The Effects Of Shame: A Case Study

Shame is the driver of many of the issues we face in our lives. Even experienced therapists do not always see the impact that shame based thinking can have on the Self, relationships and our view of the world. It remains hidden until we bring it into the light and deal with it. Many people live with shame based thinking without ever realizing that this is the driving force behind their dysfunction. However, once it is revealed, reframed and reapportioned, we can deal with it effectively. I have been writing a lot about shame recently because it is a major issue with the clients I work with and always has been.

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It reminds me of a case I dealt with many years ago which is a perfect example of how shame affects people’s decision-making in certain situations, how the consequences of such decisions are far-reaching and how things could be very different given different circumstances. The client concerned is a classic example of shame being dealt with irrationally through shame screens. He used withdrawal, anger and compensation in a process of dealing with deep shame for his actions.

I started working with F in 2008 and therapy lasted three years. I have sought permission to use his story but in the following case-study, names and places have been changed. This is his story ( in his words though some is from memory):

” I have always been someone who has felt copious amounts of shame, though I have only just realised it recently as shame and where it came from. I always thought that there was something fundamentally wrong with me. I have had a number of relationships over the years and all of them were dogged by my shame and not feeling good enough. It is much better these days but I still feel the effects daily. It is a question of management and staying aware of triggers and effects. However, the story that is told here rocked me to the core and meant that I might lose a person that I care deeply about. I still don’t fully understand why I did what I did and how it developed from a little “devilish” thought to a major ruse that needed almost military style planning to keep it going.

I had just been separated from a lady I had been with for 10 years. It was a terrible split for me and I struggled badly, initially mentally but also had physical symptoms including headaches, nausea and general pain. I drank increasing amounts of alcohol, I slept badly and my diet consisted of TV dinners and junk food. I was living in a small apartment in a small town and the split coincided with the advent of winter. I was miserable and didn’t see a way forward. At times, I thought about ending it all and even researched and thought about the easiest way to do it without excessive pain. As the split became more acrimonious, I felt very low and recognize now that shame played a major factor in this. I truly felt that she had left me because I was a bad person and she couldn’t stand who I was. This thought developed in my mind and I was constantly triggered back to issues from my childhood and difficulties understanding why my parents said the things they did about me. I believed them and that became my mantra about myself. It affected every relationship I had had to that point and was happening again before my very eyes. My reaction to this was to let myself completely go, engrossed in thoughts of self- hatred. I became unkempt and drank more. I went out once every few week to shop but had junk food delivered. I was at my lowest possible point. I took two weeks off work and laid in bed for one of them.

Then one day, I decided to make out I was seriously ill (I wasn’t) and built a whole story around hospital visits and imaginary diagnoses. When I spoke to my new partner about this, I felt even more shame but kept it going until it was too much and I told her I was cured. This caused much suspicion and questioning but I maintained the ruse.

The relationship developed and the idea of us meeting came up. I readily agreed and I was feeling fairly good about myself. What I didn’t realize was that she had been listening to the lies but never actually believed much of what I said. She challenged me continually and I denied everything and felt more shame as a result. Today, we are still together but the relationship does not have a basis of trust, unsurprisingly. I am trying to lead a more genuine life where I express myself honestly but it is a work in progress. However, the trust needs building from the ground up and causes problems every day. If only, I could have my time again.

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