Shame, Pride, and Relational Trauma

Concepts and Psychotherapy

Ken Benau

• Publisher: Routledge
• Year: 2022
• Print ISBN: 9781138362376
• eBook ISBN: 9780429759512
• Edition: 1
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

Shame, Pride, and Relational Trauma is a guide to recognizing the many ways shame and pride lie at the heart of psychotherapy with survivors of relational trauma. In these pages, readers learn how to differentiate shame and pride as emotional processes and traumatic mind/body states. They will also discover how understanding the psychodynamic and phenomenological relationships between shame, pride, and dissociation benefit psychotherapy with relational trauma. Next, readers are introduced to fifteen attitudes, principles, and concepts that guide this work from a transtheoretical perspective. Therapists will learn about ways to conceptualize and successfully navigate complex, patient-therapist shame dynamics, and apply neuroscientific findings to this challenging work. Finally, readers will discover how the concept and phenomena of pro-being pride, that is delighting in one's own and others' unique aliveness, helps patients transcend maladaptive shame and pride and experience greater unity within, with others, and with the world beyond.

1Shame, Pride, and Relational TraumaWhat Are They and Why Do They Matter in Psychotherapy?

DOI: 10.4324/9780429425943-2

Introduction

How we think and feel about ourselves, others, and our relationships are basic to being human. It follows that devaluing ourselves, shame, or valuing ourselves and our accomplishments, pride, lie at the heart of who we are and how we relate to ourselves and others. When a person is traumatized by the actions and inactions of others, shame and pride will always be essential features of their intrapersonal, self with self, and interpersonal, self with other, landscape.

How does understanding shame and pride as emotional processes and traumatic mind/body states inform psychotherapy with survivors of relational trauma (RT) (Schore, 2001)? This chapter begins by defining RT, introducing the reader to some of the challenges facing survivors in psychotherapy and life. It then describes concepts and characteristic phenomena of shame and pride that include observable behavior, subjective experience, and differentiating shame and guilt as well as shame and humiliation. This chapter closes with a discussion on why understanding shame and pride is essential to successful psychotherapy generally and specifically with RT survivors.

Because shame and pride are fundamentally about relationship, self with other (interrelating) and self with self (intrarelating), survivors of RT best describes the psychotherapy patients with whom I work. RT results from what people do to and do not do for other people. Trauma caused by natural disasters and accidents are not my focus. Although the effects of RT are also seen in patients living with more complex dissociative disorders such as Dissociative Identity Disorder (DID) (Chefetz, 2015), these too are not the patients I describe. While most survivors I work with experience some dissociation (Chapter 3), my patients do not meet the criteria for DID.

Relational Trauma (RT)

Alan Schore (2001) coined the term RT. Schore researched

the negative impact of traumatic attachments on brain development and infant mental health, the neurobiology of infant trauma, the neuropsychology of a disorganized/disoriented attachment pattern associated with abuse and neglect, trauma-induced impairments of a regulatory system in the orbitofrontal cortex, the links between orbitofrontal dysfunction and a predisposition to posttraumatic stress disorders, the neurobiology of the dissociative defense, the etiology of dissociation and body-mind psychopathology, the effects of early relational trauma on enduring right hemispheric function, and some implications for models of early intervention.

(p. 201)

Schore (2001) described the nature and effects of a caregiver’s abusive and neglectful behavior on the mind/body of the developing child. These effects have significant consequences into adulthood. The child survivor lives with a

caregiver [who] is inaccessible, and reacts to her infant’s expressions of emotions and stress inappropriately and/or rejectingly, and shows minimal or unpredictable participation in the various types of arousal regulating processes. Instead of modulating, she induces extreme levels of stimulation and arousal, either too high in abuse or too low in neglect, and because she provides no interactive repair, the infant’s intense negative emotional states last for long periods of time.

(Schore, 2001, p. 205, my emphasis)

For our purposes, RT refers to the consequences of the chronic overwhelming and/or underwhelming of a child’s developing mind/body experience and behavior. “Overwhelming” refers to abuse—physical, sexual, interpersonal, emotional, and psychological—repeatedly inflicted upon a child, with no adult intervening or helping the child survivor understand these experiences, especially that the caregiver, and not the child, is responsible for the abusive behavior.

“Underwhelming” refers to the impact of repeatedly unmet relational needs. There are many ways needs go unmet, and all involve the child not feeling seen, felt, known, and recognized (Bromberg, 2011a, 2011b) by their caregiver for who they truly are. While “underwhelming” is a consequence of “neglect,” its origins can be extreme and/or subtle. Neglect might involve a young boy left alone for days and having to “parent” his younger siblings. Less dramatic forms of underwhelm include a girl never greeted by her father when she comes home from school because others are “more important,” or the young boy whose mother dies yet is never asked how he feels.

Underwhelming, then, can reach levels of traumatic neglect and abandonment, whereas more subtle forms are characterized by some as attachment wounds that exist in relation to trauma (Erozkan, 2016). In my view, both dramatic and subtle forms of neglect reflect RT. Even with subtle yet pervasive neglect, the mind/body registers and remembers patterns of absence as with other trauma. In both dramatic and subtle underwhelm, repeatedly unmet relational needs later play out in relationship, be that through excessive self-reliance, neediness, or both. These patterns persist until, often with the help of psychotherapy, the enduring effects of unmet needs are uncovered and the patient develops new, adaptive ways of relating to their “attachment” needs both within, self with self, and between, self with significant others.

“Trauma” and “Patient”

The word origin of “trauma” is from the Greek, “a wound, a hurt, a defeat,” and earlier from the Proto-Indo-European (PIE) “trau-,” from the root “tere” with “derivatives referring to twisting, piercing” (Trauma, word origin).

If RT refers to a psychobiological wounding as a result of repeatedly overwhelming and/or underwhelming another person, what word best describes the person seeking psychotherapy? I have chosen the word “patient” in lieu of “client” following its word origin from the Latin patientem, “suffering” (Patient, word origin). I think of the people I work with as relational sufferers, not “customers” or “consumers.” To be clear, while I believe all humans are, at times, relational sufferers, not all are survivors of RT.

Patient Confidentiality

Many of the adult patients depicted in this book were psychotherapy patients who graciously gave me permission to describe our work to benefit therapists and patients alike. Some are composites of several patients or my imagined creations. To protect patient privacy, information not required to understand our work has been omitted or altered.

Shame, Pride, and Pro-being Pride: Concepts and Phenomena

Shame and Pride: Introductory Remarks

Many people assume that both shame and pride as emotions are always unwanted or negative. Who wants to feel bad about themselves (shame) and condone behavior treating others as inferior (pride)? As the reader will see, both shame and pride can be adaptive and maladaptive, and both are central to our work with RT survivors.

To be human is to experience shame, although animal behaviorists suggest shame is observed in other mammals and may be a survival adaptation (Bekoff, 2007). When a noisy baby elephant is “reprimanded” by an elder so as not to attract the attention of a predator, “shaming,” elephant-style, is at play. Shame or its prototypical, mammalian equivalent, often although not always serves as a powerful downregulator of arousal (Schore, 2003), putting a brake on many emotions (Tomkins, 1963) to preserve individual and species survival. In RT, shame is often activated within an individual whenever thoughts, feelings, and/or behavior are perceived as a threat to vital attachments, self with others and self with self.

Shame as a traumatic mind/body state (“shame state”) (Herman, 2012, 2011, 2007, 2006) is more complex and problematic than shame as an emotional process (“shame emotion”) (Chapter 2). Shame as emotion and traumatic state both put a brake on emotions, thoughts/beliefs, physical sensations, and behavior (Benau, 2021a; 2021b), precipitating states of downregulation and hypoarousal. As with other traumatic reactions, shame states also overactivate the nervous system, precipitating upregulation and hyperarousal that reflect the survivor’s self-protective reactions to interrelational and intrarelational threat and/or danger.

Pride is an emotion no less prototypal than shame. Whereas “shame makes us feel small, insignificant and worthless in every respect,” “pride, the opposite of shame, gives us a sense of bodily and mental power and worth” (Wille, 2014, p. 697). When feeling proud, we celebrate mastery and achievement (Tracy, 2016).

I have named another adaptive pride subtype “pro-being pride” (Chapter 2). Pro-being pride is not a categorical emotion such as sadness and anger. Pro-being pride is an enduring, mind/body state rooted in the pleasure of being and belonging as one truly is with others experiencing the same. Pro-being pride reflects joyful aliveness shared rather than taking pleasure in one’s attribute or achievement. Pro-being pride lies at the heart of psychotherapy generally and specifically with RT survivors. As will become clear, pro-being pride is the guiding light of this book and my work as psychotherapist.

Shame and pride in humans always involve some self-other awareness or consciousness. Without the ability to evaluate oneself, others, and how others are evaluating you, there can be no shame and pride. (See Chapter 3 for more about “attending” to self and other as regards shame and pride.)

For the most part, self-consciousness is a uniquely human capacity given the development of the frontal lobe of the neocortex (Sturm et al., 2008, 2006). In the Bible, when Adam and Eve ate from the apple and became aware of their nakedness, self-consciousness and shame banished them from Eden. Hubristic pride got them into trouble with God in the first place. To become aware that one is an object of others’ valuation and devaluation is to become self-conscious that one has either met or not met one’s own and/or others’ expectations. As Mark Twain wrote in A Connecticut Yankee in King Arthur’s Court, “It shames the average man to be valued below his own estimate of his worth” (Twain, 2011, p. 351). S...

Table of contents

• Cover
• Endorsements Page
• Half-Title Page
• Title Page
• Copyright Page
• Dedication
• Contents
• List of Tables
• Foreword
• Acknowledgments and Credits
• List of Abbreviations
• Introduction
• 1 Shame, Pride, and Relational Trauma: What Are They and Why Do They Matter in Psychotherapy?
• 2 Shame and Pride: Subtypes and Processes
• 3 Shame, Pride, Mind/Body Leave Taking, and Structural Dissociation: Psychodynamics, Phenomenology, and Psychotherapy
• 4 Setting the Stage: Transtheoretical Attitudes, Principles, and Concepts When Working with Shame and Pride in Psychotherapy with Relational Trauma
• 5 Psychotherapy with Patient, Therapist, and Dyadic Shame States: Traumatic Reactions, Therapeutic Responses, and Transformation
• 6 From Shame to Pride: Psychotherapy, Neuroscience, and Applications—Three Perspectives
• 7 Shame State to a Core Way of Being: Beyond Pro-being Pride to Radiant Joy, Grief, Integration, and Oneness
• Index