You want some shame with that?

When we are serious about our work with mental illness stigma and other tough social issues, we must eventually confront the topic of shame. This happens no matter how hard we’ve been steering away from it. Shame is the emotion that’s left over, the disgusting ingredient on the waiting room cooking show menu.

People who design anti-stigma programs know that shame is not popular. We present graduate-level neuroscience seminars that never include a single mention of shame. We sometimes use stigma as a euphemism or code word to hide our discomfort with shame. This blockade on shame talk goes beyond our general reluctance to talk about our feelings (especially for men), but it’s certainly connected. Nobody recommends using “what are you ashamed of?” as a pick-up line.

Fortunately we have the work of Dr. Brené Brown to offer some clues about the shame component of mental illness and tough social problems. Brown uses a strict analytical process to talk about hard feelings, particularly shame. She does “qualitative” research – a process that involves collecting stories and looking for patterns. It lets her access a great deal of data based on people’s real experience in the world – instead of merely tracking what happens in artificial, closed box situations. 

Brown’s work can help us distinguish between cognitive concepts and emotional experiences.  For example, self-esteem is a thought about ourselves, a cognitive concept, while shame is an emotion, something we feel. Knowing how to work within this double dynamic becomes a kind of literacy.  

Brown’s key finding is that people experience shame as they encounter a “web of layered, conflicting and competing social-community expectations that dictate who we should be, what we should be, and how we should be.” 

In other words, people get smacked with thoughts and emotions and cultural expectations all bundled together. Our emotions affect our thinking as we experience them in our gut. Our actions in response to shaming circumstances emerge from emotionally-charged thought processes combined with our mental models and with what our culture expects us to be. 

Dealing with feelings of fear, blame and disconnection is difficult for everyone. You can imagine how tough this is for people with depression or another difficult illness, or for people who must depend on others for housing or material support. 

Shame may be unwanted and disrespected as an emotion, but it’s a common element in human experience. We can’t deny shame’s existence. But shame is an emotion with no constructive value. There is nothing good about it – and no “healthy” shame. Brown spent seven years testing the proposition that shame might be used to change people. She writes

It didn’t take very long for me to reach the conclusion that there is nothing positive about shame. In any form, in any context and through any delivery system, shame is destructive. The idea that there are two types, healthy shame and toxic shame, did not bear out in any of my research.

The most effective response to shame is what Brown calls “shame resilience” – access to a process steeped in connection and empathy. The toxic opposites can involve “numbing out” – alcohol and drugs, isolation and despair. We perpetuate our own shame when we individualize (“I am the only one”) or pathologize (“something is wrong with me”) or reinforce (“I should be ashamed”). We perpetuate shame when we insulate ourselves (separating "us" and "them") or give ourselves permission to stereotype people.

Brown’s research identified four key components of shame resiliency: 

• The ability to recognize and understand shame triggers
• High levels of critical awareness
• The willingness to reach out to others
• The ability to speak shame.

Since shame comes bundled with our toughest social problems, and is always destructive, we should support shame resilience in the programs we design. 

• We can model shame resilience, designing messages that show people making connections and talking through problems.
• We can emphasize commonality, not pathology, by showing how the experiences that make us feel the most alone are actually universal experiences.
• We can scour our programming of common shame triggers. We might start by putting ordinary people, not professionals, at the center of our programs. Many people in Brown’s research associated shame with education and helping professionals. According to Brown, the mere presence of a person with credentials in a room can have a shaming effect.

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The easiest way to learn more about Brené Brown’s work is to watch her two TED talks, or visit her website http://www.brenebrown.com/ The quotes in this blog post are from her 2007 book, I thought it was just me (but it isn’t): telling the truth about perfectionism, inadequacy and power.