Feb 16, 2003

That loathing feeling

If you feel bad about yourself all the time, it could be that you suffer from shame-proneness. Jane Feinmann explains how over-critical parenting can lead to a lifetime of depression

Jane Feinmann
The Guardian
February 16, 2003

If you're looking after a small child today, the chances are that you'll stop it in its tracks by delivering a sharp rebuke or look of displeasure. As a parent, you know instinctively the value of this simple but effective technique. But according to new research, you should think twice before underlining any reproach with a muttered, 'You should be ashamed of yourself.'

Shame, as we all know, is an unpleasant emotion, literally paralysing the body and provoking a desire to sink into the ground. From childhood on, we're super-sensitive to any threat to our basic need for approval, which is why instilling a sense of shame is such an effective socialising agent.

But scientists have started to realise that there is a far more sinister aspect to this everyday emotion; something that, because of its uniquely destructive nature, remained hidden to mental-health practitioners, from Freud onwards, for most of the 20th century.

Toxic shame is the name psychologists have given to a syndrome that they believe underpins large swathes of mental-health problems, from depression and anorexia to violence and bullying. 'There's a big difference,' says Paul Gilbert, Professor of Psychology at the University of Derby, 'between what psychologists call external shame, which is an unpleasant but just about tolerable feeling that other people look down on you and make bad judgements about you, and internal shame, which is toxic and which is about feeling undesirable and unlovable.

'It's the latter, of course, the deep hatred of yourself, that you don't want to be the person you are, that causes the real mental-health problems. As yet there's been no study of its prevalence but there is little doubt that it affects very large numbers of people, responsible for deep unhappiness in the general population as well as contributing to a substantial proportion of clinical mental illness,' he says.

At its most extreme, toxic shame develops as a result of sexual or physical abuse of young children, which, because it occurs at a time when the brain is being physically sculpted by experience, may irreversibly alter neural development, researchers from the Department of Biopsychiatry at Harvard Medical School reported last year.

More commonly, childhood experience of being repeatedly or traumatically shamed, where care is 'harsh and austere, when parental responses are stern and critical more often than affectionate and loving', leads to the development of 'shame-proneness' - a vulnerability to experiencing shame, to interpreting events as proof of your personal unattractiveness. 'Life provides constant opportunities to feel shame because you are poor or you aren't wearing the right trainers,' says Gilbert. 'How we cope depends on how well our brains are equipped to deal with them.'

Since the mid-90s, researchers have been building up a picture of how shame-prone people behave. 'They're people for whom life is a battle, who feel they have to earn their love and defend their place in the world,' says Gilbert. 'There's evidence that a high proportion of people who are vulnerable to depression suffer from internal shame, not least because feeling alone and empty is part of the syndrome.

Body Shame (Routledge) co-edited by Gilbert, also provides evidence that early 'toxic' shaming affects the way people feel they look, leading to eating disorders and body- dysmorphic disorder. 'The debate about the effect on women of constantly seeing and reading about super-slim models fails to take account of the impact on those who are shame-prone,' he says. 'For them, these images put a harsh spotlight on what's wrong with their bodies, that supermodels are winners and they are losers.'

But the most recent findings on the quality of shame are perhaps the greatest cause for concern. For researchers now believe that what differentiates shame from other unpleasant emotions is that the experience of shame is itself deeply shaming. People can feel guilty without it becoming internalised, largely because this emotion is focused on other people. 'Toxic shame is entirely about how you see yourself,' Gilbert claims. 'People spend a good deal of their lives trying to conceal it, and talking about it is instinctively avoided because it reactivates the intensity of the emotion. Sexual abuse was largely ignored in psychotherapy until the early 90s, because victims never willingly revealed their experiences.'

A series of lectures on shame for therapists at the end of last year proved to be an eye-opener, says psychoanalyst Phil Mollon. 'What surprised many practitioners was not just the "always hidden" nature of shame but also the possibilities for misunderstandings, failures of communication and inadequacies of empathy. Astonishingly, this aspect of the psychotherapeutic setting is rarely addressed.'

Gilbert says that mental-health services are searching for better ways of treating toxic shame. 'The aim must be to help people acknowledge what they feel ashamed of and learn how to give it up. We're finding people respond well to encouragement to meditate or fantasise about what it feels like to be loved unconditionally, to be seen as worthy and desirable,' he says. The next step, he says, is to help them learn compassion for themselves as well as others, thereby finding ways to tolerate normal feelings of shame.

Once people allow their emotional lives to come out of hiding, they'll need support to find better ways of relating to others or to deal with issues around the event that has caused the shame. 'It's not easy because aroused shame in these people is a fast-track, involuntary process that is difficult to control.'

For the purposes of the nursery, however, it is worth bearing in mind that the healthy emotion relates to a specific event of behaving badly. Telling a child to be ashamed of him/herself is asking for truly toxic trouble.