The Correspondence Between Shame, Guilt, and Trauma in Integrative Psychotherapy
Introduction
In my work as an integrative psychotherapist, I frequently encounter the powerful interplay between shame, guilt, and trauma. These experiences are not just emotional states but profound forces that shape a person’s sense of self and their relationships with others. By understanding how shame and guilt emerge from trauma, I can better support my clients in their journeys toward healing and self-acceptance.
Understanding Shame and Guilt
From my perspective, shame and guilt are distinct yet closely related emotions:
- Shame, in my experience, is deeply tied to identity. It’s the sense of being fundamentally flawed or unworthy. Clients often describe it as “feeling bad at the core.”
- Guilt, on the other hand, is more action-oriented. It arises when someone believes they have done something wrong or violated their own values.
While guilt can motivate reparative action, shame often leaves my clients feeling stuck and isolated. Both emotions frequently appear in the narratives of those who have experienced trauma.
Trauma as a Source of Shame and Guilt
Trauma, especially interpersonal trauma like abuse or assault, often gives rise to shame and guilt. I’ve noticed patterns in how these emotions manifest in my clients:
- Self-blame: Many trauma survivors I work with internalise blame for the events they’ve endured, even when those events were beyond their control. This self-blame often fuels feelings of shame and guilt.
- Cultural stigma: Social and cultural narratives can compound these feelings. For example, I’ve worked with clients who felt ashamed because of societal judgments about their experiences, particularly in cases of sexual violence.
- The body’s role: Trauma is not just psychological—it’s stored in the body. Clients often describe physical sensations of shame, like a “heavy chest” or a “sinking stomach.”
My Approach to Shame, Guilt, and Trauma in Therapy
As an integrative psychotherapist, I draw on a range of theories and techniques to address the correspondence between shame, guilt, and trauma. Here are some of the key perspectives that guide my practice:
1. Attachment Theory
I’ve found that shame often stems from disrupted attachments, especially in childhood. Helping my clients rebuild a sense of safety and trust in relationships is a cornerstone of my work.
2. Relational Psychotherapy
Informed by the work of Stolorow and Atwood, I focus on the relational contexts in which shame and guilt emerge. I aim to create a therapeutic relationship that is empathic and non-judgmental, offering a safe space for my clients to explore their feelings.
3. Trauma-Informed Care
Trauma-informed principles guide my approach. I prioritise creating a space that feels safe and empowering for my clients, acknowledging the role that shame and guilt play in their healing journeys.
How I Address These Emotions in Therapy
When working with clients, I use a variety of interventions tailored to their needs. Here are some strategies I often rely on:
Normalising Emotions
Many of my clients feel isolated in their shame and guilt. I help them understand that these emotions are common among trauma survivors, which often reduces their sense of alienation.
Mindfulness Practices
I guide clients in mindfulness exercises to observe their emotions without judgment. This can help them separate their sense of self from the intense feelings of shame or guilt.
Challenging Self-Blame
Using cognitive techniques, I work with clients to identify and reframe unhelpful beliefs about their responsibility for the trauma.
Rewriting Trauma Narratives
Encouraging clients to tell their stories can be incredibly healing. Together, we explore their narratives to find more compassionate ways of understanding what happened to them.
Somatic Work
Trauma often leaves its mark on the body. I incorporate somatic techniques to help clients release the shame and guilt stored in their physical selves.
A Client’s Journey
One client, whom I’ll call Jane, came to me after surviving an abusive relationship. She carried an immense amount of shame, believing she was “weak” for not leaving sooner, and guilt for exposing her children to the environment.
Through mindfulness, we worked on observing her emotions without judgment. Using somatic experiencing, Jane began to recognise how her body held the tension of shame. As she grew more comfortable in therapy, we explored the systemic and psychological factors that contributed to her situation, helping her reframe her narrative.
Over time, Jane developed a sense of self-compassion. She could see her survival as an act of strength rather than a flaw, and her guilt transformed into a motivation to nurture her children and herself.
Conclusion
In my practice, I’ve seen how deeply shame, guilt, and trauma intertwine to shape the lives of my clients. By approaching these emotions with empathy and integrating various therapeutic perspectives, I can help clients unravel their pain and move toward healing. Addressing these complex dynamics isn’t easy, but it’s some of the most rewarding work I do.
References
- Orange, D. M. (2011). The Suffering Stranger: Hermeneutics for Everyday Clinical Practice. Routledge.
- Stolorow, R. D., & Atwood, G. E. (1992). Contexts of Being: The Intersubjective Foundations of Psychological Life. Routledge.
- van der Kolk, B. A. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Penguin Books.