Shame and Medicine Exeter
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Speaking of Shame

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 weather outside her office window. Light, sharp, and breezy.

If researching shame takes a toll, Luna hasn’t paid it. Instead, she speaks about shame with enthusiasm and a sense of fascination.

That fascination is common in researchers who have found, in one particular area, a subject so rich and universal that it becomes a life’s work to unpack. And Luna has done a huge amount of that unpacking already. She is a lead investigator on the Wellcome-funded Shame and Medicine project, she recently co-authored a book (with its own podcast series) on how the emotion was weaponised during the Covid pandemic, and is now educating police officers about the effects of shame.

To begin our interview, I ask her why. How is it that shame has become so fascinating and relevant to our everyday lives?

Shame is so interesting, Luna tells me, “because it’s such a powerful force.” Unlike many other emotions, shame is a “relational one” – one that always involves other people. “What’s implicit when people experience shame is an expectation of other people: we worry about being looked at or judged.”

This is what gives shame its power.  Because it’s inextricably bound up with social norms and the ways people see us, shame can actually shape the way we behave. If we see proliferate advertising that favours a body type that we don’t have, for example, the feeling of shame can be so potent that we will modify our behaviour as a result. We do this because – though experiences of shame fluctuate wildly, from the personal to the systemic, from the harmful to the benign – the experience is always underscored by a threat: “In shame, one’s social survival is at stake. That’s what makes it more powerful than other emotions.”

This power makes it all the more surprising that, until recently, shame has been under-acknowledged in public discourse. Despite its sway over us, we have spent years avoiding the subject – and the potentially dangerous consequences of doing so. We don’t talk about shame, says Luna, because we are stuck in a catch 22. “Admitting to feeling shame is shameful,” she notes, “which is why it’s taboo. For us to talk about shame, to even bring it up, means admitting that we are vulnerable.”

This path of least resistance has allowed shame to go unnoticed in public life. And that’s not always a bad thing. As Luna is quick to add, shame can be a “pro-social” emotion: experiencing shame (or rather, anticipating the experience) leads to positive outcomes such as social cohesion and, when we feel shame for a harmful habit, opportunities for growth. For example, we’d feel a great deal of shame if we ran around naked which, naturist preferences aside, is probably a good thing.

However, the reverse is true in certain public institutions, where shaming cultures perpetuate some of the emotion’s more negative consequences. Through Shame and Medicine, Luna finds that hierarchical institutions, like the NHS and the police, use shame as a tool to coerce professional behaviour. Sometimes this happens intentionally through a ‘name, blame and shame’ culture, and sometimes shaming is inadvertent and accidental. And while there is value in finding ways to make sure people perform their jobs consistently (a doctor’s autonomy is all well and good until she’s amputating the next flu patient), the potency of shame can have destructive implications when bad habits and biases become systemic.

This is especially unhelpful when ‘mistakes’ are made. In many cases, Luna tells me, “shame is individualised. We attribute shame to individuals and specific forces, when what’s causing these issues is often systemic social forces and workplaces cultures. Consequently, there’s a huge propensity to attribute blame, rather than learn from what has happened.”

In the context of Louise Casey’s damning police report, the existence of a shaming culture is something to tackle head-on. If the threat of experiencing shame causes staff to turn a blind eye to instances of police misconduct, for example, that behaviour can continue unchecked.

Significantly, research also finds that victims and offenders – two groups that police officers interact with on a daily basis – are often deeply affected by not only trauma, but shame as well. Many readers will empathise with the fact that survivors of traumatic assault bear painful experiences of shame. Fewer would recognise just how much it affects criminal offenders, many of whom have internalised shame and the effects of abuse at an early age.

The consequences are no less powerful. “There is no violence that doesn’t have shame as it’s root cause,” Luna tells me, citing the psychiatrist Donald Nathanson. “When people’s deep feelings of shame are triggered by a situation, they lash out – violence becomes a way of reclaiming power.”

So what can be done? Now we are slowly waking up to the power – and potential danger – of shame in public life, how can we start to address it?

Opening up about our experiences, Luna says, is a good first step. The conversation around shame has shifted in the last two decades, thanks to bold researchers and public figures who went against the grain to speak on the topic. “People like Brené Brown have helped shift the taboo, by making shame less threatening as a topic.” Seen this way, every conversation about shame takes a small, but meaningful chip off the stigma against shame.

Another practical step is teaching people about shame’s influence on behaviour. This idea, which Luna is developing as part of a new ‘shame competency’ project, takes aim at how little we currently know about this crucial emotion.

Educating people about the prevalence of shame and the ways it influences behaviour, Luna says, is key to developing not only people’s awareness, but their competency, when dealing with shame. “My work helps organisations mitigate the negative effects of shame,” she tells me, “by helping people to recognise when shame might be driving someone’s behaviour, and giving them the confidence to adjust or tailor their response in those situations.”

Luna herself is confident that we’re ready for change. “We can all become shame competent. While shame is inevitable, competency training can make people aware of its power, its inherently social nature, and its effect on behaviour.”

She pauses, and recalls a moment where Donald Nathanson was told that speaking about shame at a conference would “ruin his reputation”. She smiles – wise to the tortoise-like speed with which social norms eventually catch up with wisdom. “I think that’s changed now. Today, people mostly find shame fascinating.”

Speaking to Luna, you can see why. While it may be some time before we’re able to talk about shame openly and competently, there is something deeply fascinating about an emotion that is able to reveal so much about the way we live. Luna’s research may have paved the way forward, but it’s the fascination with which she talks about shame that is infectious, and essential to driving the next wave of progress.


This article was written by Ben Dickenson Bampton, a writer and visual storyteller who specialises in connecting great ideas about our world with the audiences and communities they serve.


30th January 2024


Photo by Thomas Kinto on Unsplash


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