Shame and Medicine Exeter
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Personal responsibility vs social determinants of health: how us GPs can avoid shaming our patients when trying to help. 

15 July 2024

I’ve enjoyed The BMJ’s focus on societal causes of ill health recently and Dr Lucinda Hiam et al’s article deeply resonated with me. Mainly because as a GP, I’ve always been troubled by my colleagues, often well meaning, but equally…

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It’s a shame about shame research

2 July 2024

I was honoured to be invited to the Researching Shame Conference in Birmingham on 5th June 2024 on account of research published more than a decade ago exploring whether shame is a concomitant of poverty.[1]  Although learning a great deal…

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How permission to have shame can be a game changer

17 June 2024

Probably the most recognised “antidote” to shame is compassion. Paul Gilbert who developed Compassion Focus Therapy originally created the model to apply to shame. Equally, Brené Brown created Shame Resilience Theory with the intention of helping people manage their shame…

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Excerpt from ‘Out of Patients’

29 May 2024

“Excerpt from Out of Patients: A Novel is published with permission from the University of Nevada Press.”   Women go to physicians more than men. Partly that’s having a uterus, because menstrual periods can be flighty, and because women control fertility. A…

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What is the Difference Between Shame and Stigma?

8 May 2024

When I speak to healthcare workers about shame, and why we need to understand shame and its effects, the question I hear most frequently is: “What’s the difference between shame and stigma?” Stigma has been a very useful idea in…

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Chronic Shame, Serious Mental Illness (SMI), Lived Experience & Audit Culture

8 April 2024

As I write this I have just come through an acute episode of shame. I’ve been hiding from myself for days. In such panic I’ve had trouble breathing. I have a tendency to hold my breath. Not on purpose, my…

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How shame highlighted the importance of deconstructing biomedical science and building patient-centred care

11 March 2024

After graduating from medical school in 2018, I had an experience that led me to feel shame upon recognising that I could not communicate with patients from their perspective. Patients with chronic or asymptomatic diseases, including hypertension, diabetes, and dyslipidaemia,…

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When we hurt our patients: Shame in clinical encounters for breast cancer treatment

19 February 2024

There are many reasons why shame may be experienced during treatment for breast cancer. Shame about the diagnosis, about how a lump was found (or not found) can be experienced. Shame about risk factors such as alcohol intake, hormonal factors…

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Speaking of Shame

30 January 2024

My conversation with Luna Dolezal seems like a contradiction. For someone whose philosophy career has taken her deep into the emotion of shame and its powerful – sometimes troubling – effects on our everyday lives, Luna’s demeanour is like the…

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Moral Injury: a manifestation of shame in Healthcare workers

8 January 2024

I’ve always thought that if shame were an animal it would be a box jellyfish, at times delivering its effect slowly through repeated contact with its tentacles and at other times swiftly, with a sudden and devastating sting. As a…

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Feeling ‘not-so-likeable’: historicising loneliness as a shamed emotion

11 December 2023

There are all kinds of reasons why we might feel lonely. From philosophical explorations of loneliness as an essential part of being human, to political critiques of modern alienation, toxic individualism, and unjust systems of marginalisation and exclusion, a number…

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Healing together after medical harm: A bittersweet journey

21 November 2023

A peppermint candy was all I needed. Whenever I cried after making a mistake in my spelling test in first grade, my teacher, dear Madame Carty, would always give me a peppermint to soothe my feelings. I didn’t know it…

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Reflective Practice: A Tool to Process Shame 

30 October 2023

It was really odd starting medical school in the middle of the pandemic. Continually reminded of the pertinent reality of the career paths upon which we had embarked, we remained incredibly distant from any true clinical learning environment. For this…

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4 October 2023

Post-op drifting after reconstructive surgery, in a wide-open, multi-bed recovery room partitioned by wavy muslin walls, I heard one strangled sentence above the racket of skittering curtain hooks. “Honey, I’m a monster!” My gaze swiveled toward a half-hidden silhouette backlit…

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How do you draw guilt and shame?

11 September 2023
How do you draw guilt and shame?             Figure 1 Zino Loci #1 ‘Guilt + Shame’ (2023) Zino Loci #1 can be seen in full here: As the curator of the Zineopolis art zine...Read full article

Shame and hoarding disorder

24 August 2023

I have a many-layered relationship with shame, like many of us do. I grew up as a Roman Catholic, and those jokes about “Catholic guilt” don’t come from nowhere. I’m also gay, and while I see that as an absolute…

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Shame and professional ideals

24 July 2023

Shame followed me throughout my medical career, although it is only now that I am able to see it and name it. At 19, I was overwhelmed by the thought of the cadaver in front of me as a man…

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VIOLENT SHAME – the bigger picture

4 July 2023

I worked for many years in health and social care settings, specialising in advocacy, mental health, trauma, and then with an increasing focus on behaviour, conflict, aggression and violence. I regularly heard phrases like “he won’t learn if he gets…

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Shame and Telemedicine

5 June 2023

It is clear that shame can get in the way of the successful delivery of healthcare and can clearly impact on health outcomes. People who are anxious about shameful exposure may avoid seeking help in the first place, may regularly…

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Shame in the Psychosexual Therapy Room

17 May 2023

Shame and sex are synonymous with each other. This entwined relationship has led me, as a psychosexual therapist, to explore shame for my PhD research. Through my research, I have recognised that anxiety in sexual difficulties is only one part…

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Wary and watchful: Life with hepatitis C  

17 April 2023

I have been producing some creative work over the past three years based on my lived experience of having hepatitis C (now cured). Hepatitis C is a viral liver disease passed on by blood-to-blood contact and it is frequently associated…

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Vaccine Hesitancy, Death Shaming and COVID-19

20 March 2023

On the 24th of August 2021, the online media platform New Frame published a satirical cartoon by the South African illustrator Carlos Amato. The cartoon depicts several rows of gravestones, each etched with a trope from vaccine-hesitant discourses: ‘My body…

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Maternity care for women of a higher weight – how is shame experienced?

28 February 2023

For most women, pregnancy and birth should be a time of excitement, anticipation and promise. However, women of a higher weight* can have a negative experience of maternity care due to experiencing weight stigma from healthcare professionals. Stigma involves negative…

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The clothes of shame

7 February 2023

A knotted gut. Breathlessness. Intense self-loathing. Wanting to hide. Ruminating and agonising for days. Rationalisation and learning.   These familiar and habitual sensations, behaviours and outcomes accompanied times of perceived failure and humiliation; ranging from school, such as when being…

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Researching a painful taboo in healthcare

9 January 2023

Through work such as the Shame and Medicine project we have become more aware of the significant but silent impact shame can have on healthcare. Feeling shame or embarrassment about our health problems and difficulties coping with them, or even…

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Shame in Healthcare Consultations: A Case Study on Mental Health

7 December 2022

Consultations involving mental health service users and healthcare managers are often difficult. Individuals with lived experience of mental health conditions may be less inclined to participate. This is partly due to mental health conditions frequently being accompanied by feelings of…

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Moving Shame 2021 Workshop

14 November 2022
Figure 1 Zine front cover by Elizabeth Fortnum. Figure 2 Zine by Elizabeth Fortnum using art created by participants at the Moving Shame (2021) workshop. Arriving home, I open my front door to find a small, neatly packaged parcel in...Read full article

Shame and ‘This Is Going to Hurt’

24 October 2022

The opening scene of the BBC’s television series This Is Going To Hurt (2022) finds Adam Kay (Ben Whishaw), acting registrar in obstetrics and gynaecology, asleep in his car. A sound drags him to consciousness. Siren-like to begin with, it…

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Does research on medical professionalism reflect a medical ‘culture of shame’?

4 October 2022

Becoming-a-physician through medical education is a process which can be mediated by shame experiences. The pervasiveness of shame in medical training suggests that there is a ‘shame culture’ in medicine across predominantly English-speaking learning contexts. Shame is frequently used as…

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How we think about ‘good’ and ‘bad’ emotions in medicine

12 September 2022

In her article Biomedicine Inside Out , sociologist Sky Gross argues that the emotional attitude of surgeons in the operating theatre is shaped by the architectures and rituals of surgical practices, and not merely by a professional desensitisation – as…

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The Call Centre

23 August 2022

“The Call Centre” is a participatory film that animates longer-term ethnographic research conducted over the past 24 months across the United Kingdom by London School of Economics’ Covid and Care Research Group, led by Professor Laura Bear. It highlights the…

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China and the COVID-19 blame game

1 August 2022

COVID-19 is not going away.  Indeed, in China, in recent weeks, the pandemic has leapt from nowhere to dominate social media, even appearing once more on official news channels. While waves of the pandemic have spread around the world over…

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Shame and Depression: A Hyperawareness of The Social World

11 July 2022

In 2001 Andrew Solomon published his book ‘The Noonday Demon: An Atlas of Depression’, in which he gives an account of what it means to experience depression. He describes how depression is “a loss of feeling, a numbness, [which] had…

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My medical education

21 June 2022

When I look back at my early 20’s and my time at medical school, shame overshadows much of my experiences. There is so much joy, and I have been so privileged, but shame has an ability to hide this. I…

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“Medicine and doctors, be humble!”

31 May 2022

“Medicine and doctors, be humble!”   Medicine is meaningless I am a doctor who assumed the power of medicine My job is to diagnose and treat patients I was taught that doctors were virtuous people   My husband was also…

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On Shame, Empathy, and COVID-19 vaccinations

25 April 2022

We have all likely felt shame during the COVID-19 pandemic. Perhaps you felt ashamed of not being “productive enough” while working at home. Perhaps you felt shame when you got sick with COVID-19 and then infected a loved one. Perhaps…

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Haunted by shame, silenced by stigma: the experience of mothers living apart from their children as a result of state-ordered court removal

6 April 2022

Mothers who have their children removed by the state are haunted by the shame of being judged a deeply flawed mother. They are haunted, too, by the ‘ghosts’ of the children they have lost – a unique form of loss…

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Understanding ongoing stigma in COVID-19

14 March 2022

I first became intrigued by the issue of COVID-19 stigma when Tom Hanks and his wife Rita Wilson were the first celebrities to ‘come out’ and announce that they had contracted COVID-19, back in March 2020. Their frank disclosure, at…

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Shame on you for being human: Combating physician fears of disclosing mental health struggles

23 February 2022

Medicine is a profession that attracts a certain type of person. To get into medical school you have to be a driven, high achiever. That often correlates with perfectionism and a competitive streak, not explicitly for competing with others, but…

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Poverty-induced stigma, shame and humiliation in healthcare settings

1 February 2022

The roots of many healthcare concerns and ethical issues lie in poverty, especially in resource-scarce countries. The inextricable link between poverty and health manifests in the wide acknowledgement of poverty as a social determinant of health. Recent research continues to…

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Shame, blame and back again: policymaking in the age of COVID

31 January 2022

All governments like to blame someone else when things go wrong. The temptation to shame other people for your policy mistakes can be irresistible and we’ve seen it again with COVID-19. But, spreading fear and shaming individuals is counterproductive. It…

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Shame, blame, and complex, poorly-understood illness

4 January 2022

In October 2021, the National Institute for Health and Care Excellence (NICE) published their updated clinical guidance for the diagnosis and management of myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome (ME/CFS). The very first section of this guideline (1.1.1) instructs clinicians…

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Shame, ‘Common Sense’, and COVID-19: Notes from Mass Observation

14 December 2021

On the 6th of July 2021, the health secretary, Sajid Javid, announced that the UK had entered a ‘new chapter’ of the COVID-19 pandemic ‘based on the foundations of personal responsibility and common sense.’ Despite claiming to turn a page,…

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Hiding in shame: the history of the early Dutch family movement in psychiatry

22 November 2021

Once upon a time, a young Dutchman emigrated across the Atlantic in hopes of making his American dream come true. Some decades later, he was indeed a successful businessman, a millionaire, and respected in the highest circles. Grateful to his…

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Controlling fertility, reproducing shame: UK policies and reproductive injustice

1 November 2021

Many people think that government interference into peoples’ reproductive choices is largely a thing of the past, or only occurs in countries with repressive governments. Given this widespread assumption, you might be surprised to read some recent UK headlines: “Guidance…

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What does it mean to live and work within a culture of shame?

11 October 2021

The speaking voice in my ears paused and then, with a soft breath, started to sing. I stopped in surprise. The daffodils I had watched peek through the peat and grow into spindly budded things were blooming bright yellow along…

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Samuel Beckett’s blushing body of work

21 September 2021

Embarrassment is shame’s awkward cousin. At least, that’s the story told by many theories of emotion. Shame is a feeling that floods our whole being, that colours us to the core. Embarrassment is skin deep. Sweats, stutters and blushes –…

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Understanding Experiences of Weight-Related Shame in Clinical Experience

25 August 2021

Research shows that many people living with obesity experience weight-related shame in clinical practice. Unsolicited weight-loss advice from GPs, medical equipment that fails to accommodate larger body sizes and concerns about being judged for their weight by healthcare providers are…

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How I Came to Study Shame and Humiliation in Finnish Healthcare

5 July 2021

  The medical field is not where my own career path exists. I came to know the field from another point of view – from being the daughter of an ALS patient and a member of a family who has…

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Shame-Sensitive Dental Care for Patients with Complex Lives: Part II

6 May 2021
Towards Shame-Sensitive Dental Practice Peninsula Dental Social Enterprise runs a Community Dental Clinic in Plymouth for vulnerable people, including those who are affected by homelessness and who have drug and alcohol addictions. We aim to work in a trauma-informed way,...Read full article

Shame-Sensitive Dental Care for Patients with Complex Lives: Part I

27 April 2021

Shame and Dentistry: Considering the Impact of Vulnerable Individuals’ Experiences People with complex lives and complex needs related to homelessness or other severe disadvantage are no strangers to shame. Many will have experienced judgement regarding their economic situation, literacy, personal…

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Shame, Stigma and Social Threats in Experiences of Chronic Persistent Pain

22 March 2021

  Avoidance of clinical care is common for those who experience shame and stigma often to the detriment of care procurement. This avoidance can be an effort to protect from further shaming. For those who experience chronic persistent pain (CPP)…

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Shame and Hormonal Contraceptive Mental Health Side Effects

11 March 2021

  The development of the first hormonal contraceptive in 1960 was considered one of the most important inventions of the 20th century, and worldwide it has continued to pave the way for sexual freedom and reproductive choice. Besides family planning,…

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Shame across Times and Spaces: Women’s Experiences of ‘Virginity Testing’ and ‘Re-Virginisation’

17 February 2021

  ‘Virginity testing’, which refers to the medical or non-medical practice that is expected to determine the existence of the ‘hymen’, has been covered by a wide variety of media outlets in the last few months of 2020. We have…

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Shame and the formation of the professional medical identity

2 February 2021

“Is doctor something I wanted to do or something I wanted to be?” – Emily Silverman “Shame becomes inevitably bound up with the process of identity formation which underlies man’s striving for self, for valuing, and for meaning. The experience…

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Shame and Self-harm: Association and Avoidance

7 January 2021

In Imogen Tyler’s recent monograph, Stigma: The Machine of Inequality, she opens the introduction with a vignette describing her conversation with Stephanie, a woman who talked about her experience of joblessness, poverty, and housing and unemployment benefits. The vignette is…

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Public Humiliation and PTSD in World War I Veterans

4 November 2020

Disabled Ex-Soldiers, the Police and the Exeter Magistrates The difficulties that First World War ex-servicemen, particularly those with post-traumatic stress disorder (PTSD), experienced in civilian life have been researched and discussed specifically in the context of their medical treatment. Less…

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Shame and Cynicism in Medical Novels

16 October 2020

Alongside the official textbooks of the medical curriculum, there appears a second canon, a hidden curriculum. Consisting of essays, films, folktales, jokes, novels, plays, poems and television shows, this repository is a refuge, a place where doctors and other healthcare…

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Shame, Stigma and COVID-19

22 September 2020

Shame and stigma have been prominent features of the COVID-19 pandemic. Stigma, in particular, has been identified as an urgent issue related to COVID-19 by health organizations worldwide, including Public Health England, the CDC and the WHO. Stigma negatively impacts…

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Shame Regulation in Organisations: How and Why Doctors are Shamed

27 August 2020

Organisations are created with a purpose. In order to fulfil that purpose there needs to be forms of control within the organisation over the workforce. This post discusses the significance of shame as a disciplinary force explaining how and why…

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Asian Shame and Addiction

20 August 2020

Having had the opportunity to read about shame in academic literature in more depth and detail, I became increasingly interested in learning about shame in relation to different cultural backgrounds, especially migrant and minority-ethnic groups in light of my past research…

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