Låt oss tala om skam! : Psykoterapeuters upplevelser av att arbeta med skam.
Introduction: Shame seems to be one of our most unpleasant emotions. There are connections between shame and depression, acute stress syndrome and it is one of the main reason for committing suicide.
Questions: What are psychotherapist´ views on the role of shame in the therapeutic process? Which are psychotherapist experiences when reducing shame has had a positive impact on humans well being? On the contrary what prevents us regulating shame and what are the difficulties in working with shame?
Method: The study has a qualitative and hermeneutic approach and method of analysis is thematic. Five experienced psychotherapists participate.
Result: Therapists have no experience of working with shame as a primary emotion. People are seeking therapy when shame is observed as anxiety or as a defence. Shame prevents us from our deep feelings as anger, sadness, love and interest etc. The non-verbal markers of shame do something with the whole personality and are close to our opinion about our self, that who I am.
Discussion: The experience of shame reminds of the experience of anxiety and fear. Thereby we need to treat shame in the same way as we treat anxiety given Malan´s triangle of conflict. Otherwise the risk is high that the patient terminates treatment prematurely. The contrary to shame is that we are lovable and we need to reach that experience if we will be able to regulate shame in treatment. To achieve these, qualities as self-compassion, acceptance, non-judgemental is needed. Furthermore the therapist´ ability to create an alliance and that we start to speak about shame are important.
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