Understanding Shame: How It Impacts Mental Health and How Therapy Can Help

Shame is a frequent companion in the therapy room. It creeps into our lives, convincing us that our very core is unworthy and unlovable. While shame can take many forms, I consistently see it in my work with LGBTQ+ clients.

Growing up knowing you are different — and fearing that this difference could jeopardise your connection with family, friends, or community — can lead to a deep, internalised sense of being “bad.” But shame is not unique to LGBTQ+ individuals.

Anyone who has been denied safety, acceptance, or security in expressing their authentic self can carry this heavy emotional burden. I also see it in male clients who feel pressured to conform to hypermasculine standards of achievement, appearance, and status. Shame, in its many forms, does not discriminate.

What Is Shame?

Psychologist Lisa Etherson identifies two key types of shame:

  • State shame: A temporary emotional response, typically triggered when we feel exposed, caught out, or guilty for something we have done.
  • Trait shame: A more persistent, enduring belief that we are fundamentally flawed, inadequate, or unworthy.

Shame exists on a broad emotional spectrum — from mild discomfort to overwhelming feelings of worthlessness, even annihilation.

Where Does Shame Come From?

Etherson’s Shame Containment Theory offers insight into the developmental function of shame in childhood. Often, shame acts as a protective mechanism: when a child experiences shame after doing something perceived as “bad,” it encourages behaviour adjustment to maintain the approval of caregivers.

Ideally, caregivers help the child co-regulate this experience, allowing them to process and release shame in a healthy way. But when caregivers are unable to provide this containment — due to their own emotional struggles or external pressures — the child may begin to internalise the belief that they themselves are bad, not just their actions.

For LGBTQ+ individuals, this dynamic can be especially damaging. Many grow up without affirming role models and are exposed to negative societal messages — from bullying at school to anti-LGBTQ rhetoric in religion, politics, and media. As they begin to understand their identity, they may internalise the belief that being LGBTQ+ is inherently wrong or dangerous, leading to deep, chronic shame.

How Shame Shows Up in Everyday Life

Shame rarely announces itself directly. Instead, it often disguises itself in subtle or unexpected ways, including:

  • Perfectionism and overachievement: Striving for flawlessness to avoid being perceived as inadequate.
  • Emotional numbing or detachment: Withdrawing emotionally to avoid vulnerability or exposure.
  • People-pleasing and over-accommodation: Prioritising the needs of others in hopes of earning approval.
  • Self-sabotage or self-criticism: Nurturing a harsh inner critic that fuels negative self-talk and self-defeating behaviours.
  • Addiction or compulsive behaviours: As described in Alan Downs’ The Velvet Rage, some individuals, particularly gay men, may turn to substances, sex, or material success as coping mechanisms for shame — but this pattern applies broadly across all populations.

The Impact of Chronic Shame on Mental Health

When shame becomes chronic, it seeps into your sense of self, affecting how you relate to yourself and others. It can lead to:

  • Relational disconnection: Struggles with intimacy or fear of revealing your “unworthy” self.
  • Emotional dysregulation: Overwhelming emotional responses, from anger to shutdown.
  • Imposter syndrome: Feeling like a fraud, even in the face of clear achievements.

How Therapy Can Help You Heal from Shame

Working with shame in therapy requires patience, compassion, and a multi-faceted approach. Here’s how therapy for shame can help you loosen its grip:

1. Creating a Safe, Compassionate Space

Shame flourishes in secrecy and isolation. The first step is creating a safe, non-judgmental space where you can bring your shame into the light. Being compassionately witnessed begins the healing process.

2. Recognising Shame Triggers and Patterns

Through reflection and psychoeducation, you can learn to recognise the thoughts, feelings, and behaviours driven by shame — whether shaped by family dynamics, societal pressures, or past experiences.

3. Practicing Self-Compassion

Drawing on John Bradshaw’s work, therapy helps you re-parent the wounded inner child carrying chronic shame. You’ll practice self-compassion — speaking to yourself with the same kindness you would offer a hurting child.

4. Integrating Somatic and Mindfulness Techniques

Shame is not just cognitive; it’s also stored in the body. Somatic approaches like grounding, breathwork, and mindfulness help regulate the physical sensations of shame and reduce emotional reactivity.

5. Addressing Societal and Cultural Shaming

For marginalised groups, including LGBTQ+ individuals, shame is often compounded by systemic oppression. Therapy may involve unpacking internalised societal shame and reclaiming your identity with pride, resilience, and self-acceptance.

Ready to Loosen Shame’s Grip?

If you’re ready to start healing from shame and move toward greater self-compassion, confidence, and freedom, I invite you to book a discovery call today. Let’s explore how we can work together toward your healing, growth, and emotional wellbeing.

 

 

References

Bradshaw, J. (1990). Homecoming: Reclaiming and championing your inner child.
DeYoung, P. A. (2015). Understanding and treating chronic shame: A relational/neurobiological approach.
Downs, A. (2012). The Velvet Rage: Overcoming the pain of growing up gay in a straight man’s world.
Etherson, L. (2023). Shame Containment Theory — A new approach to shame.

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