The Power of Shame in Men Who Are Depressed: Implications for Counselors

Researchers and theorists on male development have suggested that the socialization experiences of men leave them particularly vulnerable to shame (Osherson & Krugman, 1990). When men experience depression, feelings of shame not only may play a role in the depression itself but also affect men's ability to receive help from counseling because the very act of seeing a counselor can be experienced as a sign of masculine weakness and, therefore, may evoke shameful emotions. Effective counseling with depressed men requires strategies for reducing shame; yet, there is very little in the men's studies or counseling literature that provides help for practitioners in achieving this goal. The purpose of this article is to fill this need by (a) reviewing the literature on the role of shame for depressed men and (b) providing counselors with recommendations for reducing shame, illustrated with case studies. Definitions of Shame Shame is a complex psychological construct, consisting of cognitive (self-attacking thoughts), affective (emotional pain), and behavioral components (submissive facial and postural expressions, as well as social withdrawal actions). Although individuals initially may feel shame in response to a particular interpersonal event, it has the potential to pervade the self, "embracing our worth, our adequacy and our very dignity as human beings ... leaving us feeling naked, defeated, and intensely alone" (Kaufman, 1985, p.7). Blum (2008) examined the research on the felt phenomena of shame and derived a three-part description: (a) intense emotional pain, including the possibility of anger and rage against self and/or others; (b) a feeling of wanting to hide; and (c) a feeling that the self is bad, unworthy, and somehow deficient. Contemporary research on the nature of shame suggests that there are two forms: external and internal. External shame occurs when we believe we have caused someone to look down on us as unattractive, undesirable, or inadequate in some way, or we believe that others would reject us if some undesired aspect of ourselves were exposed. Internal shame consists of both self-critical cognitions and negative feelings about ourselves (e.g., something specific like our weight or appearance; or a more general deficiency, like our worth and desirability [Gilbert, 2000, 2011]). These two forms of shame have been empirically demonstrated to be highly correlated (Goss, Gilbert, & Allan, 1994). As Gilbert (2000) noted, if individuals believe that they are inadequate or deficient (internal shame), they are likely to believe others see them in the same way (external shame). In either form, shame is a maladaptive emotion in the sense that it does not promote a productive behavior that serves the person feeling it. Unlike guilt, which can be relieved by making amends to the person(s) who has been wronged, no such similar action is available to relieve feelings of undesirability and fundamental deficiency (Greenberg & Iwakabe, 2011). Shame and Depression Shame has been linked strongly with depression (both subclinical and suicidal levels) in a number of studies, including an extensive meta-analysis of shame--depression research (Allan, Gilbert, & Goss, 1994; Kim, Thibodeau, & Jorgensen, 2011; Tangney, Wagner, & Gramzow, 1992). The reasons for this association are less clear. One theory is that the ruminative nature of shame--the repetitive, focused attention on why rejection has taken place or what the individual's supposed negative attributes are--leads to depressive symptoms (Orth, Berking, & Burkhardt (2006). In a similar way, the self-attacking cognitions that are part of the shame experience may lead to a depressed mood (Greenberg & Iwakabe, 2011). Even in the absence of a firmly established causal link between shame and depression, there are, nevertheless, similarities between the phenomena of shame and depression; feelings of helplessness, inadequacy, failure, and deficiency of self are hallmarks of both emotional states (Cochran & Rabinowitz, 2000). …