The Psychoanalysis of Shame OCR
The Psychoanalysis of Shame OCR
The Psychoanalysis of Shame OCR
pg. 355
Presented at the Scientific Meeting of the Boston Psychoanalytic Society, 26 March 1969.
or latency (French, 1958, pp. 460-1). As In many instances the focus of intense shame
development proceeds shame tends to concen is displaced from the self on to external objects—
trate upon aspects of the self which are exposed one’s relatives, one's friends, etc. For example,
to others and may therefore be manifested it is not uncommon for an adolescent to be
through obsessive preoccupations with certain intensely ashamed of his parents and therefore
parts of the body. A common example is an to avoid being seen with them.
obsessive concern with the size or shape of the
nose. Although this type of symptom may at
times be relieved by eradicating the apparent hi
‘ defect ’ through plastic surgery, in many
There are many highly sensitive people who
instances it remains after surgery since the
underlying shame tends to persist. An 18-year- react to criticism or rejection with intense shame
old girl believed that her nose was too large and
from early life onwards. They are often quite
secretive and may be incorrectly perceived by
persuaded her parents to permit her to have a
others to be snobbish.1 These highly sensitive
nasal plastic operation even though they did not
believe it was necessary. Surgery was successful
people often develop perfectionistic aspirations,
from a cosmetic point of view, but within a few
in the hope of reaching an unassailable state.
They may also pay careful attention to the atti
weeks the patient came to a psychiatrist in the
hope that he might persuade the surgeon to tudes of others and may modify their behaviour
reconstruct her nose in its original form, since in extreme ways in order to avoid criticism.
she was now embarrassed about its shape. In
Although they may have a strong wish to be the
centre of attention, they may not act upon this
other cases, following surgery the shame shifts
wish, due to an equally strong fear of being
to other parts of the body. A 20-year-old girl
initially had a plastic operation on her nose
criticized or rejected.
because she believed it was too large. A few
Schizophrenic patients are usually quite sensi
months later she became preoccupied with her tive to criticism and readily experience intense
breasts and underwent a plastic operation in
shame. Because of this sensitivity they often
order to reduce their size. Her intense shame
become very shy (Jacobson, 1964, pp. 197-205).
It is my opinion that many of these patients
was not relieved by these procedures, but was
again displaced; she now sought a plastic oper start off in life with a constitutional limitation
ation on her legs, which she described as ‘ too in the ego’s ability to avoid shame through
heavy At this point the family called a halt to normal defensive measures. Superimposed upon
this basic limitation may be the effects of exces
surgery and sent her for psychotherapy.
The obsessions to which shame gives rise may sive shaming during childhood, which may force
readily undergo displacement. For example, a the patient to use much of his free ego energy
young male college student manifested obsessive for suppressing or repressing shameful thoughts,
cleanliness as one of his symptoms. In analysis feelings and impulses. The resulting depletion
it was determined that in early adolescence he of ego energy may then add to the basic weak
ness of the ego, making it more susceptible to
was ashamed of being Jewish and was obsessively
preoccupied with this issue. For several years psychotic developments. It is worth noting that
thereafter he hid his Jewish identity and was
when such a patient becomes psychotic, he often
temporarily relieved of his shame. However, in
develops symptoms which reflect his intense
late adolescence he felt guilty about his behaviour
shame, such as delusions of being watched, of
and began to admit that he was Jewish. This
having his mind read, etc.
change reactivated his shame and gave rise to a
new symptom in the form of obsessive cleanli
ness, which arose largely as a displacement of IV
the previous obsession, since it was based to a Those sensitive people who have strong
considerable degree upon the unconscious fear primary shame reactions often experience, in
that others might consider him to be a * dirty addition, a secondary shame, which can be
Jew described as ‘ feeling ashamed of reacting
1 The tendency to misperceive in this manner is found relatively secure defences against shame may not experi
most commonly in people who experience little shame ence this affect to any significant degree and may therefore
and who do not readily empathize with those who have not perceive it accurately in others.
intense shame. In other words, individuals who have
J In discussing the resistances which are observed in relation to secondary shame, Grecnson (1967, pp. 126-8) has
used the term * resistance to resistance*.
for such a student will obviously require con In many instances the analyst has to stimulate
siderable analysis of the underlying shame. further self-exposure by repeatedly urging the
patient to communicate in detail. Sometimes an
VI • exploratory guess ’ will help to overcome the
Although the alleviation of shame during shame barrier (Ferenczi, 1911; Levin, 1965). A
psychoanalysis depends mainly upon the acqui single woman of 35 with a moderately deep
sition of insight, some degree of alleviation depression talked repetitively, like a broken
results merely from the patienfs efforts to com record, about her fear that she would never be
municate to the analyst. When a patient brings able to marry because men invariably dropped
up a new topic in the face of shameful feelings, her after a brief relationship. The therapist
the very act of verbalizing tends to mitigate the guessed that by talking only about heterosexual
shame. The analyst’s neutrality plays an import issues she was avoiding the topic of homo
ant role in this change, since he does not express sexuality, and he communicated this guess to
intolerant attitudes towards the patient nor does her. She immediately confessed her homosexual
he react with intense shame himself and therefore affairs and it was then possible to analyse her
avoid discussing topics which arouse the patienfs intense shame concerning them. It is worth
shame. In fact, the analyst adopts a serious, noting that this patient had gone to a previous
shame-diluting attitude and is ready to hear therapist for over a year without revealing her
more. homosexuality to him.
When a patienfs primary shame gives rise to Patients who manifest severe blocking in
severe blocking during psychoanalysis, he may analysis are often labelled with a diagnosis of
develop intense secondary shame concerning the hysteria. Such blocking can be thought of as
blocking itself and may feel that he is failing in phobic in nature, since it is based upon a high
the analysis. As a consequence, he may manifest level of fear (i.e. the fear of experiencing intense
a depressive response to treatment, often with shame). Patients with such fear usually have an
increasing reluctance to come to the sessions. If inability to defend successfully against shame by
the secondary shame is then clarified, the patient expressing their sexual fantasies as derivatives
usually becomes more tolerant of the blocking that are removed from deeper shameful content
and the depressive response to treatment dis (Levin, 1964).
appears. Many patients experience intense shame in
As the analysis proceeds, the blocks themselves relation to feelings of afiection. Several years
will tend to disappear. This change depends to a ago I undertook the treatment of an unmarried
considerable degree upon the analysfs clarifi middle-aged woman who complained of long
cation of the primary shame responsible for the standing depression. After a few weeks of
blocks. Such clarification is facilitated by the therapy she made a major confession, to the
use of such terms as * self-consciousness \ effect that for a period of two years in her early
* embarrassment *, * shame * and • humiliation * 20s she had been the ‘ mistress ’ to a married
at appropriate times, thereby giving the patient man. When she first discussed this affair, her
useful labels to apply to his underlying feelings remorse focused mainly upon the illicit nature of
and reactions. the relationship. With further analysis, however,
Sometimes the analyst intentionally reinforces it became clear that she had been deeply in love
secondary shame as a means of counteracting with this man, but was ashamed to admit it.
the patienfs withholding tendencies. For After this shame was clarified, it diminished
example, the analyst may tell the patient that, considerably; and the intensity of her love broke
in order for the analysis to be successful, the through into consciousness. She was then able
patient has to make repeated efiorts to express to grieve about losing this man. Following this
his thoughts and fantasies. Such a remark can phase of treatment, her depression diminished
shame a patient into complying, since it suggests and she was freer in her relationships with men
that the analyst will be disappointed if the in general.
patient does not continue to face his resistances. Much of the analysis of shame must focus
Furthermore, whether it is made explicit or not, upon the ‘ fear of experiencing shame,,which I
the analysfs expectation that the patient will be have labelled ‘ shame anxiety ’(1967a). This
utterly truthful contains a threat of disapproval type of anxiety, which is as basic as castration
if the patient is found to be using dishonesty as anxiety, is felt largely as a combination of self
a defence. consciousness and the fear of being shamed by
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