Competent Psychotherapy

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This page is my newsletter, where I publish some of my ideas on psychotherapy and getting help.

I also recently saw an ad for a depression drug. The ad said that some people still felt depressed after taking the antidepressant drug. Their solution was to take another drug on top of the old drug.

Perhaps the solution lies in the direction of understanding the underlying condition, towards developing greater emotional resilience and flexibility.

This is the mission of competent psychotherapy.

Emotional Problems Are Emotions

A man came to see me not long ago, at risk of losing his job. He found it difficult to finish tasks on time. He made promises he could not or would not keep. He was so perfectionistic, that he couldn’t begin the process of performing any task until everything was ready and in place in his mind.

As you might imagine, the man found it next to impossible to start much of anything essential. His superiors offered help, bringing in people from HR and providing coaches. He also began to work in psychotherapy with me.

Yet all of the assistance, including my work, failed to help him complete his work on time. His superiors’ concern shifted to anxiety, then to irritation. Soon, frustration and rage followed. Then, painfully, the inevitable: he was fired. So what happened here? Why did this gifted individual bring the wrath of his company upon his shoulders?

How was it that he could not use his common sense? How can we best understand the situation?

  • If we understand that emotional problems result from emotional states existing within a person, we can think more clearly about the situation. 

The man feels he cannot do the work required, for reasons he cannot fathom. He feels guided by a series of compulsive avoidances. They are always presented, by his mind, as reasonable and as a quest for an improved product.

 

However, since the net result was to enrage his employers and earn their rejection, we can imagine that there was more going on than met the eye.

 

  • This is the great truth in counseling and psychotherapy: Invisible forces (emotions) are running the show in ways the person himself may not at all understand.

What are these forces? Certainly, intense anger was somewhere at work. Zeroing in on the emotional details of the situation, it’s striking to note how much he made other people mad. He brought to life in others the feeling he could not bear. And he did it in such a way that they rejected him.

 

This emotional scenario forms the basis of our initial hypothesis regarding the problem. If we take these elements and use them to consider what was going on inside of the client, we can begin to imagine, talk about, and think about the possibility that the client is struggling with a great deal of anger. Anger, which he, himself, both rejects and denies.

 

Rejection and denial are a large part of why he ends up being controlled by his avoidances. He unconsciously evokes anger in others, so that they will reject him. He is actually rejecting his own anger. That he must elicit the rejection of others in order to reject his own anger is a serious problem indeed.

 

  • It is in the nature of emotional problems that they repeat.

The man’s rejection of the anger is enacted in a very complex way. He involves others as participants in his invisible inner drama and trauma. This is a serious emotional problem with major repercussions, needing intensive work and attention.

 

We are working to try to enlarge his understanding of himself before he brings down the wrath of the gods again at his new place of employment.

 

  • So, you can see that what is denied inside of you still has great power and force.

 

Emotions can turn on you, damage you. Understanding as much as possible about the strata of emotion that live within is most useful for any human being. When talking with friends doesn’t provide insight, relief, or understanding, then it might be time to take things up a level. Take your problem to a professional.

 

Even then, there are few easy or simple answers. But there is hope.

 

 

Buried Alive: Uncovering Emotional Problems

Why Hidden Feelings Don’t Really Rest in Peace

What do we really know about emotional problems after several hundred years of intense study?

Well, not too much really.

It is still possible for a trained psychiatrist to assert that there is no evidence proving brain chemistry problems exist, or chemical imbalances really exist. These ideas are merely theories and hypotheses about what might be behind our most persistent and repetitive emotional problems.

Brain kinks? Not proven!

On the other side of the equation is the talk therapy group, who suggests that emotional problems are essentially learned.

These are problems that evolve through the painful and difficult challenges of growing up. Emotional problems develop as a person struggles to master their emotions in order to function in relationships with others; and in order to work, to love, and to play in the world.

Is this proven? No!

Can it be? Probably not.

Still, we go on helping people continue to develop. And many get better.

I’ve been on the “talking, thinking, and feeling” side of the street for 40 years now. I will try to summarize what appears to me to be a slowly growing consensus regarding emotional problems:

Buried feelings

  • Emotional problems seem to consist of intensely uncomfortable feelings. They are buried within a person. What does it mean to be “buried”? We will have to leave that to your imagination.  We do not really know. It just looks that way.

Protected feelings

  • Buried emotions are hidden away beneath something. They are protected and exempted from being felt all the time. This is accomplished by some form of avoidance, forgetting, or other way of keeping bad feelings from being experienced.

Stirred feelings

  • It’s easiest for me to imagine that the feelings are there always, but hidden by a tarpaulin or thrown into a closet with the door tightly shut. Though they are gone, they are not dead. They stir.

Uncovered feelings

  • When the feelings are felt, they can create intense, even convulsive discomfort. Why don’t they stay hidden? What does it take to stir them up? It seems that the cover-ups we create for persistent bad feeling are not at all sturdy, but weak.

We can only hide so much from ourselves. When something occurs that reminds us of feelings that are similar to the ones we’ve hidden, we may experience an echo of intense discomfort inside. You see, it may be that our emotional problems were, in essence, simple.

But, because we needed to hide from too much pain, we built flimsy closets to contain more than we could manage. It was the best we could do at the time.

It usually takes two people to help recover the formerly unbearable feelings…and learn to live with them in plain sight.

I think people have always worked to help each other understand feelings in themselves and in others. We come together to help each other to achieve a balanced perspective.

When feelings are buried very deeply, then a specialist, a therapist, may be in order. He or she will go the distance required to help you develop an understanding of those deeply buried regions.

The goal is to liberate the original buried discomfort. The aim is to allow it to become a smaller part of the whole. We don’t want to live with a scary monster hiding in an inner closet.

The result of successful help from amateurs or professionals (we all provide help) is often a renewed and refreshed sense of wellbeing– and the liberating sense that we have a new lease on life.

 

Where Do Emotional Problems Come From?

Exploring Neurosogenesis and Emotional Development

What do crying babies tell us? They need or want something that they cannot find in themselves. They need someone else to provide calm or comfort. What happens when we don’t give our babies the right amount of assistance, that “Goldilocks” amount of help: not too much and not too little?

Well, we all know the answers here. Too much help leads to a spoiled baby; a child who can’t tolerate frustration, and therefore can’t accomplish much. This is because he or she has not learned to manage the feelings that arise when difficult, or even easy tasks are undertaken.

On the other hand, the baby that is given too little has a different problem and challenge. How does he or she cope with wants and needs that aren’t satisfied– ones the child’s own parents do not respond to, or understand, for reasons of their own?

This baby has to learn to accept disappointment, at best. At worst, this child has to learn to give up on hope. To keep hoping is too painful; the need is never satisfied. Therefore, hope equals disappointment, and the solution to this painful equation is to abandon hope. You have to give up hope in order to survive.

I believe this equation is an important part of the foundation of depressive states of mind: One gives up to live in less pain.

All of us have undergone this process, and still experience some of it throughout life.

The Problem with Giving Up

Giving up hope has many potential ramifications. For example, learning to deny that you want something by becoming indifferent to it is a form of disavowal: “Oh, I don’t care if I’m loved, or if I feel safe, or if anything good happens to me.” Giving up or denial saps your motivation for forward movement in life, in some cases.

Although I argue that emotional problems originate in early experience, understanding them in their historical evolution is helpful. Still, it does not produce as profound a change as you and I want. Why is that?

It is because the emotional problem exists in the deeper emotional realm, which is not changed by thought. Contact with the unpleasant emotions, mediated by another person, seems to be the key factor in helping people work with, change, and become less dominated by their old feelings. It’s a lot like developing a good serve or, even better, like learning a new language. It is initially exciting, then the sheer amount of work involved becomes clear, and despair sets in. Many circumstances determine whether you keep with it, or allow yourself to give up.

On the other hand, our baby who has not had to learn to struggle or experience frustration, and certainly not been stopped or stifled by it, has a different set of problems. This person, who has it too easy, may very well have a successful path through life, simply and correctly judging the amount of difficulty tolerable and going after it. However, if he or she misjudges their frustration tolerance, and keeps biting off more than he or she can chew, then this “spoiled” baby may eventually risk developing a lower opinion of him or herself.

The idea that we can be divided into two groups, one that didn’t get enough and one that got too much is, of course, a vast oversimplification and elementary first look at neurosogenesis. It is just one of many dimensions comprising our emotional development. The more we understand of ourselves, the freer we can become in living our lives.

 

 

 

The Emotional Set Point

Learning to recalibrate your emotions

Sometimes your car tells you something is wrong. At the garage, they tell you nothing is wrong, except that the sensor needs to be reset or replaced. They do it, and you’re good to go. The car is working, and the car’s internal observers, its sensors, are properly calibrated.

Emotional Problems are Misinformation

Emotional problems are like sensors that are sending the wrong message. Removal of these sensors isn’t possible, though some attempt this through suicide and self-mutilation. Resetting your emotions is, instead, the approach of choice. Resetting is a big deal, a big job, a big process. It’s not quick and easy, unfortunately. It’s about feeling more than thinking. It’s about learning to think about, and with, feeling.

Emotional Problems are Reset with Practice and Persistence

Resetting emotions, unlike resetting mechanical devices, is very much a matter of practice, practice, and yet more practice. Persistence is key. Most of us experience things through familiar lenses; that is to say, the way we originally experience things tends to be repeated over and over again. The predictability of our own experiential patterns is what becomes the focus in understanding ourselves coherently.

The structure and shape of our understanding of ourselves is more or less constant, even in its variability. The profound conservatism of our innermost character ensures that change is extremely difficult and minimal. That’s exactly why it takes so much persistence and practice, over an extended period of time, to obtain a shift in the knowledge of ourselves, and the experience of life itself. One of the most common challenges is the intrusive feeling of anxiety. It can keep people from spreading their wings in so many different ways. A client recently noticed that she seemed to be in the process of finding herself, after decades of fears. She feels increasingly free of the limiting fear that had slowed her way down.

Emotional Problems are Reset with Help

Resetting is time consuming, and requires meticulous attention to detail. The work is best accomplished with another person: either a friend, a mentor, or, in deep matters, a therapist. The outside person provides an outside perspective that moves in the direction of correcting the faulty sensor. The outsider also provides a more reasonable assessment of the situations that have left you overwhelmed with emotions you don’t necessarily understand. Of course, since internal sensors are often set early in life, you may not have had a chance to understand them. You were likely too young to think systematically about the effects of interpersonal experience.

So, emotional problems can be understood as misinformation about the state of one’s self, the state of the outer world, and the state of affairs between them. The emotions that arise to meet certain situations can be too intense or disturbing. When this is the case, it’s sign that you need some help.

An intense response is appropriate when the world delivers a profoundly disturbing experience. If normal everyday interactions provoke over-the-top, intense feelings, then you will need the help of another person to get your perspective better balanced. We’ve all been there. Often friends or family member will help us when we are unsure our emotions are appropriate. They may affirm our reactions, saying, “Yes, that response make sense” or steer us differently saying, “No, that reaction was too much.” And we get our balance back.

The aim of psychotherapy, too, is to assist us in achieving comfortable, reasonable balances. The goal of the work is to see emotions align appropriately so that they help us, guide us, inform us, and satisfy us.

 

 

 

 

How Does Psychotherapy Work?

What is the real help of counseling?

Psychotherapy has been thought of in several key ways:

1. The focus has been on the competence of the therapist.

2. The focus has been on the personality characteristics of the patient.

3. And most recently, the focus has been on the fit between both people.

Counseling is the Comfort of a “Good Fit”

The “fit” refers to the intangibles of connection between therapist and client. We know so little, and yet so much about emotional engagement. We really need to turn more to the poets than the scientists, to appreciate the invisible emotional dimensions and depths that people bring to their encounters.

It turns out that emotional fit is important because it’s through a tuned-in relationship that people can begin to understand what’s going on inside.

Emotional problems consist of emotions buried deep inside a person. Those feelings are perceived as a threat because of their feared intensity which, of course, is why they were buried in the first place. What we need is help to understand, accept, and come to terms with those buried feelings. Then, we can become more whole and wholehearted.

Counseling Bolsters the Capacity for Understanding

Historically, the first idea in psychotherapy regarding help to a patient was called the “interpretation.” The interpretation was and is an explanation that enables the patient to think about unconscious forces or emotions that remain hidden and misunderstood.

In order to understand something, it must be conscious, in a state of awareness. Interpretation may go something like this: It may be that you’re angry because your boss looked at you in a way that reminded you of your father.

The effort is made to expand and extend awareness, allowing feelings to become more accessible to the thought process.

The patient only knows that he or she is suffering, sensing the inner disturbance, but unable to think about it clearly. Today, psychotherapy can more immediately help clients by sensing the hidden emotions that cause the distress. Through articulation, emotions begin to be felt and understood. It is through understanding hidden emotions that an individual moves toward health and well-being.

Counseling Supports the Regulation of Emotional Intensity

Once there was a man who couldn’t finish his assignments. He was struggling to contain, and conceal from himself, deeply angry feelings that he’d harbored most of his life. He created a standard of perfection, insisting that he knew and understood everything before he began any assignment.

As you can imagine, he never began anything. Motivation is essentially emotion; when emotions are poorly regulated, problems arise. Regulating the intensity of emotions is one of the principle tasks we face throughout childhood and, indeed, throughout all of life. We all have various difficulties and problems large and small, but we struggle on in spite of them.

When babies struggle with intense feelings, they become overwhelmed. They cry, needing the help of someone else to help regulate them, calm them and assure safety again. This helps explain a critical quality of psychotherapy. At times, when we are troubled or distressed, we can’t provide ourselves the comfort, safety, or answers we need. It all must come from the outside us– from somewhere else, with someone else.

Counseling Provides the Time to Heal

Classical analysis has been criticized for taking too much time. Some of this criticism has been addressed through a more rapid attunement to the emotions that are creating problems. Still, therapy is a time-consuming process.

Emotional growth and development are not the same as intellectual development. It all takes the right fit, significant effort, consistent repetition, and devoted practice.

 

Problems and Mental States

Learning to Unbury Uncomfortable Feelings for Increased Understanding

What Lies Beneath?

Emotional problems (we all have them) are about emotions. Often these emotions influence us outside of our awareness and leave us feeling troubled, confused, or angry, without understanding why. We keep making the same mistakes, no matter how hard we try not to. We keep being late, keep being last-minute, keep forgetting, failing or flopping when it would be critical not to.

We seem to be involved in our own demolition and we can’t figure out why.

In most emotional problems, there is a pattern repeating itself, but its reasons and its motivations, remain elusive. There is a reason for this hidden quality. It is the force that powers our emotional problems.

Freud famously called it ” the unconscious,” but we know more about it now.

Not So Dead and Buried

Here’s the short course on unconsciousness:

We make things unconscious. We send them away.

We bury them when they become uncomfortable and repetitive. This is our way of protecting ourselves. When no one else knows about our bad feelings, soon, we don’t either.

By the way, I am fairly certain this way of understanding can’t be proven, but tons of clinical experience, by thousands of clinicians over the last several centuries, offers strong evidence and support that forgetting and burying feelings is a universal process.

So, what does burying bad feelings have to do with emotional problems and why does the afflicted individual have so much trouble understanding what the problem is?

Well, we have established that people bury bad feelings. Okay.

Where do they go? Now, we don’t really know, but they appear not to disappear completely. They seem to stir within from time to time, creating disturbance and discomfort in the person. Disrupted, unconscious emotions can play a significant role, causing a person to behave in ways that are unhelpful or destructive. He or she may then take unusual or extreme measures to return those forgotten feelings to their oblivion. These evasive maneuvers often comprise the visible part of the problem – the symptom.

For example, a young man procrastinated so persistently that he was on the verge of losing his job. When he came to see me, he had no conscious clue about what was driving this behavior. After a few sessions, it became clear that he was struggling to keep hidden a vast reservoir of self-loathing. Making the discovery did not instantly solve the problem, but it began the process of clarification and understanding that is the basis of effective psychotherapy.

Remember, the stirring of the buried feelings and the associated discomfort is all together like an underwater earthquake. It is mysterious to the person experiencing it. A person may have spent years trying not to feel or consciously know the reality of what they were feeling. I think people do this all of the time – otherwise feelings couldn’t fade and we could never calm down or overcome slights and injuries.

It is when the individual has had to bury too much that emotional problems surround the site of the burial.

Working to Uncover Understanding

Solutions lie in the direction of understanding a person’s underlying condition and moving towards developing greater emotional resilience and flexibility. The fundamental job of the therapist and the patient is to do the necessary work to retrieve the living feelings and bring them the ultimate relief of being understood. Then, at last, the individual is in a position to understand the whole of him or herself without being compromised by the need not to know.

 

 

Medicines and Your Mind

Understanding emotional problems requires more than a prescription

Medicines can help you, but what do they really do and what really helps in the end, when the issue is emotional problems?

Your physician, who wants to help, believes that relief for many kinds of emotional pain can be given through medication. Anxiety can be diminished, depression can be lightened, and attention deficits can be modified. This is true, all true.

But…

The problem isn’t that drugs don’t modify feelings, they do. It’s that drugs cannot, by themselves, enable your mind to take charge of itself. They can modify and minimize the overwhelming effects of out-of-control emotions, but they do not retrain your brain.

The Work Your Meds Can’t Do

Medicines cannot teach you, by practice, how to understand what is happening. They cannot teach you how to resolve or improve what is happening. Ultimately, it is only through deep understanding that people are able to harness and master the intense feelings that continue to overwhelm and disturb their functioning in life.

That’s why, time and again, the conservative recommendation for the treatment of emotional problems is the one-two combination punch of meds and psychotherapy. There seems to be no substitute for one-on-one personal help that aims at developing deeper understanding of your feelings.

Emotional problems appear to be caused by emotional flooding at levels visible and invisible. The flood of feelings swamps your ability to understand what’s what, and to maintain a useful perspective. The natural counterweight to emotional flooding is greater understanding.  This way, you can keep your head above water when the flood tides run.

The Decision to Seek Complete Therapy is Yours

Please understand: Your insurance company will be more than happy to support your drug habit. It is relatively inexpensive, and seemingly supported by hard scientific data.

On the other hand, if you wish to discuss your feelings with a professional, you may find less cooperation by your insurance provider, as therapy seems to be on the softer side of the scientific street. Despite the overwhelming empirical evidence of psychotherapy’s usefulness, insurance companies over the past two decades have been happy to retreat from a robust reimburse schedule for those seeking psychotherapy. This means that the average consumer is left high and dry when it comes to support for these not inexpensive services.

Your doctor, wanting to help and save you money, will prescribe you medicine. Often he or she will do this, not even knowing a psychotherapist to recommend. It is important that you understand that psychotherapy is a part of your treatment plan, and that you, by yourself, might have to initiate the process of finding someone that can help you to learn to master your emotions fully.

Many of my clients come to me, happy to be on the medications prescribed by their physicians. As they begin to reach a clearer understanding of themselves, they revisit their providers, asking if it is all right to stop taking their prescriptions. Most of the time it is, and they do. Our therapy work then continues, focused purely on developing a deep and useful emotional understanding of what’s not been working internally.

So to be clear: Medicines often work well to help dull the edge of emotional problems.

They simply cannot do the big job of understanding intense emotions deep inside you.

For the big job of transforming misery into better living, you need the detailed and repetitive practice work of putting feelings into words, while you are being carefully listened to by someone who understands how people hurt and how they heal.

 

The New Understanding of Emotional Problems

If someone tells you that mental illness – emotional problems – cannot be understood, don’t you believe them!

What infants teach us about emotional problems

There is a new emerging consensus about the development and treatment of the vast majority of emotional problems. To be clear, we are not talking about profound mental illness like schizophrenia here, but rather depression, panic, anxiety, and destructive or self-destructive behavior that comprise that vast majority of serious problems affecting many people.

The new paradigm emerges from infant research, in which close observation of interactions between parent and child show how quickly and early development patterns of behavior are acquired.  It’s really amazing to see movies made about parent-child interaction. With a skilled observer guiding your eye, you can begin to see specific behavioral adaptations that an infant makes to its caretaker based on the feeling the caretaker brings up for the child. Basically, does the child feel calmed or frightened by its caretaker’s behavior? A frightened child will turn away to seek comfort. If it feels comforted, it will turn toward his or her caretaker and the two will feel safe together.

Understanding that an infant or toddler will turn away from what does not relieve its fear, we learn that this act of turning away to seek safety becomes incorporated into a habit. From a habit, it becomes fixed into its character, and as a result is slow to change. This is true for all babies and their parents. In the case of parents, who themselves have not been sensitively raised, their tendency will be to raise children who are less able to tolerate discomfort, are more responsive to fear, and will have problems in areas like intimacy and self-discipline.

Interaction shapes internalization

The new paradigm arises out of what is called attachment theory, which refers to how secure or insecure the infant feels in relation to its parent. Freud thought emotional problems came from inside the child and while he pointed us in the right direction, he didn’t link caretaking behavior to the inculcation of emotional problems. Where Freud ignored aspects of the environment, we now understand more clearly how early problems with fear and anger begin in an interactional context before they become internalized.

Feel free to move forward

If all of this is too big a leap for you to make, the good news is that it doesn’t matter. Learning to regulate the intensity of your emotions is a process that you can learn, with the help of a therapist or a teacher who can assist you in discovering what it is that is bothering you, and help you calm it down. While it is sometimes useful to have a few ideas about the origins of emotional problems, the treatment of these issues always takes place in the present, not the past.

So, despite what you may have been told, the old idea of spending years talking about your childhood is not the proper focus for treating an emotional problem that still exists in the present.

Understanding the new paradigm of emotional problems helps us to see how far we have come since Sigmund Freud first began his historical collaboration with colleagues and patients, giving rise to modern day psychotherapy and our ability to help people with intensely disturbing emotional problems.

The art and science of psychotherapy is continuing to advance in many exciting ways, as understanding it becomes both clearer and more profound. We are able to help people with a wider range of emotional difficulties that might previously have seemed beyond the reach of a psychotherapist.

 

Hate and the Therapeutic Process

Surrendering Self-Contempt for the Sake of Real Change

As I meet with clients, one of the most common patterns I encounter is that of people who describe their problem, saying, “I hate it” or “I hate this about myself.” Since we cannot get rid of ourselves, we also cannot get rid of our problems.

Our problems are a part of us, like it or not.

So an early step in the therapeutic process is for the therapist and the client to assess the client’s relationship to his or her own problem. When I hear “I hate myself, “I have learned to jump on that familiar remark, and immediately begin a change process. I explain that hating something in him or herself prevents us from working with it. It will be impossible to promote change. Hatred seems to lock everything up in a frozen mess.

  • Begin the process of changing your mind.

The first thing to do is emphasize the way the person thinks — this is not easy, but proceeds from frequent repetition and practice. The client must work to change damaging thoughts, set aside self-hatred, and struggle to take a more thoughtful nuanced view of the issue at hand. He or she must come to recognize that it is simply unhelpful to hate him or herself -regardless of the issue. It doesn’t matter whether the problem is jealousy, philandering, chronic underachieving, or over-drinking.

Hatred focuses the attention in a wrathful bath of fury, negativity, all joined with a wish to inflict pain on the enemy inside of you. This is not the mindset needed to coax, cajole, push, or pull (gently) the emotional – behavioral complexes that need change and development.

  • Learn how to change, one step at a time.

Necessarily, the person also needs to learn what change is about. This is the objective from the very beginning therapy to the end of the process. Ideally, this process is ongoing.

Change consists of many small, manageable adjustments over time. Then after a while, the client and the therapist will see that a gradual shift is taking place. It all begins by lightening up on the self-hatred, even though it seemed reasonable to harbor it because the problem has been painful and costly in so many different ways.

  • Understand and address the real issues.

As the self-hatred abates in intensity after a time, a client’s thinking about the multiple issues embedded in the problem becomes more possible. A more sophisticated understanding begins to develop. Gradually, decision points emerge, which allow the person to begin to modify the heart of the problem.

So, when you find yourself hating something about yourself or about a family member, it is important to consider how to modify the intensity of the passion. People often say, “I hate a quality about my parent. I would hate that in myself.” At that point, I often know what we are going to be dealing with, because we all identify with our parents. In some sense, parents do exist inside of us; as children we take in impressions of our mothers and fathers. When those impressions result in hatred, some people unknowingly end up hating themselves. This can become a problem and large focus of attention.

Our goal, in a successful therapy, is to eventually understand the reality of our internal images regarding our parents and ourselves, so that we may ultimately accept them. If we don’t accept them, we can’t change them or improve them.

These are the payoff moments for all concerned, making the whole journey and its many difficulties and sacrifices worth it.

 

Shame

What is it, where does it come from, what does it do, and how do you deal with it?

  • What is shame?

Shame is a powerful inner force, a hidden retardant for the development of your self. The greater the feeling of shame you have within, the harder it is to think and act in a free and flexible way. When you live with shame, you feel you always need to keep your sharp eyes peeled, lest you reveal to the world what a bad person you are, at least in your own opinion.

Shame is actually feeling that you are bad, evil, wrong, or sinful compounded and intensified by a harsh inner judgment that says indeed, you are even worse. Shame is a moral conviction of your inferiority and essential badness.

  • Where does shame originate?

All children, from time to time, are going to feel bad. But if they are never welcomed or embraced by the world, that bad feeling can morph from feeling bad to the sense of being bad. At this point, a child may then decide that they and their badness must be rejected or condemned. This kind of internal shame is formed over time, through a long stewing or steeping process, as the feelings of badness soak into a person’s sense of self.

  • What does shame do?

When you feel ashamed, you feel you must arrange to cover it all up so the bad bits are hidden away. Unfortunately, if those bits aren’t available for work, they cannot be integrated, and they require that you expend energy to keep them pushed down or hidden. Worse, you probably aren’t even aware that this is going on. The whole process is beneath the surface and unconscious.

Still, all those hidden parts will rise to the surface from time to time, accompanied by intense feelings of shame. To cope, you will probably find yourself retreating or isolating in order to stabilize your sense of wellbeing.

When you are plagued with shame, it is difficult to be whole-hearted. A high degree of fragmentation becomes necessary to keep your badness concealed from your own eyes and those of the world.

  • How do you deal with shame?

You have to hollow it out with understanding. You really do need other people to help you through it. You need to see yourself as good, not just through your own eyes (we now know your view of yourself is suspicious and your perspective is dubious), but also by being accepted by someone else.

Gradually, you will come to understand that your shame is misplaced. It is a confusion from long ago that ultimately doesn’t hold water.

  • What is the difference between shame and guilt?

Shame is to be distinguished from feelings of guilt or remorse. If you threw a brick through a window you’d feel reasonably guilty for having done that bad thing. Shame, is different. It is persistent. It is a lingering, unpleasant, burdensome state of mind. It is an ongoing bad feeling that acts as a drag force on creativity, and saps your ability to live well.

Essentially, shame makes you tend to turn away from the world and leads you to live a more isolated existence. When a person feels a sense of shame, he or she therefore tends to believe it. We tend to believe what we feel, for better and for worse. It takes conscious effort in a relationship to loosen the strictures of shame. Many types of relationships can offer varying degrees of relief, but a relationship with a therapist is tailor-made for this sort of undertaking.