Pain in disguise

1. Pain in disguise Working with aspects of shame in EFT

2. Objectives • Understand shame in EFT • Recognisetriggers, markers and cues in session • Understand effective interventions for working with shame

3. Shame in perspective • Shame is a universally experienced emotion, essential to human experience • It can be painful, terrifying for us, for couples • For us the reactivity of shame can bring up our own shame – are we good enough therapists? • In Stage One, we are containing Secondary, Reactive aspects of Shame • Inevitably we will explore primary shame in Step 3 to put in the cycle, not heighten • In Stage two we will understand the fears and needs that may be bound to shame • The way shame becomes regulated and integrated is with another person

4. One experiential definition • Defining the Experience of Shame: 'Shame is above all a sense of personal inadequacy of some kind, the sinking apprehension that I am not going to measure up to something or somebody, that I will be shown up as deficient (or possibly too much) in some important way.  At their most extreme, shame experiences are among the most intensely negative and debilitating, even life-threatening feelings that we can have. This is because the experience of shame in extreme forms has a way of cutting to the bone of our sense of basic worth and capacity to survive and cope ...' - Wheeler (1997)

5. Another experiential description “The binding effect of shame involves the whole self. Sustained eye contact with others becomes intolerable ... speech is silenced. Exposure itself eradicates the words, thereby causing shame to be almost incommunicable to others.. ..The excruciating observation of the self which results, this torment of self-consciousness, becomes so acute as to create a binding, almost paralyzing effect upon the self.” Kaufman 1980 [p. vii].

6. Shame in Attachment theory • “Indeed, a number of clinical studies reviewed in Separation suggest that defensive exclusion leads to a split in Internal Working Models. One set of working models – accessible to awareness and discussion and based on what a child has been told – represents the parent as good and the parent’s rejecting behaviour as caused by the “badness” of the child.” (Bretherton, 1982). • Bowlby saw shame as an adaptive response in a young child to a deep emotional dilemma: • My caretakers are not available or hurt or reject me; it could be them at fault (that’s too frightening to contemplate) so it must be me. I am flawed, I am not lovable enough; I cannot be enough • Shame action tendency is to hide attachment needs; deny attachment needs/emotions to self (and others); I fear vulnerability, exposure • Needs are not met (or needs are responded to with anger or flooding by caregiver, siblings, peer group, culture etc)

7. A B • Significant relationship • High regard • Dependence x A B • Failure to respond to need • Unintended • Deliberate • Impact on self: Fear, distress, rage A B • Disconnection • Possibility of repair

8. Causes of shame Breaking the interpersonal bridge (by parents, siblings, peer groups, culture) • Parents shaming children (or partners shaming partners) into desired behaviour without understanding the disruptive impact shame is liable to have • Parents, siblings, peer groups, culture, partners conveying that the child or adult is embarrassing them • Consistently being told you are a disappointment (inherently deficient) • Being belittled • Comparison (negative) with others • Blame – fixed or transferred • Performance expectations • Humiliation, mocking, ridicule • Expressions of disgust/contempt

9. A process of internalisation & identity formation World Shame Event/s Identification Internalisation (Working models of self/other) Identity Unworthy Unlovable Deficient Others Internal Working Model Self

10. Why is this important for us? • We have to take account of defensive exclusion (disowned needs, emotions) in our work • It gives us clues about primary emotion • It flags up the need for relentless validation of the secondary emotions to help the clients climb onto the Interpersonal Bridge with us so that they can do it with their partners • If we can help partners integrate the disowned parts we can help take away the power of shame in the relationship

11. Shame spectrum emotions • Guilt • Humiliation • Embarrassment • Secondary Shame • Primary Shame

12. Reactive/Secondary Shame • Secondary shame is more situation specific, less chronic and pervasive, generated by self-criticism/contempt/disgust and pathogenic beliefs about self as bad from family of origin/culture • Markers – harsh vocal quality, facial expression such as curled lip, sneer indicating contempt towards self • ANGER – Defensive anger is different from Attachment Protest as it masks the experience of helplessness and victimization • HIDING/TURNING AWAY - Shame’s organising tendency/action tendency is to hide vulnerability, avoidance and leads to.. • Hiding of other primary, vulnerable emotions such as sadness or fear

13. Clip • Jon

14. Shame as a primary emotion • Primary adaptive shame – tells us our social standing is at risk so we can protect our connectedness to group by conforming to group standards • Primary maladaptive shame – chronic, stuck and generalised in lots of different situations. Core sense of self as worthless, unlovable, defective and inferior. • Unacknowledged primary shame due to threat to fragile ego shows up as social anxiety, substance abuse, obsessiveness, perfectionism, narcissistic personality • What reactivity looks like with primary shame: • Internalised, turning away, hiding, intense self-consciousness • Externalised, pushing away, lashing out at perceived source of shame, at trigger • Combination: Lash out, then hide

15. Shame as a Primary Emotion • Recognising • Visual cues: looking down, covering eyes, looking away • Behavioural cues: turning away, shrinking, turning inwards • Therapist internal response • Client somatic responses (commonly in stomach – disgust/repulsion, tightness, clenching pain) • Verbal cues: Self disgust/self-hate comments, language • Self depreciating, shrinking, denying needs • Eckman: Sadness, guilt, shame – share the same facial expression and are easily confused • Shame (and guilt): More looking away, covering the face. Looking down and away • Sadness: More looking at, not covering face • Shame bind – isolation is painful/exposure and vulnerability too risky

16. Clips • Cassandra • Carl • Jon

17. Exercise Talk to your neighbour about what you have experienced in your self or seen in clients around the action tendencies of shame?

18. Shame in Stage 1 - Tasks • Recognising the emergence of shame in the cycle • Containing, not heightening via validation & creating an interpersonal bridge • Exploring in Step 3 to put it into the cycle

19. Recognising shame cues “The shame response is an act which reduces facial communication  . . By dropping his eyes, his eyelids, his head, and sometimes the whole upper part of his body, the individual calls a halt to looking at another person, particularly looking at the other person’s face, and to the other person’s looking at him, particularly his face.”(Tomkins, AIC Vol II p. 120) And….. “When shame is analysed, the natural, inevitable sequence from shame into humiliated fury and retaliation and thence into guilt for ”unjust” or “irrational” rage is made available to patients. They come to understand that shame is a feeling trap……shame is seen as a means by which people try to preserve their loving relationships to others.” (Lewis, The role of shame in symptom formation p.2)

20. TURNING AWAY (Shame’s action tendency to hide leads to..hiding of other primary, vulnerable emotions such as sadness or fear) ANGER (Defensive anger different from attachment protest) Reactive/ Secondary emotions FEAR I hide my fear of disconnection, rejection, abandonment from you HURT I hide my hurt, pain when you criticize Primary emotions • SADNESS/SORROW • I hide my longing for you • I hide my grief about our • disconnection • SHAME • I hide my feeling inadequate, • small, invisible, unworthy, • unloveableetc • from you • I hide my vulnerability from you • I hide my shame of shame from you

21. Shame in the Negative Cycle • Example: • Pursuer has shame when withdrawer distances • Withdrawal (or non-responsiveness)is experienced as proving my being unlovable • React in anger, criticize more harshly, pushing partner away further • Example: • Withdrawer has shame when pursuer criticizes or demands • Withdrawer feels inadequate in the partner’s eyes, a disappointment • Withdrawer numbs out the shame (defensive exclusion) and withdraws further or • Withdrawer numbs out the shame and reacts with defensive anger or rage

22. General EFT intervention principles for shame

23. What to do?

24. Exercise Given what Ihave shown you, how does this affect the way you would work with shame in the couple?

25. References • Bretherton, I. (1992). The origins of attachment theory. Developmental Psychology, 28:759-775 • Jorgensen, R. & Thomas, J. (2012). Transforming Shame using emotionally focused therapy slide pack (Used with permission). • Kaufman, G. (1980). Shame, the power of caring (3rd Edition). New York: Schenkman Books • Lewis, H. B. (1971). Shame and guilt in neurosis. New York: International Universities Press. • Middleton-Moz, J. (1990). Shame and Guilt – Masters of disguise. Florida: Health Communications • Scheff, T. & Retzinger, S.M. (1991). Emotions and Violence – shame and rage in destructive conflicts. Nebraska: Lexington Books • Tomkins, Silvan S. (1962), Affect Imagery Consciousness: Volume I, The Positive Affects. London: Tavistock. • Wheeler, G. (1997), Self and Shame: A Gestalt Approach, Gestalt Review, 1(3):221-244, 1997