Seeing and being seen: Shame in the clinical situation

Shame may prevent the patient from emerging from a psychic retreat. As begins to do so he confronts two fears, first of seeing the object more clearly and second of being seen become prominent. Seeing leads to deeper and more distressing feelings connected with guilt and depression as the damage done to good objects is recognized. However it cannot be faced if shame leads to a demand for immediate relief. Shame is a prominent feature of the analytic situation and recognizing this may help the analyst to support his patients to tolerate the discomfort of being seen so that the conflicts about seeing can be worked through. Two clinical examples are briefly discussed. In the first feelings of inferiority lessened as they were analysed and allowed appreciative and depressive feelings to emerge. In the second embarrassment was associated with progress that the patient felt he had made but was embarrassed to admit. It is argued that the analysis of shame in the analytic situation is necessary so that being seen can be tolerated and allow the conflicts over seeing to be worked through.