Jason Luoma, PhD Answers 3 Questions About Shame

On November 5th, we’ll be hosting a webinar titled The Top 5 Shame Research Findings that Should Influence Your Practice, which will be led by Jason Luoma, PhD (more information and registration details here). Jason has been conducting research on shame, self-criticism, and stigma, particularly in the context of addiction, since 2002, and has published numerous longitudinal, cross-sectional, and intervention studies including first randomized trial of an intervention focused on helping people with shame in the Journal of Consulting and Clinical Psychology.  You can see a full list of his publications, including some that are available for download here.

In preparation for this talk, we asked Jason three questions about shame and would like to share his responses with you.

Why is it important to know about shame in clinical practice?

My experience is that my most complex, chronic and stuck clients are often laboring under a great weight of shame. I’ve seen how shame leads them to withhold clinically useful information, how it leads to defensive and blaming behavior, and how it gets in the way of intimacy. I’ve seen how shame about their emotions, their bodies, and their thoughts impedes their self-awareness and makes it hard to be responsive to their own needs. Research also shows these observations to be true.

Since I started studying shame intensively about a decade ago, I have found that having a more nuanced understanding of how shame functions can help therapists be able to understand their clients behavior in a more nuanced manner and guide relevant interventions. Part of what’s tricky about shame is that the primary action tendency associated with it is to hide. This can make it hard to recognize, and often shame works in the background, unrecognized but still motivating many of the problematic behaviors that clients engage in. Knowledge of how shame functions can help us to see past the defensive and avoidant reactions and be able to bring light to what’s often a very dark and lonely place that our clients find themselves stuck in.

Where is the research at on this topic?

There is a large body of research on how shame functions. We know that some people experience shame more easily than others. And we know that this tendency towards experiencing shame is associated with a whole host of problems, such as anger, depression, anxiety, overeating, social withdrawal, loneliness, fear of intimacy, and difficulty with experiencing compassion and self-compassion. This is just a short list of many problems that have been shown to be linked to shame. What is less well developed from an empirical standpoint is how to help people struggling with chronic and pervasive shame. Shame has long been known by clinicians to be important, but is only recently been addressed by the more empirical wings of psychotherapy. At this point, the two most well established treatments for shame are acceptance and commitment therapy and compassion-focused therapy. A handful of randomized trials and a range of open trials are giving us some new ideas on what works to help people stuck in shame.

Can therapists from all kinds of clinical traditions integrate some work on shame in their practice? Is it relevant for a variety of psychological problems?

From an empirical perspective, we know that shame and self-criticism play an important role in a variety of psychological disorders including depression, post-traumatic stress disorder, borderline personality disorder, eating disorders, schizophrenia (particularly paranoia), social anxiety disorder, and substance abuse and addiction. It’s likely that shame and self-criticism are transdiagnostic processes that, if targeted successfully, could improve outcomes across a range of mental health difficulties. I think we are starting to see some early evidence that suggests this may be the case.

All clinicians are already working with shame in their clinical practices, whether they know it or not. This is particularly true for clinicians who work with clients experiencing more complex and chronic problems. Those therapists often have a well-developed repertoire of working with shame, based on whatever perspective they are coming from. A more thorough understanding of what the research has to say about shame can help them more finely tune the use of the tools they already have and also give them new techniques they can integrate into their practice.

You can learn more about Jason on his website: www.actwithcompassion.com.