ANXIETY DISORDER TREATMENT AND RECOVERY

ST. LIC. MFT 18338 | Call (310) 391-3853

Shame

Shame

Shame, along with embarrassment and humiliation, is a complex emotion brought on by
feeling exposed or betrayed. It is part of the “social emotions”, meaning that what is considered
shameful is in the context of one’s family, culture, and society.  Feelings of shame have power
over us in ways that are not often obvious, and partly because we are not even aware that it
underlies our feelings, thoughts, and behaviors.

Shame is self-oriented: it is a sense of being flawed, sometimes in a vague way. John Bradshaw
(whose books I have often recommended) describes it this way: “Guilt is the experience that you
have made a mistake, while shame is the experience that you are a mistake.” 

Early in life, shaming experiences happen in one’s family, in school, and among peers.
Clearly, it shapes, and sometimes distorts, one’s developing identity. While shame also has the
adaptive function of guiding us to conform to the ethics, morals, and rules of our environment,
negative shameful experiences cause us to feel hopeless and inadequate, and ultimately to
depression. Generally, there are categories around which one feels lacking or flawed-personal
attractiveness, physical abilities, intelligence, competence, and lovability-are common themes.

It is almost impossible to get through childhood and adolescence without experiencing at least a
few shaming experiences. It’s helpful to be aware of one’s area(s) of shame since it very much
influences how we interact in our world. Avoidance of meeting people is one response, as is often
experienced by people with social anxiety. Some people become belittling of themselves, putting
themselves down, allowing others to treat them badly. Dependence on alcohol or drugs may be used
to numb one’s awareness. For others, criticizing or ridiculing others in order to make onesself feel
less inferior is another strategy. Clearly, these strategies can have negative consequences in one’s
life.

What to do? First, it is very important to be aware of one’s area of vulnerability as well as how you
may defend yourself against it. Typically, a “shame attack” is triggered when we feel embarrassed
or humiliated by a statement or a situation. Then we may have a physical reaction-blushing, drooping
posture, lowered eyes, anxiety, or just wishing we could disappear. And we may not be able to think clearly. 

At this point it is helpful to realize one has just had a shame attack, take a deep breath or two,
or focus on something outside of yourself in order to calm yourself and regain focus, which will allow
you to reassess the situation and determine an appropriate and life-affirming response.

As mentioned, almost any of John Bradshaw’s books discuss shame and have exercises to aid in
exploring this. For a more intellectual understanding of shame read Donald L. Nathanson, “Shame and
Pride.”

Anxiety in the Movies

It is so much easier to watch characters with anxiety in a movie than to experience it ourselves.
Here is a link to a site with a list of movies where a main character has an anxiety disorder:
http://panicdisorder.about.com/cs/toppicks/tp/filmcharacters.htm.

Depression

Depression is a much talked about topic today. It seems, according to the National Institute of
Mental Health, that about 12% of the population in the U.S. is suffering with it at any given time.
This includes children and the elderly. Pharmaceutical companies educate us about the symptoms
of depression on television ads of their product. Yet I find there is a lot of confusion about depression,
perhaps because this one word describes different states of being.

People with long-standing or severe anxiety disorders are often also depressed. For some people
it is a secondary depression, meaning they are demoralized by the anxiety as well as the limits it
imposes on their lives and understandably feel “down” about it. Anxiety disorders and depression may
overlap in the symptom profile; difficulties with concentration, sleeping, restlessness, body aches, to
name just a few, are typical. One clinician or psychiatrist may diagnose depression, another may
diagnose the anxiety disorder.
Sadness and grief regarding a significant loss are sometimes labeled depression. Part of the grieving
process involves a period of depression. In addition, a prolonged period of grieving may turn into a
clinical (meaning biochemical) depression.
Some people may have a negative, pessimistic (“scroogelike”) personality. These personality traits
do not usually lead to a fulfilling life and this person may be diagnosed as depressed.
Then there is the mild, chronic sense of inner emptiness that permeates one’s being due to early
childhood losses or disappointments that wax and wane with time and circumstance.
Major depression is a severe form where the sufferer feels incapacited to go on with their daily
routine. Cognitive distortions and psychotic episodes may be present.

There are a few more, though less common,  forms of depression. Differentiation of these reactions
or symptoms is important because it informs the appropriate treatment. Many people today are being
assessed and diagnosed by their family practice doctors who are not always able to make these
differentiations.  More than ever, we need to be informed consumers.

Book Recommendation

This month I recommend “I Thought My Father was God”  edited by Paul Auster.
This book is a compilation of short, true stories written and sent to NPR and read on the
radio. This anthology contains 179 stories on various topics- love, death, dreams, animals, war-
are a few.  Great reading for short periods of time.

Parting Words

From Carl Sandburg: ” Life is like an onion; you peel off one layer at a time, and sometimes you weep.”