Shame and Medicine Exeter
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How permission to have shame can be a game changer

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 better and placed a large emphasis on compassion. However, in my clinical experience as a psychosexual therapist, the concept of compassion is elusive for most people. When the suggestion of compassion is presented to people, the response is almost always the same, “I find being compassionate towards myself impossible”. I have also observed that for a lot of people, the difficulty in accessing self-compassion can bring a sense of failure, which inevitably creates more shame.

According to the Oxford English dictionary, compassion is the sensitivity to suffering and distress with a desire to alleviate that distress. For many people with shame, they can feel like they are fundamentally bad and are deserving of their suffering. Therefore, the shift from that space into one of self-compassion can be too big a leap. It does not make sense to them to consider themselves with kindness.

Whilst I agree that compassion is a vital element of shame work, considering self with compassion is likely to be something to work towards, rather than something accessed quickly. As part of my research into shame, I have developed Shame Containment Theory. This theory uses the power of permission to have shame as the precursor to compassion.

Shame can be the most intolerable emotion we have. Karl Jung described it as a soul eating emotion and likewise, Gershen Kaufman describes shame as soul murder. I think both terms accurately capture the devastation that shame can bring. Therefore, the concept of permission, whether that be to have shame, or to experience shame, can feel paradoxical.

Giving permission to your shame flies in the face of many of the common messages that we receive about shame. For example, contained within a popular meditation app are courses and guided meditations on how to heal and let go of your shame. These messages explicitly tell us that we should eradicate shame to feel better about ourselves or fulfil our true potential. These types of narratives shame shame. However, shame has a vital purpose which is to protect us and keep us safe.

Once again, the notion that shame is protective can seem paradoxical, given how terrible this emotion can feel. However, shame keeps us attached to caregivers when we are very small children. It allows us to be pro-social and to be included in groups and cultures. Its purpose is to ensure that our relational bonds remain intact.

If we consider shame from the perspective of it being a much-needed part of our human experience, we can give permission for it being present within us. Even when shame has caused difficulty in our lives, we can usually see where shame has been trying to protect us. For example, our shame may tell us that we don’t deserve to go for a job promotion. We would be terrible at it and the interview would highlight our incompetence. This does not sound like shame is doing a great job at helping us be pro-social or achieve our goals. However, shame in this instance is trying to prevent us from being seen by keeping us small. We are in a much safer position when we are here, rather than being seen and vulnerable. When we examine what shame is up to more closely, we can begin to appreciate the job it is trying to do. It does not mean we have to like it, but we can give it permission for attempting to keep us safe.

In giving permission for shame to do its job, which is to protect us, we can allow ourselves to feel shame. This is because we have given shame meaning. Giving shame meaning can be a game changer because there is now a reasonable explanation for why we have done and thought certain things. We can give ourselves permission to have carried out some of the actions we have found shameful. From here, we can start to work more closely with shame and head towards the ultimate goal of self-compassion. Permission is a powerful tool that can help us to change our relationship with shame.


Lisa Etherson, Doctoral Researcher, Teeside University –


17th June 2024


Photo by Dan Meyers on Unsplash













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