Therapists’ experiences of shame: an interpretative phenomenological analysis

Shame is a crucial issue frequently overlooked in the therapeutic context because it has many hiding places and inevitably reverberates with experiences of shame in the therapist. Therapists can be vulnerable to shame from multiple sources and without awareness of the activation of their shame, therapists risk reacting in ways that are not therapeutic. This, in turn, is likely to impact the therapeutic relationship and outcomes. The concealment and neglect of the therapist’s shame is reflected in a lack of attention to this aspect of the subject in the literature.
This qualitative study explored how therapists conceptualise shame, how it presents in their practices and how they work with shame issues. Using Interpretative Phenomenological Analysis (IPA) eight psychological therapists were interviewed to elucidate their experiences of shame in the clinical encounter. Four superordinate themes that captured the key experiences of shame for therapists were identified: The Impact of Shame on the Self, Noticing Shame, Therapeutic Reactions to Shame, Shame and Issues of Power. The themes were developed through an intensive process in accordance with IPA framework.
Shame is portrayed as striking at the core of the self and causing physiological, behavioural, emotional and cognitive reactions which involve one’s entire being. In all its forms, shame is considered relational. The findings highlighted the importance of empathic relationships with supervisors and colleagues in mitigating the debilitating effects of shame. Building shame resilience in therapists is underscored as critical in tolerating the vulnerability in meeting clients and colleagues in powerful affective states of being shamed and shaming. Therapists are encouraged to face into experiences of shame in themselves and with their clients, and to see these experiences as valuable opportunities for growth.