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The influence of shame on posttrauma disorders: have we failed to see the obvious?

Taylor TF - Eur J Psychotraumatol (2015)

Bottom Line: Recent changes to diagnostic criteria have added anger, guilt and shame alongside fear as significant emotional states associated with the disorder.This article suggests that shame is a frequent, often poorly recognised sequel to trauma, occurring as a result of the meaning the individual places on the traumatic experience and on subsequent interpersonal and environmental events.Examination of potential shame-related changes in self-concept, close interpersonal relationships and social inclusion are recommended for individuals who have experienced a range of traumas to identify and address any underlying unacknowledged shame.

View Article: PubMed Central - PubMed

Affiliation: School of Psychology, Social Work and Social Policy, University of South Australia, Adelaide, Australia; terry.taylor@mymail.unisa.edu.au.

ABSTRACT

Background: While fear is known to be the dominant affect associated with posttraumatic stress disorder (PTSD), the presence and possible influence of other emotions is less well explored. Recent changes to diagnostic criteria have added anger, guilt and shame alongside fear as significant emotional states associated with the disorder. This article suggests that shame is a frequent, often poorly recognised sequel to trauma, occurring as a result of the meaning the individual places on the traumatic experience and on subsequent interpersonal and environmental events.

Methods: The article reviews the literature on the socio-interpersonal aspects of the posttraumatic experience with particular emphasis on the emotion of shame as both primary and secondary emotion, in its intrapersonal and interpersonal contexts, and in adaptive and maladaptive forms.

Results: The review suggests that posttrauma shame, and maladaptive shame regulation strategies, often manifesting as anger, substance abuse, social withdrawal or depression, may play an important role in the maintenance or exacerbation of the symptoms of PTSD and the development of co-morbidities.

Conclusion: The recognition of shame and maladaptive shame regulation strategies in PTSD treatment and management is critical. However, because shame is frequently considered a painful and discomforting emotion, it may fail to be addressed in the therapeutic setting by both client and therapist. Examination of potential shame-related changes in self-concept, close interpersonal relationships and social inclusion are recommended for individuals who have experienced a range of traumas to identify and address any underlying unacknowledged shame.

No MeSH data available.


Related in: MedlinePlus

Compass of shame-avoidant behaviours and masking emotions (Webb, 2010, developed from Nathanson, 1992).
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Figure 0001: Compass of shame-avoidant behaviours and masking emotions (Webb, 2010, developed from Nathanson, 1992).

Mentions: Scheff (1994) described shame as the “master emotion” with a central role in evoking a range of other emotions. Nathanson (1987, 1992) similarly conceptualised shame as a key emotion, proposing a “Compass of Shame,” with shame in a central position and shame-related behaviours summarised as: “attack other,” “attack self,” “withdrawal,” and “avoidance.” The theory behind the Compass of Shame suggested that individuals develop scripts or schemas in order to ignore, reduce, or displace shame, without directly addressing its origin. Webb (2003, 2010) proposed developments to this concept, suggesting that the behaviours map a compass of shame-avoidance rather than shame itself. He adopted the language used by participants in a qualitative study to rename Nathanson's (1987) “withdrawal” and “avoidance” poles as “hide from other” and “hide from self,” thereby more clearly identifying the bi-polar dimensions of aggression and alienation of the basic shame-avoidant responses. The four poles thus correspond to the social behaviours of “aggression,” “depression,” “isolation,” and “addiction,” together with their associated avoidant emotions of fear, anger, distress, and disgust (see Fig. 1).


The influence of shame on posttrauma disorders: have we failed to see the obvious?

Taylor TF - Eur J Psychotraumatol (2015)

Compass of shame-avoidant behaviours and masking emotions (Webb, 2010, developed from Nathanson, 1992).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4580708&req=5

Figure 0001: Compass of shame-avoidant behaviours and masking emotions (Webb, 2010, developed from Nathanson, 1992).
Mentions: Scheff (1994) described shame as the “master emotion” with a central role in evoking a range of other emotions. Nathanson (1987, 1992) similarly conceptualised shame as a key emotion, proposing a “Compass of Shame,” with shame in a central position and shame-related behaviours summarised as: “attack other,” “attack self,” “withdrawal,” and “avoidance.” The theory behind the Compass of Shame suggested that individuals develop scripts or schemas in order to ignore, reduce, or displace shame, without directly addressing its origin. Webb (2003, 2010) proposed developments to this concept, suggesting that the behaviours map a compass of shame-avoidance rather than shame itself. He adopted the language used by participants in a qualitative study to rename Nathanson's (1987) “withdrawal” and “avoidance” poles as “hide from other” and “hide from self,” thereby more clearly identifying the bi-polar dimensions of aggression and alienation of the basic shame-avoidant responses. The four poles thus correspond to the social behaviours of “aggression,” “depression,” “isolation,” and “addiction,” together with their associated avoidant emotions of fear, anger, distress, and disgust (see Fig. 1).

Bottom Line: Recent changes to diagnostic criteria have added anger, guilt and shame alongside fear as significant emotional states associated with the disorder.This article suggests that shame is a frequent, often poorly recognised sequel to trauma, occurring as a result of the meaning the individual places on the traumatic experience and on subsequent interpersonal and environmental events.Examination of potential shame-related changes in self-concept, close interpersonal relationships and social inclusion are recommended for individuals who have experienced a range of traumas to identify and address any underlying unacknowledged shame.

View Article: PubMed Central - PubMed

Affiliation: School of Psychology, Social Work and Social Policy, University of South Australia, Adelaide, Australia; terry.taylor@mymail.unisa.edu.au.

ABSTRACT

Background: While fear is known to be the dominant affect associated with posttraumatic stress disorder (PTSD), the presence and possible influence of other emotions is less well explored. Recent changes to diagnostic criteria have added anger, guilt and shame alongside fear as significant emotional states associated with the disorder. This article suggests that shame is a frequent, often poorly recognised sequel to trauma, occurring as a result of the meaning the individual places on the traumatic experience and on subsequent interpersonal and environmental events.

Methods: The article reviews the literature on the socio-interpersonal aspects of the posttraumatic experience with particular emphasis on the emotion of shame as both primary and secondary emotion, in its intrapersonal and interpersonal contexts, and in adaptive and maladaptive forms.

Results: The review suggests that posttrauma shame, and maladaptive shame regulation strategies, often manifesting as anger, substance abuse, social withdrawal or depression, may play an important role in the maintenance or exacerbation of the symptoms of PTSD and the development of co-morbidities.

Conclusion: The recognition of shame and maladaptive shame regulation strategies in PTSD treatment and management is critical. However, because shame is frequently considered a painful and discomforting emotion, it may fail to be addressed in the therapeutic setting by both client and therapist. Examination of potential shame-related changes in self-concept, close interpersonal relationships and social inclusion are recommended for individuals who have experienced a range of traumas to identify and address any underlying unacknowledged shame.

No MeSH data available.


Related in: MedlinePlus