Shame in the therapy hour Front Matter

Shame is prevalent among individuals undergoing psychotherapy. Yet, there is limited guidance for clinicians trying to help their clients deal with shame-related concerns. This book explores the manifestations of shame and presents several approaches for treatment. Master clinicians from a wide variety of different theoretical and practice orientations offer candid insights into all aspects of shame, including how it develops, how it relates to psychological difficulties, how to recognize it, and how to help clients resolve it. Strategies for dealing with therapist shame are also provided, since the therapist's own shame can be triggered during sessions and may complicate the therapeutic process. Detailed case studies are included. "Shame is a common emotion that contributes to many problems that bring clients into therapy, such as poor psychological adjustment, interpersonal difficulties, and overall poor life functioning (see Tangney & Dearing, 2002). Not only is shame a factor underlying many of the reasons that clients seek psychotherapeutic help, but clients may feel shame as a result of needing help with their emotional concerns. Once in therapy, clients may further experience shame while discussing intimate details about themselves. Shame is therefore likely to be elicited frequently in therapy, though signals of client shame may be subtle. If a therapist fails to recognize client shame, the client's shame-related problems will likely continue. Furthermore, clients who experience unacknowledged shame in the context of therapy may feel misunderstood, resulting in an empathic failure on the part of the therapist. Such empathic failure may result in premature termination of therapy. Therefore, therapists must recognize, acknowledge, and address client experiences of shame--to both build a therapeutic alliance and resolve the shame. The intent of this book is to provide clinicians with guidance for dealing with client shame. All aspects of shame are covered, including how shame develops, how it relates to psychological difficulties, how to recognize shame and how to help clients resolve shame-related problems. The chapters bring together wisdom and insight gained from years of clinical experience, shared by master clinicians who have struggled to manage and positively transform shame in the therapy hour. In particular, the chapter authors provide specific strategies that they use to help their clients resolve shame-related issues, and they illustrate these techniques using detailed examples and clinical dialogue. We are delighted with the resulting volume of chapters by gifted authors who provide outstanding insights into the clinical presentation, management, and resolution of shame in the therapy hour. The intended audience for this book includes clinical and counseling psychologists, psychiatrists, social workers, marital and family therapists, addictions counselors, and other mental health providers. The book should be of interest to clinicians in training as well as seasoned professionals, the majority of whom are unlikely to have had any specific training in shame-related issues but who almost certainly encounter clients' shame experiences on a daily basis. We expect that readers will benefit from the material on different levels; new therapists are most likely to benefit from the notion of being attuned to client shame as an important aspect of therapy, whereas experienced therapists are more likely to see the book as a much-needed set of tools for addressing the longstanding challenge of helping clients work through shame in a way that will prevent future negative consequences"--Introduction. (PsycINFO Database Record (c) 2011 APA, all rights reserved) The Psychodynamics Of Shame / Andrew P. Morrison -- The Inner World Of Shaming And Ashamed : An Object Relations Perspective And Therapeutic Approach / Michael Stadter -- Emotion-focused Therapy And Shame / Leslie S. Greenberg & Shigeru Iwakabe -- Treating Shame : A Functional Analytic Approach / Kelly Koerner, Mavis Tsai & Elizabeth Simpson -- Shame And The Paradox Of Group Therapy / Elizabeth L. Shapiro And Theodore A. Powers -- Shame In Families : Transmission Across Generations / Edward Teyber, Faith Mcclure & Robert Weathers -- Shame In Couple Therapy : Helping To Heal The Intimacy Bond / Norman B. Epstein & Mariana K. Falconier -- Therapy With Refugees And Other Immigrants Experiencing Shame : A Multicultural Perspective / Emi Furukowa & Dennis J. Hunt -- Therapy With Shame-prone Alcoholic And Drug-dependent Clients / Ronald T. Potter-efron -- The Role Of Shame In The Development And Treatment Of Borderline Personality Disorder / Shireen L. Rizvi ... [et Al.] -- Ptsd As A Shame Disorder / Judith Lewis Herman -- Body Image And Eating Disorders : A Compelling Source Of Shame For Women / Jennifer L. Sanftner & Mary Tantillo -- Therapist Shame : Implications For Therapy And Supervision / Nicholas Ladany, Rebecca Klinger & Lauren Kulp -- Shame In Psychotherapy And The Role Of Compassion Focused Therapy / Paul Gilbert -- Connections : A 12-session Psychoeducational Shame Resilience Curriculum / Brené Brown, Virginia R. Hernandez & Yolanda Villarreal -- Working With Shame In The Therapy Hour : Summary And Integration / Tangney And Dearing. Edited By Ronda L. Dearing And June Price Tangney. Includes Bibliographical References And Index. The psychodynamics of shame / Andrew P. Morrison The inner world of shaming and ashamed : an object relations perspective and therapeutic approach / Michael Stadter Emotion-focused therapy and shame / Leslie S. Greenberg and Shigeru Iwakabe Treating shame : a functional analytic approach / Kelly Koerner, Mavis Tsai and Elizabeth Simpson Shame and the paradox of group therapy / Elizabeth L. Shapiro and Theodore A. Powers Shame in families : transmission across generations / Edward Teyber, Faith McClure and Robert Weathers Shame in couple therapy : helping to heal the intimacy bond / Norman B. Epstein and Mariana K. Falconier Therapy with refugees and other immigrants experiencing shame : a multicultural perspective / Emi Furukowa and Dennis J. Hunt Therapy with shame-prone alcoholic and drug-dependent clients / Ronald T. Potter-Efron The role of shame in the development and treatment of borderline personality disorder / Shireen L. Rizvi ... [et al.] Posttraumatic stress disorder as a shame disorder / Judith Lewis Herman Body image and eating disorders : a compelling source of shame for women / Jennifer L. Sanftner and Mary Tantillo Therapist shame : implications for therapy and supervision / Nicholas Ladany, Rebecca Klinger and Lauren Kulp Shame in psychotherapy and the role of compassion focused therapy / Paul Gilbert Connections : a 12-session psychoeducational shame resilience curriculum / Brené Brown, Virginia Rondero Hernandez and Yolanda Villarreal Working with shame in the therapy hour : summary and integration / June Price Tangney and Rhonda L. Dearing. Cover 1 Title Page 2 Copyright 5 Dedication 6 Contents 8 Contributors 12 Introduction 18 Part I: Shame From Multiple Therapeutic Perspectives 36 01. The Psychodynamics of Shame 38 02. The Inner World of Shaming and Ashamed: An Object Relations Perspective and Therapeutic Approach 59 03. Emotion-Focused Therapy and Shame 83 04. Treating Shame: A Functional Analytic Approach 105 05. Shame and the Paradox of Group Therapy 128 06. Shame in Families: Transmission Across Generations 149 07. Shame in Couple Therapy: Helping to Heal the Intimacy Bond 179 08. Therapy with Refugees and Other Immigrants Experiencing Shame: A Multi-Cultural Perspective 206 Part II: Challenging Problems in Therapy: Shame-Based Clinical Disorders 228 09. Therapy with Shame-Prone Alcoholic and Drug-Dependent Clients 230 10. The Role of Shame in the Development and Treatment of Borderline Personality Disorder 247 11. Post-Traumatic Stress Disorder as a Shame Disorder 271 12. Body Image and Eating Disorders: A Compelling Source of Shame for Women 286 Part III: Shame in the Other Chair 314 13. Therapist Shame: Implications for Therapy and Supervision 316 Part IV: Shame-Focused Strategies 333 14. Shame in Psychotherapy and the Role of Compassion-Focused Therapy 335 15. Connections: A 12-Session Psychoeducational Shame Resilience Curriculum 365 Part V: Shame: Future Directions 383 16. Working with Shame in the Therapy Hour: Summary and Integration 385 Index 415 About the Editors 437 Shame in the therapy hour Excessive shame can be associated with poor psychological adjustment, interpersonal difficulties, and overall poor life functioning. Consequently, shame is prevalent among individuals undergoing psychotherapy. Yet, there is limited guidance for clinicians trying to help their clients deal with shame-related concerns. This book explores the manifestations of shame and presents several approaches for treatment. It brings together the insights of master clinicians from different theoretical and practice orientations, such as psychodynamics, object relations, emotion-focused therapy, functional analysis, group therapy, family therapy, and couples therapy. The chapters address all aspects of shame, including how it develops, how it relates to psychological difficulties, how to recognize it, and how to help clients resolve it. Strategies for dealing with therapist shame are also provided, since therapist shame can be triggered during sessions and can complicate the therapeutic alliance. With rich, detailed case studies in almost every chapter, this book will be a practical resource for clinicians working with a broad range of populations and clinical problems.