Academic journal article Journal of Marital and Family Therapy

The Systemic Treatment of Shame in Couples

Academic journal article Journal of Marital and Family Therapy

The Systemic Treatment of Shame in Couples

Article excerpt

Among the most perplexing challenges encountered by couples therapists are instances where treatment does not proceed according to the therapist's expectations. Couples may become entrenched in blaming, stuck in repetitive arguments, or drop out of therapy. Shame often plays a major and concealed role in these situations.

The patterns connected with shame have only recently been recognized and their complexities and connection with other phenomena begun to be explored by systems-oriented couples therapists. Understanding these patterns in couple systems often illuminates a multitude of previously unexplained events, ranging from missed appointments to the escalation of seemingly straightforward problems into spiraling cycles of withdrawal, blame, or violence. Many difficult diagnostic circumstances, including depression, post-traumatic stress disorder, substance abuse, borderline, and other personality disorders, fit into this scheme.

Our focus is on couples' shame dynamics, that is, how shame becomes imbedded in the system, is expressed by each member, and becomes both causal and consequential. We propose that clinical thinking in connection with couples therapy be reorganized to include a systemic understanding of shame. The use of shame as a central organizing principle to reexamine couples' dynamics and treatment is important across the full range of therapeutic parameters, including couples' presenting problems, individual diagnoses of the partners, and the therapist's theoretical orientation.

Our goal in this paper is to help therapists expand their conceptualization of treatment to consciously include how shame operates in couples. We present a systemic definition of shame and a review of the theory and treatment literature of shame in couples and families. Using a blend of strategically oriented (Friedman, 1980; Guttman, 1991; Todd, 1986), psychoeducational (Guerney, Brock, & Coufal, 1986; Jacobson & Margolin, 1979; McFarlane, 1991 ; Miller, Miller, Nunnaly, & Wackman, 1991), and relational techniques(Jordan, 1989), we focus on therapeutic stance, treatment planning, and various interventions.

DEFINITIONS OF SHAME

To feel shame is to feel fundamentally bad as a person (Kaufman, 1980, 1989). Shame includes a judgment of the self, by the self, as inadequate and worthless, devalued in one's own and others' eyes (Jacobson, 1964; White, 1959). Shame is revealed through direct or indirect, verbal or nonverbal expressions. "I feel ashamed" is a direct expression of shame; "I feel crummy" or "I feel bad" often indicates unacknowledged shame (Lewis, 1971). The list of words that are direct expressions of shame include humiliated, chagrined, embarrassed, degraded, self-conscious, low self-esteem, shy, feeling ridiculous, sheepishness, discomfort, disconcerted, abasement, abashed, disgraced, ignominy, dishonor, and mortified (Kaufman, 1989; Lewis, 1971; Retzinger, 1987). Less direct indications of shame include the use of the words guilt, ought to, and should. Nonverbal expressions of shame include downcast eyes, not making eye contact, changes in skin tone, and frozen facial expressions.

More subtle, less direct, but frequently unnoticed interactional expressions of shame take the form of defenses used against the experience of shame. These defenses are verbal and nonverbal interactions characterized by one of the following: rage, contempt, striving for perfection, striving for power, transfer of blame through projection, internal withdrawal, humor, or denial (Bradshaw, 1988; Fossum & Mason, 1986; Kaufman, 1980, 1989; Lansky, 1991 ; Nichols, 1991 ; Retzinger, 1987). Resorting to such defenses when experiencing shame is an attempt to protect oneself through distortion or camouflage. The individual and others are distracted by an interaction that is fueled by unacknowledged shame and ignited by content and behavior that seemingly have nothing to do with this most miserable feeling state. …

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