Shame: An Emotion Needing Exceptional Interventions

Shame can inflict deep and lasting psychological harm. However, its pervasive negative effects often go unrecognized by both patients and their providers, and thus, it may remain wholly unaddressed. Shame may be mistaken for guilt, embarrassment, or humiliation, but shame darkens patients' quality of life much more profoundly than these other emotions. For this reason, there is a greater need for providers to remain alert to cues that patients may feel shame and if they suspect this and are right, they may seek to help patients reduce their shame. This article discusses what shame is, how to detect it, and, once detected, how providers might best intervene. The experience of shame commonly results from a wide range of negative social experiences, including discrimination, social exclusion, and patients being medically ill. Recognizing and addressing shame are critical skills that providers should strive to acquire. The interventions discussed here may significantly help undo the shame that these patients self-inflict.