Abstract
This practice article considers the empirical research on the relationship between shame and trauma resulting from interpersonal violence. It explores the evidence suggesting that shame rather than fear is a better predictor for the development of PTSD and presents the argument that shame, along with fear, should be acknowledged and addressed in the course of intervention with trauma survivors. The article defines shame in its relation to other self-conscious emotions, discusses the mechanism underlying the formation of shame, gathers evidence for the actions of shame in the maintenance of PTSD/C-PTSD and barriers to healing, and examines research supporting practice principles for working with shame. It provides guidance for identifying the unique ‘web of shame’ that may present in trauma survivors, an understanding of how shame effects behavior and emotional responses and suggests therapeutic strategies for working with shame. A case example is presented along with practice principles for working with shame in social work interventions with survivors of interpersonal violence.
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References
Aakvaag, H. F., Thoresen, S., Wentzel-Larsen, T., Dyb, G., Røysamb, E., & Olff, M. (2016). Broken and guilty since it happened: A population study of trauma-related shame and guilt after violence and sexual abuse. Journal of Affective Disorders, 204, 16–23. https://doi.org/10.1016/j.jad.2016.06.004
American Psychiatric Association. (2017). Diagnostic and statistical manual of mental disorders (5th Ed.). https://doi.org/10.1176/appi.books.9780890425596.
Anderson, T., Fende Guajardo, J., Luthra, R., & Edwards, K. M. (2010). Effects of clinician-assisted emotional disclosure for sexual assault survivors: A pilot study. Journal of Interpersonal Violence, 25(6), 1113–1131. https://doi.org/10.1177/0886260509340542
Andrews, B., Brewin, C. R., Rose, S., & Kirk, M. (2000). Predicting PTSD symptoms in victims of violent crime: The role of shame, anger, and childhood abuse. Journal of Abnormal Psychology, 109(1), 69–73. https://doi.org/10.1037/0021-843X.104.2.277
Au, T. M., Sauer-Zavala, S., King, M. W., Petrocchi, N., Barlow, D. H., & Litz, B. T. (2017). Compassion-based therapy for trauma-related shame and posttraumatic stress: Initial evaluation using a multiple baseline design. Behavior Therapy, 48(2), 207–221. https://doi.org/10.1016/j.beth.2016.11.012
Badour, C. L., Resnick, H. S., & Kilpatrick, D. G. (2017). Associations between specific negative emotions and DSM-5 PTSD among a national sample of interpersonal trauma survivors. Journal of Interpersonal Violence, 32(11), 1620–1641.
Beck, J. G., McNiff, J., Clapp, J. D., Olsen, S. A., Avery, M. L., & Hagewood, J. H. (2011). Exploring negative emotion in women experiencing intimate partner violence: Shame, guilt, and PTSD. Behavior Therapy, 42(4), 740–750.
Bockers, E., Roepke, S., Michael, L., Renneberg, B., & Knaevelsrud, C. (2016). The role of generalized explicit and implicit guilt and shame in interpersonal traumatization and posttraumatic stress disorder. The Journal of Nervous and Mental Disease, 204(2), 95–99. https://doi.org/10.1097/NMD.0000000000000428
Brown, B. (2006). Shame resilience theory: A grounded theory study on women and shame. Families in Society: THe Journal of Contemporary Social Services, 87(1), 43–52. https://doi.org/10.1606/1044-3894.3483
Buchbinder, E., & Eisikovits, Z. (2003). Battered women’s entrapment in shame: A phenomenological study. American Journal of Orthopsychiatry, 73(4), 355–366. https://doi.org/10.1037/0002-9432.73.4.355
Budden, A. (2009). The role of shame in posttraumatic stress disorder: A proposal for a socio-emotional model for DSM-V. Social Science & Medicine, 69(7), 1032–1039. https://doi.org/10.1016/j.socscimed.2009.07.032
DeCou, C. R., Mahoney, C. T., Kaplan, S. P., & Lynch, S. M. (2019). Coping self-efficacy and trauma-related shame mediate the association between negative social reactions to sexual assault and PTSD symptoms. Psychological Trauma: Theory, Research, Practice, and Policy, 11(1), 51–54.
Dorahy, M. J., & Clearwater, K. (2012). Shame and guilt in men exposed to childhood sexual abuse: A qualitative investigation. Journal of Child Sexual Abuse, 21(2), 155–175. https://doi.org/10.1080/10538712.2012.659803
Forgash, C., & Knipe, J. (2012). Integrating EMDR and ego state treatment for clients with trauma disorders. Journal of EMDR Practice and Research, 6(3), 120–128. https://doi.org/10.1891/1933-3196.6.3.120
Gilbert, P. (2011). Shame in psychotherapy and the role of compassion focused therapy. In R. L. Dearing & J. P. Tangney (Eds.), Shame in the therapy hour (pp. 325–354). American Psychological Association.
Goldsmith, R. E., Gerhart, J. I., Chesney, S. A., Burns, J. W., Kleinman, B., & Hood, M. M. (2014). Mindfulness-based stress reduction for posttraumatic stress symptoms: Building acceptance and decreasing shame. Journal of Evidence-Based Complementary & Alternative Medicine, 19(4), 227–234. https://doi.org/10.1177/2156587214533703
Hahn, W. K. (2004). The role of shame in negative therapeutic reactions. Psychotherapy, 41(1), 3–12.
Harris, R. (2009). ACT made simple: An easy-to-read primer on acceptance and commitment therapy. Oakland, CA: New Harbinger.
Harman, R., & Lee, D. (2010). The role of shame and self-critical thinking in the development and maintenance of current threat in post-traumatic stress disorder. Clinical Psychology & Psychotherapy, 17(1), 13–24. https://doi.org/10.1002/cpp.636
Herman, J. (1992). Trauma and recovery: The aftermath of violence, from domestic abuse to political terror. Basic Books.
Hernandez, V., & Mendoza, C. (2011). Shame resilience: A strategy for empowering women in treatment for substance abuse. Journal of Social Work Practice in the Addictions, 11(4), 375–393. https://doi.org/10.1080/1533256X.2011.622193
La Bash, H., & Papa, A. (2014). Shame and PTSD symptoms. Psychological Trauma: Theory, Research, Practice, and Policy, 6(2), 159–166. https://doi.org/10.1037/a0032637
Lee, C., Gavriel, H., Drummond, P., Richards, J., & Greenwald, R. (2002). Treatment of PTSD: Stress inoculation training with prolonged exposure compared to EMDR. Journal of Clinical Psychology, 58(9), 1071–1089. https://doi.org/10.1002/jclp.10039
Lee, D., Scragg, P., & Turner, S. (2001). The role of shame and guilt in traumatic events: A clinical model of shame-based and guilt-based PTSD. British Journal of Medical Psychology, 74(4), 451–466. https://doi.org/10.1348/000711201161109
Leskela, J., Dieperink, M., & Thuras, P. (2002). Shame and posttraumatic stress disorder. Journal of Traumatic Stress, 15(3), 223–226. https://doi.org/10.1023/A:1015255311837
Lewis, M. (2003). The role of the self in shame. Social Research, 70(4), 1181–1204.
MacGinley, M., Breckenridge, J., & Mowll, J. (2019). A scoping review of adult survivors’ experiences of shame following sexual abuse in childhood. Health & Social Care in the Community, 27(5), 1135–1146. https://doi.org/10.1111/hsc.12771
Mills, L. (2008). Shame and intimate abuse: The critical missing link between cause and cure. Children and Youth Services Review, 30(6), 631–638. https://doi.org/10.1016/j.childyouth.2008.01.010
Morley, C. (2003). Towards critical social work practice in mental health. Journal of Progressive Human Services, 14, 61–84. https://doi.org/10.1300/J059v14n01_05
Rennison, C. M. (2014). Feminist theory in the context of sexual violence. In G. Bruinsma & D. Weisburd (Eds.), Encyclopedia of Criminology and Criminal Justice (pp. 1617–1627). Springer. https://doi.org/10.1007/978-1-4614-5690-2_70
Robertson, T. E., Sznycer, D., Delton, A. W., Tooby, J., & Cosmides, L. (2018). The true trigger of shame: Social devaluation is sufficient, wrongdoing is unnecessary. Evolution and Human Behavior, 39(5), 566–573. https://doi.org/10.1016/j.evolhumbehav.2018.05.010
Saraiya, T., & Lopez-Castro, T. (2016). Ashamed and afraid: A scoping review of the role of shame in post-traumatic stress disorder (PTSD). Journal of Clinical Medicine, 5(11), 94. https://doi.org/10.3390/jcm5110094
Schoenleber, M., Sippel, L. M., Jakupcak, M., & Tull, M. T. (2015). Role of trait shame in the association between posttraumatic stress and aggression among men with a history of interpersonal trauma. Psychological Trauma: Theory, Research, Practice, and Policy, 7(1), 43–49. https://doi.org/10.1037/a0037434
Talbot, N. L. (1996). Women sexually abused as children: The centrality of shame issues and treatment implications. Psychotherapy, 33(1), 11–18.
Trumbull, D. (2003). Shame: An acute stress response to interpersonal traumatization. Psychiatry, 66(1), 53–64. https://doi.org/10.1080/00332747.2020.1717308
Ullman, S. E. (2011). Is disclosure of sexual traumas helpful? Comparing experimental laboratory versus field study results. Journal of Aggression, Maltreatment & Trauma, 20(2), 148–162. https://doi.org/10.1080/10926771.2011.546751
Van Vliet, K. J. (2008). Shame and resilience in adulthood: A grounded theory study. Journal of Counseling Psychology, 55(2), 233–245. https://doi.org/10.1037/0022-0167.55.2.233
Wilson, J. P., Droždek, B., & Turkovic, S. (2006). Posttraumatic shame and guilt. Trauma, Violence, & Abuse, 7(2), 122–141. https://doi.org/10.1177/1524838005285914
Wong, M. R., & Cook, D. (1992). Shame and its contribution to PTSD. Journal of Traumatic Stress, 5(4), 557–562. https://doi.org/10.1002/jts.2490050405
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Plante, W., Tufford, L. & Shute, T. Interventions with Survivors of Interpersonal Trauma: Addressing the Role of Shame. Clin Soc Work J 50, 183–193 (2022). https://doi.org/10.1007/s10615-021-00832-w
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DOI: https://doi.org/10.1007/s10615-021-00832-w