Shame and Connection in the Therapeutic Relationship

The BTP workshop on Why Shame Matters: Relational Perspectives on Working with Shame takes place via Zoom, on Saturday 4th March 2023, with catch-up available after the event. Our expert trainers for the day include: Orit Badouk Epstein, Dr Elaine Arnold and Linda Cundy

In this Online Live CPD conference our three expert trainers will consider shame as a relational issue. This includes looking at shame through the lens of attachment and childhood bonds, as well as through the lens of race and intergenerational trauma and discrimination, and through the relationship with self and the cycle of self-loathing.

Ahead of this workshop we have an article by our guest blogger is Hannah Creedon, an Integrative Counselling Psychotherapist who specialises in working with the LBGTQ+ community. Hannah shares an exploration of shame and how we can work effectively with shame within the therapeutic relationship. Shame is so central a component of trauma, and can form a barrier which prevents connection and healing for anyone living with trauma. If you are looking to find out more about repeating patterns in therapy and the impact of trauma and shame why not join us for the online Shame Conference: Why Shame Matters: Relational Perspectives on Working with Shame.

Internalised Shame Unmasked

When a client speaks about their internal world with self judgement and criticism, it is often due to internalised shame. The requirement for some of us to hide parts of ourselves in order to stay safe can have lasting effects on our relationship with ourselves. Embodied shame often results in us inheriting messages of unworthiness, and sadly those messages become applicable to our internal world. This can often result in being stuck in loops of self-deprecation where we may end up ‘shaming’ our shame. This can all happen out of our awareness, which undoubtedly has an effect on relationships, both with others and with ourselves.

This is something we as therapists may come across regularly, especially when working with clients from marginalized groups. When talking about internalised racial shame this description, written anonymously by someone going by the acronym SR, tells of the lasting effects of being taught to be ashamed for who they are:

“I became the queen of code switching, becoming the person I needed to be in order to stay safe. Pretend pretend pretend. Assimilate assimilate assimilate. Hide hide hide. Shame was at the very core of my experience of being an immigrant child…Fast forward a couple of decades and I’m more at ease with my sense of self and identity and proud of my heritage. But I haven’t forgotten the trauma of my past nor have I forgotten the individuals, groups and systems that created such fear and shame. There will always be an element of mistrust and suspicion when working with systems and models that weren’t created with BIPOC communities in mind.” (The Burden of Internalised Racial Shame)

Research conducted by Stonewall unsurprisingly discovered that LGBTQ+ individuals experience disproportionately high levels of oppression based on their identity, and the reaction to this can often manifest in internalised homophobia, which is rooted in shame (LGBT in Britain – Hate Crime and Discrimination). Internalised shame may not manifest in obvious ways, but may look like anxiety, depression, self-destructive behaviours or a feeling of general unworthiness.

We must name the shame, in order to understand it. Our clients may not be ready to sit with a therapist or anyone for that matter who sees them differently to how they see themselves. They may not understand why we do not see them as unworthy, when shame says that they are the problem. Shame acts like an ugly mirror, deflecting from the fact that shame itself is the problem.

Guilt versus Shame

Brené Brown ( describes the difference between guilt and shame, stating that guilt is uncomfortable to sit with, and painful to admit, but it does not fundamentally cause the same relational destruction as shame. She uncovered that guilt is:

adaptive and helpful—it’s holding something we’ve done or failed to do up against our values and feeling psychological discomfort”.

However shame is:

“the intensely painful feeling or experience of believing that we are flawed and therefore unworthy of love and belonging—something we’ve experienced, done, or failed to do makes us unworthy of connection”.

Fundamentally, guilt may be understood as being outward (e.g based in our actions or behaviours), whereas shame is directed more inward (e.g. our sense of self). The results of this are potentially far reaching, but fundamentally self-blame can be a huge barrier to change. The initial reaction to this is often deep sadness and loss at the life lived through the burden of shame. There is certainly a difference between sitting with something we have done wrong, versus the belief that we ARE wrong.

Carolyn Spring and Shame

A very important resource on the work of shame in the therapeutic relationship is the work of Carolyn Spring. In her book Unshame – Healing Trauma-based Shame Through Psychotherapy (2019) she describes her experiences and shares intimate details of her sessions as the client.

Spring describes her shame as an empty ‘thing’ “in the space between her and her therapist; and that it held them apart and stopped them from connecting. She admits that “everything about me felt wrong and I didn’t know that was shame, I thought it was just the way it was, just the way it always had been, just the way it would always be”.

Understanding this core belief of ‘wrongness’ can be really helpful when empathising with a client’s shame, by seeing it as a prison that keeps clients trapped in the ‘distance’ (i.e. they may be disconnected from their ability to experience any level of self-compassion). As Spring describes, shame means living life with the handbrake on, limiting our capacity and stifling our growth. This led to deep self-loathing for Spring, and she writes in a chapter titled The Safety of Self Hatred:

Instead of going through the shame of a trial I just plead guilty and put myself in prison. Because I can’t bear to hear the evidence… I hate myself because everyone else has always hated me. I know this isn’t true, but just right now it feels like it is true, and that’s enough”.

What happens next in her session is very enlightening, as her therapist suggests that they breathe through the sense of unsafety rather than dismantle it. This approach of sitting with and being alongside is profound for Spring in that it doesn’t “shame the shame”. Spring writes that she felt in that moment that ‘dismantle’ is an apt word, because the self-hatred felt like a “fortified castle, mechanical metal all bolts and latches and ramparts and rust”. Spring and her therapist agree that hating herself feels safe; and they then go on to focus on her body, which allows her to stay relationally connected.

This self-reflection is an excellent example of how shame and self-hatred perpetrate both the abuse of herself and the abuse she experienced in early life. Spring defines her own self-hatred as a strategy rather than a reality, because this hatred doesn’t actually make her safe.

Exploring Shame with Clients

We may often come across clients who feel shame about the reasons for coming to therapy, or that they need it in the first place.

Shameful responses may look like ‘but others have it worse’ or ‘my problems are not that bad’, even from clients who have experienced an extraordinary amount of trauma in their lives. Shame has been described by Augusten Burroughs in his book This is How as a “landfill emotion. It’s not organic, like joy. It was dumped there by somebody else.”

Burroughs’s sentiment might mean that shame (like landfills) do not exist without other people. Since a client’s shame is often relational and systemic, it is in the therapeutic relationship that it can hopefully be healed. By inquiring who the shaming voice is, what they want, and most importantly when they first heard it assists to identify and conceptualise the feelings of shame.

Challenging the narrative that the client is unworthy or unlovable can be very frightening for them, and that fear can cause panic. Panic can often lead to disconnection, both from themselves and from the session, and it is our job to help keep the client connected to us as much as possible. With the popularity of online therapy during the Covid19 pandemic, this may feel like quite a challenge. By being attuned to our client’s facial expression, breathing and non-verbal cues, we can help them to stay with us by reassuring them that they are not alone in exploring this difficult territory.

The belief that the antithesis to shame is connection, to really see and hear clients, can mean sitting with them and creating a space that feels safe enough to explore that shame. A trauma informed approach to this would be to work with clients towards nervous system regulation, to help facilitate new safe communication to the body. Working towards ‘safe’ connection can be a long process, but non-judgmental approaches often work best here. If a client, for example, was told by their primary caregiver/givers that their emotions are wrong or too much, they are more inclined to believe that they are wrong.

Shame can often be diminished by both connection and vulnerability. It thrives in the shadows, behind bars, in the unsaid. Brené Brown in conversation with Andy Hinds in 2013 described three practices to engage in that can encourage vulnerability: Asking for help, setting boundaries and apologising when we are wrong. (‘Messages of Shame Are Organized Around Gender‘, The Atlantic, 26 April 2013).

This is especially helpful, she believes, when working with people who identify as male, as shame can manifest differently depending on a person’s gender identity (or lack thereof). Male identifying people can be socialised into believing that weakness of any type is shameful, and so would imprison themselves and hide their struggles, even from themselves. Clients often speak about something just feeling wrong or ‘off’, but not understanding why. This may be an indication of shame working, so much so that it is difficult to even identify it in the first place.

To diminish a client’s core belief that they are unworthy is to distance their need for safety, which is fundamental to certain client groups, such as those with Complex Post-Traumatic Stress Disorder (CPTSD). To be in the position of giving unconditional empathy and really seeing a client challenges the shame narrative. It brings them closer to the part of themselves that doesn’t want to be seen, as this part may have been in a lot of pain. Even when clients say they don’t know what to speak about in sessions, it can be helpful to speak to the part of them that did show up to that day.

Allowing clients to freely communicate their shame can be a really transformative in integrating the shame. Being alongside clients in their self-hatred, while simultaneously trying not to rescue them from it can be very challenging. However, by subverting this paradigm, we are showing them how to sit with their discomfort. This may gradually help to break the loop of self-deprecation, and help the client to redirect their attention in order to look at what else they may need to feel safe. This of course looks different for everyone, but honest non-judgmental acceptance in the therapeutic relationship can be profoundly healing.

Want to find out more? The BTP Workshop on Why Shame Matters: Relational Perspectives on Working with Shame takes place via Zoom, on Saturday 4th March 2023, with catch-up available after the event.


If you found this blogpost helpful please share it with your peers. You can also say something in the comments section below.

About Our Guest Blogger:

Hannah Creedon (she/her) is an Integrative Counselling Psychotherapist based in Brighton & Hove (UK). Hannah has been working with the LGBTQ+ community for over 3 years and is a founding member of Rampion Counselling and Psychotherapy; a Counselling and Psychotherapy practice in Brighton and Hove, offering an affirmative, inclusive and confidential service to anyone who might be facing a mental health issue.

* there are affiliate links in this post, if you buy a book using one of these affiliate links we will get a very small fee. It all helps! Thank you!

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