Abstract
Shame is common and a universal part of the human condition. It is a factor in mental illness, and shame issues frequently arise in psychotherapy. There has been much theorizing about shame, but less research on how psychotherapists address this in their practice. This qualitative research study looked at how psychotherapists conceptualize shame, how shame issues present in psychotherapy, what approaches therapists find helpful in working with shame and the impact of shame in the therapy process itself. Eight psychotherapists were interviewed. Shame was found to be ubiquitous in psychotherapy. Psychotherapists mainly conceptualized shame as clients' negative beliefs about the self. Shame presented itself in clients' beliefs, relationship difficulties, somatic cues and defensive reactions to shame. In working with shame, therapists did not find it helpful to confront the beliefs directly. They did find that the importance of relationships in all their facets (to the therapist, family, groups, community, self, and God) was essential. Therapists described multiple approaches to managing shame in the therapy process itself. The good, bad and ugly aspects of shame were considered. Social workers are encouraged to pay attention to the dynamics of shame in their interactions. In addition, early childhood development and secure attachment need to be supported to develop an adaptive relationship with shame.