Starovoytov V.V. Kilborne B. The Importance of Shame in Clinical Work // The Round Robin. Psychologist-Psychoanalyst Practitioners. Division of Psychoanalysis (39), JAPA. Spring 2007 (Translated by V. Starovoytov)

Abstract: This article is devoted to investigation of the importance of shame in clinical work. The author singles out two main forms of shame: humanizing shame and toxic shame. Kilborne writes about important difference between shame and guilt in connection to the threat to internal orientation. He writes that the subject of shame and trauma has been seriously neglected in the media and in the major psychoanalytic journals. According to him, the trauma of neglect and mother’s non-responsiveness (as well as the trauma of physical abuse) have devastating effects on both sensory and psychic organization, on body image and psychic structure. He discusses the interrelations between hubris, shame and trauma. In the course of investigation Kilborne singles out different aspects of shame. He explains why Freud and others have focused on guilt at the expense of shame, and why recognizing shame can be difficult. He gives examples of toxic shame and its great destructiveness, writes about the importance of attunement of mother and her child in connection with the themes of shame, trauma and development. As the result of his investigation, Kilborne comes to the conclusion that in its toxic forms shame leads to serious distress and despair both in patients and in therapists; it can be passed from generation to generation in the form of narcissistic preoccupations that negate the feelings of connection in children; it can be related to trauma not responded to and to intolerable feelings of rage, mistrust, and isolation. By contrast, in its humanizing forms, shame can be one of the most powerful therapeutic resources we have.

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