Shame and guilt in psychotherapy

Abstract

Research work on shame originates from relational psychoanalytic models, following the shift from neurotic to narcissistic patients. In classical psychoanalysis shame has been completely overlooked. Shame and guilt are two of the major feelings integrated into the personality structure. Both develop and interlace according to developmental logic. While guilt produces tension through a bad conscience and is the companion of unacceptable actions, shame is a signal reminding us that such as we are, we are not worthy of attention. The fear about what kind of a person you may be in the eyes of others is the sign of self-respect deficiency. Projecting this painful experience onto others it leads into the feeling that one is not respected. Striving for admiration is the easiest way to fight against this feeling. Shame and guilt are indispensable parts of our control mechanism. Without guilt a man lacks conscience and without shame a man is a shameless psychopath. Where there is too much guilt or where there is pathological intensity of guilt these are signs of superego conflict; however, where there is too much shame taken away from reality this may generate narcissistic pathology and it may harm the self. This would represent a serious obstacle in the psychotherapeutic process. The purpose of this paper is to bring light to this new knowledge on the phenomenology, the development and the function of shame and guilt, and to encourage therapists to accept these “difficult” patients.