From the Guidelines
Shame is characterized by feelings of worthlessness, inadequacy, and self-loathing, often accompanied by physical symptoms such as blushing, sweating, and increased heart rate, as well as behavioral symptoms like avoidance of eye contact and social withdrawal, as noted in the context of grief and bereavement 1.
Symptoms of Shame
The symptoms of shame can be understood in the context of its impact on an individual's emotional, physical, and social well-being. Key aspects include:
- Emotional symptoms: feelings of worthlessness, inadequacy, self-loathing, and a desire to hide or disappear
- Physical symptoms: blushing, sweating, increased heart rate, and a sense of heaviness or tension in the body
- Behavioral symptoms: avoidance of eye contact, closed body postures (hunched shoulders, lowered head), and withdrawal from social interactions
- Cognitive symptoms: negative self-talk, rumination about perceived failures, and a preoccupation with others' judgments
Importance of Recognizing Shame
Recognizing these symptoms is crucial because chronic shame can contribute to depression, anxiety, addiction, and relationship difficulties if left unaddressed 1. The distinction between shame and guilt is also important, with shame targeting one's entire self-worth and guilt focusing on specific behaviors.
Clinical Considerations
In clinical practice, it's essential to approach patients with sensitivity and awareness of the potential for shame, especially in contexts like grief, bereavement, or chronic illness management 1. Using positive, strength-based language can help build therapeutic relationships and mitigate feelings of shame and guilt.
Conclusion is not allowed, so the answer ends here.
From the Research
Symptoms of Shame
The symptoms of shame can be complex and varied, but research has identified some key characteristics.
- Shame is often associated with anxiety symptoms, particularly social anxiety disorder (SAD) and generalized anxiety disorder (GAD) 2, 3.
- Internal shame, which involves negative self-evaluations, is a significant predictor of depressive symptoms 4, 5.
- External shame, which involves perceived negative evaluations of others, is more strongly associated with social anxiety symptoms than internal shame 2, 5.
- Shame can manifest as feelings of worthlessness, self-blame, and negative self-evaluations, which can contribute to depressive symptoms 6, 5.
- Guilt, while distinct from shame, can also contribute to depressive symptoms, particularly when it involves exaggerated responsibility for uncontrollable events or "free-floating" guilt divorced from specific contexts 5.
Association with Anxiety and Depressive Symptoms
Research has consistently shown that shame is more strongly associated with anxiety and depressive symptoms than guilt.
- Shame has been found to be a significant predictor of social anxiety symptoms, even after controlling for guilt and other anxiety symptoms 3, 4.
- Internal shame has been found to be associated with depressive symptoms, and cognitive behavior therapy (CBT) has been shown to reduce internal shame in patients with SAD 4.
- The association between shame and depressive symptoms is complex, and may involve other factors such as behavioral and characterological self-blame 6, 5.