acceptance. Positive imagery and self affirmation (Mantras) the client creates reduce the anxiety and depression and create hope and self determination. Check out the National Institute of Health in Bethesda, Marylsnd for supporting research.
Namaste’
Doing heart to heart work for self and with others; interacting (caring and connecting) in a way that assists the client to change their internal mental models. Validating the person’s experiences. Coaching how to self reflect and be mindful. Gently talking shame. Shame can hide behind other emotions so assisting clients to recognise shame; separating from other emotions, working through it and moving their energy from inside outwards…
Shame can stand in the way of healing in a big way sometimes. I’ve experienced this with clients that have physical symtoms. Shame is an important aspect to address in the treatment of various symptoms.
Excellent insights.
Not only patients but myself too, and still working on it’s different aspects. I suffered from PTSD which was greatly relieved after a rewind which acknowledged a childhood incident which had got lodged in my brain as something to be ashamed of.
Now I am dealing with over-reacting to rejection which also stems back to a sense of shame and consequent lack of self-compassion. I use mindfulness a lot and also mental props and actual reminders in the form of small objects notes etc. I find that the notes need to be changed frequently!
I hope these thoughts are useful to others.
I had a student only this week, who said that being kind to himself when he did not get to the gym helped. He said instead of sinking into days of self loathing, lounging in bed and doing no exercise, by later in the same day he had gone for a walk.