Academic journal article European Journal of Psychotraumatology

The Influence of Shame on Posttrauma Disorders: Have We Failed to See the Obvious?

Academic journal article European Journal of Psychotraumatology

The Influence of Shame on Posttrauma Disorders: Have We Failed to See the Obvious?

Article excerpt

Responsible Editor: Marylene Cloitre, National Center for PTSD in Palo Alto, CA, USA.

Copyright: © 2015 Terry F. Taylor. This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License, allowing third parties to copy and redistribute the material in any medium or format, and to remix, transform, and build upon the material, for any purpose, even commercially, under the condition that appropriate credit is given, that a link to the license is provided, and that you indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.

Received: 13 June 2015; Revised: 10 August 2015; Accepted: 24 August 2015; Published: 22 September 2015

Competing interests and funding: There is no conflict of interest in the present study for the author. No funding has been received to support the study.

*Correspondence to: Terry F. Taylor, School of Psychology, Social Work and Social Policy, University of South Australia, Magill Campus, Adelaide, Australia, Email: terry.taylor@mymail.unisa.edu.au

For the abstract or full text in other languages, please see Supplementary files under 'Article Tools'

For the first time, the diagnostic criteria for posttraumatic stress disorder (PTSD) in the Diagnostic and Statistical Manual of the American Psychiatric Association, 5th Edition (DSM-5) (American Psychiatric Association [APA], 2013), have included persistent negative emotional states of fear, horror, anger, guilt, or shame. Whether, and how, these emotional states might influence the course of the disorder has received limited coverage in the existing literature.

This article explores theories of shame and maladaptive shame regulation, and the role these might play in the exacerbation and perpetuation of posttrauma disorders. It examines the literature on trauma-related shame. It discusses its role as a primary affect occurring in the peri-traumatic period, and as a secondary emotion following appraisal. It further defines its intrapersonal and interpersonal manifestations and their interactions, its connection with neurobiological processes and the importance of its recognition in treatment and management.

Shame in everyday life

Shame in Western culture is considered a virtually invisible, ubiquitous part of everyday life by Scheff (2014); associated with feelings of weakness, vulnerability, and the likelihood of rejection (Lansky, 2003); and hidden, because it is shameful in itself (Kaufman, 1989). Because the experience of shame is often considered to be painful and disempowering, and because recognition of shame in itself can be felt as shameful, it has been suggested that it may evoke any one, or a combination of, maladaptive shame regulation strategies or defences (Elison, 2005; Elison, Garofolo, & Velotti, 2014; Nathanson, 1987, 1992; Velotti, Elison, & Garofolo, 2014; Webb, 2003, 2010). These reactions are consistent with many of the symptoms and co-morbidities of PTSD. They include anger and violence, substance addiction and isolation (Van der Kolk, 2013), and the often-accompanying feelings of hopelessness and helplessness that can progress to depression, and ultimately to suicide (Violanti, Andrew, Mnatsakanova, Hartley, Fekedulegn, & Burchfiel, 2015).

Shame and guilt: distinguishing between the two emotions

There are differing contemporary theoretical accounts of the nature of shame and guilt. One group of authors represented by M. Lewis (2003), Tangney and Dearing (2002), and Tracy and Robins (2004), consider shame a destructive emotion with little or no adaptive value, and guilt the adaptive and mature emotion. These authors, some of whom have received prominence as a result of their authorship of the Test of Self Conscious Affect (Tangney, Wagner, & Gramzow, 1989), consider both guilt and shame to be "self-conscious emotions"--a product of evaluation of one's behaviour or one's "self" with reference to a particular standard. …

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