How to Ease the Pain of Trauma-Induced Shame
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with Bessel van der Kolk, MD;
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with Bessel van der Kolk, MD; Ruth Lanius, MD, PhD; Peter Levine, PhD; Thema Bryant-Davis, PhD; Richard Schwartz, PhD; Pat Ogden, PhD; Janina Fisher, PhD; Kathy Steele, MN, CS; Stephen Porges, PhD; Martha Sweezy, PhD, LICSW; Deb Dana, LCSW; Ruth Buczynski, PhD
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Having worked in a wraparound program with child and teen survivors of complex trauma for the last 7 years, I have observed a great deal of shame, moral injury, and inability to tolerate positive feedback and warmth and empathy. I learned to caution teams not to be overly effusive with praise in team meetings with the client and family, as it was almost a rule that the client would regress in their emotions and behaviors the following day/week and family members would discount their progress and determine that child/youth was “faking it.” I have also worked with clients who could not accept that they did not fight the abuser of their vulnerable parent or of their very young self (failure to protect). Thank you for offering valuable strategies for helping clients to handle positive feelings, to move forward from moral injury. Also, when examples were offered regarding the protective value of shame and its role in inhibiting the ability to feel comfortable with positive feelings, such as, “My father would say, ‘Wipe that smile off your face,'” I could actually hear a father telling his son that and recall the son’s regressions the day after positive team meetings. This was a very valuable session, and I will be reviewing and using it in my own work and in coaching others.
I was impressed by the ongoing attention to and discussion of being in touch with our own as well as our clients nervous systems responses. It highlights that the therapeutic partnership truly requires connection and regulation in both systems.
I was happy to be reminded in such clear yet gentle ways about tending to responses to “positive” emotions as well as “negative”ones, building tolerance by engaging in titration of the experiences with attention to and thought,feelings, body sensations-coming at it from mental and physical perspectives.
I see many possibilities for application in my practice,
Excellent talk. I particularly found it helpful to hear how behaviors associated with shame are often protective and work to help people experience a sense of safety and survival.
Also, on a side note, I have been increasing my work using teletherapy, (phone, not zoom) especially with clients in their 20’s, and I have been noticing that they have been doing incredibly deep, profound work, and one reason that I think this is happening is because they are freed up from the sense of shame and exposure of sitting across from another person who is looking directly at them. In general, they are able to express and experience fragility more readily and they are doing incredibly meaningful work. As a psychologist in her 60’s, trained in psychoanalytic psychotherapy, I would never have believed it.
This session was particularly helpful in understanding some of my own behaviors and those around me. As I have moved forward thru healing from traumas, involuntary reactions were revealed as a stepping stone to releasing the emotions and their connections further healing. Bless you for bringing this information to heal long suffering trauma to the surface to be released. How shame was protecting throughout experiences and dissociating protection was pivotal in my understanding. Running and hiding helped me survive and is not longer necessary. Big stuff for me.
I’m not a trained therapist, but I have a partner who has severe CPTSD and has been going through a very dark 6 months. This program has been a lifesaver for me because I have to be a partner and a de facto therapist while they don’t feel safe enough in a therapeutic relationship. It would be such a great benefit to those of us in these supporting roles to have deeply skilled therapists (like the panelists here) would directly offer insights, skills, and techniques to supportive roles other than professional therapists. My partner has expressed that if it wasn’t for me trying to learn about (and skillfully work with) their CPTSD, they would have opted for suicide months ago. I’m strongly encouraging any amount of experienced, skilled support that you can offer to the non-professional community. Please feel free to reach out to me for insights and collaborative efforts. What you all already do is deeply appreciated! Many thanks, Sara M. thefutureiswisdom@gmail.com
apply during counseling sessions with clients dealing with various losses and unfinished business or unresolved issues. This was very informative and helpful. An invaluable asset to clinical library; unfortunately, unable to purchase package at this time. VB
I wish I had this information years ago when I was working in direct services as a counselor – yet, as a Functional Nutrition Counselor I work with the connection of the body, mind and spirit with my clients and these presentations are a compliment to the work I am doing!
Heartfelt thanks for this so important information!
What I learned today about easing the pain of trauma-induced shame is; when working with clients who experience moral injury, positive invocation can be very triggering. Introduce positive feelings slowly and carefully.
As Somatic Educator with The TRAGER Approach, I will be even more aware of how the positive experience of calm aliveness can be triggering. I may need to pause even more to titrate the pacing of soothing movements and help clients savor micromoments of pleasurable awareness at the edges of hyper and hypo arousal. It is critical to be attuned to the body’s cues of resistance, of unsafety.
It’s interesting to begin to put together the meaning and adult implications of the reaching out and connecting ideas of attachment /cry for help’s immobility state and the pause in self assertion mandated by the early caregiver’s shameful no. How does the therapist develop a healthy surround clinically for these seemingly opposite needs. Or maybe I’m misunderstanding something.
I liked the idea of asking the other parts to give permission before dealing with the inner critic as well as bringing inner critic into a separate room. Also, it was good to be reminded about how uncomfortable people can be with positive emotions and sensations. Overall the whole program was rich. Thank you!
Thank you for this meeting. It helps me to validate what I feel and therefore helping cliënts. Keywords are validating, not judging and compassion. It is the opposite of toxid positivy. I liked the input of dr Wilson, because another aproach i liked and find very helpful is ACT.
Great explanation of the dynamics of Moral Injury, which allows one to be with the client. Take away is you cannot go back and erase the experience.
Gratitude 🙏
Thank you to all who were a part of this training.
My take away is having a little part of each therapeutic type explained around treating shame and self harm to see how the different methods really work together to address shame in the body, in the perspective of what the job shame has done/is doing for the client.
I am not a therapist. I am a writer. My motivation in my work is a fascination with how people ‘tick’.
I have met and become fond of a traumatised person and was interested in your sessions.
Ultimately, despite not quite understanding everything said, I realise that PATIENT LOVING is possibly the only way forward.
I wonder if any of you agree.
Yes I think Patient Loving is the only way out. Mixed with some common sense. There are endless numbers of people who will confront and structure and love in a challenging way till exhaustion sets in. But Loving has endless resilience to it if it is honest and not inappropriately seductive.
Yes. I believe loving and gentleness is so effective and so necessary, Love is a great part of the cure. and a foundation to healing!
So tnx for everything I have heard today. It gave me so much.
I appreciated the point about not saying, “It wasn’t your fault,” in response to shame responses, due to how that could make someone feel shame about feeling shame. This is something I have done, and connects with some previously noted pieces of the puzzle that have pointed towards that not being as helpful as I thought.
This session was so powerful. I now know how to identify my own shame.I have learnt various ways i can walk with clients
I enjoyed the session and learned the importance of not dismissing shame. Particularly, I learned the possibility of helping clients somatically to work through where they feel shame in their bodies and to let them know shame is a protector.
The moral injury section was really moving. Especially the story about the soldier. Lots of reminders about not being able to take someone’s pain away, rather accompany them in their journey through it.
Thank you for an excellent session.
Just wanna say thanks!
This was incredibly helpful, thank you so much! I felt like I got supervision for one particular client I am working with, and it will help inform my sessions with her so much
Shame. An awareness of exposure, our nakedness exposed for all to see and ridicule, our flaws put on display which renders us acutely aware of our vulnerability and inadequacy. Unless there is a covering which cleanses, protects and equips, shame will attempt to keep us hidden in dark and foul corners.
This session was hugely interesting for me. As a Hypnotherapist I often work with parts therapy. If nothing else works, it’s usually a part that is preventing progress! Today’s session gave me further insight into the relationship of shame and how to proceed with caution around shame and to understand how that part is working for the client. I hadn’t considered using the clients posture before but will now be able to incorporate that into some conversations. I do look for ideo-motor responses both in and out of trance and these can be very subtle, even a tiny movement of a finger. The comparison of suicidal or para-suicidal self harm was interesting and how self harm can be a kind of addiction because I hadn’t considered that before. Apart from finding this helpful with clients, I had a real Ah-ha moment that helped me fully understand what is happening with a family member.
Pamela Needham, UK
I found the concept of moral injury and it’s link to shame and trauma to be extremely helpful. I have not previously thought of it this way and I think it has many applications. For one thing, I immediately thought of the process that we as white people go through when we learn about racism and how we have unwittingly participated in harming others even as we have striven to be anti-racist. As a young person, I learned that it was shameful to be racist. Connecting this kind of shame to the idea of moral injury helps me to understand this shame in a way that gives me a path forward.
Thank you.
I really liked the use of more than one voice dominating the client’s narrative. It reminded me of a youtube video that I used for a mindfulness presentation I developed. It does refer to mindfulness, but in doing so it uses the two wolves anaology. If you are interested in viewing it please google – How Mindfulness Empowers Us – it was created by happify
I meant the parts rather than the voice
Thank you for this!! So helpful and insightful. I really loved looking at shame as a protective part – makes total sense. The information and conceptualization around moral injury stimulated a lot of thought about how to more effectively treat this complex issue. I’ll be chewing on this for weeks. Thanks again.
Thank you for this program.
Your affirmation that the work we do can change the world is helpful in this moment of seemingly overwhelming systemic corruption and mis-leadership.
The parts of the program that felt most encouraging to me were ones in which I could recognize interventions I had made with clients, more on the basis of intuition than theory but which worked for the client and in retrospect I see that they were consistent with the approach you and your team were advocating. I am reminded of the lessons from previous teachers that had become “reflexes”.
An idea I had learned from Dr. Peter Levine some years ago was SLOW SLOW SLOW and take time to find the feeling in the body.
His description of slowly moving in and out of posture of shame reiterated this and is similar to a method from NLP. The idea of watching the client’s micro movements for evidence of incomplete actions frozen by the trauma is familiar from Levine’s SE.
The strategy of creating new “goodness” to counterbalance the “badness” of the moral injury moment seems familiar from Levine and Ben Colodzin. Colodzin incorporated practical ecological restoration work into his multifaceted trauma healing retreats.
An idea of VALUING and VALIDATING the troublesome part felt familiar.
A new and useful idea was that of asking permission of all the OTHER parts BEFORE engaging with the “Firefighter” troublesome part.
I plan to keep this in mind and try some different ways of introducing it into my practice. “No one does that job better. It is a hard job. How could we do even better? Could someone else help?”
I look forward to hearing more about methods to help the client access and experience their “Authentic/Core Self”
I have been aware of the neurochemical payoffs from self-harm from the pioneering work of Dr. Mira Z. Amiras on the subculture of BDSM.
The idea of asking the client “How long does the relief last?” is new to me and seems worthwhile – in sensitively chosen context.
Also helpful was the idea of the caregivers of a child who has to be told, “No!” following up by promoting secure attachment and validating the child’s choice to withdraw from danger AND repairing the “shame break/brake”.
The idea that cognitively contradicting the client’s self-negation could be counter productive rings true; “failure of empathy”, “alienating”, probably also too arousing. One guideline I’ve carried forward from teachers in the “understatement” strategy is to tone it down to a “homeopathic dose”, a self-validation that is so minimal that to a normal person it would feel like “damning with faint praise” but to the bearer of shame it is small enough to be credible and non-threatening.
The strategy of holding space for client’s conflict – on the one hand observation that “Right here and now we are safe” AND the body FEELS unsafe BOTH being true.
The guidance for counselor to focus on cushioning their own response to discomfort and focusing on BEING PRESENT WITH THE CLIENT as the CLIENT encounters their own feelings, processes their feelings, and learns to bring their response down to manageable size – sound right to me. This points, again, to the inner work that counselors must do in order to remain connected and responsive to the client while at the same time self-regulated; a sophisticated mindfulness practice.
The idea of “befriending the client’s nervous system” is a shift of perspective. That may take some time to sink in for me . . . I can identify with allowing PART of myself to resonate on a body level with what the client’s body is going through, while another part of myself witnesses and reaches for compassion both for my own discomfort-in-resonance and for the client’s struggle.
The idea of “moral injury” was new to me.
I appreciate your EXCELLENT offerings.
Thank you,
Fred V. Cook
Thank you all for another insightful session. Helps me to better understand the generational dissociation and shame for academic prowess and financial successes seen in marginalized and disenfranchised communities….in communities where our systems continuously Other them, dismiss them and ridicule them…and take away gains (as with ancestors) when made. Think: destruction/neglect of infrastructure, schools, art, nature, clean air & water, homes, businesses and even violation against places & ways of worship, one’s language, culture and beliefs. Too do “well” is to assimilate…and to open yourself up to ridicule, shame and more trauma. The collective moral injury of a people.
Helpful terms/aspects:
– “the parts”
– “the inner critic”
– “the core self”
– “recovery is complex”
– “hold the past, while creating new goodness”
– “notice, savor micro-moments”
Yes Tara, I agree. The flashbacks as a form of self harm was very interesting information that I found myself looking deeper into.
I found this really helpful in relation to specific clients and general information to be stored for potential help in the future. I will look at clients trauma and reactions through the lens of what I have learned this evening and try to employ the recommended approaches.
Thank you to all. Carole.
Hi, just a quick word since it’s getting late in Finland: I want to be more curious and respective of the different parts instead of trying to “fix” or get rid of any of them. I need to be more slow and patient. The need to titrate positive emotions was a novel idea to me. Many thanks, have enjoyed.
Thank you so much! I will use
the things I learned with my clients. I loved the comment about the trauma clients hand movement and that they wanted a hand to hold. Connection and love is the key. I will be more observant of body language from now on.
It was valuable to listen to this a second time.
I believe that the sensitivity to pacing and the realization that wanting your client to feel better, experiencing positive emotions to improve their life, has to be handled with care. They have possibly been connected with discomfort for so long, that positive emotions can be another source of discomfort. I can appreciate that a gradual introduction and a recalibration process, over an extended period, could be very helpful in moving to that next level. Great video and group of experts. Thank you.
I found the discussion of titrating client’s experience of positive emotions to be helpful, and also the consideration of flashbacks as a possible form of self harm. Thank you!
Wow! This was so useful in so many ways, thankyou. What I’m mostly taking away is the understanding of why a warm approach and pleasurable feelings might actually be triggering and the need to pace that. Currently experiencing that with clients. Thankyou
Not a professional, just wanting to understand myself and be more fulfilled in my life.
I didn’t know that shame is a normal response that has a biological function. I know that I feel shame and have been trying to “forgive” myself for things…..and there were tips on how to break that process down better and for it to be more effective for me.
I am so grateful for your generous offering. I am inspired to observe the bodies of my clients and also my own body. I loved listening to Pat Odgen describe once again the healing power of listening to the body. I cherish this sharing with patients how wise symptoms have been in the past as well as learning about the nervous system.
I loved listening to all of you. Thank you!
I continue to be surprised and encourgaged by the techniques where the therapists’ nervous system can affect the client in postive and negative ways. Also, how we can engage in physical activiites/skills to correct some of the clients problems and experiences. Being trained mainly with CBT, this is all new.
Thanks for this series and the experts involved to teach use that there are many more things we can add to our therapeutic tool box.
Thank you for this generous gift. My giving self is reinforced and more able to function.
Thanks so much. very informative. I have a client who has a secret that her shame won’t let her to open up about it. She imagined herself in a deep/dark hollow . I am using EMDR practice with her to be able to support her to decreased her shame and moral injury.
The part about moral injury was such a huge insight for me around clients that I work with because of how much they care and take responsibility for others (especially around societal mores or religious ideals). The idea that we can’t take it back or make it okay, but to simply hold the space for it as we move forward and create new good things in the world is an important practice that I will help them implement.
Defining moral injury and how to work with it was very helpful. Thank you.
positive feelings are uncomfortable and dangerous
I’d love to discuss more what it looks like when a client is using flashbacks as a form of self-harm. 🙂
As someone experienced with IFS Therapy, I found this segment expanded my skills and intuition.
One statement which really stood out for me was early in the segment, when Janina Fisher said, “Shame arises as a survival response; as a parasympathetic brake, that causes the child’s body to pause.” (Where the graphic depicted a child approaching the stove.) I’ve long thought about the origin of shame as being an “emergency brake for us as toddlers and children; however, I just hadn’t recognized the obvious neurological mechanism of parasympathetic activation. Thank you, Dr. Fisher, for mentioning this important detail!
re: shame can afford a sense of control
4 functions resulting from shame attack the other, attack the self, avoidance and no internal connection
Fischer’s question “how did shame help you survive”
VanderKolk teaching on The Tough Parts—exile the shame
Somatic tension is precursor of action
?Who benefits from this question?
Tx goal—help process and regulate shame not eliminating it
Repetitive flashbacks may be method of self punishment
Fischer “It works”. Adrenaline, endorphins. Cost Benefit of self harm exploration
Nash— “The mortal enemy of moral injury is Love”
The window of tolerance
My appreciation for each wise presenter
Thank you
I am loving the event… it is really helping me to identify shame more in my clients. I am recognised that i have naturally used the method of postures and held trauma to release pain and regulate nervous system. I am a Physiotherapist in UK working with chronic pain and ‘syndromes’ and I feel shame is a big thing in our culture. (I have seen it in myself with the moral shame and addictive flashbacks). To help myself as I am a “Felt sense” person I have used the 5 elements of nature to self regulate…
I have just finished writing a book about my experiences and my clients.
Thank you so much.